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Infant haemodynamics

Amy K Keir, Oliver Karam, Nicolette Hodyl, Michael J Stark, Helen G Liley, Prakesh S Shah, Simon J Stanworth
AIM: To assess the prevalence, types and indications for fluid bolus therapy in neonates with haemodynamic compromise. METHODS: This was a pragmatic, international, multicentre observational study in neonatal units across Australasia, Europe and North America with a predefined study period of 10-15 study days per participating neonatal unit between December 2015 and March 2017. Infants ≤28 days of age who received a fluid bolus for the management of haemodynamic compromise (≥10 mL/kg given at ≤6 h) were included...
October 16, 2018: Journal of Paediatrics and Child Health
Martin Kluckow, Hazel Carlisle, Margaret Broom, Patricia Woods, Michele Jeffery, Deepa Desai, Nick Evans
OBJECTIVE: To explore the efficacy and risks of oral paracetamol in later (>2 weeks old) treatment of patent ductus arteriosus (PDA). STUDY DESIGN: A multicentre double-blind placebo-controlled randomised pilot trial in three neonatal intensive care units in Australia. Infants born <33 weeks with haemodynamically significant PDA were treated with a 5-day course of oral paracetamol or placebo. Cardiac ultrasounds were used to document haemodynamic parameters...
October 15, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Jamie N Colombo, Michael C Spaeder, Michael R Hainstock
OBJECTIVE: We aimed to investigate the incidence and causes of readmission of infants with single-ventricle and shunt-dependent biventricular CHD following routine, outpatient cardiac catheterisation. BACKGROUND: Cardiac catheterisation is commonly performed in patients with single-ventricle and shunt-dependent biventricular CHD for haemodynamic assessment and surgical planning. Best practices for post-procedural care in this population are unknown, and substantial variation exists between centres...
October 12, 2018: Cardiology in the Young
Aylin Aygün, Martin Poryo, Gudrun Wagenpfeil, Antonia Wissing, Daniel Ebrahimi-Fakhari, Michael Zemlin, Ludwig Gortner, Sascha Meyer
AIM: We assessed the risk factors for transient acute kidney injury in very low birth weight (VLBW) infants treated for patent ductus arteriosus (PDA) using the serum creatinine-based criteria in Kidney Disease: Improving Global Outcomes. METHOD: This retrospective study of infants requiring ibuprofen and, or, surgery for haemodynamic relevant PDAs was performed at the University Children's Hospital of Saarland, Homburg, Germany, from January 2009 to December 2015...
September 3, 2018: Acta Paediatrica
M F Siddiqui, S Lloyd-Fox, P Kaynezhad, I Tachtsidis, M H Johnson, C E Elwell
A novel multi-wavelength broadband near infrared spectroscopy (NIRS) system has been employed to simultaneously measure haemodynamic changes alongside changes in cellular oxygen utilization by measurement of oxidation state of mitochondrial enzyme cytochrome-c-oxidase (oxCCO). The aim of this study was to investigate the role of oxCCO in neural responses to functional activation in infants. Studies were performed using a NIRS broadband system in 33 typically developing infants aged between 4 and 6 months. Responses were recorded over the right temporal lobe while infants were presented with engaging videos containing social and non-social content...
2018: Advances in Experimental Medicine and Biology
Nilüfer Okur, Cüneyt Tayman, Mehmet Büyüktiryaki, Gülsüm Kadıoğlu Şimşek, Buse Ozer Bekmez, Nahide Altuğ
OBJECTIVE: Serum lactate levels provide information on metabolic capacity at the cellular level. In addition, lactate reflects tissue perfusion and oxygenation status. The aim of this study was to determine the usefulness of high lactate levels as a marker in hemodynamically significant patent ductus arteriosus (hsPDA), which may lead to tissue perfusion defects. METHODS: Preterm infants with gestational age ≤32 weeks and birthweight ≤1500 g were included...
September 2, 2018: Journal of Clinical Laboratory Analysis
Kimberly I Mills, Sarah J van den Bosch, Kimberlee Gauvreau, Catherine K Allan, Ravi R Thiagarajan, David M Hoganson, Christopher W Baird, Meena Nathan, James A DiNardo, John N Kheir
BACKGROUND: Following stage 1 palliation, delayed sternal closure may be used as a technique to enhance thoracic compliance but may also prolong the length of stay and increase the risk of infection. METHODS: We reviewed all neonates undergoing stage 1 palliation at our institution between 2010 and 2017 to describe the effects of delayed sternal closure. RESULTS: During the study period, 193 patients underwent stage 1 palliation, of whom 12 died before an attempt at sternal closure...
August 28, 2018: Cardiology in the Young
Laurène Gautheyrou, Sabine Durand, Emilie Jourdes, Julien De Jonckheere, Clémentine Combes, Gilles Cambonie
AIM: To assess the effect of facilitated tucking (FT), a nonpharmacologic nursing intervention, on echocardiographic parameters and infant comfort collected prospectively during neonatologist-performed echocardiography. METHODS: Echocardiography was performed twice, in standard conditions and with FT; the order was randomised by computer. Echocardiography provided data on pulmonary artery flow and pressure, right and left ventricular function, and persistent ductus arteriosus...
August 24, 2018: Acta Paediatrica
Douglas Bell, Sudesh Prabhu, Kim Betts, Robert Justo, Prem Venugopal, Tom R Karl, Nelson Alphonso
OBJECTIVES: This study aims to assess the performance of tissue-engineered bovine pericardium (CardioCel®) at 24 months and beyond when used for the repair of congenital heart defects. METHODS: Between October 2012 and November 2014, CardioCel was implanted in 135 patients (140 procedures and 195 implants). Applications included the closure of septal defects (98, 50.3%), repair of pulmonary arteries (63, 32.3%), intra-atrial/intraventricular baffles (10, 5.1%), repair of systemic arteries (15, 7...
August 7, 2018: Interactive Cardiovascular and Thoracic Surgery
Tim Hundscheid, Wes Onland, Bart van Overmeire, Peter Dijk, Anton H L C van Kaam, Koen P Dijkman, Elisabeth M W Kooi, Eduardo Villamor, André A Kroon, Remco Visser, Daniel C Vijlbrief, Susanne M de Tollenaer, Filip Cools, David van Laere, Anne-Britt Johansson, Catheline Hocq, Alexandra Zecic, Eddy Adang, Rogier Donders, Willem de Vries, Arno F J van Heijst, Willem P de Boode
BACKGROUND: Much controversy exists about the optimal management of a patent ductus arteriosus (PDA) in preterm infants, especially in those born at a gestational age (GA) less than 28 weeks. No causal relationship has been proven between a (haemodynamically significant) PDA and neonatal complications related to pulmonary hyperperfusion and/or systemic hypoperfusion. Although studies show conflicting results, a common understanding is that medical or surgical treatment of a PDA does not seem to reduce the risk of major neonatal morbidities and mortality...
August 4, 2018: BMC Pediatrics
Sujith Stanley Pereira, Ajay Kumar Sinha, Joan Katherine Morris, David F Wertheim, Divyen K Shah, Stephen Terence Kempley
OBJECTIVE: To examine the feasibility of a trial allocating different blood pressure (BP) intervention levels for treatment in extremely preterm infants. DESIGN: Three-arm open randomised controlled trial performed between February 2013 and April 2015. SETTING: Single tertiary level neonatal intensive care unit. PATIENTS: Infants born <29 weeks' gestation were eligible to participate, if parents consented and they did not have a major congenital malformation...
July 26, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
Corinna Binder-Heschl, Kelly Crossley, Arjan Te Pas, Graeme Polglase, Douglas Blank, Valerie Zahra, Alison Moxham, Karyn Rodgers, Stuart Hooper
BACKGROUND: Caffeine is routinely given to preterm infants hours after birth to treat apnea of prematurity. In view of it's success, earlier administration in the delivery room is being considered, but little is known about how caffeine may effect the cardiovascular changes during the fetal to neonatal transition. Our aim was to determine the effect of prenatal caffeine administration on haemodynamic parameters in ventilated preterm lambs immediately after birth. METHODS: Catheters (carotid artery and jugular vein) and ultrasonic flow probes (pulmonary artery and carotid artery) were implanted in preterm lambs (~126 ±2 days of gestation; term is 147 days), immediately before delivery by caesarean section...
2018: PloS One
Aisling A Garvey, Elisabeth M W Kooi, Aisling Smith, Eugene M Dempsey
Near-infrared spectroscopy (NIRS) allows for continuous, non-invasive monitoring of end-organ tissue oxygenation. The use of NIRS, cerebral NIRS (cNIRS) in particular, in neonatal care has increased significantly over the last few years. This dynamic monitoring technique provides real-time information on the cerebral and haemodynamic status of the neonate and has the potential to serve as an important adjunct to patient care with some centres routinely utilising cNIRS to aid decision-making at the bedside. cNIRS values may be influenced by many variables, including cardiac, respiratory and metabolic parameters, and therefore it is essential to understand the pathophysiology behind alterations in cNIRS values...
July 9, 2018: Children
Vittorio Romagnoli, Annalisa Pedini, Monica Santoni, Grazia Scutti, Massimo Colaneri, Marco Pozzi, Paola E Cogo, Virgilio P Carnielli
AimThe aim of this study was to determine the spontaneous closure rate of patent ductus arteriosus at a 2-year follow-up, following failed medical therapy and beyond initial hospital discharge, and to evaluate in-hospital spontaneous or pharmacological closure rates.Materials and methodsA retrospective evaluation was conducted in a cohort of preterm infants admitted to the Neonatal ICU of Ancona between January, 2004 and June, 2013. Inclusion criteria were gestational age between 24+0 and 29+6 weeks or birth weight 1...
August 2018: Cardiology in the Young
Hong Liu, Feng-Xia Lu, Jie Zhou, Fei Yan, Si-Chong Qian, Xin-Ya Li, Si-Qiang Zheng, Jun-Quan Chen, Ji-Sheng Zhong, Qiao-Ling Feng, Tong Ding, Jun Fan, Hai-Tao Gu, Xiao-Cheng Liu
BACKGROUND: Robust evidence is lacking regarding the clinical efficacy, safety and cardiopulmonary performance of perventricular closure. This study investigated the perioperative efficacy, safety and cardiorespiratory performance of perventricular closure of perimembranous ventricular septal defects (pmVSDs). METHODS: Operation-naïve infants and young children aged 5-60 months with isolated pmVSDs were randomised to receive either standard open surgical or minimally invasive perventricular closure via direct entry into the ventricle with a catheter from a subxiphoid incision...
June 25, 2018: Heart: Official Journal of the British Cardiac Society
Varangthip Khuwuthyakorn, Chuleeporn Jatuwattana, Suchaya Silvilairat, Watcharee Tantiprapha
BACKGROUND: In low- and middle-income countries (LMIC), haemodynamically significant patent ductus arteriosus (hsPDA) is treated with oral indomethacin (IDC) and ibuprofen (IB) instead of intravenous formulations. No significant differences in efficacy have been reported. However, previous studies had small numbers of VLBW infants (<1500 g). OBJECTIVE: To evaluate the efficacy of oral IDC and IB for closing PDA in VLBW infants with a gestational age of 24-32 weeks...
August 2018: Paediatrics and International Child Health
Kok Wee Chong, Simon Ling, Wenyin Loh
Wheat allergy is one of the commonest food allergies in childhood and it typically presents with IgE mediated reactions, including anaphylaxis. Seizures are not typically reported to be a direct manifestation of anaphylaxis, though it can occur secondary to hypoxia following significant haemodynamic compromise. We describe a case of a previously well infant, who presented with anaphylactic shock to wheat and responded well to the initial management, but subsequently developed a cluster of brief generalised tonic clonic seizures without any ongoing haemodynamic instability...
April 2018: Asia Pacific Allergy
Thierry P Beausoleil, Marie Janaillac, Keith J Barrington, Anie Lapointe, Mathieu Dehaes
Extremely preterm infants are at higher risk of pulmonary (PH) and intraventricular (IVH) haemorrhage during the transitioning physiology due to immature cardiovascular system. Monitoring of haemodynamics can detect early abnormal circulation that may lead to these complications. We described time-frequency relationships between near infrared spectroscopy (NIRS) cerebral regional haemoglobin oxygen saturation (CrSO2 ) and preductal peripheral perfusion index (PI), capillary oxygen saturation (SpO2 ) and heart rate (HR) in extremely preterm infants in the first 72 h of life...
April 25, 2018: Scientific Reports
Ronny Knol, Emma Brouwer, Alex S N Vernooij, Frans J C M Klumper, Philip DeKoninck, Stuart B Hooper, Arjan B Te Pas
Fetal to neonatal transition is characterised by major pulmonary and haemodynamic changes occurring in a short period of time. In the international neonatal resuscitation guidelines, comprehensive recommendations are available on supporting pulmonary transition and delaying clamping of the cord in preterm infants. Recent experimental studies demonstrated that the pulmonary and haemodynamic transition are intimately linked, could influence each other and that the timing of umbilical cord clamping should be incorporated into the respiratory stabilisation...
September 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
J W Miller, R Balyan, M Dong, M Mahmoud, J E Lam, J N Pratap, J R Paquin, B L Li, J P Spaeth, A Vinks, A W Loepke
BACKGROUND: Atomised intranasal dexmedetomidine administration is an attractive option when sedation is required for paediatric diagnostic procedures, as vascular access is not required. The risk of haemodynamic instability caused by dexmedetomidine necessitates better understanding of its pharmacokinetics in young children. To date, intranasal dexmedetomidine pharmacokinetics has only been studied in adults. METHODS: Eighteen paediatric patients received dexmedetomidine 1 or 2 μg kg-1 intranasally or 1 μg kg-1 i...
May 2018: British Journal of Anaesthesia
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