Abstract:
:Extremely preterm infants often develop chronic lung disease (CLD) characterized by heterogeneous aeration; poorly supported, floppy airways; and air trapping. High-frequency jet ventilation (HFJV) with high end-expiratory pressure (optimal lung volume strategy [OLVS]) may improve airway patency, lead to better gas distribution, improve gas exchange, and facilitate extubation. In a pilot trial, this study sought to explore the effect of HFJV on oxygenation, ventilation, and ease of extubation in preterm infants with evolving CLD and refractory respiratory failure (RRF). From September 2002 to October 2004, 12 episodes of RRF developed in 10 ventilated extremely immature infants with evolving CLD (10 on conventional and two on high-frequency oscillation). Chorioamnionitis was confirmed in all infants, patent ductus arteriosus was ligated in five patients, and UREAPLASMA UREALYTICUM was cultured from trachea in four patients. HFJV with OLVS was initiated when oxygenation index (OI) > 10 or exhaled tidal volume (V TE) >or= 7 mL/kg were required to maintain partial pressure of carbon dioxide, arterial (Pa CO2) < 60 mm Hg. Inspiratory time (0.02/s) and frequency (310 to 420/min) were set initially with adjustment of pressure amplitude to keep Pa CO2 between 45 and 55 mm Hg. Ventilatory stabilization and weaning from mechanical ventilation with extubation to nasal continuous positive airway pressure (CPAP) were the goals of this approach. Gas exchange data were analyzed by Analysis of variance for repeated measures. Ten patients on 11 occasions of RRF were extubated to nasal CPAP successfully in a median of 15.5 days. Nine of 10 patients survived (one died of pentalogy of Cantrell), all required supplemental O2 at 36 weeks. Pa CO2 decreased within 1 hour after the initiation of HFJV, and OI decreased by 24 hours. Both remained significantly lower until successful extubation ( P < 0.02). Compared with conventional ventilation or high-frequency oscillatory ventilation, HFJV used with OLVS appears to improve gas exchange and may facilitate weaning from mechanical ventilation (MV) in extremely immature infants with evolving CLD. These encouraging pilot data need to be confirmed in a larger clinical trial.
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Plavka R,Dokoupilová M,Pazderová L,Kopecký P,Sebron V,Zapadlo M,Keszler Mdoi
10.1055/s-2006-954821subject
Has Abstractpub_date
2006-11-01 00:00:00pages
467-72issue
8eissn
0735-1631issn
1098-8785journal_volume
23pub_type
临床试验,杂志文章abstract::Prematurity, the major cause of perinatal morbidity and mortality, results from a multifactorial interaction of medical, historic, and psychosocial conditions. Although the literature contains several reports of prematurity risk-scoring systems, the relative importance of specific risk factors may depend on the popula...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999893
更新日期:1986-10-01 00:00:00
abstract::We tabulated the incidence of necrotizing enterocolitis (NEC) during a recent 4-year period among three neonatal intensive care units (NICUs) within a single health-care system. We then sought associations to explain differences in NEC incidence between the centers. Between January 1, 2002, and December 31, 2005, 6787...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究
doi:10.1055/s-2007-995220
更新日期:2008-01-01 00:00:00
abstract::A fiber-enriched diabetic diet that contained a modest increase in dietary fiber and a commercially available fiber supplement was studied in pregnant diabetic women for its potential glucose-lowering effects. Noninsulin-requiring gestational diabetic patients were placed on a fiber-enriched diet of increasing fiber c...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-994738
更新日期:1993-07-01 00:00:00
abstract:INTRODUCTION:Many tertiary neonatal units employ a restricted visiting policy. Webcams have previously been implemented in the neonatal unit setting in several countries. OBJECTIVES:This study aims to determine the views from parents, physicians, and nursing staff before implementation of a webcam system. METHODS:A q...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0034-1376388
更新日期:2015-02-01 00:00:00
abstract::Objective To determine the association between birthweight extremes and risk of adverse neonatal and childhood outcomes following preterm premature rupture of membranes (PPROM). Study Design This is a secondary analysis of data from the Beneficial Effects of Antenatal Magnesium Sulfate Trial. Women with nonanomalous s...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0036-1584898
更新日期:2016-10-01 00:00:00
abstract::A 27-year-old primigravida women was referred for ultrasound studies at 32 weeks' gestation because of the suspicion of fetal ventriculomegaly. Sonographic examination of the fetal brain found a marked shift of the midline, with enlarged left hemisphere and ipsilateral occipital horn, and abnormal convolutions. A 3500...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999330
更新日期:1991-01-01 00:00:00
abstract::The most common mechanism of fetal tachycardia is orthodromic reciprocating tachycardia utilizing an accessory atrioventricular connection, however, data regarding accessory connection location in patients with fetal tachycardia is limited. To investigate the location of accessory connections in fetal tachycardia, pos...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章
doi:10.1055/s-2003-40014
更新日期:2003-04-01 00:00:00
abstract::Persistent fetal bradycardia is rarely encountered during pregnancy. When it is associated with a complete atrio-ventricular (A-V) block, it may prove dangerous to the fetus or newborn. The prenatal diagnosis is vital because it necessitates close follow-up during pregnancy to detect fetal compromise and proper prepar...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2007-994152
更新日期:1997-07-01 00:00:00
abstract::To estimate the risk of preterm birth in asymptomatic women with twin pregnancies with a normal cervical length (CL) and a positive fetal fibronectin (fFN), we reviewed a retrospective cohort of twin pregnancies delivered in our practice from 2005 to 2010. Patients were screened from 22 to 32 weeks with CL and fFN at ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0031-1285827
更新日期:2012-04-01 00:00:00
abstract::Objective Our objective was to review the literature in relationship to diabetes in pregnancy in low and middle income countries. Study Design We reviewed the English language literature related to diabetes and obesity during pregnancy in low and middle income countries published over the last 20 years. Results The gl...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1584152
更新日期:2016-11-01 00:00:00
abstract::We present the outcome of a relatively large cohort of women with suspected placenta accreta who underwent prophylactic pelvic artery catheterization prior to cesarean section. All pregnant women with suspected placenta accreta who delivered in one tertiary center were included in this retrospective study. All patient...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0030-1247599
更新日期:2010-06-01 00:00:00
abstract::In order to assess the prognosis of hypertension first documented during labor, an inception cohort of all women with hypertension complicating pregnancy was assembled. In this cohort, even extreme elevations of blood pressure, regardless of the degree of proteinuria, were not associated with either maternal or fetal ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999799
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVE: Sepsis is a major cause of neonatal mortality. The gold standard for diagnosis is blood culture which suffers from low sensitivity and huge turn-around time. Flow cytometry has been extensively applied to malignant disorders and is an upcoming tool for diagnosis of nonmalignant disorders due to its rapidity ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1718370
更新日期:2020-09-29 00:00:00
abstract::I developed a single equation that simulated previously published growth charts for very low-birth-weight infants, using birth weight as the only variable. The intent of this study was to validate the equation using infants admitted to our neonatal intensive care unit (NICU) and to determine if this equation could be ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993914
更新日期:1998-02-01 00:00:00
abstract::Seventy premature infants (birthweight 1.75 kg or less, gestational age 33 weeks or less) with hemoglobin less than 10 g/dL and hematocrit less than 30% were studied and randomly divided into three groups. All of them received oral elemental iron 3 mg/kg/day and vitamin E 5 mg/kg/day during the study period. Recombina...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2007-994483
更新日期:1995-09-01 00:00:00
abstract::Introduction Our aim was to survey clinicians to assess awareness and utilization of the NICHD Neonatal Research Network outcomes estimator, which allows clinicians to use multiple factors to better estimate the likelihood that intensive care will benefit the delivered neonate. Study Design The survey tool included a ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0036-1582396
更新日期:2016-08-01 00:00:00
abstract::Hepatoblastoma accounts for less than 1% of all pediatric malignancies. However, it remains the most common malignant tumor of the liver in newborns. Less than 10% of hepatoblastoma cases are diagnosed in the neonatal period. The diagnosis can be very difficult due to the wide spectrum of presentation and differences ...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2005-872592
更新日期:2005-11-01 00:00:00
abstract::Our objective was to describe the change in the level of troponin I in patients who undergo a vaginal or cesarean delivery. We obtained troponin I levels on admission and 1 hour after delivery in women undergoing vaginal and cesarean deliveries. Exclusion criteria included <37 weeks' gestation, a history of cardiac di...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2004-820507
更新日期:2004-01-01 00:00:00
abstract::The objective of this study is to review the safety and success of a trial of labor after cesarean in a group of patients managed by a solo practitioner in a rural community. This was a retrospective review of all deliveries performed over an 11-year period by a single practitioner in a rural community. Standard contr...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2003-38317
更新日期:2003-02-01 00:00:00
abstract::Magnesium sulfate is used for seizure prophylaxis in patients with preeclampsia. It also has significant effects on calcium metabolism and could, therefore, alter the pressor response to calcium-dependent vasoconstrictors. The present in vivo rat study examined the effect of magnesium sulfate to alter the pressor resp...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999292
更新日期:1992-09-01 00:00:00
abstract::The Roberts-SC phocomelia syndrome (pseudothalidomide syndrome) is a rare, usually lethal condition involving short limbs and occasional hydrocephalus. Presented is a case in which prenatal sonographic findings were highly suggestive of this syndrome, although not definite. In this fetus, findings of hydrocephalus, sh...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999392
更新日期:1991-07-01 00:00:00
abstract::We have examined the safety and efficacy of an early postpartum discharge program in 289 patients who were identified prior to delivery and counseled and educated for discharge 12 to 36 hours after delivery. A total of 55% of the study patients were able to be discharged early. There were 4.3% significant maternal pro...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994768
更新日期:1993-09-01 00:00:00
abstract::The objective of this study was to perform antiphospholipid antibody screening in women with chronic hypertension to assess whether the presence of such antibodies is associated with adverse pregnancy outcome. Serum for anticardiolipin antibodies and lupus anticoagulant was obtained in pregnant women with chronic hype...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2004-829870
更新日期:2004-07-01 00:00:00
abstract::The findings of hyperechoic and enlarged fetal kidneys on routine antenatal ultrasonography is a non-specific finding that alerts the physician to a differential diagnosis of various genetic and non-genetic disorders, including fetal polycystic disease and Beckwith-Wiedeman syndrome. Detection of fetal or neonatal pol...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994309
更新日期:1996-04-01 00:00:00
abstract::An abdominal gunshot wound in pregnancy warrants prompt surgical exploration but does not mandate uterine evacuation. Despite an entry and exit bullet wound to the uterus an apparent desire for pregnancy termination, a conservative approach was adopted with primary repair of the uterus, in conjunction with surgical re...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999691
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVES:This article prospectively examines the use of ultrasound for antenatal detection of abnormal placental cord insertion (PCI) and compares the antenatal classification with delivered placental classification. STUDY DESIGN:This prospective cohort study examined 277 singleton pregnancies in a tertiary center. ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-3400309
更新日期:2020-01-01 00:00:00
abstract::There is increasing concern about Chlamydia trachomatis infection during pregnancy, because of reports of increased maternal, fetal, and neonatal risks. Amniotic fluid is known to possess antibacterial activity and has recently been shown to inhibit formation of chlamydial inclusions in McCoy cell culture. To further ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999341
更新日期:1991-01-01 00:00:00
abstract::Molecular amplification of parvovirus B19 DNA in an amniotic fluid sample was used to confirm the etiologic agent of a case with fetal hydrops. The polymerase chain reaction (PCR) method used is easy and fast to perform. We have a 2-year experience on its use in clinical parvovirus B19 diagnosis. The results are avail...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994518
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:We investigated the association between gestational weight gain (GWG) and postpartum depression (PPD) in women with class III obesity. STUDY DESIGN:This is a retrospective cohort of women with body mass index (BMI) ≥ 40 kg/m2 at entry to care, first prenatal visit ≤14 weeks gestation, with singleton, nonanom...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1693989
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:This study aimed to examine whether labor before cesarean affects the risk of placenta accreta spectrum (PAS) disorders in a subsequent pregnancy. STUDY DESIGN:This is a secondary analysis of the Cesarean Registry, a prospective cohort study of women undergoing cesarean between 1999 and 2002. Women with one ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1685449
更新日期:2020-05-01 00:00:00