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Infant haemodynamics

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https://www.readbyqxmd.com/read/30101317/durability-of-tissue-engineered-bovine-pericardium-cardiocel%C3%A2-for-a-minimum-of-24-months-when-used-for-the-repair-of-congenital-heart-defects
#1
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
https://www.readbyqxmd.com/read/30077184/early-treatment-versus-expectative-management-of-patent-ductus-arteriosus-in-preterm-infants-a-multicentre-randomised-non-inferiority-trial-in-europe-beneductus-trial
#2
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
https://www.readbyqxmd.com/read/30049724/blood-pressure-intervention-levels-in-preterm-infants-pilot-randomised-trial
#3
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
https://www.readbyqxmd.com/read/29995944/haemodynamic-effects-of-prenatal-caffeine-on-the-cardiovascular-transition-in-ventilated-preterm-lambs
#4
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
https://www.readbyqxmd.com/read/29987227/interpretation-of-cerebral-oxygenation-changes-in-the-preterm-infant
#5
REVIEW
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
https://www.readbyqxmd.com/read/29954463/patent-ductus-arteriosus-in-preterm-infants-born-before-30-weeks-gestation-high-rate-of-spontaneous-closure-after-hospital-discharge
#6
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
https://www.readbyqxmd.com/read/29941505/minimally-invasive-perventricular-versus-open-surgical-ventricular-septal-defect-closure-in-infants-and-children-a-randomised-clinical-trial
#7
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
https://www.readbyqxmd.com/read/29912679/oral-indomethacin-versus-oral-ibuprofen-for-treatment-of-patent-ductus-arteriosus-a-randomised-controlled-study-in-very-low-birthweight-infants
#8
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. Methods This randomised controlled study enrolled 32 infants with hsPDA for treatment with either three doses of oral IDC or oral IB...
June 18, 2018: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/29732289/an-unusual-case-of-infant-seizures-with-anaphylaxis-to-wheat
#9
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
https://www.readbyqxmd.com/read/29695729/cerebral-oxygen-saturation-and-peripheral-perfusion-in-the-extremely-premature-infant-with-intraventricular-and-or-pulmonary-haemorrhage-early-in-life
#10
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
https://www.readbyqxmd.com/read/29680790/clinical-aspects-of-incorporating-cord-clamping-into-stabilisation-of-preterm-infants
#11
REVIEW
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...
April 21, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29661383/does-intranasal-dexmedetomidine-provide-adequate-plasma-concentrations-for-sedation-in-children-a-pharmacokinetic-study
#12
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
https://www.readbyqxmd.com/read/29599384/pneumatosis-intestinalis-in-a-preterm-infant-should-we-treat-all-intestinal-pneumatosis-as-necrotising-enterocolitis
#13
Siu Jun Chew, Rajadurai Samuel Victor, Krishna Revanna Gopagondanahalli, Suresh Chandran
Gastric pneumatosisis a very rare site of pneumatosis intestinalis (PI), and we report this finding in a preterm female infant with cyanotic congenital heart disease. The infant was stable initially on nasal intermittent mandatory ventilation; however, torrential pulmonary flow through a large patent ductus arteriosus prompted closure using oral ibuprofen. After an episode of haematochezia, she developed PI, affecting mainly the gastric wall and small intestine with portal venous gas. Her bowel movements were regular, with no abdominal distension or significant gastric aspirates...
March 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29571706/prophylactic-and-early-targeted-treatment-of-patent-ductus-arteriosus
#14
REVIEW
Jonathan P Wyllie, Samir Gupta
Treatment of a haemodynamically significant patent ductus arteriosus (PDA) in the very preterm infant has been an accepted approach for several decades. However, the rationale for closure of PDA has recently been challenged due to reports of success with conservative approaches and the lack of evidence for longer-term benefits from treatment. In this article, we address an approach to assess treatment of those babies most likely to benefit.
March 7, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29551482/role-of-neonatologist-performed-echocardiography-in-the-assessment-and-management-of-patent-ductus-arteriosus-physiology-in-the-newborn
#15
REVIEW
W P de Boode, M Kluckow, P J McNamara, S Gupta
Neonatologist-performed echocardiography (NPE) is an indispensable tool in the haemodynamic management of critically ill newborn infants. NPE is used to facilitate timely diagnosis of a patent ductus arteriosus (PDA) in preterm infants and to assess its haemodynamic significance. Before treatment is considered, it is obligatory to confirm structural cardiac normality. Importantly, NPE offers the ability to guide therapeutic interventions, allowing an individualised haemodynamic management approach to the PDA...
March 7, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29532502/administering-atropine-and-ketamine-before-less-invasive-surfactant-administration-resulted-in-low-pain-scores-in-a-prospective-study-of-premature-neonates
#16
L Bourgoin, L Caeymaex, F Decobert, C Jung, C Danan, X Durrmeyer
AIM: Less invasive surfactant administration (LISA) can avoid tracheal intubation for neonatal respiratory distress syndrome, but can be painful because it requires laryngoscopy. The aim of this study was to assess the efficacy and tolerance of intravenous atropine plus ketamine administration before LISA. METHODS: We conducted a prospective observational study of all premature infants hospitalised in our French neonatal intensive care unit treated with LISA between March 2015 and March 2016...
July 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29506588/rationalising-the-use-of-cardiac-catheterisation-before-glenn-completion
#17
Lorraine James, Animesh Tandon, Alan Nugent, Sadia Malik, Claudio Ramaciotti, Gerald Greil, Luis Zabala, Joseph Forbess, Tarique Hussain
Previous studies have shown that cardiac MRI can be used to evaluate the suitability for infants to undergo the Glenn operation after having undergone the Norwood procedure. We sought to analyse our institutional data retrospectively to identify whether such a policy would be advisable in the current era. We reviewed patients who underwent the Norwood procedure between 1 January, 2006 and 1 January, 2016. All patients undergoing evaluation for the Glenn procedure received clinical evaluation, echocardiography, and cardiac catheterisation...
May 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29473101/cardiac-function-assessments-in-left-bochdalek-s-hernia-clinical-relevance
#18
Arvind Sehgal, Kenneth Tan, Peter Ferguson
The objectives of this study were to characterize peri-operative echocardiographic (ECHO) assessments of right ventricular (RV) function and pulmonary hypertension (PH) and ascertain correlation with clinical outcomes in infants with left Bochdalek's hernia (LBH). This retrospective study in a quaternary neonatal intensive care unit involved electronic database search for infants with LBH during January 2009 to July 2017. Demographics, outcomes, and ECHO parameters were accessed from archived databases. Thirty-one infants with mean gestational age and birthweight (BW) 38...
April 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29432293/is-spinal-anaesthesia-in-young-infants-really-safer-and-better-than-general-anaesthesia
#19
Nicola Disma, Natasha Clunies-Ross, George A Chalkiadis
PURPOSE OF REVIEW: Concerns regarding the potential neurotoxic effects of general anaesthesia have seen resurgence in awake spinal anaesthesia in neonates and infants. This review includes recently published data from a large prospective randomized controlled trial with view to determining if spinal anaesthesia is safer and better than general anaesthesia in this population. RECENT FINDINGS: Compared with general anaesthesia, spinal anaesthesia results in less haemodynamic instability and fewer early (<30 min) apnoeic episodes in neonates and infants undergoing inguinal herniorraphy; the overall incidence of apnoeas in the first 12 h postoperatively was similar...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29416149/maternal-and-anaesthesia-related-risk-factors-and-incidence-of-spinal-anaesthesia-induced-hypotension-in-elective-caesarean-section-a-multinomial-logistic-regression
#20
Atousa Fakherpour, Haleh Ghaem, Zeinabsadat Fattahi, Samaneh Zaree
Background and Aims: Although spinal anaesthesia (SA) is nowadays the preferred anaesthesia technique for caesarean section (CS), it is associated with considerable haemodynamic effects, such as maternal hypotension. This study aimed to evaluate a wide range of variables (related to parturient and anaesthesia techniques) associated with the incidence of different degrees of SA-induced hypotension during elective CS. Methods: This prospective study was conducted on 511 mother-infant pairs, in which the mother underwent elective CS under SA...
January 2018: Indian Journal of Anaesthesia
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