Biomedical subjects

R Baboolal

Publications and source records attributed to R Baboolal.

12 recordsLinked to original sources

PubMed2001

Variations in intraventricular hemorrhage incidence rates among Canadian neonatal intensive care units.

OBJECTIVES: To examine the variation in intraventricular hemorrhage (IVH) incidence among neonatal intensive care units and identify potentially modifiable risk factors. STUDY DESIGN: Multiple logistic regression analysis was used to examine variations in > or =grade 3 IVH, adjusting for baseline population risk factors, admission illness severity, and therapeutic risk factors. Subjects were born at <33 weeks' gestational age, admitted within 4 days of life to 1 of 17 participating Canadian NICU network sites in 1996-97, and had neuroimaging in the first 2 weeks of life. RESULTS: Of 5126 subjects <33 weeks' gestational age, 3806 had neuroimaging reports. Five of 17 sites had significantly (P <.05) different crude incidence rates of grade 3-4 IVH (odds ratios [OR] 0.2, 3.2, 2.6, 2.1, 1.9) than the hospital with median incidence. With adjustment for baseline population risk factors, perinatal risks, and admission illness severity, IVH incidence rates remained significantly (P <.05) higher at 3 sites (OR 2.9, 2.3 and 2.1). Inclusion of therapy-related variables (treatment of acidosis and vasopressor use on the day of admission) in the model eliminated all site differences. CONCLUSIONS: IVH incidence rates vary significantly. Patient characteristics explain some of the variance. Early treatment of hypotension and acidosis and mode of delivery are potentially modifiable factors and warrant further study in IVH prevention.

Canada↗

PubMed1991

Prediction of lethal pulmonary hypoplasia and chorioamnionitis by assessment of fetal breathing.

Twenty-three pregnancies with fetuses at risk for pulmonary hypoplasia were studied weekly until delivery. The amount of time spent in fetal breathing activity was recorded under controlled conditions during 1 h using real-time ultrasound. An amniotic fluid index was determined. The clinicians and the pathologist were unaware of the ultrasound findings. Eight of 23 fetuses did not breathe at the last ultrasound examination. Three babies died of pulmonary hypoplasia and two of these showed fetal breathing before birth. The three deaths were associated with rupture of the membranes at less than or equal to 20 weeks gestation and of greater than or equal to 44 days duration. One infant developed bronchopulmonary dysplasia. The amniotic fluid index in these four pregnancies was low and the newborn infants had limb contractures. Chorioamnionitis/funisitis was noted in 13 placentas. Eight fetuses were assessed for fetal breathing within 2 days of birth. The lack of fetal breathing had sensitivity, specificity, positive and negative predictive values of 0.75 for chorioamnionitis/funisitis. In this pilot study the absence of fetal breathing was of no value in predicting lethal pulmonary hypoplasia, but was related to chorioamnionitis/funisitis. We recommend further studies of fetal breathing in relation to fetal/neonatal infections.

Chorioamnionitis↗

PubMed1990

Measuring on-line compliance in ventilated infants using hot wire anemometry.

We investigated the validity of using tidal volume (VT) as measured by the neonatal volume monitor (NVM) to derive respiratory compliance. The NVM is a noninvasive device that measures VT by hot wire anemometry. The quotient of VT and the inflation pressure amplitude from the mechanical ventilator provided a measure of respiratory compliance. This was validated against the single breath occlusion technique in 15 infants (birth weight 0.9 to 4.4 kg). To ensure fully passive expiration, only paralyzed or sedated patients were studied. Only 12 of the 15 infants were analyzed because of limitations in the single breath technique. In three infants the flow-volume curves obtained were alinear, indicating inhomogeneity. In the 12 infants with acceptable single breath data, agreement between the two methods was excellent. Using the expired volume, r2 was .99. We conclude that the NVM can be used to obtain valid estimates of respiratory compliance on-line in intubated infants.

Airway Resistance↗

PubMed1986