Abstract:
:Thoracoabdominal asynchrony (TAA) and chest wall distortion (CWD) are commonly seen in preterm infants secondary to a highly compliant rib cage and poor compensation of distorting forces by inspiratory rib cage muscles. Continuous positive airway pressure (CPAP) reduces TAA and CWD by stenting the chest wall. We hypothesized that application of positive airway pressure only during inspiration and in proportion to an infant's inspiratory effort should have a similar but more pronounced effect than CPAP alone. A ventilator providing airway pressure changes in proportion to flow and volume generated by an infant (proportional assist ventilation) was used to unload the respiratory pump during inspiration. Ten preterm infants were studied [birth weight, 745 (635-1175) g; gestational age, 26.5 (24-31) wk; postnatal age 3 (1-7) d; medium (range)]. TAA and CWD were determined by respiratory inductive plethysmography. TAA was expressed as the phase angle between the rib cage and abdominal motion and CWD as the total compartmental displacement ratio. In addition, we measured tidal volume with a pneumotachograph and esophageal and airway pressure deflections with pressure transducers. Measurements were obtained during alternating periods of CPAP and two different degrees of support (Gain 1 = 1.09 +/- 0.68, Gain 2 = 1.84 +/- 0.84 cm H(2)O/mL) that were provided by a proportional assist ventilator. Phase angle and the total compartmental displacement ratio decreased with increasing gain compared with CPAP alone. Peak airway pressure increased from 0.6 to 3.8 to 7.6 cm H(2)O above positive end-expiratory pressure (PEEP) with CPAP, Gain 1, and Gain 2, respectively, as tidal volume increased from 2.8 to 4.1 to 4.7 mL/kg. Esophageal pressure changes decreased only little with increasing gain. Chest wall excursion increased and abdominal movement decreased, indicating a redistribution of tidal volume between chest and abdomen. We conclude that proportional assist ventilation reduces TAA and CWD by generating a small increase in airway pressure that occurs in synchrony and in proportion to each inspiratory effort.
journal_name
Pediatr Resjournal_title
Pediatric researchauthors
Musante G,Schulze A,Gerhardt T,Everett R,Claure N,Schaller P,Bancalari Edoi
10.1203/00006450-200102000-00008subject
Has Abstractpub_date
2001-02-01 00:00:00pages
175-80issue
2eissn
0031-3998issn
1530-0447journal_volume
49pub_type
杂志文章abstract::Seven plasma protease inhibitors were analyzed in 8-yr-old children-75 PiZ (severely deficient), one PiZ-(with a null gene), 32 PiSZ (moderately deficient), and 35 normals. In PiZ and PiSZ alpha 1-antitrypsin-deficient children, significantly higher concentrations of alph 2-macroglobulin (p less than 0.001) and antith...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198508000-00011
更新日期:1985-08-01 00:00:00
abstract::Beta cells are partially replaced in neonatal rodents after deletion with streptozotocin (STZ). Exposure of pregnant rats to a low protein (LP) diet impairs endocrine pancreas development in the offspring, leading to glucose intolerance in adulthood. Our objective was to determine whether protein restriction has a sim...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/PDR.0b013e3181e17c90
更新日期:2010-07-01 00:00:00
abstract::In an effort to characterize the hepatic abnormality in patients with alpha1-antitrypsin deficiency, three unrelated children with the disorder (Pi types ZZ and SZ), two heterozygous parents (Pi type MZ), and three normal subjects (Pi type MM) were studied. As expected, the livers of the ZZ- and SZ-deficient subjects ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197601000-00007
更新日期:1976-01-01 00:00:00
abstract::Continuous EEG monitoring has not been used widely in neonatal intensive care, especially in the care of extremely premature infants, probably in part because of a lack of a reliable quantitative method. The purpose of this study was to quantify the EEG of the very premature infants just after birth by using spectral ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000153868.77623.43
更新日期:2005-03-01 00:00:00
abstract::Insulin-like growth factor-I (IGF-I) plays an important role in the stimulation of postnatal brain growth. In transgenic (Tg) mice, IGF-I overexpression stimulates postnatal brain growth, whereas decreased IGF-I availability caused by ectopic brain expression of IGF binding protein-1 [(IGFBP-1), an inhibitor of IGF-I ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199903000-00007
更新日期:1999-03-01 00:00:00
abstract::Fetal lung cyclic AMP phosphodiesterase, cyclic AMP, phosphatidyl choline, and incorporation of precursors into phosphatidyl choline were measured in rabbits after maternal administration of hydrocortisone phosphate and aminophylline. Both agents inhibited lung phosphodiesterase activity and augmented cyclic AMP conce...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197606000-00011
更新日期:1976-06-01 00:00:00
abstract::This patient presented on the first day of life with pronounced lactic acidosis with an elevated lactate/pyruvate ratio. Urine organic acids showed Krebs cycle metabolites and mildly elevated methylmalonate and methylcitrate. The acylcarnitine profile showed elevated propionylcarnitine and succinylcarnitine. Amino aci...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/PDR.0b013e3181e5c3a4
更新日期:2010-08-01 00:00:00
abstract::Intestinal absorption and its relationship to increased total body water was studied in seven infants with congenital heart disease receiving regular diuretics due to congestive heart failure. All infants and six age-matched healthy controls were studied for a 3-d period during which time all food intake was recorded,...
journal_title:Pediatric research
pub_type: 临床试验,杂志文章
doi:10.1203/00006450-199410000-00023
更新日期:1994-10-01 00:00:00
abstract::Sudden infant death syndrome (SIDS) remains one of the primary causes of infant mortality in developed countries. Although the causes of SIDS remain largely inconclusive, some of the most informative associations implicate molecular, genetic, anatomical, physiological, and environmental (i.e., infant sleep) factors. T...
journal_title:Pediatric research
pub_type: 杂志文章,评审
doi:10.1038/pr.2014.90
更新日期:2014-09-01 00:00:00
abstract::In vitro experiments were performed to examine the contractile responsiveness of guinea pig gallbladder smooth muscle as a function of developmental age. Gallbladder muscle strips from preterm (day 50-55 gestation), newborn (days 1-3 post partum), and 1-month-old animals were stimulated with agonists that initiate the...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198603000-00003
更新日期:1986-03-01 00:00:00
abstract::The carbohydrate-deficient glycoprotein syndromes are a recently individualized group of genetic multisystemic disorders. A predominant feature is a severe involvement of the central and peripheral nervous system resulting in psychomotor retardation, seizures, ataxia, and, mostly after infancy, stroke-like episodes. T...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199305000-00024
更新日期:1993-05-01 00:00:00
abstract::Pulmonary surfactant proteins SP-B and SP-C were isolated from lavage fluids of bovine lungs and recombined (lipid/proteins, 9/1, wt/wt) with dipalmitoyl phosphatidylcholine for testing in vitro and in surfactant-deficient adult rats. Using a pulsating bubble surfactometer, we found that inflation pressures of bubbles...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198805000-00010
更新日期:1988-05-01 00:00:00
abstract::During the transition at birth to air breathing, regulation of surfactant release from alveolar type II (ATII) cells is critical. Atrial natriuretic peptide (ANP) stimulates natriuretic peptide receptor-A (NPR-A) and increases intracellular cGMP. We examined the changes in ANP and NPR-A in respiratory epithelium durin...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/PDR.0b013e318163a215
更新日期:2008-03-01 00:00:00
abstract::The possible role played by albumin in regulating brain metabolism during development has been studied. The effects of fatty acid-free BSA on lactate, glucose, 3-hydroxybutyrate, and glutamine oxidation and lipogenesis by rat neurons and astrocytes from primary culture were studied. The rate of lactate oxidation and l...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199312000-00002
更新日期:1993-12-01 00:00:00
abstract::The objective of the present study was to explore whether a free radical spin trap agent, alpha-phenyl-N-tert-butyl nitrone (PBN), influences bioenergetic failure induced in the 20-day-old fetal brain by 30 min of intrauterine ischemia in Wistar rats. Fetal brains were frozen in situ at the end of ischemia and after 1...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-200004000-00007
更新日期:2000-04-01 00:00:00
abstract::Although cisapride is widely used to treat gastrointestinal motility disorders, it has been associated with QT prolongation, torsades de pointes, and cardiac arrest. Only in children, however, has atrioventricular (AV) block after cisapride been reported. This study used Langendorff perfusion to determine the direct e...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000050122.67091.1D
更新日期:2003-03-01 00:00:00
abstract::This study aimed to characterize early neonatal microvascular function after preeclamptic pregnancy with respect to infant sex and in utero growth. Peripheral microvascular blood flow was examined prospectively from 6 to 72 h of age using laser Doppler flowmetry in a cohort of term infants of normotensive women and wo...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/pdr.0b013e318193edf1
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Type 1 diabetes (T1D) is a serious diagnosis with the prospect of grave short- and long-term complications and even death if poorly managed. An attempt has been made to describe how clinical and immunological deviations might influence each other close to the diagnosis of T1D. METHODS:Sixty-nine newly diagn...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2013.167
更新日期:2014-01-01 00:00:00
abstract::Delivery of M. nemestrina at 80% of normal gestation provides a population of neonates at high risk for hyaline membrane disease (HMD). The diagnosis of HMD was made by the presence of reticulogranular densities and air bronchograms on chest radiographs. Patchy atelectasis was seen in the lungs of animals assigned by ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197905000-00017
更新日期:1979-05-01 00:00:00
abstract::Lung development progresses through a process reliant on mechanical cell stretch. However, this process is not well defined at the molecular level. Our goal was to globally analyze the transcriptome of fetal mouse lungs following short periods of tracheal occlusion (TO) to identify cellular processes that are rapidly ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/PDR.0b013e31815eba47
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:To investigate the relationship between unexplained indirect hyperbilirubinemia of Vietnamese newborns and the polymorphism of the promoter TATA box and exon 1 of bilirubin uridine diphosphate glucuronosyltransferase (UGT1A1) gene. METHODS:A total of 149 neonates were divided into the hyperbilirubinemia gro...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/s41390-020-0825-6
更新日期:2020-12-01 00:00:00
abstract::The present study employed an animal model in an attempt to document effects on brain growth of long-term exposure to theophylline in the presence or absence of malnutrition. One group of dams was randomly divided into half. One-half was fed a 20% protein diet and the other half a 6% protein diet. Similarly, a second ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198406000-00014
更新日期:1984-06-01 00:00:00
abstract::Mutations in multidrug resistance 3 gene (MDR3 or ABCB4) underlie progressive familial intrahepatic cholestasis type 3 (PFIC3), a severe pediatric liver disease progressing to cirrhosis. Abcb4-/- mice exhibit slowly developing hepatic lesions that can be accelerated by feeding a cholic acid (CA)-supplemented diet. We ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/pdr.0b013e31802d7780
更新日期:2007-02-01 00:00:00
abstract::Leukotrienes C4 and D4 and thromboxane A2 are potent vasoconstrictors that may mediate pulmonary vasoconstriction in many clinical situations. There is a complex interaction among leukotrienes and thromboxane A2, because inhibition of thromboxane synthesis prevents some of the hemodynamic effects of exogenous leukotri...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198908000-00001
更新日期:1989-08-01 00:00:00
abstract::Human and ovine placental tissue homogenates were assayed for dipeptidase activity in vitro. Glycyl-L-leucine, L-leucyl glycine, glycyl-L-lysine, and L-lysyl glycine were hydrolyzed by placental homogenates. The pH optimum for the reaction was 8.0. The relationship between enzyme activity and concentration was linear ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198104000-00013
更新日期:1981-04-01 00:00:00
abstract::Plasma aldosterone (A), corticosterone (B), deoxycorticosterone (DOC), progesterone (P), 17-hydroxyprogesterone (17-OHP), cortisol (F), and cortisone (E) were measured simultaneously by specific radioimmunoassays in small plasma samples obtained from 174 normal infants and children between 2 hr and 15 yr of age. The s...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198001000-00010
更新日期:1980-01-01 00:00:00
abstract::We recently demonstrated that recombinant hGH exacerbates renal functional and structural injury in chronic puromycin aminonucleoside (PAN) nephropathy, an experimental model of glomerular disease. Therefore, we examined whether recombinant human (rh) IGF-I is a safer alternative for the treatment of growth failure in...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199601000-00002
更新日期:1996-01-01 00:00:00
abstract::Pulmonary surfactant is inactivated in meconium aspiration syndrome and neonatal pneumonia. Development of an exogenous surfactant less sensitive to inactivation might be useful for treating these diseases. We investigated in vitro whether addition of the cationic cyclic membrane cross-linking peptide polymyxin B (PxB...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.pdr.0000200806.32822.e6
更新日期:2006-03-01 00:00:00
abstract::The purpose of this study was to investigate atrial myocardial blood flow in the fetus under conditions of acute right ventricular pressure load and adenosine infusion. Late gestation fetal sheep were instrumented for acute right ventricular pressure loading or adenosine infusion, and regional myocardial blood flow wa...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199403000-00010
更新日期:1994-03-01 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