PubMed Health⌕ Search

Biomedical subjects

H Schachinger

Publications and source records attributed to H Schachinger.

At least 19 recordsLinked to original sources
PubMed1997

[Pulmonary causes of hypoxia in premature infants and its therapeutic possibilities].

UNLABELLED: Pulmonary illness as a cause of postnatal hypoxia in premature infants frequently calls for an extended clinical course. Concealed behind the common symptoms--cyanosis, tachypnoea, expiratory grunting, thoracic and/or epigastric retraction and nasal flaring--is a broad spectrum of respiratory disorders. Lack of surfactant plays the most important role in premature infants, although meconium aspiration, persistent fetal circulation, the post asphyxia syndrome, transient tachypnoea of the newborn and pneumonias can also be the underlying cause. 1. PREVENTION: a. Avoid preterm delivery-b. Induce maturation of the fetal lungs (antenatal maternal corticosteroid administration). 2. Treatment of the cause: Endotracheal surfactant replacement therapy. 3. Symptomatic treatment: Respiratory support, from the simple method of giving oxygen over a mask to artificial ventilation. Immature lung tissue can be destracted as a complication of artificial ventilation. Here, the cause for the pulmonary hypoxia is iatrogenic. The resultant clinical picture of bronchopulmonary dysplasia (BPD) can then determine progress of the child for weeks or months to follow. The most important measure in the prevention of BPD are, in addition to the prophylaxis and treatment of the causes of respiratory disorders in preterm infants, the skilled resuscitation in the labor ward, and most important of all, the gentle handling and loving care for the tiny premature baby.

Bronchopulmonary Dysplasia↗
PubMed1990

A European multicenter randomized controlled trial of single dose surfactant therapy for idiopathic respiratory distress syndrome.

We performed a multicenter prospective randomized controlled trial to determine the efficacy and safety of the surfactant preparation, Survanta (Abbott Laboratories, Chicago, USA), for 750-1750 g infants with idiopathic respiratory distress syndrome, (IRDS) receiving assisted ventilation with 40% or more oxygen. One hundred and six eligible infants from the eight participating centers were randomly assigned between March 1986 and June 1987 to receive either surfactant (100 mg phospholipid/kg, 4 ml/kg) or air (4 ml/kg) administered into the trachea within 8 h of birth (median time of treatment 6.2 h, range 3.2-9.1 h). The study was stopped before enrollment was completed at the request of the United States Food and Drug Administration when significant differences were observed in incidence of periventricular-intraventricular hemorrhage (PIH), between the surfactant treated and control infants. Surfactant treated infants had larger average increases in the arterial-alveolar oxygen ratio, (a/A ratio) (P less than 0.0001), and larger average decreases in FiO2 (P less than 0.0001) and mean airway pressure, (MAP) (P less than 0.017) than controls over the 48 h following treatment. The magnitude of the differences between the surfactant and control groups were 0.19 (SE = 0.03) for a/A ratio, -0.28 (SE = 0.04) for FiO2 and -1.7 cm H2O (SE = 0.70) for MAP. The clinical status on days 7 and 28 after treatment was classified using four predefined ordered categories: (1) no respiratory support; (2) supplemental O2 with or without continuous positive airway pressure (CPAP); (3) intermittent mandatory ventilation; and (4) death. There were no statistically significant differences in the status categories on days 7 or 28 between surfactant and control infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1984

[Clinical management of bronchopulmonary dysplasia].

Bronchopulmonary dysplasia is caused by several factors. Avoidance of bronchopulmonary dysplasia is directed at its causes and should always attempt the rapid weaning of the patient from the respirator. Some of the preventive measures include a) avoiding an oxygen injury; b) prevention of barotrauma; 3) sufficient moisturization and warming of the respiratory gases; d) regular cleaning of the respiratory tract and bacterial controls of the tracheal secretion; e) administration of vitamin E; f) reconsideration (restricting the use) of parenteral nutrition. Assistance in the weaning from the respiratory means a) avoidance of an open ductus arteriosus; b) paced reduction of FiO2, respiratory pressure and frequency up to intermittent mandatory ventilation and final transition to spontaneous respiration with increased mean respiratory pressure; c) avoidance of cardiac insufficiency; d) administration of corticosteroids; e) theophyllin, and f) physical therapy. The number of patients with bronchopulmonary dysplasia has remained the same in the last six years. However, the mortality until 1979 round about 50% has been reduced to 1/3, in the years 1980/81.

Bronchopulmonary Dysplasia↗
PubMed1983

[Pre- and postnatal diagnosis of abdominal wall defects (omphalocele and gastroschisis). Case reports].

Whereas the omphalocele develops from a malformation of the mesoderm during the embryonal period, the gastroschisis appears to be the result of an intrauterine vascular occlusion; defined as disruption. Definite signs of malformations are seen in omphalocele. In our patient population observed during a three year period, eight cases of abdominal wall defects were seen, four of which with Wiedemann-Beckwith syndrome and one with trisomy 18, two with an isolated omphalocele and one with a gastroschisis. The concomitance of genetic malformation syndromes implies the necessity of intrauterine diagnosis evaluation. In proven cases of chromosomopathies and signs of omphalocele in ultrasound an interruption of pregnancy may be indicated. Similarly with very unfavourable prognosis such as Edwards syndrome, a post partum operative intervention is not necessary. This decision however can only be reached through interdisciplinary consultation between the pediatrician, pediatric surgeon, midwife and parents.

Abdominal Muscles↗
PubMed1982

[Primary pulmonary hypertension in children].

Case report of an infant who, having been under cardiological observation since birth, developed the clinical symptoms of primary pulmonary hypertension at 12 months. The ECC showed right-ventricular hypertrophy, which progressed rapidly. Heart catheterization confirmed the suspected diagnosis of pulmonary hypertension without cardiovascular malformation. Treatment with isoproterenol and tolazoline was initiated but was unsuccessful: the child died at 18 months. The diagnosis was supported by the histopathology.

Cardiac Catheterization↗
PubMed1979

Correlation between fetal scalp tcPO2 and microblood samples.

In summary we would like to state that the correlation between tcPO2 recorded from human fetal scalp and microblood PO2 is quite good. High tcPO2 values are very reassuring for the clinician and indicate a good oxygenation of the fetus. In the presence of a low tcPO2 reading, other signs of fetal hypoxia like abnormal heart rate patterns or a low microblood PO2 are required to confirm the diagnosis. If a low tcPO2 is the only sign suggestive of fetal hypoxia and all other parameters are normal, we recommend removal of the electrode and reapplication in a different spot.

Blood Gas Analysis↗
PubMed1976

Ultrastructure of the neuroglial fatty metamorphosis (Virchow) in the perinatal period.

The ultrastructure of neuroglial fatty metamorphosis (GFM) has been investigated in the telencephalic white matter of 12 premature and mature infants (gestational age 22-40 weeks; survival 0-96 days). GFM was found in all cases apart from a 22-week-old fetus, and involves predominantly astrocytic cells (68.8%), then glioblasts (43.5%), but only 7.4% of oligodendrocytes. GFM, therefore, seems to be independent of the myelination process and indicates the vulnerability of the immature neuroglial population in the metabolic and circulatory disorders of the perinatal period. Since GFM is found in almost all children dying within the early postnatal period, this subtle alteration reflects a special form of minimal brain damage. The relationship between GFM, astrocytic hypertrophy and periventricular leucomalacia and their role in the telencephalic leucoencephalopathy are discussed.

Astrocytes↗
PubMed1976

Further improvements in the transport of high-risk neonates.

The transport incubator used since 1972 was modified for the CPAP method (continuous positive airway pressure). A very generous indication for the use of this ventilatory assistance in the presence of very early clinical signs of respiratory distress syndrome before or during the transport into the Children's Hospital has contributed towards improving the survival rate of infants with a birth weight of 1001-1500 grams to 84,8% and for those below 1000 grams to 39,4%.

Humans↗