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Neonatal hemodynamics

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https://www.readbyqxmd.com/read/29779927/patent-ductus-arteriosus-the-physiology-of-transition
#1
REVIEW
Poorva Deshpande, Michelle Baczynski, Patrick J McNamara, Amish Jain
The transition from intrauterine to extrauterine life represents a critical phase of physiological adaptation which impacts many organ systems, most notably the heart and the lungs. The majority of term neonates complete this transition without complications; however, dysregulation of normal postnatal adaptation may lead to acute cardiopulmonary instability, necessitating advanced intensive care support. Although not as well appreciated as changes in vascular resistances, the shunt across the DA plays a crucial physiologic role in the adaptive processes related to normal transitional circulation...
May 5, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29778972/hypnotic-agents-for-induction-of-general-anesthesia-in-cesarean-section-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
Kavita Houthoff Khemlani, Stephanie Weibel, Peter Kranke, Jan-Uwe Schreiber
STUDY OBJECTIVE: An ideal induction drug for cesarean section (CS) must have quick action, with minimum side effects such as awareness, hemodynamic compromise, and neonatal depression. Thiopentone is frequently used; however, no reliable evidence is available to support its use as a dedicated hypnotic agent in this setting. DESIGN: A systematic review and meta-analysis, using PRISMA methodology, of randomized controlled trials (RCTs), comparing women undergoing CS using thiopentone with those undergoing CS with propofol, ketamine, or benzodiazepines as hypnotic agents...
May 17, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29773497/indications-for-red-cell-transfusions-in-pediatric-patients
#3
REVIEW
Jill M Cholette, Suzie A Noronha, Jerard Seghatchian, Neil Blumberg
Red cell transfusions are amongst the most common therapeutic procedures in seriously ill children, particularly in the inpatient setting. This is despite the fact that there is no evidence base for most clinical settings, with the exception of patients with hemoglobinopathies, particularly thalassemia and sickle cell anemia. Obviously exsanguinating hemorrhage and life threatening anemia are urgent indications for which no other therapeutic approach is currently available. Most transfusions are, however, given prophylactically to prevent the complications of hypoxia or hemodynamic stability, based upon expert opinion and a faith in the oxygen carrying capacity and beneficial hemodynamic properties of transfused red cells...
May 10, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29770290/current-surgical-strategies-and-techniques-of-aortic-valve-diseases-in-children
#4
REVIEW
Kun Wang, Huifeng Zhang, Bing Jia
While the long-term outcome of surgical aortic valvotomy (SAV) appears to be better than that of balloon aortic valvuloplasty (BAV) as the primary procedure of aortic valve stenosis, the surgical strategies and techniques of treating aortic valve disease in children in other situations remain controversial. Valve repair should be first considered while replacement is still unavoidable in some cases, and new repair techniques developed by innovative surgeons are gradually becoming adopted. Some complex repair procedures such as cusp extension, leaflet replacement/reconstruction have provided satisfactory outcomes...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29747730/maternal-congenital-heart-disease-in-pregnancy
#5
REVIEW
Megan E Foeller, Timothy M Foeller, Maurice Druzin
Congenital heart disease comprises most maternal cardiac diseases in pregnancy and is an important cause of maternal, fetal, and neonatal morbidity and mortality worldwide. Pregnancy is often considered a high-risk state for individuals with structural heart disease as a consequence of a limited ability to adapt to the major hemodynamic changes associated with pregnancy. Preconception counseling and evaluation are of utmost importance, as pregnancy is contraindicated in certain cardiac conditions. Pregnancy can be safely accomplished in most individuals with careful risk assessment before conception and multidisciplinary care throughout pregnancy and the postpartum period...
June 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29740991/decreased-tissue-oxygenation-in-newborns-with-congenital-heart-defects-a-case-control-study
#6
Petja Fister, Domen Robek, Darja Paro-Panjan, Uroš Mazić, Helena Lenasi
AIM: To compare regional tissue oxygenation (rSO2) in the brain, intestine, and kidney between newborns with and without congenital heart defects (CHD). METHODS: This observational case-control study was conducted at the Neonatal Department of Children's Hospital Ljubljana between December 2012 and April 2014. It included 35 newborns with CHD and 30 healthy age- and sex-matched controls. CHD were assessed echocardiographically and divided into acyanotic and cyanotic group...
April 30, 2018: Croatian Medical Journal
https://www.readbyqxmd.com/read/29707527/treating-hypotension-in-preterm-neonates-with-vasoactive-medications
#7
REVIEW
Chloe Joynt, Po-Yin Cheung
Preterm neonates often have hypotension which may be due to various etiologies. While it is controversial to define hypotension in preterm neonates, various vasoactive medications are commonly used to provide the cardiovascular support to improve the blood pressure, cardiac output, or to treat shock. However, the literature on the systemic and regional hemodynamic effects of these antihypotensive medications in neonates is deficient and incomplete, and cautious translation of findings from other clinical populations and animal studies is required...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29698662/liberal-use-of-delayed-sternal-closure-in-children-is-not-associated-with-increased-morbidity
#8
S Ram Kumar, Nigel Scott, Winfield J Wells, Vaughn A Starnes
BACKGROUND: Delayed sternal closure (DSC) is often employed to optimize hemodynamics following pediatric cardiac surgery. Prior reports have suggested that DSC may be associated with increased morbidity. We sought to analyze the impact of a liberal policy of DSC on surgical outcomes at our center. METHODS: We retrospectively evaluated the clinical course of 1,000 consecutive patients between July 2005 and June 2015 whose sternum was electively left open following pediatric cardiac surgery...
April 23, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29695206/efficacy-and-safety-of-oral-paracetamol-versus-oral-ibuprofen-for-closure-of-patent-ductus-arteriosus-in-preterm-infants-a-randomized-controlled-trial
#9
Rania A El-Farrash, Mohammed S El Shimy, Abeer S El-Sakka, Manal G Ahmed, Dina G Abdel-Moez
OBJECTIVE: To evaluate the efficacy and safety of oral paracetamol versus oral ibuprofen in the treatment of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. STUDY DESIGN: An interventional randomized case-control study, registered in ClinicalTrials.gov ( NCT03265782 ), was conducted on 60 preterm infants with gestational age ≤ 34 weeks, postnatal age of 2-7 days and color Doppler echocardiographic evidence of hsPDA. Neonates were randomly assigned to two groups; 30 received oral ibuprofen and 30 received oral paracetamol...
April 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29694994/predicting-the-future-delivery-room-planning-of-congenital-heart-disease-diagnosed-by-fetal-echocardiography
#10
Mary T Donofrio
Advances in prenatal imaging have improved the examination of the fetal cardiovascular system. Fetal echocardiography facilitates the prenatal diagnosis of congenital heart disease (CHD) and through sequential examination, allows assessment of fetal cardiac hemodynamics, predicting the evolution of anatomical and functional cardiovascular abnormalities in utero and during the transition to a postnatal circulation at delivery. This approach allows detailed diagnosis with prenatal counseling and enables planning to define perinatal management, selecting the fetuses at a risk of postnatal hemodynamic instability who are likely to require a specialized delivery plan...
May 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29686793/invasive-group-b-streptococcus-multiloculated-perinephric-abscesses-treated-with-percutaneous-drainage
#11
J Isaac Peña-Garcia, Sana Shaikh, Alexandre Lacasse
Group B streptococcus infections (GBSI) are commonly associated with neonates and pregnant women, but may also affect nonpregnant adults. Among its spectrum of manifestations, perinephric abscess (PA) is exceedingly rare. Comorbid conditions such as diabetes mellitus (DM) and immunosuppression increase the risk of GBSI. We describe a 61-year-old Vietnamese man with compensated alcoholic cirrhosis, who presented with acute encephalopathy following subacute, progressive abdominal pain. He was afebrile and hemodynamically stable...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29682761/in-vitro-hemodynamic-evaluation-of-ecg-synchronized-pulsatile-flow-using-i-cor-pump-as-short-term-cardiac-assist-device-for-neonatal-and-pediatric-population
#12
Madison Force, Morgan Moroi, Shigang Wang, Allen R Kunselman, Akif Ündar
The objective of this study was to assess the hemodynamic properties of the i-cor ECG-synchronized cardiac assist system for off-label use as a short-term cardiac assist device for neonatal and pediatric patients and compare nonpulsatile to pulsatile flow with different amplitudes. The circuit consisted of the i-cor diagonal pump with 3 feet of ¼ inch arterial and venous tubing and a soft-shell reservoir, primed with lactated Ringer's solution and human packed red blood cells (hematocrit 42%). Trials were conducted with three different sets of cannulas (8-Fr arterial 10-Fr venous, 10-Fr arterial 12 Fr-venous, and 12-Fr arterial 14-Fr venous) with increasing flow rates at varying pseudo-patient pressures (40, 60, 80, and 100 mm Hg) and under nonpulsatile mode and pulsatile mode with pulsatile amplitudes 2000, 2500, and 3000 rpm at 36°C...
April 22, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29682496/inotropes-for-preterm-infants-50-years-on-are-we-any-wiser
#13
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/29675404/neonatal-hemodynamics-from-developmental-physiology-to-comprehensive-monitoring
#14
REVIEW
Sabine L Vrancken, Arno F van Heijst, Willem P de Boode
Maintenance of neonatal circulatory homeostasis is a real challenge, due to the complex physiology during postnatal transition and the inherent immaturity of the cardiovascular system and other relevant organs. It is known that abnormal cardiovascular function during the neonatal period is associated with increased risk of severe morbidity and mortality. Understanding the functional and structural characteristics of the neonatal circulation is, therefore, essential, as therapeutic hemodynamic interventions should be based on the assumed underlying (patho)physiology...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29675403/commentary-echocardiographic-evaluation-of-hemodynamics-in-neonates-and-children
#15
COMMENT
Yogen Singh
No abstract text is available yet for this article.
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29651161/publisher-correction-shedding-light-on-the-neonatal-brain-probing-cerebral-hemodynamics-by-diffuse-optical-spectroscopic-methods
#16
Parisa Farzam, Erin M Buckley, Pei-Yi Lin, Katherine Hagan, P Ellen Grant, Terrie Eleanor Inder, Stefan A Carp, Maria Angela Franceschini
A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.
April 12, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29649559/ultrafast-doppler-for-neonatal-brain-imaging
#17
REVIEW
Charlie Demené, Jérôme Mairesse, Jérôme Baranger, Mickael Tanter, Olivier Baud
The emergence of functional neuroimaging has dramatically accelerated our understanding of the human mind. The advent of functional Magnetic Resonance Imaging paved the way for the next decades' major discoveries in neuroscience and today remains the "gold standard" for deep brain imaging. Recent improvements in imaging technology have been somewhat limited to incremental innovations of mature techniques instead of breakthroughs. Recently, the use of ultrasonic plane waves transmitted at ultrafast frame rates was shown to highly increase Doppler ultrasound sensitivity to blood flows in small vessels in rodents...
April 10, 2018: NeuroImage
https://www.readbyqxmd.com/read/29643617/comparison-of-ropivacaine-0-2-with-or-without-clonidine-1-%C3%AE-g-kg-for-epidural-labor-analgesia-a-randomized-controlled-study
#18
Indira Kumari, Kapil Sharma, Vikram Bedi, Madhan Mohan, Hemraj Tungaria, Manish Kumar Modi
Background and Aims: The aim is to determine the effect of addition of clonidine to ropivacaine for epidural labor analgesia with regard to onset of analgesia, duration of analgesia, neonatal outcome, and quality of analgesia. Material and Methods: A total of 60 term parturients of the American Society of Anesthesiologists Grade I and II with uncomplicated pregnancy, vertex presentation, posted for on-demand epidural labor analgesia after informed consent were divided in two groups...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29642731/the-effect-of-hemodynamically-significant-patent-ductus-arteriosus-on-acute-kidney-injury-and-systemic-hypertension-in-extremely-low-gestational-age-newborns
#19
Danitza M Velazquez, Kimberly J Reidy, Madhu Sharma, Mimi Kim, Melissa Vega, Tomas Havranek
BACKGROUND: Acute kidney injury (AKI) in preterm neonates is becoming an increasingly recognized morbidity in the neonatal intensive care unit neonatal intensive care unit (NICU), yet its epidemiology, delineation and relation to numerous toxic exposures and common morbidities such as systemic hypertension is just evolving. With a frequency of the patent ductus arteriosus (PDA) as high as 70% in preterm infants born before 28-week gestation, the role of the hemodynamically significant PDA (hs-PDA) remains unclear...
April 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29628829/using-dexamethasone-as-an-adjuvant-to-levobupivacaine-in-epidural-anesthesia-to-change-the-pain-intensity-and-duration-in-painless-labor
#20
Hassan Mohamed Ali, Amr Wahdan
Background and Objective: This is a randomized controlled trial aiming at comparing the effectiveness of levobupivacaine alone versus a levobupivacaine with dexamethasone in the epidural injection for painless labor. Patients and Methods: This is a comparative randomized controlled double-blinded clinical trial with 49 patients were included in this study, all of them were primigravidas and were during vaginal delivery with a cervical dilatation ≥4 cm. Patients were included randomly in one of two groups either Group C (26 cases) with epidural levobupivacaine 0...
April 2018: Saudi Journal of Anaesthesia
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