Biomedical subjects

M W Huysman

Publications and source records attributed to M W Huysman.

3 recordsLinked to original sources

PubMed2001

Rescue use of DNase in critical lung atelectasis and mucus retention in premature neonates.

Excessive or thick pulmonary secretions are a common clinical challenge in the neonatal population. Mucus accumulation can cause many life-threatening complications, including plugging of the endotracheal tube and increasing the risk of pulmonary infections. We report 3 premature neonates who had critical pulmonary collapse secondary to mucous plugging. Different conventional methods to liquefy mucus and facilitate removal of secretions were exhausted to no avail. The rescue use of DNase was effective in reestablishing airway patency. Thus, this drug could be a valuable tool in treating atelectasis and mucus-plugging in mechanically ventilated, premature neonates.

Administration, Inhalation↗

PubMed2000

Adrenal function in sick very preterm infants.

Some very preterm neonates admitted to the neonatal intensive care unit show circulatory and respiratory problems that improve after administration of steroids. It is unclear whether these symptoms could be caused by adrenal insufficiency. The objective of our study was to investigate the cortisol levels and the cortisol release from the adrenals after ACTH in very preterm infants with and without severe illness and to find whether a relation exists between adrenal function and outcome. An ACTH test (0.5 microg) was performed on d 4 in 21 very preterm infants (gestational age, 25.6-29.6 wk; birth weight, 485-1265 g). Baseline cortisol and 17-hydroxyprogesterone (17OHP) levels and the cortisol levels 30, 60, and 120 min after ACTH administration were measured. The Score for Neonatal Acute Physiology was used to measure illness severity. All infants showed an increase in cortisol levels after ACTH, but the cortisol levels were significantly lower in the ventilated more severely ill infants. After adjusting for birth weight and gestational age, the mean baseline cortisol levels and cortisol/17OHP ratios were significantly lower and the 17OHP levels significantly higher in the ventilated infants compared with the nonventilated infants. Patients with an adverse outcome had significantly lower baseline cortisol/17OHP ratios and 60-min cortisol levels during ACTH testing (p = 0.002 and p = 0.03, respectively). These data suggest an insufficient adrenal response to stress in sick ventilated very preterm infants with gestational ages younger than 30 wk compared with nonventilated less sick preterm infants. Further studies are required to investigate whether supplementation with physiologic doses of hydrocortisone may benefit the outcome.

17-alpha-Hydroxyprogesterone↗

PubMed1994

The vitamin K controversy.

Discussion about the efficacy and safety of vitamin K prophylaxis has recently restarted. In this review, new developments in diagnosis of vitamin K deficiency (including vitamin K plasma levels and protein induced by vitamin K absence [PIVKA]-II detection) and therapy of early, classic, and late hemorrhagic disease of the newborn are highlighted. Special attention is brought to the efficacy of preventing early and late hemorrhagic disease. The recently described association between intramuscular vitamin K administration and cancer is debated. The very high plasma levels, the intramuscular injection itself, or the adjuvants in the solution might all be responsible. These factors are all absent in oral administration. Therefore, we recommend repeated oral administration for preventing classic and late hemorrhagic disease of the newborn. Additionally, we recommend maternal supplementation of vitamin K for preventing early hemorrhagic disease of the newborn, especially when the mother is using medications that interfere with vitamin K metabolism.

Administration, Oral↗