Biology of the neonate
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Biology of the neonate · Jan 2003
Application of the open-lung concept during positive-pressure ventilation reduces pulmonary inflammation in newborn piglets.
It has been shown that application of the open-lung concept (OLC) during high-frequency oscillatory ventilation (HFOV) attenuates pulmonary inflammation. We hypothesized that this attenuation could also be achieved by applying the OLC during positive-pressure ventilation (PPV). ⋯ There were no differences in tumor necrosis factor alpha levels. We conclude that application of the OLC during PPV reduces pulmonary inflammation as compared with conventional PPV and that the magnitude of this reduction is comparable to that of HFOV.
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We found recently that blood transfusions had no effect on bradycardia and hypoxemia, the clinically important components of apnea of prematurity, in mildly anemic infants. Here, we wanted to know whether this also holds true for more severely anemic patients. Nineteen preterm infants, median gestational age at birth 25 (range 22-30) weeks, age at the time of study 5.5 (range 1-13) weeks, for whom a blood transfusion was ordered because of recurrent episodes of bradycardia and/or hypoxemia in conjunction with anemia (median hemoglobin level 78 g/l, range 63-98 g/l) were investigated. ⋯ There was no significant change in the combined frequency of bradycardia and desaturation, the primary study end point - median 6.4/h (range 3.0-13.5/h) before versus 4.6/h (range 0.6-15.7/h) after transfusion -, although there was slightly less bradycardia - 0.8/h (range 0.0-8.8/h) versus 0.7/h (range 0.0-5.1/h; p < 0.05). Baseline heart and respiratory rates decreased, respectively, from 163/min (range 140-182/min) and 58/min (range 34-98/min) to 152/min (range 134-172/min) and 55/min (range 36-82/min; p < 0.01). We conclude that blood transfusions significantly reduced heart and respiratory rates in these anemic infants, but had little effect on apnea of prematurity.
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Biology of the neonate · Jan 2002
Comparative StudyUse of near infrared spectroscopy for estimation of peripheral venous saturation in newborns: comparison with co-oximetry of central venous blood.
In the intensive care of sick infants, the global oxygen reserve capacity is estimated by co-oximetry (co-ox) of blood sampled from central venous catheters. Introduction of a noninvasive alternative is desirable. Near infrared spectroscopy (NIRS) offers a technique for noninvasive bedside monitoring of tissue oxygen economy. ⋯ After bias adjusting of NIRS SvO(2) values, a nice correlation (r = 0.96, p > 0.05) between NIRS measurements of peripheral SvO(2) and co-ox of central venous blood was found. The study indicates that NIRS is practical for monitoring relative changes in central venous saturation. This might be useful in the future clinical care of newborns.
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Biology of the neonate · Jan 2002
Comparative StudyComparison of effects of perflubron and surfactant lung lavage on pulmonary gas exchange in a piglet model of meconium aspiration.
In a piglet model of meconium aspiration we compared lavage with surfactant with that with perflubron (PFOB) and a control group. A human meconium suspension was instilled into piglets which were randomized in 3 (n = 6 each) groups. After lung injury, the control group was ventilated with high-frequency oscillatory ventilation (HFOV) without suctioning and lavage. ⋯ Lavage with PFOB had intermediate effects in gas exchange and oxygenation compared to surfactant lavage. No differences were observed in arterial blood pressure and heart rate as well as in histological lung injury score between all groups. Lavage with exogenous surfactant as well as with PFOB improve pulmonary gas exchange in a piglet model of meconium aspiration.
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Biology of the neonate · Jan 2002
Partial liquid ventilation with low dose of perflubron and a low stretch ventilation strategy improves oxygenation in a rabbit model of surfactant depletion.
To demonstrate the efficacy of partial liquid ventilation (PLV) with a low dose of perflubron (PFB), severe lung injury model followed surfactant-depleted rabbits underwent PLV with either moderate tidal volume (V(T)) and high positive end-expiratory pressure (PEEP) or high V(T) and low PEEP. PLV with low-dose PFB was effective in alleviating hypoxia in a severe lung injury model if adequate PEEP was applied. We concluded that the addition of a low dose of PFB might be beneficial to a low stretch ventilation strategy, which allows a less aggressive approach to achieve adequate oxygenation with a possible reduction in further lung injury.