The Journal of pediatrics
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The Journal of pediatrics · Apr 1980
Case ReportsObstructive sleep apnea and death associated with surgical correction of velopharyngeal incompetence.
We have observed three children who developed obstructive sleep apnea immediately following construction of pharyngeal flaps designed to improve the speech of these patients with velopharyngeal incompetence. Postoperatively the patients were noted to have repeated episodes during sleep of strong respiratory efforts without airflow. ⋯ Respiratory depressants should be avoided. Airway intubation, revision of the surgery, or tracheostomy may be necessary.
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The Journal of pediatrics · Apr 1980
Serum salicylate levels and right-to-left ductus shunts in newborn infants with persistent pulmonary hypertension.
Although a right-to-left shunt via a patent ductus arteriosus is one criterion for the diagnosis of persistent pulmonary hypertension of the newborn infant, it cannot be demonstrated by simultaneous pre- and postductus arteriosus blood oxygen tensions in many infants with the clinical syndrome. In animals, exposure of the fetal ductus arteriosus to salicylates causes contriction and results in pulmonary hypertension. We postulated that maternal ingestion of salicylates and premature closure of the ductus arteriosus may explain why some infants with PPHN do not have right-to-left ductus shunts. ⋯ Serum salicylate levels were significantly greater (P less than 0.01) in infants with PPHN without right-to-left ductus shunt, indicating that the ductus arteriosus may have been closed prematurely. No other factor, including serum bilirubin, amikacin, ampicillin, or furosemide levels, could be found to account for the difference in serum salicylate levels. Premature closure of the ductus arteriosus secondary to maternal ingestion of salicylates may be one cause of PPHN and may explain the absence of right-to-left ductus shunting in some infants with the clinical syndrome.