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Hypotension and infant

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https://www.readbyqxmd.com/read/29785061/targeted-neonatal-echocardiography-tne-consult-service-in-a-large-tertiary-perinatal-center-in-canada
#1
Ismina Papadhima, Deepak Louis, Jyotsna Purna, Poorva Deshpande, Yenge Diambomba, Shoo Lee, Prakesh Shah, Dany Weisz, Afif El-Khuffash, Patrick J McNamara, Luc Mertens, Amish Jain
OBJECTIVE: To describe the utilization and study the factors associated with the impact on clinical management of a new TNE consultation service in a perinatal center. METHODS: This retrospective cohort study included all neonates who underwent TNE consultation at the neonatal unit of Mount Sinai Hospital in Toronto, Canada (November 2011 and July 2015). The consults that had "impact" were defined as those that led to a TNE suggested change in the clinical management within 6 h of its recommendation...
May 22, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29784517/treprostinil-improves-persistent-pulmonary-hypertension-associated-with-congenital-diaphragmatic-hernia
#2
Kendall M Lawrence, Holly L Hedrick, Heather M Monk, Lisa Herkert, Lindsay N Waqar, Brian D Hanna, William H Peranteau, Natalie E Rintoul, Rachel K Hopper
OBJECTIVE: To evaluate the effect of continuous treprostinil in infants with severe pulmonary hypertension associated with congenital diaphragmatic hernia (CDH) on specific markers of pulmonary hypertension severity and to report the safety and tolerability of treprostinil. STUDY DESIGN: We conducted a retrospective cohort study of infants with CDH-associated pulmonary hypertension treated with treprostinil from January 2011 to September 2016. Severity of pulmonary hypertension was assessed by echocardiogram and serum B-type natriuretic peptide (BNP) by using time points before initiation and 24 hours, 1 week, and 1 month after treprostinil initiation...
May 18, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29781504/epidural-versus-non-epidural-or-no-analgesia-for-pain-management-in-labour
#3
REVIEW
Millicent Anim-Somuah, Rebecca Md Smyth, Allan M Cyna, Anna Cuthbert
BACKGROUND: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain, and is widely used as a form of pain relief in labour. However, there are concerns about unintended adverse effects on the mother and infant. This is an update of an existing Cochrane Review (Epidural versus non-epidural or no analgesia in labour), last published in 2011. OBJECTIVES: To assess the effectiveness and safety of all types of epidural analgesia, including combined-spinal-epidural (CSE) on the mother and the baby, when compared with non-epidural or no pain relief during labour...
May 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29747671/metabolic-acidosis-as-food-protein-induced-enterocolitis-syndrome-fpies-onset-in-a-newborn
#4
Antonella Peduto, Mario Rocca, Cinzia De Maio, Federica Gallarotti, Giulia Pomero, Paolo Gancia
BACKGROUND: FPIES (Food Protein Induced Eneterolitis Syndrome) is a rare non IgE- mediated food allergy, usually affecting infants and children after first months of life. Clinical presentation is heterogeneous, usually characterised by repetitive vomiting and diarrhoea, lethargy, failure to thrive until to dehydration with hypotension and shock. The diagnosis is based on clinical criteria, after excludind other hypothetical conditions. Early recognition of FPIES is essential to set a correct dietatay management that is resolving for the patient...
May 10, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29740192/safety-of-fentanyl-for-peripherally-inserted-central-catheter-in-non-intubated-infants-in-the-neonatal-intensive-care-unit
#5
Yair Kasirer, Vibhuti Shah, Eugene W Yoon, Ruben Bromiker, Carol Mcnair, Anna Taddio
OBJECTIVE: To evaluate the safety of fentanyl in non-intubated infants undergoing peripherally inserted central catheter (PICC) placement. METHODS: A retrospective chart review of PICC placements over a 3 years' period. We compared the 12h periods before and after fentanyl for clinically significant cardiorespiratory events (spells). RESULTS: Of the 998 neonates screened, 258 were eligible. The mean standard deviation gestational age was 34...
May 8, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29733266/complications-during-therapeutic-hypothermia-after-perinatal-asphyxia-a-comparison-with-trial-data
#6
Carlijn M J Diederen, Frank van Bel, Floris Groenendaal
Complications of therapeutic hypothermia (HT) after perinatal asphyxia of a cohort of infants were compared with complications reported in the Cochrane review. The occurrence during moderate HT of bradycardia, arrhythmia, hypotension, use of inotropes, pulmonary hypertension requiring NO inhalation, air leak syndrome, elevated liver enzymes, necrotizing enterocolitis, sepsis, oliguria, thrombocytopenia, coagulopathy, and electrolyte disturbances was assessed in 168 infants with therapeutic HT following perinatal asphyxia and compared to the incidence of complications published previously in the Cochrane review...
May 7, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29692537/brown-fat-necrosis-with-calcifications-in-the-newborn-risk-factors-radiographic-findings-and-clinical-course
#7
Eleza T Golden, Paula Dickson, Stephen Simoneaux
Objective: To describe the radiographic appearance of subclinical calcified brown fat necrosis and the associated clinical and laboratory findings. Materials and Methods: Picture Archiving and Communications Sytem (PACS) was searched using keywords "soft tissue calcification" and "chest." The clinical record was searched for prior cardiac surgery, bypass, Extracorporeal Membrane Oxygentation (ECMO) and prostaglandin use. Age when calcifications were first detected, location, resolution, and associated laboratory abnormalities were recorded...
January 2018: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/29682496/inotropes-for-preterm-infants-50-years-on-are-we-any-wiser
#8
REVIEW
Aisling A Garvey, Elisabeth M W Kooi, Eugene M Dempsey
For almost half a century, inotropes have been administered to preterm infants with the ultimate goal of increasing their blood pressure. A number of trials, the majority of which focused on dopamine administration, have demonstrated increased blood pressure following inotrope administration in preterm infants and have led to continued use of inotropes in our neonatal units. We have also seen an increase in the number of potential agents available to the clinician. However, we now know that hypotension is a much broader concept than blood pressure alone, and our aim should instead be focused on improving end organ perfusion, specifically cerebral perfusion...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29667726/interventions-for-infantile-haemangiomas-of-the-skin
#9
REVIEW
Monica Novoa, Eulalia Baselga, Sandra Beltran, Lucia Giraldo, Ali Shahbaz, Hector Pardo-Hernandez, Ingrid Arevalo-Rodriguez
BACKGROUND: Infantile haemangiomas (previously known as strawberry birthmarks) are soft, raised swellings of the skin that occur in 3% to 10% of infants. These benign vascular tumours are usually uncomplicated and tend to regress spontaneously. However, when haemangiomas occur in high-risk areas, such as near the eyes, throat, or nose, impairing their function, or when complications develop, intervention may be necessary. This is an update of a Cochrane Review first published in 2011...
April 18, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29626704/serum-cortisol-levels-in-asphyxiated-infants-with-hypotension
#10
Kata Kovacs, Eniko Szakmar, Unoke Meder, Anna Cseko, Attila J Szabo, Miklos Szabo, Agnes Jermendy
No abstract text is available yet for this article.
April 4, 2018: Early Human Development
https://www.readbyqxmd.com/read/29610159/use-of-insulin-glargine-in-the-management-of-neonatal-hyperglycemia-in-an-elbw-infant
#11
Min J Hwang, Robert Newman, Katherine Philla, Elizabeth Flanigan
Neonatal hyperglycemia is common in extremely low birth weight (ELBW) infants because of physiologic stress, exogenous glucose infusion, and postnatal corticosteroid therapy for hypotension, adrenal insufficiency, and pulmonary immaturity. The use of long-acting insulin glargine has been described in the treatment of transient neonatal diabetes in the premature infant, but in these reports is a lack of regard to its use in the treatment of iatrogenic neonatal hyperglycemia. We present the case of an ELBW infant with significant hyperglycemia that was refractory to usual treatment but demonstrated a favorable response to long-acting subcutaneous insulin glargine...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29600242/circulatory-insufficiency-and-hypotension-related-to-the-ductus-arteriosus-in-neonates
#12
REVIEW
Danielle R Rios, Soume Bhattacharya, Philip T Levy, Patrick J McNamara
The biological role of the ductus arteriosus (DA) in neonates varies from an innocent bystander role during normal postnatal transition, to a supportive role when there is compromise to either systemic or pulmonary blood flow, to a pathological state in the presence of hemodynamically significant systemic to pulmonary shunts, as occurs in low birth weight infants. Among a wide array of clinical manifestations arising due to the ductal entity, systemic circulatory insufficiency and hypotension are of significant concern as they are particularly challenging to manage...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29576786/malignant-hyperthermia-report-of-two-cases-with-a-neglected-complication-in-cardiac-surgery
#13
Mahdi Neshati, Manizheh Azadeh, Parinaz Neshati, Tyrone Burnett, Ryan Saenz, Bahman Karbasi, Ghader Shahmohammadi, Eskandar Nourizadeh, Mohsen Rostamzadeh
Malignant hyperthermia (MH) can develop after contact with volatile anesthetics (halothane, enflurane, isoflurane, sevoflurane, and desflurane) as well as succinylcholine and cause hypermetabolism during anesthesia, which is associated with high mortality when untreated. Early diagnosis and treatment could be life-saving. During cardiac surgery, hypothermia and cardiopulmonary bypass make the diagnosis of MH extremely challenging compared with other settings such as general surgery. We herein report 2 cases of MH, graded as "very likely" or "almost certain" based on the MH clinical grading scale...
October 2017: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/29554082/postnatal-developmental-changes-in-the-sensitivity-of-l-type-ca-2-channel-to-inhibition-by-verapamil-in-a-mouse-heart-model
#14
Hironori Sagawa, Shinsuke Hoshino, Kengo Yoshioka, Wei-Guang Ding, Mariko Omatsu-Kanbe, Masao Nakagawa, Yoshihiro Maruo, Hiroshi Matsuura
BACKGROUND: In the clinical setting, verapamil is contraindicated in neonates and infants because of the perceived risk of hypotension or bradyarrhythmia. However, it remains unclear whether there is an age-dependent difference in the sensitivity of cardiac L-type Ca2+ channel current (ICa,L ) to inhibition by verapamil. METHODS: Ventricular myocytes were enzymatically dissociated from the hearts of 6 different age groups (0, 7, 14, 21, 28 days and 10-15 weeks) of mice using a similar Langendorff-perfusion method...
March 19, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29506479/a-case-of-an-infant-suspected-as-image-syndrome-who-were-finally-diagnosed-with-mirage-syndrome-by-targeted-mendelian-exome-sequencing
#15
Yoon-Myung Kim, Go Hun Seo, Gu-Hwan Kim, Jung Min Ko, Jin-Ho Choi, Han-Wook Yoo
BACKGROUND: Adrenal hypoplasia is a rare congenital disorder, which can be classified into a non-syndromic form, without extra-adrenal features, and a syndromic form, with such features. Despite biochemical and molecular genetic evaluation, etiologic diagnosis cannot be performed in many patients with adrenal hypoplasia. CASE PRESENTATION: The patient in this case was a boy born at 31 weeks of gestation with a weight of 882 g (< 3rd percentile) to non-consanguineous parents...
March 5, 2018: BMC Medical Genetics
https://www.readbyqxmd.com/read/29502880/pulmonary-hypertension-associated-with-hypoxic-ischemic-encephalopathy-antecedent-characteristics-and-comorbidities
#16
Satyan Lakshminrusimha, Seetha Shankaran, Abbot Laptook, Scott McDonald, Martin Keszler, Krisa Van Meurs, Ronnie Guillet, Sanjay Chawla, Beena G Sood, Sonia Bonifacio, Abhik Das, Rosemary D Higgins
OBJECTIVE: To determine the characteristics of term infants with persistent pulmonary hypertension of the newborn (PPHN) associated with moderate or severe hypoxic ischemic encephalopathy (HIE). METHODS: We compared infants with and without PPHN enrolled in 2 randomized trials of therapeutic hypothermia: the induced hypothermia trial of cooling to 33.5°C for 72 hours vs normothermia, and the "usual-care" arm (33.5°C for 72 hours) of the optimizing cooling trial...
May 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29499081/beta-blockers-for-prevention-and-treatment-of-retinopathy-of-prematurity-in-preterm-infants
#17
REVIEW
Siree Kaempfen, Roland P Neumann, Kerstin Jost, Sven M Schulzke
BACKGROUND: Retinopathy of prematurity (ROP) is a vision-threatening disease of preterm neonates. The use of beta-adrenergic blocking agents (beta-blockers), which modulate the vasoproliferative retinal process, may reduce the progression of ROP or even reverse established ROP. OBJECTIVES: To determine the effect of beta-blockers on short-term structural outcomes, long-term functional outcomes, and the need for additional treatment, when used either as prophylaxis in preterm infants without ROP, stage 1 ROP (zone I), or stage 2 ROP (zone II) without plus disease or as treatment in preterm infants with at least prethreshold ROP...
March 2, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29479560/atypical-perioperative-management-for-duodenal-obstruction-in-an-infant-with-heterotaxy-syndrome-a-case-report
#18
Hirofumi Obinata, Shinichi Nishibe, Yoko Ishihara
Background: Heterotaxy syndrome (HS) is characterized by a wide variety of cardiac and extra-cardiac malformations, including pulmonary valve stenosis, interruption of the inferior vena cava, total anomalous pulmonary venous connection (TAPVC), asplenia, polysplenia, intestinal malrotation, and preduodenal portal vein (PDPV). We report the case of a heterotaxic infant with an infracardiac TAPVC and preduodenal portal vein who experienced repetitive hemodynamic instability during urgent laparotomy for duodenal obstruction...
2018: JA Clinical Reports
https://www.readbyqxmd.com/read/29470360/oral-supplementation-with-bovine-colostrum-prevents-septic-shock-and-brain-barrier-disruption-during-bloodstream-infection-in-preterm-newborn-pigs
#19
Anders Brunse, Päivi Worsøe, Susanne Elisabeth Pors, Kerstin Skovgaard, Per Torp Sangild
Preterm infants have increased risk of neonatal sepsis, potentially inducing brain injury, and they may benefit from early initiation of enteral milk feeding. Using preterm pigs as models, we hypothesized that early provision of bovine colostrum to parentally nourished newborns protects against sepsis and neuroinflammation during bloodstream infection. Preterm newborn pigs were administered 10 CFU/kg of intra-arterial Staphylococcus epidermidis (SE, an opportunistic pathogen often causing sepsis in preterm infants), followed by administration of total parenteral nutrition (TPN, SE + TPN, n = 15) or oral provision of bovine colostrum with supplementary parenteral nutrition (SE + COL, n = 14), and compared with uninfected, TPN-nourished controls (CON + TPN, n = 11)...
February 21, 2018: Shock
https://www.readbyqxmd.com/read/29450194/avoiding-arterial-hypotension-in-preterm-neonates-ahip-a-single-center-randomised-controlled-study-investigating-simultaneous-near-infrared-spectroscopy-measurements-of-cerebral-and-peripheral-regional-tissue-oxygenation-and-dedicated-interventions
#20
Gerhard Pichler, Nina Höller, Nariae Baik-Schneditz, Bernhard Schwaberger, Lukas Mileder, Jasmin Stadler, Alexander Avian, Jasmin Pansy, Berndt Urlesberger
Introduction: Up to 50% of preterm infants admitted to intensive care units require cardiocirculatory support. The aim of the present study was to assess whether simultaneous monitoring of cerebral tissue oxygenation index (cTOI) and peripheral tissue oxygenation index (pTOI) using near-infrared spectroscopy (NIRS) in combination with dedicated intervention guidelines may help avoiding arterial hypotension and catecholamine administration in preterm neonates. Study design: Preterm neonates <37 weeks of gestation were included in a single center randomized controlled study...
2018: Frontiers in Pediatrics
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