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pulmonary hypertension in infants

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https://www.readbyqxmd.com/read/29777282/ambulatory-intravenous-inotropic-support-and-or-levosimendan-in-pediatric-and-congenital-heart-failure-safety-survival-improvement-or-transplantation
#1
Sotiria C Apostolopoulou, George A Vagenakis, Alexandros Tsoutsinos, Felicia Kakava, Spyridon Rammos
End-stage heart failure (HF) frequently needs continuous inotropic support in hospital and has high morbidity and mortality in absence of heart transplantation. This study reports outcome, efficacy, and safety of continuous ambulatory inotropes (AI) and/or periodic levosimendan (LS) infusions in pediatric HF patients. The study included 27 patients, median age 9.4 (0.1-26.1) years, with severe HF (6 myocarditis, 13 dilated cardiomyopathy, 2 restrictive cardiomyopathy, 6 repaired congenital heart disease). Dobutamine and milrinone AI were administered in 21 patients through a permanent central catheter for median duration 1...
May 18, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29764471/inhaled-nitric-oxide-as-a-rescue-therapy-in-a-preterm-neonate-with-severe-pulmonary-hypertension-a-case-report
#2
Martina Busè, Francesco Graziano, Fabio Lunetta, Giorgio Sulliotti, Vincenzo Duca
BACKGROUND: Inhaled nitric oxide (iNO) has been approved for the treatment of persistent pulmonary hypertension of the newborn (PPHN) in term and near-term newborns. Its role in the management of persistent pulmonary hypertension in preterm infants is not clear. Although guidelines do not exist, some studies have shown that iNO could be used as a rescue therapy in preterm neonate with severe pulmonary hypertension. CASE PRESENTATION: We describe the case of a preterm neonate, born at 30 + 1 weeks of gestation, with hypoxic respiratory failure not responding to maximal conventional therapy...
May 15, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29756460/inhaled-fasudil-lacks-pulmonary-selectivity-in-thromboxane-induced-acute-pulmonary-hypertension-in-newborn-lambs
#3
Shawn F L Hanson, Michael H Terry, Dafne T Moretta, Gordon G Power, Sean M Wilson, Farzana Alam, Fakhrul Ahsan, Arlin B Blood, Paresh C Giri
INTRODUCTION: Pulmonary hypertension (PH) is a potentially deadly disease for infants and adults with few existing medical interventions and no cure. In PH, increased blood pressure in the pulmonary artery eventually leads to heart failure. Fasudil, an antagonist of Rho-kinase, causes vasodilation leading to decreased systemic artery pressure and pulmonary artery pressure (PAP). This study compared the effects of fasudil administered as either an intravenous infusion or inhaled aerosol in newborn lambs...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29733266/complications-during-therapeutic-hypothermia-after-perinatal-asphyxia-a-comparison-with-trial-data
#4
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/29720910/a-retrospective-review-of-infants-receiving-sildenafil
#5
Aliva De, Payal Shah, Jacqueline Szmuszkovicz, Shazia Bhombal, Stanley Azen, Roberta M Kato
OBJECTIVE: The purpose of the study was to assess mortality in an infant population receiving sildenafil. METHODS: A retrospective review of hospitalized infants at Children's Hospital Los Angeles who received sildenafil between 2008 and 2012 was conducted. Patient characteristics, comorbidities, and treatment characteristics were analyzed. Primary outcome was mortality at discharge. Sildenafil dosage ranges were based on the Sildenafil in Treatment-Naïve Children, Aged 1-17 Years, With Pulmonary Arterial Hypertension trial and were categorized as small (<1...
March 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29712611/the-development-of-extracorporeal-membrane-oxygenation
#6
Don K Nakayama
Evolving from the development of heart-lung machines for open-heart surgery, extracorporeal membrane oxygenation has reemerged as a rescue modality for patients with acute respiratory failure that cannot be supported by conventional modes of ventilation. The history of extracorporeal membrane oxygenation begins with the discovery of heparin, fundamental to the success of extracorporeal circulation and membrane lungs. Engineers and scientists created suitable artificial membranes that allowed gas exchange while keeping gas and blood phases separate...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29703879/progressive-pulmonary-vein-stenosis-in-down-syndrome-infant-a-rare-cause-of-pulmonary-hypertension
#7
Z Norazah, D S Joyce Darshinee
Pulmonary veins stenosis in a Down Syndrome infant with normal connection pulmonary vein is rare and precise incidence of this disease is unknown. We report a case of progressive multiple pulmonary vein stenosis in a Down Syndrome infant with congenital heart disease and transient myeloproliferative leukaemia. This case-report aims to improve awareness among physicians and sonographers of this disease and the importance of pulmonary vein assessment in congenital heart disease with unexplained pulmonary hypertension...
April 2018: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/29703037/fatal-malignant-pertussis-with-hyperleukocytosis-in-a-chinese-infant-a-case-report-and-literature-review
#8
Shu-Feng Tian, Hong-Mei Wang, Ji-Kui Deng
RATIONALE: Pertussis has re-emerged on a global scale and is an ongoing public health problem, even in countries with high rates of vaccination. Hyperleukocytosis [white blood cell (WBC) count >100 × 10/L] is a rare complication that strongly predicts mortality in cases of severe pertussis. PATIENT CONCERNS: We report a case of severe pertussis in an infant who initially presented with persistent cyanotic cough, tachypnea, and grunting. The infant's condition deteriorated rapidly, and she was transferred to the pediatric intensive care unit (PICU) during her third hour of hospitalization...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29702711/acute-post-tracheostomy-clinical-decompensations-in-infants-are-there-predictive-markers
#9
Michael F Nyp, Jane B Taylor, Antonio Petralia, Alexandra Oschman, Mike Norberg, Robert A Weatherly, William Truog, Winston Manimtim
OBJECTIVE:  To report on the population of infants receiving a tracheostomy, identify acute post-tracheostomy clinical decompensations, and seek predictive markers associated with acute complications following the placement of a tracheostomy. STUDY DESIGN:  Retrospective deidentified clinical data was provided by the Infant Pulmonary Data Repository at Children's Mercy Hospital, Kansas City. Data from infants undergoing tracheostomy from January 1, 2008 through September 30, 2016 were divided into one of two study groups based on clinical correlations: (1) no acute decompensations within 72 hours post-tracheostomy or (2) acute clinical decompensation defined as sustained escalation of respiratory care within the 72 hours following tracheostomy...
April 27, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29681105/lethal-persistent-pulmonary-hypertension-of-the-newborn-in-bohring-opitz-syndrome
#10
Masaya Kibe, Satoshi Ibara, Hidehito Inagaki, Takema Kato, Hiroki Kurahashi, Toshiro Ikeda
Bohring-Opitz syndrome (BOS) is a rare disease with a number of characteristic features, including hypertelorism, prominent metopic suture, exophthalmos, cleft palate, abnormal posture, and developmental retardation. Here, we report a BOS patient presenting with lethal persistent pulmonary hypertension of the newborn (PPHN) and inspiratory respiratory failure. The female infant was treated with nitric oxide and vasodilator, which did not improve her condition. The inspiratory respiratory failure required management with deep sedation...
May 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29625733/evidence-of-echocardiographic-markers-of-pulmonary-vascular-disease-in-asymptomatic-infants-born-preterm-at-one-year-of-age
#11
Philip T Levy, Meghna D Patel, Swati Choudhry, Aaron Hamvas, Gautam K Singh
OBJECTIVE: To test the hypothesis that echocardiographic markers of pulmonary vascular disease (PVD) exist in asymptomatic infants born preterm at 1-year corrected age. STUDY DESIGN: We conducted a prospective cohort study of 80 infants born preterm (<29 weeks of gestation) and 100 age- and weight-matched infants born at term and compared broad-based conventional and quantitative echocardiographic measures of pulmonary hemodynamics at 1-year corrected age. Pulmonary artery acceleration time (PAAT), a validated index of pulmonary vascular resistance, arterial pressure, and compliance, was used to assess pulmonary hemodynamics...
April 3, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29625730/natural-history-of-postnatal-cardiopulmonary-adaptation-in-infants-born-extremely-preterm-and-risk-for-death-or-bronchopulmonary-dysplasia
#12
Hussnain Mirza, Jorge A Garcia, Elizabeth Crawford, Julie Pepe, Matthew Zussman, Rajan Wadhawan, William Oh
OBJECTIVE: To study the natural history of postnatal cardiopulmonary adaptation in infants born extremely preterm and establish its association with death or bronchopulmonary dysplasia (BPD). STUDY DESIGN: This was a prospective, observational, cohort study of infants born extremely preterm (<29 weeks). Initial echocardiogram was performed at <48 hours of life, followed by serial echocardiograms every 24-48 hours until 14 days of life. Resolution or no resolution of pulmonary hypertension (PH) at 72-96 hours was considered normal or delayed postnatal cardiopulmonary adaptation, respectively...
April 3, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29610158/lung-volume-reduction-surgery-for-respiratory-failure-in-infants-with-bronchopulmonary-dysplasia
#13
Bongyeon Sohn, Samina Park, In Kyu Park, Young Tae Kim, June Dong Park, Sung-Hye Park, Chang Hyun Kang
Lung volume reduction surgery (LVRS) can be performed in patients with severe emphysematous disease. However, LVRS in pediatric patients has not yet been reported. Here, we report our experience with 2 cases of pediatric LVRS. The first patient was a preterm infant girl with severe bronchopulmonary dysplasia, pulmonary hypertension, and hypothyroidism. The emphysematous portion of the right lung was removed via sternotomy and right hemiclamshell incision. The patient was discharged on full-time home ventilator support for 3 months after the surgery...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29600242/circulatory-insufficiency-and-hypotension-related-to-the-ductus-arteriosus-in-neonates
#14
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/29597832/maternal-pufa-omega-3-supplementation-prevents-hyperoxia-induced-pulmonary-hypertension-in-the-offspring
#15
Ying Zhong, Daniel Catheline, Ali Houeijeh, Dyuti Sharma, Li-Zhong Du, Capucine Besengez, Philippe Deruelle, Philippe Legrand, Laurent Storme
Pulmonary hypertension (PH) and right ventricular hypertrophy (RVH) affect 16-25% of premature infants with bronchopulmonary dysplasia (BPD), contributing significantly to perinatal morbidity and mortality. Polyunsaturated fatty acids ω-3 (PUFA ω-3) can improve vascular remodeling, angiogenesis, and inflammation under pathophysiological conditions. However, the effects of PUFA ω-3 supplementation in BPD-associated PH are unknown. The present study aimed to evaluate the effects of PUFA ω-3 on pulmonary vascular remodeling, angiogenesis, and inflammatory response in a hyperoxia-induced rat model of PH...
March 29, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29596267/a-stewardship-program-to-optimize-the-use-of-inhaled-nitric-oxide-in-pediatric-critical-care
#16
Tanya Di Genova, Christina Sperling, Ashley Gionfriddo, Zelia Da Silva, Leanne Davidson, Jason Macartney, Michael Finelli, Robert P Jankov, Peter C Laussen
PURPOSE: Inhaled nitric oxide (iNO) is a pulmonary vasodilator that is approved for use in term and near-term neonates with hypoxic respiratory failure associated with evidence of pulmonary hypertension. However, it is commonly used in infants and children to treat a variety of other cardiopulmonary diseases associated with pulmonary hypertension and hypoxic respiratory failure. In critically ill children, iNO therapy may be continued for a prolonged period, and this increases the risk for adverse consequences including toxicity and unnecessary costs...
April 2018: Quality Management in Health Care
https://www.readbyqxmd.com/read/29594085/stress-signals-during-sucking-activity-are-associated-with-longer-transition-time-to-full-oral-feeding-in-premature-infants
#17
You Gyoung Yi, Byung-Mo Oh, Seung Han Shin, Jin Yong Shin, Ee-Kyung Kim, Hyung-Ik Shin
Several treatments have been proposed to shorten the time to the attainment of full oral feeding (FOF) for premature infants, but there are only a few evaluation methods useful in estimating predictors of this period. We investigated whether specific items within the disorganized sucking patterns described by the Neonatal Oral-Motor Assessment Scale (NOMAS) could estimate the time to FOF in preterm infants with feeding difficulty. Preterm infants diagnosed with a disorganized sucking pattern in the NOMAS evaluation before 50 weeks of postmenstrual age were included...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29592985/caffeine-to-prevent-respiratory-failure-and-improve-outcome-in-infant-pertussis
#18
John Evered, Eric Pfeifer, Matthew Gracianette
Pertussis remains a dangerous disease for children around the world, especially for infants less than 6 months old. In this age group, high mortality and morbidity have been linked to the effects of the pertussis toxin, including lymphocytosis, pulmonary hyperviscosity and pulmonary hypertension. This paper reports on an infant with pertussis who received therapeutic caffeine. Caffeine might improve outcomes in pertussis by preventing apnoea, improving respiratory drive and decreasing pulmonary complications...
March 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29575641/nt-pro-bnp-a-marker-for-worsening-respiratory-status-and-mortality-in-infants-and-young-children-with-pulmonary-hypertension
#19
Shahnawaz M Amdani, Muhammad Umair M Mian, Ron L Thomas, Robert D Ross
AIM: To evaluate predictors of morbidity and mortality in pediatric patients with pulmonary hypertension (PH), laboratory and echocardiographic measures of PH were analyzed. METHODS: A retrospective review of all infants and children < 2 years of age with PH from January 2011 to August 2016 was conducted. Correlations were determined using Spearman's rank correlation coefficients. Differences in characteristics between survivors and nonsurvivors were analyzed and Kaplan-Meier survival curves were generated...
March 25, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29569581/genetic-basis-for-childhood-interstitial-lung-disease-among-japanese-infants-and-children
#20
Itaru Hayasaka, Kazutoshi Cho, Takuma Akimoto, Masahiko Ikeda, Yutaka Uzuki, Masafumi Yamada, Koh Nakata, Itsuko Furuta, Tadashi Ariga, Hisanori Minakami
BackgroundGenetic variants responsible for childhood interstitial lung disease (chILD) have not been studied extensively in Japanese patients.MethodsThe study population consisted of 62 Japanese chILD patients. Twenty-one and four patients had pulmonary hypertension resistant to treatment (PH) and hypothyroidism, respectively. Analyses of genetic variants were performed in all 62 patients for SFTPC and ABCA3, in all 21 PH patients for FOXF1, and in a limited number of patients for NKX2.1.ResultsCausative genetic variants for chILD were identified in 11 (18%) patients: SFTPC variants in six, NKX2...
February 2018: Pediatric Research
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