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Neonatal hemodynamics

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https://www.readbyqxmd.com/read/28102856/the-impact-of-integrated-evaluation-of-hemodynamics-using-targeted-neonatal-echocardiography-with-indices-of-tissue-oxygenation-a-new-approach
#1
Y N Elsayed, R Amer, M M Seshia
OBJECTIVE: To study the impact of integrated evaluation of hemodynamics (IEH) using targeted neonatal echocardiography, together with regional tissue oxygenation, fractional oxygen extraction using near-infrared spectroscopy on the management of infants with compromised hemodynamics. STUDY DESIGN: Retrospective cohort comparison of two groups of infants with compromised hemodynamics. EPOCH 1: did not undergo IEH (January 2012 to March 2014); EPOCH 2: underwent IEH (April 2014 to December 2015)...
January 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28077821/ascending-aortic-constriction-promotes-cardiomyocyte-proliferation-in-neonatal-rats
#2
Zhenhua Wang, Sebastian Schmull, Hui Zheng, Jianggui Shan, Rongjiang Zou, Song Xue
Adult heart suffering from increased workload will undergo myocardial hypertrophy, subsequent cardiomyocyte (CM) death, and eventually heart failure. However, the effect of increasing afterload on the neonatal heart remains unknown. We performed ascending aortic constriction (AAC) in neonatal rats 8-12 hours after birth (P0, P indicates postpartum). Seven days after surgery, in vivo heart function was evaluated using cardiac ultrasonography. Haematoxylineosin and Masson staining were used to assess CM diameter and collagen deposition...
January 11, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28068947/urinary-neutrophil-gelatinase-associated-lipocalin-in-the-evaluation-of-patent-ductus-arteriosus-and-aki-in-very-preterm-neonates-a-cohort-study
#3
Anna Sellmer, Bodil H Bech, Jesper V Bjerre, Michael R Schmidt, Vibeke E Hjortdal, Gitte Esberg, Søren Rittig, Tine B Henriksen
BACKGROUND: A patent ductus arteriosus (PDA) is frequently found in very preterm neonates and is associated with increased risk of morbidity and mortality. A shunt across a PDA can result in an unfavorable distribution of the cardiac output and may in turn result in poor renal perfusion. Urinary Neutrophil Gelatinase-associated Lipocalin (U-NGAL) is a marker of renal ischemia and may add to the evaluation of PDA. Our primary aim was to investigate if U-NGAL is associated with PDA in very preterm neonates...
January 10, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28061522/placental-transfusion-strategies-in-italy-a-nationwide-survey-of-tertiary-care-delivery-wards
#4
Barbara Perrone, Stefano Ghirardello
Objective Delayed umbilical cord clamping and cord milking are placental transfusion strategies that produce higher iron stores and better hemodynamic conditions in a newborn. We aimed to evaluate their current practice in tertiary-care delivery wards in Italy. Study Design A multiple-choice questionnaire was e-mailed to all the 101 Italian tertiary-care delivery wards. The comparative analysis between categorical variables was performed by the χ(2) test. Result We obtained an 85% (86/101) response rate...
January 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28049742/feasibility-of-mid-frequency-ventilation-among-infants-with-respiratory-distress-syndrome
#5
Ramachandra Bhat, John Kelleher, Namasivayam Ambalavanan, Robert L Chatburn, Eduardo Mireles-Cabodevila, Waldemar A Carlo
BACKGROUND: Mid-frequency ventilation, a strategy of using conventional ventilators at high frequencies, may reduce lung injury but has had limited evaluation in neonates. Hence, a randomized crossover study was designed to assess the feasibility of using mid-frequency ventilation in preterm infants with respiratory distress syndrome. METHODS: Twelve preterm infants (≥500 g and ≥24 weeks gestational age) who were receiving pressure-limited conventional ventilation with frequencies ≤60 breaths/min for respiratory distress syndrome were randomized to periods of mid-frequency ventilation (conventional ventilation with the fastest frequency up to 150 breaths/min that gave complete inspiration and expiration) or conventional ventilation (frequency ≤60 breaths/min), each lasting 2 h using a crossover design...
January 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28027669/the-vertebroplacental-ratio-as-an-alternative-to-the-cerebroplacental-ratio-in-the-evaluation-of-the-fetus-at-the-end-of-pregnancy
#6
José Morales-Roselló, Asma Khalil, Victoria Fornes Ferrer, David Hervas-Marín, Nuria Peralta Llorens, Juan Rubio Moll, Alfredo Perales-Marín
OBJECTIVE: Low cerebroplacental ratio (CPR) near term has emerged as a marker of fetal adverse outcome. The aim of this study was to evaluate the predictive accuracy of an alternative ratio using the vertebral artery (vertebroplacental ratio or VPR) for acid-base status at birth. METHODS: This was a prospective cohort study of 1470 pregnancies undergoing an ultrasound assessment of the umbilical artery, middle cerebral artery and vertebral artery Doppler beyond 34 weeks' gestation within 14 days of delivery...
December 27, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28026887/combined-spinal-epidural-anesthesia-with-hypobaric-ropivacaine-in-sitting-position-significantly-increases-the-incidence-of-hypotension-in-parturients-undergoing-cesarean-section
#7
Zhendong Xu, Fuyi Shen, Yueqi Zhang, Yiyi Tao, Xiubing Chen, Zhiqiang Liu
AIM: Maternal position during induction of combined spinal-epidural anesthesia (CSEA) may affect hemodynamics and block characteristics. This study aimed to assess whether the sitting position is more likely to induce hypotension and higher block level than the lateral position in CSEA with hypobaric ropivacaine. METHODS: Ninety American Society of Anesthesiologists physical status I and II parturients undergoing elective cesarean section were randomized into three groups: the sitting, left-lateral, and right-lateral position groups...
December 27, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28024912/early-diagnosis-and-outcome-prediction-of-neonatal-hypoxic-ischemic-encephalopathy-with-color-doppler-ultrasound
#8
B Guan, C Dai, Y Zhang, L Zhu, X He, N Wang, H Liu
PURPOSE: To describe the ultrasound presentation of the brain and cerebral hemodynamics in neonates with hypoxic-ischemic encephalopathy (HIE) by comparison with control subjects. MATERIAL AND METHODS: During June 2012 to April 2013, full term neonates who had clinical evidence of HIE were enrolled. Healthy newborns without HIE were used as a control group. Cerebral parenchyma, size of lateral ventricles and hemodynamic parameters of cerebral arteries were studied using two-dimensional duplex and color Doppler ultrasound...
December 23, 2016: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28009319/-ultrasound-monitoring-of-central-and-cerebral-hemodynamics-during-the-treatment-of-arterial-hypotension-in-preterm-infants
#9
A Zakrevskyy, O Karapetyan, V Agashkov, K Kosenko
The purpose of the study was to evaluate and identify patterns of changes in central and cerebral hemodynamics in neonates with low and extremely low birth weight and birth asphyxia, in order to achieve the early diagnosis of disorders of the central hemodynamics and autoregulation of cerebral blood flow, for timely fluid correction and inotropic therapy. Observation data on 44 preterm infants who were treated at the Kharkiv City Perinatal Centre and Regional Children's Clinical Hospital №1 of Kharkiv has been analyzed...
November 2016: Georgian Medical News
https://www.readbyqxmd.com/read/28004188/comparative-study-of-the-efficacy-and-safety-of-paracetamol-ibuprofen-and-indomethacin-in-closure-of-patent-ductus-arteriosus-in-preterm-neonates
#10
Abd El-Rahman El-Mashad, Heba El-Mahdy, Doaa El Amrousy, Marwa Elgendy
: In this prospective study, we compared the efficacy and side effects of indomethacin, ibuprofen, and paracetamol in patent ductus arteriosus (PDA) closure in preterm neonates. Three hundred preterm neonates with hemodynamically significant PDA (hs-PDA) admitted at our neonatal intensive care unit were enrolled in the study. They were randomized into three groups. Group I (paracetamol group) received 15 mg/kg/6 h IV paracetamol infusion for 3 days. Group II (ibuprofen group) received 10 mg/kg IV ibuprofen infusion followed by 5 mg/kg/day for 2 days...
February 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27984250/a-randomized-controlled-trial-of-music-use-during-epidural-catheter-placement-on-laboring-parturient-anxiety-pain-and-satisfaction
#11
Dan M Drzymalski, Lawrence C Tsen, Arvind Palanisamy, Jie Zhou, Chuan-Chin Huang, Bhavani S Kodali
BACKGROUND: Although music is frequently used to promote a relaxing environment during labor and delivery, the effect of its use during the placement of neuraxial techniques is unknown. Our study sought to determine the effects of music use on laboring parturients during epidural catheter placement, with the hypothesis that music use would result in lower anxiety, lower pain, and greater patient satisfaction. METHODS: We conducted a prospective, randomized, controlled trial of laboring parturients undergoing epidural catheter placement with or without music...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27982342/in-vitro-evaluation-of-two-types-of-neonatal-oxygenators-in-handling-gaseous-microemboli-and-maintaining-optimal-hemodynamic-stability-during-cardiopulmonary-bypass
#12
Neelima Marupudi, Shigang Wang, Luiz Fernando Canêo, Fabio Biscegli Jatene, Allen R Kunselman, Akif Undar
Objective: Usually only FDA-approved oxygenators are subject of studies by the international scientific community. The objective of this study is to evaluate two types of neonatal membrane oxygenators in terms of transmembrane pressure gradient, hemodynamic energy transmission and gaseous microemboli capture in simulated cardiopulmonary bypass systems. Methods: We investigated the Braile Infant 1500 (Braile Biomédica, São José do Rio Preto, Brazil), an oxygenator commonly used in Brazilian operating rooms, and compared it to the Dideco Kids D100 (Sorin Group, Arvada, CO, USA), that is an FDA-approved and widely used model in the USA...
September 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27978510/optimizing-cerebral-autoregulation-may-decrease-neonatal-regional-hypoxic-ischemic-brain-injury
#13
Jennifer K Lee, Andrea Poretti, Jamie Perin, Thierry A G M Huisman, Charlamaine Parkinson, Raul Chavez-Valdez, Matthew O'Connor, Michael Reyes, Jillian Armstrong, Jacky M Jennings, Maureen M Gilmore, Raymond C Koehler, Frances J Northington, Aylin Tekes
BACKGROUND: Therapeutic hypothermia provides incomplete neuroprotection for neonatal hypoxic-ischemic encephalopathy (HIE). We examined whether hemodynamic goals that support autoregulation are associated with decreased brain injury and whether these relationships are affected by birth asphyxia or vary by anatomic region. METHODS: Neonates cooled for HIE received near-infrared spectroscopy autoregulation monitoring to identify the mean arterial blood pressure with optimized autoregulatory function (MAPOPT)...
December 16, 2016: Developmental Neuroscience
https://www.readbyqxmd.com/read/27941485/anesthetic-management-of-a-tracheoesophageal-fistula-in-a-patient-with-a-large-uncorrected-aortopulmonary-window
#14
Adam C Adler, James M Steven, Matthew A Jolley
Aortopulmonary window is a rare form of congenital heart disease that requires significant anesthetic considerations. Cardiac involvement is a well-known comorbidity identified in patients with tracheoesophageal fistula (TEF). Identification of coexisting lesions, specifically congenital heart disease, is crucial before undergoing repair of a TEF. Understanding the complex physiology and expected changes occurring during the anesthetic and surgical intervention for correction of TEF with a significant unrepaired shunting defect is crucial to prevent hemodynamic instability...
December 9, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27931653/hemodynamic-coherence-in-critically-ill-pediatric-patients
#15
REVIEW
Ö Erdem, J W Kuiper, D Tibboel
Differences in physiology and pathophysiology make the treatment of developing, critically ill children particularly challenging as compared to that of adults. Significant differences in the cardiovascular system of neonates and children in size, weight, body proportions, and metabolism should be considered. Hemodynamic monitoring is crucial for early warning of pending deterioration and to guide therapy. Current monitoring is limited to the macrocirculation, but an adequately functioning macrocirculation does not guarantee a well-functioning microcirculation...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27923943/venovenous-ecmo-support-in-an-infant-with-single-ventricle-physiology-and-catastrophic-pulmonary-venous-abnormalities
#16
Richard P Fernandez, Don Hayes, Patrick I McConnell, Darren Berman
Extracorporeal membrane oxygenation (ECMO) is an accepted treatment modality for life support refractory to conventional efforts in neonates with complex congenital heart lesions. Cannulation for ECMO can be accomplished by venovenous (VV) access where patients receive primarily respiratory support or venoarterial (VA) access which provides complete cardiopulmonary support. VV ECMO delivered by a single-vessel cannulation with a dual-chamber venous cannula allows for respiratory support while the patient remains dependent upon intrinsic cardiac function to support hemodynamics...
December 6, 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27923236/the-effect-of-head-positioning-and-head-tilting-on-the-incidence-of-intraventricular-hemorrhage-in-very-preterm-infants-a-systematic-review
#17
Karen A de Bijl-Marcus, Annemieke J Brouwer, Linda S de Vries, Gerda van Wezel-Meijler
BACKGROUND: Despite advances in neonatal intensive care, germinal matrix-intraventricular hemorrhage (GMH-IVH) remains a frequent, serious complication of premature birth. Neutral head position and head tilting have been suggested to reduce the risk of GMH-IVH in preterm infants during the first 72 h of life. OBJECTIVE: The aim of this study was to provide a systematic review of the effect of neutral head positioning and head tilting on the incidence of GMH-IVH in very preterm infants (gestational age ≤30 weeks)...
December 7, 2016: Neonatology
https://www.readbyqxmd.com/read/27908646/left-ventricular-function-in-healthy-term-neonates-during-the-transitional-period
#18
Amish Jain, Afif F El-Khuffash, Bart C W Kuipers, Adel Mohamed, Kim A Connelly, Patrick J McNamara, Robert P Jankov, Luc Mertens
OBJECTIVES: To evaluate whether incorporating conventional, tissue Doppler imaging and speckle tracking echocardiography are reliable and can characterize changes in left ventricular (LV) function properly in healthy neonates in the early transitional newborn period. STUDY DESIGN: A prospective observational study was conducted in 50 healthy term neonates with a mean ± SD gestational age and birth weight of 39.3 ± 1.2 weeks and 3.5 ± 0.44 kg, respectively...
November 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27877133/decomposition-of-near-infrared-spectroscopy-signals-using-oblique-subspace-projections-applications-in-brain-hemodynamic-monitoring
#19
Alexander Caicedo, Carolina Varon, Borbala Hunyadi, Maria Papademetriou, Ilias Tachtsidis, Sabine Van Huffel
Clinical data is comprised by a large number of synchronously collected biomedical signals that are measured at different locations. Deciphering the interrelationships of these signals can yield important information about their dependence providing some useful clinical diagnostic data. For instance, by computing the coupling between Near-Infrared Spectroscopy signals (NIRS) and systemic variables the status of the hemodynamic regulation mechanisms can be assessed. In this paper we introduce an algorithm for the decomposition of NIRS signals into additive components...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27875570/towards-a-tissue-engineered-contractile-fontan-conduit-the-fate-of-cardiac-myocytes-in-the-subpulmonary-circulation
#20
Daniel Biermann, Alexandra Eder, Florian Arndt, Hatim Seoudy, Hermann Reichenspurner, Thomas Mir, Arlindo Riso, Rainer Kozlik-Feldmann, Kersten Peldschus, Michael G Kaul, Tillman Schuler, Susanne Krasemann, Arne Hansen, Thomas Eschenhagen, Jörg S Sachweh
The long-term outcome of patients with single ventricles improved over time, but remains poor compared to other congenital heart lesions with biventricular circulation. Main cause for this unfavourable outcome is the unphysiological hemodynamic of the Fontan circulation, such as subnormal systemic cardiac output and increased systemic-venous pressure. To overcome this limitation, we are developing the concept of a contractile extracardiac Fontan-tunnel. In this study, we evaluated the survival and structural development of a tissue-engineered conduit under in vivo conditions...
2016: PloS One
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