Abstract:
:Preterm infants are exposed to frequent painful procedures and agitating stimuli over the many weeks of their hospitalization in the neonatal intensive care unit (NICU). The adverse neurobiological impact of pain and stress in the preterm infant has been well documented, including neuroimaging and neurobehavioral outcomes. Although many tools have been validated to assess acute pain, few methods are available to assess chronic pain or agitation (a clinical manifestation of neonatal stress). Both nonpharmacologic and pharmacologic approaches are used to reduce the negative impact of pain and agitation in the preterm infant, with concerns emerging over the adverse effects of analgesia and sedatives. Considering benefits and risks of available treatments, units must develop a stepwise algorithm to prevent, assess, and treat pain. Nonpharmacologic interventions should be consistently utilized prior to mild to moderately painful procedures. Sucrose may be utilized judiciously as an adjunctive therapy for minor painful procedures. Rapidly acting opioids (fentanyl or remifentanil) form the backbone of analgesia for moderately painful procedures. Chronic sedation during invasive mechanical ventilation represents an ongoing challenge; appropriate containment and an optimal environment should be standard; when indicated, low-dose morphine infusion may be utilized cautiously and dexmedetomidine infusion may be considered as an emerging adjunct.
journal_name
Pediatr Resjournal_title
Pediatric researchauthors
McPherson C,Miller SP,El-Dib M,Massaro AN,Inder TEdoi
10.1038/s41390-019-0744-6subject
Has Abstractpub_date
2020-08-01 00:00:00pages
168-175issue
2eissn
0031-3998issn
1530-0447pii
10.1038/s41390-019-0744-6journal_volume
88pub_type
杂志文章,评审abstract::Pulmonary hypoplasia has been associated with absent or hypoplastic pulmonary artery in four cases in humans. Despite these reports, the effects of decreased pulmonary arterial flow on fetal lung growth have not been adequately studied. This study defines the effects of left pulmonary artery (LPA) ligation on fetal lu...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199002000-00004
更新日期:1990-02-01 00:00:00
abstract::Antibodies of restricted specificity have been identified in the human in response to certain antigens. The present study analyzed tetanus and diphtheria antitoxins isolated from selected human sera and suggested a restricted response in antibody production to each of these antigens. Purified antibodies from eight ser...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197712000-00009
更新日期:1977-12-01 00:00:00
abstract::Respiratory parameters of skeletal muscle were determined in permeabilized muscle fibers by adapting a technique described by Veksler et al. for cardiac fibers (Biochim Biophys Acta, 892:191-196, 1987). This method consists of the permeabilization of muscle fibers by saponin by allowing respiratory substrates and inhi...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199207000-00004
更新日期:1992-07-01 00:00:00
abstract::The effects of passive respiratory syncytial virus (RSV) immune serum given as preinoculation prophylaxis, postinoculation prophylaxis, and as therapy on d 5 after inoculation were evaluated in an illness model of RSV infection in BALB/c mice. Pre- and postinoculation prophylaxis reduced RSV replication in lung after ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199308000-00013
更新日期:1993-08-01 00:00:00
abstract::Endothelin (ET)-1 is a potent vasoconstrictor peptide that modulates basal pulmonary vascular resistance (PVR) in the normal ovine fetus and contributes to high PVR after chronic intrauterine pulmonary hypertension. Although high PVR is present in premature lambs with severe hyaline membrane disease (HMD), whether ET-...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199808000-00006
更新日期:1998-08-01 00:00:00
abstract::The effects of an emulsified intravenous fat preparation (Intralipid) on bilirubin transport were analyzed by cholestyramine extraction, spectrophotometric analysis, Sephadex gel filtration, peroxidase assay, bilirubin uptake by red blood cells, and by toxicity in tissue culture (L-929) cells. Intralipid is capable of...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197703000-00004
更新日期:1977-03-01 00:00:00
abstract::Studies have shown that human neonates who develop group B streptococcal sepsis usually lack opsonic antibody (Ab) to their infecting strain and that these neonates may also have impaired polymorphonuclear leukocyte (PMN) function. The present study was designed to determine the efficacy of administration of PMNs or o...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198012000-00031
更新日期:1980-12-01 00:00:00
abstract::New information is emerging concerning the influence of environmental factors (e.g., viruses, pollutants, nutrients) on fetal lung development and the prenatal modulation of cellular and molecular effectors essential to the control of airway function, which may shed new light into the pathogenesis of chronic obstructi...
journal_title:Pediatric research
pub_type: 杂志文章,评审
doi:10.1038/s41390-019-0657-4
更新日期:2020-01-01 00:00:00
abstract::Milk gangliosides inhibit Vibrio cholerae enterotoxin and Escherichia coli heat-labile enterotoxin. Human milk gangliosides showed considerably higher enterotoxin-inhibitory activity compared to bovine and formula milk gangliosides as measured in vitro by enzyme-linked immunosorbent assay and in vivo in rabbit small b...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198605000-00008
更新日期:1986-05-01 00:00:00
abstract::We have previously shown that milk sensitization aggravates intestinal dysfunction in the malnourished guinea pigs, suggesting that it may also impair the recovery from malnutrition. To test this hypothesis, the growing guinea pigs were malnourished by feeding only maize for 7 d and then were refed for 21 d with a bal...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199812000-00018
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:Current tools to predict the severity of respiratory syncytial virus (RSV) infection might be improved by including immunological parameters. We hypothesized that a combination of inflammatory markers would differentiate between severe and mild disease in RSV-infected children. METHODS:Blood and nasopharyng...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2012.163
更新日期:2013-02-01 00:00:00
abstract:INTRODUCTION:The Coulter LH780 hematology analyzer can evaluate mean neutrophil volume (MNV), conductivity (MNC), scatter (MNS), and distribution width (DW). We sought to investigate the value of volume, conductivity, and scatter (VCS) parameters in diagnosis and treatment efficacy of neonatal sepsis. RESULTS:We obser...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2011.16
更新日期:2012-01-01 00:00:00
abstract::Meconium aspiration syndrome (MAS) is a serious condition in newborns, associated with a poorly characterized inflammatory reaction. The aim of this study was to investigate a possible role for complement in pulmonary pathophysiology and systemic inflammation in experimental MAS. MAS was induced by instillation of mec...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000141983.32466.2A
更新日期:2004-11-01 00:00:00
abstract::We determined whether closing the ductus arteriosus of the fetal lamb several d before birth would cause persistent pulmonary hypertension after birth. Six experimental fetuses who had their ductus arteriosus ligated 3-17 d before delivery, three control fetuses who had sham ligation of the ductus arteriosus 14 d befo...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198903000-00005
更新日期:1989-03-01 00:00:00
abstract::Children with nephropathic cystinosis store 50 to 100 times normal amounts of free cystine in many cells and display negligible lysosomal cystine transport in their leucocytes and cultured fibroblasts. A patient with intermediate (adolescent) cystinosis exhibited a similar deficiency of egress out of fibroblast lysoso...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198702000-00016
更新日期:1987-02-01 00:00:00
abstract:BACKGROUND:Maternal exposure to pesticides during pregnancy may cause oxidative hemolysis leading to neonatal hyperbilirubinemia. This investigation examined for associations between maternal use of pesticides or repellents during pregnancy and neonatal hyperbilirubinemia requiring phototherapy. METHODS:We used the da...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/s41390-020-1100-6
更新日期:2020-08-05 00:00:00
abstract::BACKGROUNDThe aims of this study were to (i) compare the concentrations of two neural injury markers, S100B protein and neuron-specific enolase (NSE), in intrauterine growth-restricted (IUGR) fetuses and in fetuses with appropriate growth-for-gestational-age (AGA), and (ii) investigate potential relationships between ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2017.108
更新日期:2017-09-01 00:00:00
abstract::We studied the mechanisms by which C16:0 lysophosphatidylcholine (LPC) and albumin inhibit the surface activity of calf lung surfactant extract (CLSE) by using a pulsating bubble apparatus with a specialized hypophase exchange system, plus adsorption and Wilhelmy balance measurements. In the absence of inhibitors, CLS...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199907000-00015
更新日期:1999-07-01 00:00:00
abstract::The mechanisms of how glutamine benefits critically ill patients have not been established. The purpose of this study was to determine the effects of dietary and endogenously produced glutamine on small intestinal morphology using light and transmission electron microscopy in artificially reared rat pups. It was hypot...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-200209000-00021
更新日期:2002-09-01 00:00:00
abstract::Vagal responsivity to orogastric stimulation is necessary for gastrointestinal function and may reflect autonomic regulation. Our study evaluated vagal responsivity during gavage feeding as an index of preterm clinical status. Vagal and behavioral responsivity of 26 preterm infants during gavage feeding was measured. ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199103000-00003
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Protein intake may modulate cardiac structure and function in pathological conditions, but there is a lack of knowledge on potential effects in healthy infants. METHODS:Secondary analysis of an ongoing randomized clinical trial comparing two groups of infants receiving a higher (HP) or lower (LP) protein co...
journal_title:Pediatric research
pub_type: 杂志文章,随机对照试验
doi:10.1038/pr.2016.30
更新日期:2016-06-01 00:00:00
abstract::Heart rate variability (HRV) is reported increasingly in pediatric research, but different strategies used to identify and manage potential outlier beats impact HRV parameter values in adults and animals. Do they in pediatrics? To compare the impact of different strategies to identifying and managing outliers, we used...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/PDR.0b013e318123fbcc
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:This study aimed to assess cortical gray matter growth and maturation in neonates with congenital heart disease (CHD). METHODS:Thirty-one (near) term neonates with severe CHD (8 univentricular heart malformation (UVH), 21 d-transposition of great arteries (d-TGA) and 2 aortic coarctation) underwent cerebral...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2016.145
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Social determinants of health (SDH) can substantially impact health outcomes. A systematic review, however, has never been conducted on associations of SDH with congenital heart disease (CHD) outcomes. The aim, therefore, was to conduct such a systematic review. METHODS:Seven databases were searched through...
journal_title:Pediatric research
pub_type: 杂志文章,评审
doi:10.1038/s41390-020-01196-6
更新日期:2020-10-17 00:00:00
abstract::Four protein dietary groups of rats were used in this study, namely: 27% casein diet fed throughout gestation and lactation (group C-C); 27% gestation, 10% lactation (group C-D); 10% gestation, 27% lactation (group D-C); 10% throughout gestation and lactation (group D-D). Mean body weight of group D-D at warning was 1...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197503000-00008
更新日期:1975-03-01 00:00:00
abstract::Epidermal growth factor (EGF), a potent mitogen present in milk, is postulated to play an important physiologic role in the ontogeny of the intestine. An artificial rat milk, free of EGF, was developed and fed to newborn rats in an effort to evaluate the physiologic role of EGF on intestinal glucose transport. Compari...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198704000-00017
更新日期:1987-04-01 00:00:00
abstract::Genetic typing of serum transferrin was performed in a group of 88 extremely premature infants (gestation age less than 32 wk) and in a control group of 351 full-term infants, using isoelectric focusing technique on ultrathin layer of polyacrilamide gel. A major incidence of C2 type was found among the preterm infants...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198212000-00011
更新日期:1982-12-01 00:00:00
abstract:BACKGROUND:Earlier attempts to deliver effective lung doses of surfactant by aerosolization were unsuccessful, mostly because of technical shortcomings. We aimed at quantifying the lung deposition of poractant alfa with a new supraglottic delivery system for surfactant atomization in an experimental neonatal model. ME...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/s41390-019-0696-x
更新日期:2020-05-01 00:00:00
abstract::Previous studies have demonstrated metabolic dysfunction in the mononuclear cells of some children with abnormal cell-mediated immunity. Interpretation of these observations has been complicated by the extreme heterogeneity of cell types examined. The glycolytic metabolism of relatively enriched T-cells, non-T mononuc...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198002000-00005
更新日期:1980-02-01 00:00:00
abstract::Alveolar hypoxia increases pulmonary artery pressure in lambs and sheep but increases lung lymph flow only in lambs; the reasons for this are unknown. To test the hypothesis that hypoxia-induced pulmonary venous constriction could in part explain the fluid filtration response in young lambs, eight young lambs (13 +/- ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198712000-00013
更新日期:1987-12-01 00:00:00