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Infant haemodynamics

Neichuan Zhang, Haiyun Yuan, Xiangyu Chen, Jiawei Liu, Qifei Jian, Meiping Huang, Kai Zhang
Studying the haemodynamics of the central shunt (CS) and modified Blalock-Taussig shunt (MBTS) benefits the improvement of postoperative recovery for patients with an aorta-pulmonary shunt. Shunt configurations, including CS and MBTS, are virtually reconstructed for infants A and B based on preoperative CT data, and three-dimensional models of A, 11 months after CS, and B, 8 months after MBTS, are reconstructed based on postoperative CT data. A series of parameters including energy loss, wall shear stress, and shunt ratio are computed from simulation to analyse the haemodynamics of CS and MBTS...
2019: Computational and Mathematical Methods in Medicine
Shiraz Badurdeen, Calum Roberts, Douglas Blank, Suzanne Miller, Vanesa Stojanovska, Peter Davis, Stuart Hooper, Graeme Polglase
Brain injury in the asphyxic newborn infant may be exacerbated by delayed restoration of cardiac output and oxygen delivery. With increasing severity of asphyxia, cerebral autoregulatory responses are compromised. Further brain injury may occur in association with high arterial pressures and cerebral blood flows following the restoration of cardiac output. Initial resuscitation aims to rapidly restore cardiac output and oxygenation whilst mitigating the impact of impaired cerebral autoregulation. Recent animal studies have indicated that the current standard practice of immediate umbilical cord clamping prior to resuscitation may exacerbate injury...
February 27, 2019: Brain Sciences
Karl Wilhelm Olsson, Anders Jonzon, Richard Sindelar
AIM: We assessed whether early haemodynamically significant patent ductus arteriosus (hsPDA) predicted persistent PDA in extremely preterm infants. METHODS: This prospective observational study of 60 infants born at 22-27 weeks of gestational age without any major congenital anomalies or heart defects was conducted at Uppsala University Children's Hospital from November 2012 to May 2015. Respiratory and systemic circulatory parameters were continuously recorded and echocardiographic examinations performed daily during the first three days of life...
February 12, 2019: Acta Paediatrica
Ronan McKenna, Lindsay Joseph, Philip Sargent, Meryta May, Sarah Tozer, Seweryn Bialasiewicz, Claire Heney, Luregn J Schlapbach, Julia E Clark
AIM: The human parechovirus (HPeV) has emerged as a pathogen causing sepsis-like presentations in young infants, but there is a lack of data on HPeV presentations requiring intensive care support. We aimed to characterise the clinical presentation, disease severity, management and outcome of a population-based cohort of children with microbiologically confirmed HPeV infection requiring admission to paediatric intensive care units (PICUs) in Queensland, Australia during a recent outbreak...
January 24, 2019: Journal of Paediatrics and Child Health
Erika B Rosenzweig, Steven H Abman, Ian Adatia, Maurice Beghetti, Damien Bonnet, Sheila Haworth, D Dunbar Ivy, Rolf M F Berger
Paediatric pulmonary arterial hypertension (PAH) shares common features of adult disease, but is associated with several additional disorders and challenges that require unique approaches. This article discusses recent advances, ongoing challenges and distinct approaches for the care of children with PAH, as presented by the Paediatric Task Force of the 6th World Symposium on Pulmonary Hypertension. We provide updates of the current definition, epidemiology, classification, diagnostics and treatment of paediatric PAH, and identify critical knowledge gaps...
January 2019: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Mohamed Shalabi Ahmed, Regan E Giesinger, Mohamed Ibrahim, Michelle Baczynski, Deepak Louis, Karl P McNamara, Amish Jain, Dany E Weisz, Patrick J McNamara
AIM: To evaluate the clinical and echocardiography modulators of treatment response in hypoxemic preterm infants exposed to inhaled nitric oxide (iNO). METHODS: In this multicentre retrospective study, clinical parameters, including oxygenation, ventilation and haemodynamics, were collected for preterm infants <36 weeks gestation before and 2 h after initiation of iNO for acute hypoxemia. Comprehensive echocardiography, performed near the time iNO initiation, was analysed by experts blind to the clinical course...
December 8, 2018: Journal of Paediatrics and Child Health
Radoslaw Jaworski, Andrzej Kansy, Mariusz Birbach, Anna Brodzikowska-Pytel, Monika Kowalczyk-Domagala, Grazyna Brzezinska-Rajszys, Bohdan Maruszewski
We present the surgical implantation of the Edwards Inspiris Resilia® aortic valve in mitral position for mechanical mitral valve failure in a severely ill infant after valve replacement because of anomalous origin of the left coronary artery from the pulmonary artery. The biological valve was chosen because the child could not receive oral anticoagulation and was for several months on heparin infusion. The procedure was safely performed with good haemodynamic result.
February 2019: Cardiology in the Young
Amy K Keir, Oliver Karam, Nicolette Hodyl, Michael J Stark, Helen G Liley, Prakesh S Shah, Simon J Stanworth
AIM: To assess the prevalence, types and indications for fluid bolus therapy in neonates with haemodynamic compromise. METHODS: This was a pragmatic, international, multicentre observational study in neonatal units across Australasia, Europe and North America with a predefined study period of 10-15 study days per participating neonatal unit between December 2015 and March 2017. Infants ≤28 days of age who received a fluid bolus for the management of haemodynamic compromise (≥10 mL/kg given at ≤6 h) were included...
October 16, 2018: Journal of Paediatrics and Child Health
Martin Kluckow, Hazel Carlisle, Margaret Broom, Patricia Woods, Michele Jeffery, Deepa Desai, Yan Chen, Nick Evans
OBJECTIVE: To explore the efficacy and risks of oral paracetamol in later (>2 weeks old) treatment of patent ductus arteriosus (PDA). STUDY DESIGN: A multicentre double-blind placebo-controlled randomised pilot trial in three neonatal intensive care units in Australia. Infants born <33 weeks with haemodynamically significant PDA were treated with a 5-day course of oral paracetamol or placebo. Cardiac ultrasounds were used to document haemodynamic parameters...
January 2019: Journal of Perinatology: Official Journal of the California Perinatal Association
Jamie N Colombo, Michael C Spaeder, Michael R Hainstock
OBJECTIVE: We aimed to investigate the incidence and causes of readmission of infants with single-ventricle and shunt-dependent biventricular CHD following routine, outpatient cardiac catheterisation. BACKGROUND: Cardiac catheterisation is commonly performed in patients with single-ventricle and shunt-dependent biventricular CHD for haemodynamic assessment and surgical planning. Best practices for post-procedural care in this population are unknown, and substantial variation exists between centres...
December 2018: Cardiology in the Young
Aylin Aygün, Martin Poryo, Gudrun Wagenpfeil, Antonia Wissing, Daniel Ebrahimi-Fakhari, Michael Zemlin, Ludwig Gortner, Sascha Meyer
AIM: We assessed the risk factors for transient acute kidney injury in very low birth weight (VLBW) infants treated for patent ductus arteriosus (PDA) using the serum creatinine-based criteria in Kidney Disease: Improving Global Outcomes. METHOD: This retrospective study of infants requiring ibuprofen and, or, surgery for haemodynamic relevant PDAs was performed at the University Children's Hospital of Saarland, Homburg, Germany, from January 2009 to December 2015...
September 3, 2018: Acta Paediatrica
M F Siddiqui, S Lloyd-Fox, P Kaynezhad, I Tachtsidis, M H Johnson, C E Elwell
A novel multi-wavelength broadband near infrared spectroscopy (NIRS) system has been employed to simultaneously measure haemodynamic changes alongside changes in cellular oxygen utilization by measurement of oxidation state of mitochondrial enzyme cytochrome-c-oxidase (oxCCO). The aim of this study was to investigate the role of oxCCO in neural responses to functional activation in infants. Studies were performed using a NIRS broadband system in 33 typically developing infants aged between 4 and 6 months. Responses were recorded over the right temporal lobe while infants were presented with engaging videos containing social and non-social content...
2018: Advances in Experimental Medicine and Biology
Nilüfer Okur, Cüneyt Tayman, Mehmet Büyüktiryaki, Gülsüm Kadıoğlu Şimşek, Buse Ozer Bekmez, Nahide Altuğ
OBJECTIVE: Serum lactate levels provide information on metabolic capacity at the cellular level. In addition, lactate reflects tissue perfusion and oxygenation status. The aim of this study was to determine the usefulness of high lactate levels as a marker in hemodynamically significant patent ductus arteriosus (hsPDA), which may lead to tissue perfusion defects. METHODS: Preterm infants with gestational age ≤32 weeks and birthweight ≤1500 g were included...
September 2, 2018: Journal of Clinical Laboratory Analysis
Kimberly I Mills, Sarah J van den Bosch, Kimberlee Gauvreau, Catherine K Allan, Ravi R Thiagarajan, David M Hoganson, Christopher W Baird, Meena Nathan, James A DiNardo, John N Kheir
BACKGROUND: Following stage 1 palliation, delayed sternal closure may be used as a technique to enhance thoracic compliance but may also prolong the length of stay and increase the risk of infection. METHODS: We reviewed all neonates undergoing stage 1 palliation at our institution between 2010 and 2017 to describe the effects of delayed sternal closure. RESULTS: During the study period, 193 patients underwent stage 1 palliation, of whom 12 died before an attempt at sternal closure...
August 28, 2018: Cardiology in the Young
Laurène Gautheyrou, Sabine Durand, Emilie Jourdes, Julien De Jonckheere, Clémentine Combes, Gilles Cambonie
AIM: To assess the effect of facilitated tucking (FT), a nonpharmacologic nursing intervention, on echocardiographic parameters and infant comfort collected prospectively during neonatologist-performed echocardiography. METHODS: Echocardiography was performed twice, in standard conditions and with FT; the order was randomised by computer. Echocardiography provided data on pulmonary artery flow and pressure, right and left ventricular function, and persistent ductus arteriosus...
December 2018: Acta Paediatrica
Douglas Bell, Sudesh Prabhu, Kim Betts, Robert Justo, Prem Venugopal, Tom R Karl, Nelson Alphonso
OBJECTIVES: This study aims to assess the performance of tissue-engineered bovine pericardium (CardioCel®) at 24 months and beyond when used for the repair of congenital heart defects. METHODS: Between October 2012 and November 2014, CardioCel was implanted in 135 patients (140 procedures and 195 implants). Applications included the closure of septal defects (98, 50.3%), repair of pulmonary arteries (63, 32.3%), intra-atrial/intraventricular baffles (10, 5.1%), repair of systemic arteries (15, 7...
August 7, 2018: Interactive Cardiovascular and Thoracic Surgery
Tim Hundscheid, Wes Onland, Bart van Overmeire, Peter Dijk, Anton H L C van Kaam, Koen P Dijkman, Elisabeth M W Kooi, Eduardo Villamor, André A Kroon, Remco Visser, Daniel C Vijlbrief, Susanne M de Tollenaer, Filip Cools, David van Laere, Anne-Britt Johansson, Catheline Hocq, Alexandra Zecic, Eddy Adang, Rogier Donders, Willem de Vries, Arno F J van Heijst, Willem P de Boode
BACKGROUND: Much controversy exists about the optimal management of a patent ductus arteriosus (PDA) in preterm infants, especially in those born at a gestational age (GA) less than 28 weeks. No causal relationship has been proven between a (haemodynamically significant) PDA and neonatal complications related to pulmonary hyperperfusion and/or systemic hypoperfusion. Although studies show conflicting results, a common understanding is that medical or surgical treatment of a PDA does not seem to reduce the risk of major neonatal morbidities and mortality...
August 4, 2018: BMC Pediatrics
Sujith Stanley Pereira, Ajay Kumar Sinha, Joan Katherine Morris, David F Wertheim, Divyen K Shah, Stephen Terence Kempley
OBJECTIVE: To examine the feasibility of a trial allocating different blood pressure (BP) intervention levels for treatment in extremely preterm infants. DESIGN: Three-arm open randomised controlled trial performed between February 2013 and April 2015. SETTING: Single tertiary level neonatal intensive care unit. PATIENTS: Infants born <29 weeks' gestation were eligible to participate, if parents consented and they did not have a major congenital malformation...
July 26, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
Corinna Binder-Heschl, Kelly Crossley, Arjan Te Pas, Graeme Polglase, Douglas Blank, Valerie Zahra, Alison Moxham, Karyn Rodgers, Stuart Hooper
BACKGROUND: Caffeine is routinely given to preterm infants hours after birth to treat apnea of prematurity. In view of it's success, earlier administration in the delivery room is being considered, but little is known about how caffeine may effect the cardiovascular changes during the fetal to neonatal transition. Our aim was to determine the effect of prenatal caffeine administration on haemodynamic parameters in ventilated preterm lambs immediately after birth. METHODS: Catheters (carotid artery and jugular vein) and ultrasonic flow probes (pulmonary artery and carotid artery) were implanted in preterm lambs (~126 ±2 days of gestation; term is 147 days), immediately before delivery by caesarean section...
2018: PloS One
Aisling A Garvey, Elisabeth M W Kooi, Aisling Smith, Eugene M Dempsey
Near-infrared spectroscopy (NIRS) allows for continuous, non-invasive monitoring of end-organ tissue oxygenation. The use of NIRS, cerebral NIRS (cNIRS) in particular, in neonatal care has increased significantly over the last few years. This dynamic monitoring technique provides real-time information on the cerebral and haemodynamic status of the neonate and has the potential to serve as an important adjunct to patient care with some centres routinely utilising cNIRS to aid decision-making at the bedside. cNIRS values may be influenced by many variables, including cardiac, respiratory and metabolic parameters, and therefore it is essential to understand the pathophysiology behind alterations in cNIRS values...
July 9, 2018: Children
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