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Biomedical subjects

L García Guereta

Publications and source records attributed to L García Guereta.

5 recordsLinked to original sources
PubMed1995

[Adenosine triphosphate (ATP) in the management of paroxysmal supraventricular tachycardia: experience in the neonatal period].

INTRODUCTION AND OBJECTIVE: The management of supraventricular tachycardia (SVT) in infants is somewhat controversial since numerous methods of treatment are effective. Regardless of the treatment chosen, it is important to quickly stop the tachycardia in neonates with SVT because they may suddenly become hemodynamically unstable. METHODS: Seventeen episodes of SVT treated with intravenous ATP are studied in 3 newborns (two were preterm infants: 30 and 34 weeks of pregnancy). Ages at presentation ranged from 2 to 27 days. RESULTS: ATP is effective in all episodes of SVT, with a mean intravenous doses between 0.10 and 0.50 mg/kg/dose. All patients showed short sinus arrest after ATP. No adverse side effects or hemodynamics changes occurred after ATP administration. CONCLUSIONS: ATP is a safe and reliable antiarrhythmic in neonatal period, including prematurity. We reviewed the experience in ATP management of SVT, mainly in pediatric population.

Adenosine↗
PubMed1993

[Perioperative management of systemic pulmonary shunts in the neonatal period].

We have analyzed 36 newborns (19 males and 17 females), with cyanotic cardiopathies in whom a systemic-pulmonary shunt had been performed. These patients were admitted to the Neonatal Intensive Care Unite between January 1985 and June 1990. We studied the perioperative events with the aim of describing the general features of this palliative surgery in the neonatal period and to determine the factors which indicate a bad prognosis. The age at admission was 10.5 +/- 16.5 days and at surgery was 19.5 +/- 20 days. Cardiopathy types included: 13 pulmonary atresias, 9 pulmonary stenoses, 6 D-transposition of the great arteries and 8 tetralogies of Fallot. Of these patients, 83% required prostaglandin administration before surgery. Cardiac catheterization was performed in 54% (in 1/3 balloon atrioseptostomy was performed). The mean diameter of the pulmonary branches was 3.5 +/- 0.7 mm. In 89%, a modified Blalock-Taussig shunt and in 11% a central aorto-pulmonary shunt were performed. The size of the prosthetic graft used was 4 mm in diameter in 77% of the cases, 5 mm in 20% and 3 mm in 3% of the patients. The mortality rate was 27% (intraoperative = 0%, early postoperative = 16%, late postoperative = 11%) with two critical periods: the initial 48 postoperative hours and the reoperation. Bad prognosis factors related to mortality are; preoperative (shorter gestational age and low newborn weight), operative (performance of a central aortopulmonary shunt, surgical ligation of the ductus during operation) and postoperative (arrhythmias, metabolic acidosis in the immediate postoperative period, lower oxygen saturation at 24 hours after the operation, hemorrhage). Our data are compared with other reports of systemic-pulmonary shunt in the neonatal period.

Aorta, Thoracic↗
PubMed1992

[Congenital and post-operative chylothorax in the neonatal period].

In a retrospective survey of the patients admitted to the Neonatology Department during a 15 year period (october 1975-september 1990), we found 7 cases of chylothorax: 4 subsequent to cardiac surgery and 3 congenital. The incidence of chylothorax relative to the total number of admissions to NICU was 1.06% and 1.2% in respect to total admissions after cardiac surgery. The clinical outcome was good for all patients except one who died during resuscitation maneuvers following delivery. Only one patient required surgery to control chylothorax and the rest were successfully managed with medical treatment. We found that patients with postsurgical chylothorax drained a larger volume of pleural fluid, needed larger volumes of replacement fluid and required parental nutrition and mechanical ventilation for a longer period of time.

Cardiac Surgical Procedures↗