[Consequences of intrauterine hypoxia in the newborn].
In the above paper authors introduced current opinions regarding diagnosis, prevention and management in asphyxiated newborn infants with multiorgan disfunction and injury.
Asphyxia Neonatorum↗
Biomedical subjects
Janusz Gadzinowski
Publications and source records attributed to Janusz Gadzinowski.
[An effectiveness of surfactant lung lavage (SLL) in meconium aspiration syndrome (MAS)].
UNLABELLED: The aim of our study was to evaluate an effect of surfactant lung lavage (SLL) in severe meconium aspiration syndrome (MAS). MATERIAL: 22 neonates were divided into 2 groups: group A treated with SLL (n = 11) and group B--historic control (n = 11). The criteria for entry into the study were as follows: stain amniotic fluid, meconium below vocal cords, gestational age > 35 wks, time after delivery < 6 h, clinical manifestation of severe respiratory insufficiency, need for mechanical ventilation (FiO2 > 0.4) and pathological chest X-ray. METHOD: SLL was done between 1. and 6. hours of life with natural surfactant (Survanta) in concentration 5 mg of phospholipids/1 ml 0.9% NaCl (15 ml of solution per kg). Following data were analyzed IO, PaO2, FiO2 (before treatment and 1, 2, 4, 48 hours after), duration of hospitalization, death rate. RESULTS: The mean value in group A (+/- SD) before SLL were as follow: IO 19.0 (12.4). PaO2--51.4 mmHg (14.1). FiO2--0.8 (0.3); after 1 hour: IO--13.7 (9.4). PaO2--63.8 mmHg (16.8). FiO2--0.7 (0.3). After 48 hours: IO--4.2 (2.4). PaO2--60.5 mmHg (7.2). FiO2--0.38 (0.1); duration of IMV--5.6 days (4.1); duration of hospitalization--20.5 days (8.8). No deaths occurred. In group B in 1st hour of life mean value (+/- SD) were as follows: IO 22.4 (14.5). PaO2--47.7 mmHg (12.1). FiO2--0.8 (10.3); after 1 hour: IO--21.5 (17.8). PaO2--52.2 mmHg (24.1). FiO2--0.7 (0.3); after 48 hours: IO--7.6 (5.8). PaO2--57.7 (16.4) mmHg. FiO2--0.5 (0.3); duration of IMV--5.9 days (4.8); duration of hospitalization--22.4 days (11.3). One newborn died in group B. CONCLUSION: Our pilot SLL study showed the benefit of this procedure in newborns with severe MAS. In treating MAS, SLL allows to achieve lower IO and higher of PaO2 after 1 hour, shorten the time of mechanical ventilation and hospitalization.
Birth Weight↗
[Changes of mechanics of breathing in newborns after pharmacological ligation of persistent ductus arteriosus (PDA)].
In this paper we introduced results of pulmonary function measurements (PFM) at newborns with persistent ductus arteriosus (PDA). 18 newborns with PDA were examined, all treated in Department of Neonatology, Poznan (mean birth weight 1186.4 +/- 187.1 g; mean gestational age 28.3 +/- 3.6 wks). PDA was defined by clinical criterions and Doppler echocardiographic studies. Pharmacological treatment was provided with indomethacin 0.2 mg/kg every 12 hours. PFM (pneumotachometric method) was done before pharmacological treatment, after three doses of indomethacin and 7 days after beginning of cure. We noted significant increase of mechanical tidal volume (p < 0.05) and drop of mean airway pressure (p < 0.05) after treatment. In all PFM we observed greater efficiency of treatment and greater dynamics of changes in PFM in group of newborns with higher birth weight (1000-1750 g vs. 501-999 g).
Anti-Inflammatory Agents, Non-Steroidal↗
[Single nasal prong versus infant flow driver in very low birth weight infants: clinical efficacy of two modes of nasal continuous positive airway pressure (CPAP)].
The authors compared efficacy of two different NCPAP techniques in VLBW newborn with respiratory insufficiency. Among the patients with IFD support the higher weaning rate and the lower supplemental oxygen requirement as well as secondary infections incidents was observed.
Equipment Design↗
[Clinical value of hypoxanthine concentration assays in diagnosis of hypoxia in newborns].
The purpose of this study was to asses the usefulness of hypoxanthine (HYP) concentration as an indicator of hypoxia. Concentration of HYP (HPLC method) in the umbilical arterial cord blood was determined in 145 newborns. Newborns were studied in four groups: premature asphyxiated, term asphyxiated, premature non-asphyxiated, term non-asphyxiated. Newborns were classified as hypoxic if they had: pH < 7.15, BE < -7.0 mmol or PaO2 < 10 mmHg. Reduced umbilical arterial pH, PaO2 and BE correlated directly with increased concentrations of HYP. The highest correlations were observed for HYP and PaO2. The levels of HYP for asphyxiated and non-asphyxiated newborns were different. The results show that HYP concentration is an important indicator in detection of asphyxia in newborns. Strong correlation between parameters of acid base balance and HYP concentration was observed in the studied groups. Increased concentration of HYP confirms intrauterine hypoxia independently of maturity.
Apgar Score↗
[Thoracoventropagus: case presentation].
Conjoined twinning is a rare event occurring once in every 50,000 to 100,000 live births as a result of incomplete fission of the embryonic disc before the 3rd week of pregnancy. Conjoined twins are classified according to the area of union, the most common site being the chest and the upper abdomen. We report the case of thoracoventropagus diagnosed prenatally and on the postnatal course. Other types of conjoined twins with regard to coexisting anomalies, management and prognosis are discussed.
Abnormalities, Multiple↗
[Reasons for the high perinatal mortality rate in Wielkopolska Region based on data from the Mother and Child Health Institute].
Contribution to prepare present paper were extremely unsatisfied result of perinatal mortality rate in Wielkopolska, the region in which for many years efficiently works three-level perinatal care system and exists high class III level center. The main reasons of such situation Authors suspect in incorrect full filling of rapport forms prepared by maternal hospitals in Poland and in interpretation coming only just from 70% Polish hospitals performing care over mother and newborn. We suggest also, that estimation of perinatal mortality should take place after elimination of number of deaths due to developmental, lethal defects and malformations, classified in accordance with ICD-10 code.
Catchment Area, Health↗
[Selected parameters of mechanical ventilation of the newborn infants after PDA surgical ligation].
In the above study we introduced initial results of pulmonary function measurements (PFM) in newborns with respiratory distress syndrome, after a surgical ligation of persistent ductus arteriosus (PDA). Material comprised seven newborns admitted in Department of Neonatology University of Medical Sciences in Poznań. Mean birth weight of our patient was 1072.9 +/- 187.1 g, and average maturity was 27.0 +/- 1.6. Diagnosis of PDA was established on the basis of clinical and Doppler examination. PFM was carried out with pneumotachometric method by VenTrak station immediately before and during 24 hours after the surgical intervention. Only mechanical breaths were analysed. We noted significantly higher values of dynamic compliance (Cdyn) and lower mean airways pressure (MAP) after ligation of PDA. The drop of resistance of airways (Raw) was small and had no statistical value.
Ductus Arteriosus, Patent↗