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High flow oxygen and neonates

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https://www.readbyqxmd.com/read/29788839/phenobarbital-pharmacokinetics-in-neonates-and-infants-during-extracorporeal-membrane-oxygenation
#1
Pavla Pokorná, Martin Šíma, Václav Vobruba, Dick Tibboel, Ondřej Slanař
INTRODUCTION: The disposition of drugs is potentially changed due to extracorporeal membrane oxygenation (ECMO) in neonates and infants. METHODS: The aim of the study was to evaluate the individual pharmacokinetics (PK) of phenobarbital and the effect of PK covariates in neonates and infants undergoing ECMO. Sixteen patients (7 neonates, 9 infants) treated with phenobarbital during ECMO (centrifugal-flow pump circuits) were enrolled in the PK study. Phenobarbital serum concentrations were measured using a fluorescence polarization immunoassay...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29710737/cerebral-glucose-deficiency-versus-oxygen-deficiency-in-neonatal-encephalopathy
#2
A M Rudolph
Hypoxic-ischemic encephalopathy (HIE) in newborn infants is generally considered to result from decreased arterial oxygen content or cerebral blood flow. Cerebral injury similar to that of HIE has been noted with hypoglycemia. Studies in fetal lambs have shown that ventilation with 3% oxygen did not change cerebral blood flow, but ventilation with 100% oxygen resulted in marked reduction in cerebral blood flow, glucose delivery and glucose consumption. Blood glucose concentration falls markedly after birth; this, associated with the fall in cerebral blood flow, greatly reduces glucose supply to the brain...
April 24, 2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29669712/er-chaperone-grp78-protects-heart-from-ischemia-reperfusion-injury-through-akt-activation
#3
Xukun Bi, Guangyu Zhang, Xiaoding Wang, Chau Yt Nguyen, Herman I May, Xiaoting Li, Ali Al-Hashimi, Richard C Austin, Thomas G Gillette, Guo Sheng Fu, Zhao V Wang, Joseph A Hill
<u>Rationale:</u> Restoration of coronary artery blood flow is the most effective means of ameliorating myocardial damage triggered by ischemic heart disease. However, coronary reperfusion elicits an increment of additional injury to the myocardium. Accumulating evidence indicates that the unfolded protein response (UPR) in cardiomyocytes is activated by ischemia/reperfusion (I/R) injury. Xbp1s, the most highly conserved branch of the UPR, is protective in response to cardiac I/R injury. GRP78, a master regulator of the UPR and an Xbp1s target, is up-regulated after I/R...
April 18, 2018: Circulation Research
https://www.readbyqxmd.com/read/29649792/comparison-of-different-compression-to-ventilation-ratios-2-1-3-1-and-4-1-during-cardiopulmonary-resuscitation-in-a-porcine-model-of-neonatal-asphyxia
#4
Matteo P Pasquin, Po-Yin Cheung, Sparsh Patel, Min Lu, Tze-Fun Lee, Michael Wagner, Megan O'Reilly, Georg M Schmölzer
BACKGROUND: High-quality chest compression is essential during neonatal cardiopulmonary resuscitation (CPR). However, the optimal compression to ventilation ratio (C:V) that should be used during neonatal CPR to optimize coronary and cerebral perfusion while providing adequate ventilation remains unknown. OBJECTIVE: We hypothesized that different C:V ratios (e.g., 2: 1 or 4: 1) will reduce the time to return of spontaneous circulation (ROSC) in severely asphyxiated piglets...
April 12, 2018: Neonatology
https://www.readbyqxmd.com/read/29572879/patient-specific-atrial-hemodynamics-of-a-double-lumen-neonatal-cannula-in-correct-caval-position
#5
Jamil Muhammad, Mohammad Rezaeimoghaddam, Bilgesu Cakmak, Reza Rasooli, Ece Salihoglu, Yahya Yıldız, Kerem Pekkan
Clinical success of pediatric veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is associated with the double lumen cannula cardiovascular device design as well as its anatomic orientation in the atrium. The positions of cannula ports with respect to the vena cavae and the tricuspid valve are believed to play a significant role on device hemodynamics. Despite various improvements in ECMO catheters, especially for the neonatal and congenital heart patients, it is still challenging to select a catalogue size that would fit to most patients optimally...
March 23, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29538356/abdominal-near-infrared-spectroscopy-in-a-piglet-model-of-gastrointestinal-hypoxia-produced-by-graded-hypoxia-or-superior-mesenteric-artery-ligation
#6
May W Chen, Michael Reyes, Ewa Kulikowicz, Laura Martin, David J Hackam, Raymond C Koehler, Jennifer K Lee
BackgroundAbdominal near-infrared spectroscopy (aNIRS) may detect gastrointestinal hypoxia before necrotizing enterocolitis develops. We sought to validate aNIRS during splanchnic hypoxia and hypoperfusion in neonatal piglets.MethodsAnesthetized piglets underwent systemic hypoxia or 3 h superior mesenteric artery (SMA) ligation with aNIRS monitoring.ResultsDuring progressive hypoxia, gastrointestinal tissue oxyhemoglobin saturation measured by aNIRS decreased linearly with oxyhemoglobin saturation measured directly in the portal vein...
May 2, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29531447/comparative-study-between-noninvasive-continuous-positive-airway-pressure-and-hot-humidified-high-flow-nasal-cannulae-as-a-mode-of-respiratory-support-in-infants-with-acute-bronchiolitis-in-pediatric-intensive-care-unit-of-a-tertiary-care-hospital
#7
Mihir Sarkar, Rajasree Sinha, Satyabrata Roychowdhoury, Sobhanman Mukhopadhyay, Pramit Ghosh, Kalpana Dutta, Shibarjun Ghosh
Background: Early initiation of appropriate noninvasive respiratory support is utmost important intervention to avoid mechanical ventilation in severe bronchiolitis. Aim: This study aims to compare noninvasive continuous positive airway pressure (nCPAP) and hot humidified high-flow nasal cannulae (HHHFNC) as modes of respiratory support in infants with severe bronchiolitis. Methods: Prospective, randomized, open-label pilot study done in a tertiary-care hospital Pediatric Intensive Care Unit (PICU)...
February 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29404717/pulse-oximetry-findings-in-newborns-with-antenatally-diagnosed-congenital-heart-disease
#8
Isabel E Mawson, Pratusha L Babu, John M Simpson, Grenville F Fox
A retrospective review of admission preductal oxygen saturations of neonates with antenatally diagnosed critical congenital heart disease (CCHD) was performed to investigate the differences in newborn pulse oximetry (Pulsox) by specific CCHD diagnosis. Saturations were recorded at median of < 1 h (range < 1-9 h) after delivery. Data was stratified by CCHD diagnosis and analysed according to the three different admission Pulsox thresholds, ≤ 90, ≤ 92 and ≤ 95%. Of the 276 neonates studied, 208 were clinically well at admission, with no co-morbidities, gestation > 34 weeks and birth weight > 1...
May 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29375728/steel-reinforced-composite-silicone-membranes-and-its-integration-to-microfluidic-oxygenators-for-high-performance-gas-exchange
#9
Harpreet Matharoo, Mohammadhossein Dabaghi, Niels Rochow, Gerhard Fusch, Neda Saraei, Mohammed Tauhiduzzaman, Stephen Veldhuis, John Brash, Christoph Fusch, P Ravi Selvaganapathy
Respiratory distress syndrome (RDS) is one of the main causes of fatality in newborn infants, particularly in neonates with low birth-weight. Commercial extracorporeal oxygenators have been used for low-birth-weight neonates in neonatal intensive care units. However, these oxygenators require high blood volumes to prime. In the last decade, microfluidics oxygenators using enriched oxygen have been developed for this purpose. Some of these oxygenators use thin polydimethylsiloxane (PDMS) membranes to facilitate gas exchange between the blood flowing in the microchannels and the ambient air outside...
January 2018: Biomicrofluidics
https://www.readbyqxmd.com/read/29320927/benefits-of-using-high-volume-low-pressure-tracheal-tube-in-children-undergoing-congenital-cardiac-surgery-evidence-from-a-prospective-randomized-study
#10
Rakesh Chand, Saibal Roy Chowdhury, Emmanuel Rupert, Chandan Kumar Mandal, Pradeep Narayan
BACKGROUND: In the past 2 decades, usage of high-volume-low-pressure microcuffed tracheal tubes in smaller children has increased. However, there is paucity of evidence of its usage in smaller children undergoing congenital cardiac surgery. The aim of this study was to assess if microcuff endotracheal tubes in neonates and younger children undergoing congenital cardiac surgery is associated with better outcomes than uncuffed tubes. METHODS: We carried out this single-center, prospective, randomized study between June and November 2016...
January 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29197078/cardiopulmonary-anomalies-in-incontinentia-pigmenti-patients
#11
Giuliana Onnis, Andrea Diociaiuti, Paola Zangari, Patrizia D'Argenio, Caterina Cancrini, Lorenzo Iughetti, May El Hachem
BACKGROUND: Incontinentia pigmenti (IP) is a rare inherited genodermatosis that usually involves the skin, and also teeth, oral cavity, central nervous system, eyes, blood with eosinophilia, and rarely skeletal system, breast, heart, and lungs. Skin lesions usually appear early, at birth or within the first 2 weeks of life, with four different phases tending to follow Blaschko lines that may overlap. CASE REPORT: We report a rare case of a neonate with transient reversible pulmonary hypertension that presented at day 9 of life...
January 2018: International Journal of Dermatology
https://www.readbyqxmd.com/read/29075011/neonatal-exposure-to-high-oxygen-levels-leads-to-impaired-ischemia-induced-neovascularization-in-adulthood
#12
Raphael Mathieu, Sylvie Dussault, Michel Desjarlais, François Rivard, Wahiba Dhahri, Anik Cloutier, Anne-Monique Nuyt, Alain Rivard
Adverse perinatal conditions can lead to developmental programming of cardiovascular diseases. Prematurely born infants are often exposed to high oxygen levels, which in animal models has been associated with endothelial dysfunction, hypertension, and cardiac remodeling during adulthood. Here we found that adult mice that have been transiently exposed to O2 after birth show defective neovasculariation after hindlimb ischemia, as demonstrated by impaired blood flow recovery, reduced vascular density in ischemic muscles and increased tissue damages...
October 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29046161/inhaled-nitric-oxide-in-preterm-neonates-with-refractory-hypoxemia-associated-to-oligohydramnios
#13
Jorge Luis Alvarado Socarras, Javier Castro Monsalve, Fredi Alexander Diaz Quijano
BACKGROUND: Therapy with inhaled nitric oxide (iNO) is effective in the management of pulmonary hypertension and severe hypoxemia. However, these benefits have not been demonstrated in preterm infants (<34 weeks). The objective of this report is to present the experience of eight cases of preterm neonates with respiratory distress syndrome (RDS) and refractory hypoxemia, with oligohydramnios history. METHODS: We evaluated the clinical feature of 8 preterm neonates with severe hypoxemia who had maternal antecedents of oligoamnios, mainly due to premature rupture of membranes...
2018: Current Drug Discovery Technologies
https://www.readbyqxmd.com/read/28947032/the-use-of-high-flow-nasal-cannula-hfnc-as-respiratory-support-in-neonatal-and-pediatric-intensive-care-units-in-germany-a-nationwide-survey
#14
Florian Schmid, Dirk Manfred Olbertz, Manfred Ballmann
BACKGROUND: High-flow nasal cannula (HFNC)1 is a technique of oxygen supply, initially being used as a potentially less-invasive alternative to nasal continuous positive airway pressure (nCPAP)2 for premature infants/neonates, which nowadays crosses the border of neonatal care. HFNC builds up a positive end-expiratory pressure (PEEP)3 but lacks the opportunity for continuous monitoring. Therefore, pressure-depending complications are a risk. Our goal was to evaluate the current use of HFNC in Germany regarding indications, techniques of application and complications experienced...
October 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28943321/a-randomized-pilot-study-comparing-the-role-of-peep-o-2-flow-and-high-flow-air-for-weaning-of-ventilatory-support-in-very-low-birth-weight-infants
#15
Chang-Yo Yang, Mei-Chin Yang, Shih-Ming Chu, Ming-Chou Chiang, Reyin Lien
BACKGROUND: There is a lack of evidence to guide step-wise weaning of positive pressure respiratory support for premature infants. This study sought to compare the efficacy of three weaning protocols we designed to facilitate weaning of very low birth weight (VLBW, less than 1500 g) preterm infants from nasal continuous positive airway pressure (NCPAP) support. METHODS: This was a prospective, randomized, controlled trial of VLBW preterm infants who received positive pressure ventilatory support in our neonatal intensive care unit (NICU) from April 2008 through March 2009...
September 6, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28883928/cpap-impact-a-protocol-for-a-randomised-trial-of-bubble-continuous-positive-airway-pressure-versus-standard-care-for-high-risk-children-with-severe-pneumonia-using-adaptive-design-methods
#16
Andrew G Smith, Michelle Eckerle, Tisungane Mvalo, Brian Weir, Francis Martinson, Alfred Chalira, Norman Lufesi, Innocent Mofolo, Mina Hosseinipour, Eric D McCollum
INTRODUCTION: Pneumonia is a leading cause of mortality among children in low-resource settings. Mortality is greatest among children with high-risk conditions including HIV infection or exposure, severe malnutrition and/or severe hypoxaemia. WHO treatment recommendations include low-flow oxygen for children with severe pneumonia. Bubble continuous positive airway pressure (bCPAP) is a non-invasive support modality that provides positive end-expiratory pressure and oxygen. bCPAP is effective in the treatment of neonates in low-resource settings; its efficacy is unknown for high-risk children with severe pneumonia in low-resource settings...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/28791491/retinal-vegf-levels-correlate-with-ocular-circulation-measured-by-a-laser-speckle-micro-system-in-an-oxygen-induced-retinopathy-rat-model
#17
Tadashi Matsumoto, Yuta Saito, Takashi Itokawa, Tomoaki Shiba, Mari S Oba, Haruo Takahashi, Yuichi Hori
PURPOSE: We used a Laser speckle flowgraphy (LSFG)-micro system to examine the relationship between ocular blood flow and retinal vascular endothelial growth factor (VEGF) at retinopathy onset in oxygen-induced ischemic retinopathy (OIR) model rats. METHODS: Sixteen 50/10 OIR rats were compared with 17 control rats reared in room air. In postnatal day 14 (P14) and P18 rats, we measured and analyzed the left eye's mean blur rate (MBR) by setting a rubber band on the optic nerve head center, using the LSFG-Micro...
October 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28771211/the-fetus-can-teach-us-oxygen-and-the-pulmonary-vasculature
#18
REVIEW
Payam Vali, Satyan Lakshminrusimha
Neonates suffering from pulmonary hypertension of the newborn (PPHN) continue to represent an important proportion of patients requiring intensive neonatal care, and have an increased risk of morbidity and mortality. The human fetus has evolved to maintain a high pulmonary vascular resistance (PVR) in utero to allow the majority of the fetal circulation to bypass the lungs, which do not participate in gas exchange, towards the low resistance placenta. At birth, oxygen plays a major role in decreasing PVR to enhance pulmonary blood flow and establish the lungs as the organ of gas exchange...
August 3, 2017: Children
https://www.readbyqxmd.com/read/28700565/nasal-continuous-positive-airway-pressure-influences-bottle-feeding-in-preterm-lambs
#19
Nathalie Samson, Audrey Michaud, Rahmeh Othman, Charlène Nadeau, Stéphanie Nault, Danny Cantin, Michaël Sage, Céline Catelin, Jean-Paul Praud
BackgroundIn preterm infants, the time from initiation to full oral feeding can take weeks, which represents a very worrisome problem in neonatal medicine. Although current knowledge suggests that oral feeding should be introduced early, this is often delayed due to the need for prolonged nasal continuous positive airway pressure (nCPAP). Indeed, most caregivers fear that nCPAP could disrupt sucking-swallowing-breathing coordination and induce tracheal aspiration. The goal of the present study was to assess the impact of nCPAP delivered by the Infant Flow System on the physiology of sucking-swallowing-breathing coordination during bottle-feeding in preterm lambs over 24 h...
December 2017: Pediatric Research
https://www.readbyqxmd.com/read/28661028/increased-use-of-heated-humidified-high-flow-nasal-cannula-is-associated-with-longer-oxygen-requirements
#20
Rachael C Heath Jeffery, Margaret Broom, Bruce Shadbolt, David A Todd
AIM: There has been an increased use of heated humidified high flow nasal canula (HFNC) in premature babies (PBs) admitted to our neonatal unit. The aim of this study is to identify clinical characteristics in PBs < 29 weeks gestational age (GA) that distinguish between those who did not or did receive HFNC. METHODS: This study compared prospectively collected data from 2010 to 2012. Comparisons were undertaken between PBs<29 weeks GA who received continuous positive airway pressure (CPAP: 44/72 (61...
December 2017: Journal of Paediatrics and Child Health
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