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 hours). The infants were also studied for a 12-hour period during which no pancuronium bromide was administered. During both study periods, the order of which was randomized, heart rate, blood pressure, PO2, and intracranial pressure were continuously measured. The amounts of handling during the pancuronium and control periods were similar. The results revealed a significantly greater duration of hypoxia (PO2 less than 50 torr) (56.1 vs 23.6 minutes, P less than .001) and hyperoxia (PO2 greater than 70 torr) during the control period (92.5 vs 13 minutes, P less than .001). Durations of intracranial pressure elevation 10 cm H2O above the infant's baseline were significantly less during paralysis (6.7 vs 58.8 minutes, P less than .001) as were spikes of intracranial pressure to greater than 25 cm H2O (1.6 vs 24.4, P less than .05). There was no significant improvement in blood gas values, fractional inspiratory oxygen, or ventilator settings during muscle relaxation. Pancuronium reduced periods of nonoptimal oxygenation and elevated intracranial pressure and may therefore help to decrease adverse sequelae for the low-birth-weight, ventilated neonate.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Finer NN,Tomney PM

subject

Has Abstract

pub_date

1981-05-01 00:00:00

pages

641-6

issue

5

eissn

0031-4005

issn

1098-4275

journal_volume

67

pub_type

临床试验,杂志文章,随机对照试验
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    authors: COMMITTEE ON INFECTIOUS DISEASES.,COMMITTEE ON FETUS AND NEWBORN.

    更新日期:2017-09-01 00:00:00

  • Motivational interviewing with parents for obesity: an RCT.

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    doi:10.1542/peds.2014-1987

    authors: Pakpour AH,Gellert P,Dombrowski SU,Fridlund B

    更新日期:2015-03-01 00:00:00

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    abstract::A 34-day-old previously healthy boy born full term presented to the emergency department with fever at home (38.1°C), fussiness, and decreased oral intake for 1 day. He was difficult to console at home. He had decreased oral intake without emesis, diarrhea, or a change in urine output. He did not have rhinorrhea, coug...

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    doi:10.1542/peds.2015-1406

    authors: Horner K,Yamada M,Zuccoli G,Rosenberg S,Greene S,Vellody K,Zuckerbraun NS

    更新日期:2016-01-01 00:00:00

  • Abusive head trauma: judicial admissions highlight violent and repetitive shaking.

    abstract:OBJECTIVE:Confessions are uncommon in abusive head trauma (AHT) cases, and there is debate over whether shaking alone can cause the injuries characteristic of AHT. The objective of this article is to correlate legal statements by perpetrators with medical documentation to offer insights into the mechanism of injury. M...

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    doi:10.1542/peds.2009-3647

    authors: Adamsbaum C,Grabar S,Mejean N,Rey-Salmon C

    更新日期:2010-09-01 00:00:00

  • Maternal, neonatal, and placental features associated with diffuse chorioamniotic hemosiderosis, with special reference to neonatal morbidity and mortality.

    abstract:OBJECTIVE:Our purpose was to examine the significance of diffuse chorioamniotic hemosiderosis (DCH) on neonatal morbidity and mortality. METHODS:Using data from a retrospective case-control study, we analyzed 46 singleton placentas with DCH from infants who were delivered and/or admitted to the neonatal intensive care...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.113.4.800

    authors: Ohyama M,Itani Y,Yamanaka M,Goto A,Kato K,Ijiri R,Tanaka Y

    更新日期:2004-04-01 00:00:00

  • Management of pituitary-adrenal suppression secondary to corticosteroid therapy.

    abstract::Withdrawal of steroid medications from patients who have been receiving them for management of chronic disease carries the risk of certain serious complications. An understanding of adrenal physiology, coupled with a rational plan for evaluating the individual patient, when necessary, and for protecting against certai...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Chamberlin P,Meyer WJ 3rd

    更新日期:1981-02-01 00:00:00

  • Endemic iron deficiency associated with Helicobacter pylori infection among school-aged children in Alaska.

    abstract:OBJECTIVES:Rural Alaska Natives have a high prevalence of iron deficiency and Helicobacter pylori infection. The objective of this study was to estimate the prevalence of iron deficiency, iron-deficiency anemia, and active H pylori infection among school-aged children in rural Alaska. METHODS:We enrolled 68% (688) of ...

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    pub_type: 杂志文章

    doi:10.1542/peds.2005-1129

    authors: Baggett HC,Parkinson AJ,Muth PT,Gold BD,Gessner BD

    更新日期:2006-03-01 00:00:00

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2004-1616

    authors: Williams JV,Eichenfield LF,Burke BL,Barnes-Eley M,Friedlander SF

    更新日期:2005-01-01 00:00:00

  • Massachusetts Metabolic Disorders Screening Program: III. Sarcosinemia.

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Levy HL,Coulombe JT,Benjamin R

    更新日期:1984-10-01 00:00:00

  • Evaluation and treatment of the human immunodeficiency virus-1--exposed infant.

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    journal_title:Pediatrics

    pub_type: 指南,杂志文章,实务指引

    doi:10.1542/peds.114.2.497

    authors: King SM,American Academy of Pediatrics Committee on Pediatric AIDS.,American Academy of Pediatrics Infectious Diseases and Immunization Committee.

    更新日期:2004-08-01 00:00:00

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    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2016-1758J

    authors: LeBourgeois MK,Hale L,Chang AM,Akacem LD,Montgomery-Downs HE,Buxton OM

    更新日期:2017-11-01 00:00:00

  • Teaching community pediatrics to pediatric residents: strategic approaches and successful models for education in community health and child advocacy.

    abstract::To improve child health at a community level, pediatricians require knowledge and skills that have not been traditionally included in residency training. Recent policy statements from the American Academy of Pediatrics and requirements from Accreditation Council for Graduate Medical Education Residency Review committe...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2004-2825J

    authors: Shipley LJ,Stelzner SM,Zenni EA,Hargunani D,O'Keefe J,Miller C,Alverson B,Swigonski N

    更新日期:2005-04-01 00:00:00

  • Late Pregnancy β Blocker Exposure and Risks of Neonatal Hypoglycemia and Bradycardia.

    abstract:BACKGROUND AND OBJECTIVES:β blockers are widely used in the treatment of hypertensive disorders during pregnancy. These medications cross the placenta and may cause physiologic changes in neonates exposed in utero. We sought to define the risks of neonatal hypoglycemia and bradycardia associated with maternal exposure ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2016-0731

    authors: Bateman BT,Patorno E,Desai RJ,Seely EW,Mogun H,Maeda A,Fischer MA,Hernandez-Diaz S,Huybrechts KF

    更新日期:2016-09-01 00:00:00

  • Fatal Haemophilus influenzae endocarditis diagnosed by echocardiography in an infant.

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Laird WP,Nelson JD,Weinberg AG,Huffines FD

    更新日期:1979-09-01 00:00:00

  • Clinical significance of primary vesicoureteral reflux and urinary antibiotic prophylaxis after acute pyelonephritis: a multicenter, randomized, controlled study.

    abstract:OBJECTIVES:To evaluate the role of primary vesicoureteral reflux (VUR) in increasing the frequency and severity of urinary tract infections (UTIs) and renal parenchymal damage among patients with acute pyelonephritis and to determine whether urinary antibiotic prophylaxis reduces the frequency and/or severity of UTIs a...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1542/peds.2005-1362

    authors: Garin EH,Olavarria F,Garcia Nieto V,Valenciano B,Campos A,Young L

    更新日期:2006-03-01 00:00:00

  • Reducing bedtime tantrums: comparison between positive routines and graduated extinction.

    abstract::A total of 36 toddlers and preschool children exhibiting bedtime tantrum activity were randomly assigned to one of three groups: positive routines, graduated extinction, or control. Positive routines involved changing the child's bedtime to coincide with when he naturally fell asleep, as well as parent and child engag...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Adams LA,Rickert VI

    更新日期:1989-11-01 00:00:00

  • Adverse childhood experiences and sexually transmitted diseases in men and women: a retrospective study.

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.106.1.e11

    authors: Hillis SD,Anda RF,Felitti VJ,Nordenberg D,Marchbanks PA

    更新日期:2000-07-01 00:00:00

  • Resource utilization for observation-status stays at children's hospitals.

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    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1542/peds.2012-2494

    authors: Fieldston ES,Shah SS,Hall M,Hain PD,Alpern ER,Del Beccaro MA,Harding J,Macy ML

    更新日期:2013-06-01 00:00:00

  • Maternal Depression in Early Childhood and Developmental Vulnerability at School Entry.

    abstract:OBJECTIVES:To assess the relation between exposure to maternal depression before age 5 and 5 domains of developmental vulnerability at school entry, overall, and by age at exposure. METHODS:This cohort study included all children born in Manitoba, Canada, who completed the Early Development Instrument between 2005 and...

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    pub_type: 杂志文章

    doi:10.1542/peds.2020-0794

    authors: Wall-Wieler E,Roos LL,Gotlib IH

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  • Dobutamine pharmacokinetics and cardiovascular responses in critically ill neonates.

    abstract::The pharmacokinetics and pharmacodynamics of dobutamine were studied in 13 critically ill neonates requiring inotropic support. Dobutamine was administered as a constant infusion in increasing doses of 2.5, 5, and 7.5 micrograms/kg per minute. During dobutamine infusions, there were significant increases in cardiac ou...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Martinez AM,Padbury JF,Thio S

    更新日期:1992-01-01 00:00:00

  • A Healthy Toddler With Fever and Lethargy.

    abstract::A 21-month-old previously healthy girl presented to the emergency department initially with fever, rhinorrhea, and poor oral intake. She was subsequently discharged from the hospital on amoxicillin for treatment of acute otitis media but presented hours later on the same day with continued poor oral intake, decreased ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2018-0412

    authors: Suri NA,Meehan CW,Melwani A

    更新日期:2019-05-01 00:00:00

  • Medical correlates of infant development.

    abstract::Attempts to correlate developmental outcome with medical complications affecting the fetus and infant have focused on the prenatal, intrapartum, and postnatal periods. The time beyond the newborn stage has not been explored in detail. The aim of this study was to relate events occurring during the gestational and neon...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.61.3.470

    authors: Littman B,Parmelee AH Jr

    更新日期:1978-03-01 00:00:00

  • Integrating Psychological Screening Into Medical Care for Youth With Abdominal Pain.

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    pub_type: 杂志文章

    doi:10.1542/peds.2017-2876

    authors: Cunningham NR,Moorman E,Brown CM,Mallon D,Chundi PK,Mara CA,Pentiuk S,Lynch-Jordan AM,Dykes DMH,Elfers J,Farrell MK

    更新日期:2018-08-01 00:00:00

  • Maternal smoking and congenital heart defects.

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2007-1519

    authors: Malik S,Cleves MA,Honein MA,Romitti PA,Botto LD,Yang S,Hobbs CA,National Birth Defects Prevention Study.

    更新日期:2008-04-01 00:00:00

  • Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial.

    abstract:OBJECTIVE:The goal was to investigate the efficacy of orally administered probiotics in preventing necrotizing enterocolitis for very low birth weight preterm infants. METHODS:A prospective, blinded, randomized, multicenter controlled trial was conducted at 7 NICUs in Taiwan, to evaluate the beneficial effects of prob...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1542/peds.2007-3007

    authors: Lin HC,Hsu CH,Chen HL,Chung MY,Hsu JF,Lien RI,Tsao LY,Chen CH,Su BH

    更新日期:2008-10-01 00:00:00

  • Outdoor air pollution, genetic susceptibility, and asthma management: opportunities for intervention to reduce the burden of asthma.

    abstract::Outdoor air pollution at levels occurring in many urban areas around the world has substantial adverse effects on health. Children in general, and children with asthma in particular, are sensitive to the adverse effects of outdoor air pollutants, including ozone, nitrogen oxides, and respirable particulate matter. A g...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2008-2233G

    authors: Gilliland FD

    更新日期:2009-03-01 00:00:00

  • Primary angiitis of the central nervous system: neurologic deterioration despite treatment.

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    pub_type: 杂志文章

    doi:10.1542/peds.2009-2729

    authors: De Tiège X,Van Bogaert P,Aeby A,Salmon I,Parpal H,Poppe AY,Maris C,Lanthier S

    更新日期:2011-04-01 00:00:00

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

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    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

  • Pulse Oximetry and Auscultation for Congenital Heart Disease Detection.

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    pub_type: 杂志文章

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    更新日期:1991-08-01 00:00:00