Pediatric research
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There is little information regarding the comparative hemodynamic effects of adding milrinone or levosimendan to dopamine infusion in hypoxia-reoxygenated (H-R) newborns. ⋯ Twenty-eight piglets (1-4 d, 1.5-2.5 kg) were instrumented for continuous monitoring of systemic MAP and pulmonary arterial pressure (PAP), CI, and carotid, superior mesenteric, and renal arterial flows. Piglets were randomized with blinding to sham-operated, H-R control (saline), and H-R dopamine (10 μg/kg/min) with D+M or D+L groups. H-R piglets underwent H-R followed by 2 h of drug infusion after reoxygenation. Tissue was collected for biochemical/oxidative stress testing and histological analysis.
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Mild therapeutic hypothermia (HT) reduces brain injury in survivors after perinatal asphyxia. Recent guidelines suggest that resuscitation of term infants should be started with air, but supplemental oxygen is still in use. It is not known whether supplemental oxygen during resuscitation affects the protection offered by subsequent HT. ⋯ In an established neonatal rat model, hypoxia-ischemia (HI) was followed by 30-min reoxygenation in either 21% O(2) or 100% O(2) before 5 h of NT (37 °C) or HT (32 °C). The effects of HT and 100% O(2) on histopathologic injury in the hippocampus, basal ganglia, and cortex, and on postural reflex performance 7 d after the insult, were estimated by linear regression.
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Randomized Controlled Trial Multicenter Study
Seven- to eight-year follow-up of the CoolCap trial of head cooling for neonatal encephalopathy.
We sought to determine whether 18- to 22-mo neurodevelopmental outcomes predicted functional outcomes at 7-8 y for survivors of the CoolCap study of therapeutic hypothermia for neonates with hypoxic-ischemic encephalopathy. ⋯ All surviving children who participated in the CoolCap study and were assessed at 18 mo were eligible for reassessment using the WeeFIM instrument that qualitatively measures self-care, mobility, and cognitive function. Center investigators obtained consent from the families for a certified researcher to administer the WeeFIM instrument by phone.
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Randomized Controlled Trial
Television viewing at mealtime reduces caloric compensation in peripubertal, but not postpubertal, girls.
The effect of television viewing (TVV) and pubertal status of 9- to 14-y-old girls on mealtime food intake (FI) after a premeal glucose drink was determined. On four separate mornings, girls randomly received equally sweetened drinks containing Sucralose (control) or glucose (1.0 g/kg body weight) in 250 mL of water 2 h after a standardized breakfast. FI from an ad libitum pizza meal was measured 30 min later with or without TVV. ⋯ In postpubertal girls (n = 8), glucose reduced FI by ~27% in both the no TVV and TVV conditions, but in peripubertal girls (n = 17), reduction in FI was 22% without TVV and only 1% while TVV. Appetite correlated with FI at 30 min only in postpubertal girls. TVV at mealtime reduced caloric compensation after consumption of the glucose drink in peripubertal, but not postpubertal, girls, with no effect on mealtime FI. (Clinical trial number NCT01025687.)
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Near-infrared spectroscopy is a noninvasive method for monitoring brain oxygenation. The aim of the study was to investigate differences between cerebral oxygenation in different brain regions in newborns. In a prospective study, we monitored simultaneously left and right frontoparietal and temporo-occipital regional cerebral oxygen saturation (rScO2) and cerebral fractional tissue extraction (cFTOE: (arterial oxygen saturation (SaO2) - rScO2)/SaO2) using near-infrared spectroscopy. ⋯ A decrease and increase over time for rScO2 and cFTOE values was detected for all four brain regions, most pronounced for infants with GA <32 wk. Cerebral oxygenation in stable preterm and term neonates seems not to differ between different regions of the brain during the early neonatal period. However, variability of individual measurements was quite high as indicated by large limits of agreement.