Journal of pediatric surgery
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Comparative Study
The cerebrovascular response to prolonged hypoxia with carotid artery and jugular vein ligation in the newborn lamb.
This study was designed to evaluate the effect of ligation of the carotid artery and/or jugular vein, after exposure to prolonged (4 hours) hypoxia, and the effect of acute normalization of PaO2 after prolonged hypoxia with vessel ligation, on the cerebral circulation. Twelve 1- to 7-day-old lambs were anesthetized with pentobarbital. Catheters were placed in the femoral artery and vein, left ventricle, lingual artery, and sagittal sinus. ⋯ With regard to physiological variables, there were no differences between the groups. CBF increased 106% (P < .001 compared with the baseline value) after 4 hours of hypoxia, maintaining cerebral oxygen consumption (CMRO2) and oxygen transport (OT) constant in both groups. Ligation of either the carotid artery or jugular vein after 4 hours of hypoxia, did not alter CBF responses to hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS)
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Case Reports
Extracorporeal membrane oxygenation in infants with congenital diaphragmatic hernia and cardiac malformations.
Since the introduction of neonatal extracorporeal membrane oxygenation (ECMO) in Canada, the authors have treated three infants with congenital diaphragmatic hernia (CDH) who had serious congenital cardiac anomalies (among 26 infants with CDH treated with ECMO). To determine the incidence of and outcome for infants with combined lesions who received ECMO, 19 years' data (April 1973 to October 1992) from the Extracorporeal Life Support Organization (ELSO) registry were reviewed. Seventeen infants with combined cardiac and diaphragmatic lesions were registered as receiving ECMO in the United States or Canada. ⋯ Five (29.4%) of the 17 infants survived. A congenital cardiac lesion may not be an absolute contraindication to ECMO in infants with CDH. Decisions to cannulate for ECMO should be based on the potential outcome of the underlying cardiac defect.