RESUMO
Thirty-three of 616 consecutively admitted newborn infants had trombocytopenia (platelet count less than 150,00/mm). Only 16 of these were among the 356 infants with lung disease. However, 12 of the 16 were among the 90 infants with a diagnosis of a perinatal aspiration syndrome. The 12 thrombocytopenic infants were the only infants with PAS considered to have pulmonary hypertension. The duration of significant right-to-left shunting of blood paralleled the duration of thrombocytopenia in these infants; PHN was not associated with thrombocytopenia in other neonatal lung diseases. Thus, platelets appear to be important in the pathogenesis of PHN complicating PAS.
Assuntos
Hipertensão Pulmonar/complicações , Doenças do Recém-Nascido/complicações , Pneumopatias/complicações , Trombocitopenia/complicações , Humanos , Doença da Membrana Hialina/complicações , Recém-NascidoRESUMO
Ductal shunting significantly affected the time necessary for aortic diastolic pressure to fall to one-half an initially selected value (t1/2). Fourteen premature infants with clinical evidence of left-to-right ductal shunting had a mean t1/2 of 277 msec (range 133 to 383 msec) compared with a mean t1/2 of 455 msec (range 332 to 567 msec) in 14 neonates with no clinical evidence of ductal shunting (P less than 0.01). Seven older infants with ductal shunting confirmed at cardiac catheterization had a mean t1/2 of 360 msec (range 240 to 392 msec). Infant catheterization data and animal studies are suggestive of an inverse relationship between the magnitude of shunt and the t1/2. The t1/2 determined by diastolic pressure analysis is a useful method for serial evaluation of ductus arteriosus shunting.
Assuntos
Diástole , Permeabilidade do Canal Arterial/fisiopatologia , Doenças do Prematuro/fisiopatologia , Contração Miocárdica , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Circulação Pulmonar , Resistência VascularRESUMO
Forty-six neonates with hypoxemia were treated with tolazoline, a pulmonary vasodilator, within the first two days of life. Eight of ten (80%) infants without apparent lung disease responded with a mean increase in PaO2 of 116 torr within one hour of beginning tolazoline infusions. One of the responding infants and two nonresponders died. Thirty-six additional infants with a variety of pulmonary disorders had severe hypoxemia which was refractory to mechanical ventilation. Twenty-one (58%) responded with a mean increase in PaO2 of 130 torr within one hour after beginning tolazoline and 13 (62%) of these survived. Fifteen patients had little or no improvement in PaO2 following tolazoline and only three (20%) of these infants survived. Responders could not be distinguished from nonresponders by clinical or laboratory features prior to therapy with tolazoline. Fourteen infants experienced complications possibly related to tolazoline.
Assuntos
Hipóxia/tratamento farmacológico , Doenças do Recém-Nascido/tratamento farmacológico , Pneumopatias/tratamento farmacológico , Circulação Pulmonar , Tolazolina/uso terapêutico , Feminino , Hemorragia Gastrointestinal/induzido quimicamente , Humanos , Recém-Nascido , Masculino , Tolazolina/efeitos adversosRESUMO
Repeated transfusions of small increments of blood are frequently required for the sick newborn infant to correct endogenous hypovolemia and/or to replace blood obtained repeatedly for monitoring purposes. Current practices of blood banks are rarely geared to supply the small amounts of blood used for these individual transfusions. To provide a more efficient system, a walking donor program was established in which an appropriate hospital-based individual is cross matched as a donor for an infant for the duration of the infant's hospital stay. The program eliminates wastage of blood and donors and reduces the number of infectious agents to which the infant may be exposed.