Adenosine infusion improves oxygenation in term infants with respiratory failure.

Abstract:

OBJECTIVES:Adenosine infusion causes selective pulmonary vasodilation in fetal and neonatal lambs with pulmonary hypertension. We investigated the effects of a continuous infusion of adenosine on oxygenation in term infants with persistent pulmonary hypertension of newborn (PPHN). DESIGN:A randomized, placebo-controlled, masked trial comparing the efficacy of intravenous infusion of adenosine to normal saline infusion over a 24-hour period. SETTING:Inborn and outborn level III neonatal intensive care units at a university medical center. PARTICIPANTS:Eighteen term infants with PPHN and arterial postductal PO2 of 60 to 100 Torr on inspired O2 concentration of 100% and optimal hyperventilation (PaCO2 <30 Torr) were enrolled into the study. Study infants were randomly assigned to receive a placebo infusion of normal saline, or adenosine infusion in doses of 25 to 50 microg/kg/min over a 24-hour period. PARTICIPANTS:Eighteen term infants with PPHN and arterial postductal PO2 of 60 to 100 Torr on inspired O2 concentration of 100% and optimal hyperventilation (PaCO2 <30 Torr) were enrolled into the study. Study infants were randomly assigned to receive a placebo infusion of normal saline, or adenosine infusion in doses of 25 to 50 microg/kg/min over a 24-hour period. RESULTS:Nine infants each received adenosine or placebo. The two groups did not differ in birth weight, gestational age, or blood gases and ventilaator requirements at the time of entry into the study. Four of nine infants in the adenosine group and none of the placebo group had a significant improvement in oxygenation, defined as an increase in postductal PaO2 of > or =20 Torr from preinfusion baseline. The mean PaO2 in the adenosine group increased from 69 +/- 19 at baseline to 94 +/- 15 during 50 microg/kg/min infusion rate of adenossine and did not change significantly in the placebo group. Arterial blood pressure and heart rate did not change during the study in either group. The need for extracorporeal membrane oxygenation, incidence of bronchopulmonary dysplasia, and mortality were not different in the two groups. CONCLUSION:Data from this pilot study indicate that adenosine infusion at a dose of 50 microg/kg/min improves PaO2 in infants with PPHN without causing hypotension or tachycardia. Larger trials are needed to determine its effects on mortality and/or need for extracorporeal membrane oxygenation in infants with PPHN.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Konduri GG,Garcia DC,Kazzi NJ,Shankaran S

subject

Has Abstract

pub_date

1996-03-01 00:00:00

pages

295-300

issue

3

eissn

0031-4005

issn

1098-4275

journal_volume

97

pub_type

临床试验,杂志文章,随机对照试验
  • Successful treatment of juvenile chronic granulocytic leukemia with marrow transplantation.

    abstract::A 46-month-old boy with juvenile chronic granulocytic leukemia was treated intensively with hydroxyurea, dimethyl myleran, cyclophosphamide, and total body irradiation. He then received a marrow transplant from an HL-A matched brother. Thirty-two months after the transplantation, he is hematologically normal and remai...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Sanders JE,Buckner CD,Stewart P,Thomas ED

    更新日期:1979-01-01 00:00:00

  • The International Liaison Committee on Resuscitation (ILCOR) consensus on science with treatment recommendations for pediatric and neonatal patients: pediatric basic and advanced life support.

    abstract::This publication contains the pediatric and neonatal sections of the 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (COSTR). The consensus process that produced this document was sponsored by the International Liaison Committee on ...

    journal_title:Pediatrics

    pub_type: 杂志文章,实务指引

    doi:10.1542/peds.2006-0206

    authors: International Liaison Committee on Resuscitation.

    更新日期:2006-05-01 00:00:00

  • Improving Access to Care at Autism Treatment Centers: A System Analysis Approach.

    abstract:OBJECTIVE:The prevalence of autism spectrum disorder is steadily increasing and placing more demands on already overburdened diagnostic and treatment systems. A thoughtful, systematic reorganization of autism service delivery may reduce delays and better meet the growing need. METHODS:Two clinical centers in the Autis...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2015-2851M

    authors: Austin J,Manning-Courtney P,Johnson ML,Weber R,Johnson H,Murray D,Ratliff-Schaub K,Tadlock AM,Murray M

    更新日期:2016-02-01 00:00:00

  • Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infection in pediatric private practice.

    abstract:BACKGROUND:Universal screening of sexually active adolescents for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) has been recommended in settings in which prevalence is 2% or greater. Although believed to be above 2%, the prevalence of CT and GC infection in private practice settings has not been clearly est...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.108.6.e103

    authors: Best D,Ford CA,Miller WC

    更新日期:2001-12-01 00:00:00

  • Childhood overweight and maturational timing in the development of adult overweight and fatness: the Newton Girls Study and its follow-up.

    abstract:OBJECTIVE:Although several studies have suggested that early menarche is associated with the development of adult overweight, few have accounted for childhood overweight before menarche. STUDY DESIGN:A 30-year follow-up of the original participants in the Newton Girls Study, a prospective study of development in a coh...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2004-1604

    authors: Must A,Naumova EN,Phillips SM,Blum M,Dawson-Hughes B,Rand WM

    更新日期:2005-09-01 00:00:00

  • Clinical Interventions to Promote Breastfeeding by Latinas: A Meta-analysis.

    abstract:CONTEXT:Breastfeeding duration and exclusivity among Latinas fall below recommended levels, indicating a need for targeted interventions. The effectiveness of clinical breastfeeding interventions for Latinas remains unclear. OBJECTIVE:To systematically review the documented effectiveness of clinical breastfeeding inte...

    journal_title:Pediatrics

    pub_type: 杂志文章,meta分析,评审

    doi:10.1542/peds.2015-2423

    authors: Wouk K,Lara-Cinisomo S,Stuebe AM,Poole C,Petrick JL,McKenney KM

    更新日期:2016-01-01 00:00:00

  • Intravenous ceftriaxone and calcium in the neonate: assessing the risk for cardiopulmonary adverse events.

    abstract:OBJECTIVES:Unsolicited reports regarding potentially serious adverse drug reactions in neonates and young infants were reported to the Food and Drug Administration, leading to changes in the package label for ceftriaxone. This report describes and summarizes the reported cases that led to safety concerns regarding the ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2008-3080

    authors: Bradley JS,Wassel RT,Lee L,Nambiar S

    更新日期:2009-04-01 00:00:00

  • Primary care physician supply and children's health care use, access, and outcomes: findings from Canada.

    abstract:OBJECTIVES:To describe the relationship of primary care physician (PCP) supply for children and measures of health care access, use, and outcomes. METHODS:We conducted a population-based, cross-sectional study of all Ontario children from 2003 to 2005. We used health administrative data to calculate county-level suppl...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2009-2821

    authors: Guttmann A,Shipman SA,Lam K,Goodman DC,Stukel TA

    更新日期:2010-06-01 00:00:00

  • Smoking patterns among adolescents with asthma attending upper secondary schools: a community-based study.

    abstract:OBJECTIVE:Smoking among people who have asthma may be a serious health problem. We studied the prevalence of smoking and the relations between smoking and asthma, symptoms, medicine, and gender differences among adolescents with asthma. METHODS:A national cross-sectional study on health and lifestyles was performed in...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.111.5.e562

    authors: Precht DH,Keiding L,Madsen M

    更新日期:2003-05-01 00:00:00

  • Smoking in the movies increases adolescent smoking: a review.

    abstract:OBJECTIVE:Despite voluntary restrictions prohibiting direct and indirect cigarette marketing to youth and paid product placement, tobacco use remains prevalent in movies. This article presents a systematic review of the evidence on the nature and effect of smoking in the movies on adolescents (and others). METHODOLOGY...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2005-0141

    authors: Charlesworth A,Glantz SA

    更新日期:2005-12-01 00:00:00

  • Neonatal hyperbilirubinemia and risk of autism spectrum disorders.

    abstract:OBJECTIVE:To investigate the association between neonatal hyperbilirubinemia and autism spectrum disorders (ASD). METHODS:We conducted a large case-control study nested within the cohort of singleton term infants born between 1995 and 1998 at a northern California Kaiser Permanente hospital. Case subjects (n = 338) we...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2004-1870

    authors: Croen LA,Yoshida CK,Odouli R,Newman TB

    更新日期:2005-02-01 00:00:00

  • Pharmacokinetic comparison of intravenous and oral chloramphenicol in patients with Haemophilus influenzae meningitis.

    abstract::The pharmacokinetics of chloramphenicol following intravenous and oral administration were studied in 14 infants with Haemophilus influenzae meningitis. Following five days of treatment with intravenous chloramphenicol (100 mg/kg/day every six hours), oral chloramphenicol was substituted at the same dose. Multiple ser...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Yogev R,Kolling WM,Williams T

    更新日期:1981-05-01 00:00:00

  • Timing of adiposity rebound and adiposity in adolescence.

    abstract:OBJECTIVES:To investigate associations between timing of adiposity rebound (AR; the period in childhood where BMI begins to increase from its nadir) and adiposity (BMI, fat mass) at age 15 years in the Avon Longitudinal Study of Parents and Children (ALSPAC). METHODS:The sample consisted of 546 children with AR derive...

    journal_title:Pediatrics

    pub_type: 杂志文章,随机对照试验

    doi:10.1542/peds.2014-1908

    authors: Hughes AR,Sherriff A,Ness AR,Reilly JJ

    更新日期:2014-11-01 00:00:00

  • Heated, humidified high-flow nasal cannula therapy: yet another way to deliver continuous positive airway pressure?

    abstract:OBJECTIVE:The goal was to estimate the level of delivered continuous positive airway pressure by measuring oral cavity pressure with the mouth closed in infants of various weights and ages treated with heated, humidified high-flow nasal cannula at flow rates of 1-5 L/minute. We hypothesized that clinically relevant lev...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2007-0957

    authors: Kubicka ZJ,Limauro J,Darnall RA

    更新日期:2008-01-01 00:00:00

  • Serum apolipoproteins A-I and B in 2,854 children from a biracial community: Bogalusa Heart Study.

    abstract::Serum apolipoprotein A-I (apo A-I) and apolipoprotein B (apo B) profiles were examined in 2,854 children, 5 to 17 years of age, from a total biracial community. Black boys had higher apo A-I levels than white boys (P less than .001), whereas girls showed no such race-related difference. Black-white difference in apo A...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Srinivasan SR,Freedman DS,Sharma C,Webber LS,Berenson GS

    更新日期:1986-08-01 00:00:00

  • Prolonged use of large intravenous steroid pulses in the rheumatic diseases of children.

    abstract::Nineteen children with rheumatic diseases refractory to standard treatment were given repeated large "pulses" of corticosteroid therapy. The pulses consisted of four repeated doses of 500 mg of hydrocortisone given intravenously over 20 to 30 minutes at six-hour intervals or of single intravenous injections of 30 mg/k...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Miller JJ 3rd

    更新日期:1980-05-01 00:00:00

  • Translating child abuse research into action.

    abstract::The Child Abuse Recognition Experience Study revealed that primary care clinicians did not always follow the legal mandate to report suspected child abuse to child protective services. National child abuse experts representing different disciplines met in a 2-day conference in January 2007 to discuss and develop new s...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2008-0715c

    authors: Flaherty EG,Sege RD,Hurley TP

    更新日期:2008-09-01 00:00:00

  • C-reactive protein in the diagnosis, management, and prognosis of neonatal necrotizing enterocolitis.

    abstract:OBJECTIVE:In this prospective, observational study, we determined whether serum C-reactive protein (CRP) correlated with necrotizing enterocolitis (NEC) stages II and III. We hypothesized that serial CRP measurement if used as an adjunct to abdominal radiographs would improve the identification of infants with NEC. ME...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2004-1806

    authors: Pourcyrous M,Korones SB,Yang W,Boulden TF,Bada HS

    更新日期:2005-11-01 00:00:00

  • Reducing distress in mothers of children with autism and other disabilities: a randomized trial.

    abstract:BACKGROUND:Compared with other parents, mothers of children with autism spectrum disorder or other neurodevelopmental disabilities experience more stress, illness, and psychiatric problems. Although the cumulative stress and disease burden of these mothers is exceptionally high, and associated with poorer outcomes in c...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2013-3164

    authors: Dykens EM,Fisher MH,Taylor JL,Lambert W,Miodrag N

    更新日期:2014-08-01 00:00:00

  • Parental attitudes about confidentiality in a pediatric oncology clinic.

    abstract::Children and parents who attend pediatric oncology clinics often develop close relationships with other patients and may question clinic staff about another child's disease, therapy, or status. To assess parental attitudes concerning the dissemination of information by the clinic staff, questionnaires were mailed to t...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Patno KM,Young PC,Dickerman JD

    更新日期:1988-02-01 00:00:00

  • Varicella zoster virus meningitis in a previously immunized child.

    abstract::We are reporting a previously well 5-year-old child with varicella-zoster meningitis who had a history of a previous immunization against varicella. This child also developed a transient sensorineural hearing loss. The child was treated with acyclovir and made a full recovery. ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.114.2.e273

    authors: Schwab J,Ryan M

    更新日期:2004-08-01 00:00:00

  • Overt glucocorticoid excess due to inhaled corticosteroid therapy.

    abstract::Inhaled corticosteroids have become an important therapeutic option in the treatment of childhood asthma. The preparations currently available for pediatric use (beclomethasone dipropionate and triamcinolone acetonide) do not, in general, cause significant hypothalamic-pituitary-adrenal axis suppression and physical s...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Hollman GA,Allen DB

    更新日期:1988-03-01 00:00:00

  • Improving Anaphylaxis Care: The Impact of a Clinical Pathway.

    abstract:BACKGROUND:Recommended durations of observation after anaphylaxis have been widely variable, with many ranging from 4 to 24 hours. Prolonged durations often prompt admission for ongoing observation. METHODS:In a multidisciplinary quality improvement initiative, we revised our emergency department (ED) anaphylaxis clin...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2017-1616

    authors: Lee J,Rodio B,Lavelle J,Lewis MO,English R,Hadley S,Molnar J,Jacobstein C,Cianferoni A,Spergel J,Zielinski L,Tsarouhas N,Brown-Whitehorn T

    更新日期:2018-05-01 00:00:00

  • The Rights of Children for Optimal Development and Nurturing Care.

    abstract::Millions of children are subjected to abuse, neglect, and displacement, and millions more are at risk for not achieving their developmental potential. Although there is a global movement to change this, driven by children's rights, progress is slow and impeded by political considerations. The United Nations Convention...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2019-0487

    authors: Uchitel J,Alden E,Bhutta ZA,Goldhagen J,Narayan AP,Raman S,Spencer N,Wertlieb D,Wettach J,Woolfenden S,Mikati MA

    更新日期:2019-12-01 00:00:00

  • Brief approaches to developmental-behavioral promotion in primary care: updates on methods and technology.

    abstract::Well-child visits are a critical opportunity to promote learning and development, encourage positive parenting practices, help children acquire behavioral self-control, enhance the development and well-being of children and their families, identify problems not amenable to brief in-office counseling, and refer for ser...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2013-1859

    authors: Glascoe FP,Trimm F

    更新日期:2014-05-01 00:00:00

  • Controlled evaluation of muscle relaxation in the ventilated neonate.

    abstract::To assess the effects of muscle relaxation on the critically ill ventilated neonate, pancuronium bromide was administered for a 12-hour period to ten low-birth-weight neonates (960 to 2,000 gm) of 26 to 34 weeks gestation, all whom required mechanical ventilation and were studied within 48 hours of birth (six to 39 ho...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Finer NN,Tomney PM

    更新日期:1981-05-01 00:00:00

  • Simulation in Pediatric Emergency Medicine Fellowships.

    abstract:BACKGROUND AND OBJECTIVES:Graduate medical education faces challenges as programs transition to the next accreditation system. Evidence supports the effectiveness of simulation for training and assessment. This study aims to describe the current use of simulation and barriers to its implementation in pediatric emergenc...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2014-4158

    authors: Doughty CB,Kessler DO,Zuckerbraun NS,Stone KP,Reid JR,Kennedy CS,Nypaver MM,Auerbach MA

    更新日期:2015-07-01 00:00:00

  • Cognitive function and behavior of children with adenotonsillar hypertrophy suspected of having obstructive sleep-disordered breathing.

    abstract:OBJECTIVE:The purpose of this study was to determine whether risks of impaired cognitive function could be predicted for children or groups of children with adenotonsillar hypertrophy who were suspected of having obstructive sleep-disordered breathing, from historical and polysomnographic variables used separately or i...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2006-0173

    authors: Suratt PM,Peruggia M,D'Andrea L,Diamond R,Barth JT,Nikova M,Perriello VA Jr,Johnson ML

    更新日期:2006-09-01 00:00:00

  • Effects on breastfeeding of changes in maternity length-of-stay policy in a large health maintenance organization.

    abstract:OBJECTIVE:The purpose of this study was to evaluate the effects on breastfeeding rates of a private-sector early discharge program and a subsequent government mandate guaranteeing 48 hours of hospital coverage. METHODS:Interrupted time-series analyses were conducted on retrospective data from the automated medical rec...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.111.3.519

    authors: Madden JM,Soumerai SB,Lieu TA,Mandl KD,Zhang F,Ross-Degnan D

    更新日期:2003-03-01 00:00:00

  • Insulin receptors in cystic fibrosis: increased receptor number and altered affinity.

    abstract::Patients with cystic fibrosis are known to have pancreatic disorganization with associated pancreatic exocrine insufficiency. Endocrine hormonal secretion is also affected but diminution in insulin secretion is rarely accompanied by overt diabetes. We studied seven patients with cystic fibrosis to determine their carb...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Lippe BM,Kaplan SA,Neufeld ND,Smith A,Scott M

    更新日期:1980-05-01 00:00:00