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Biomedical subjects

W D Müller

Publications and source records attributed to W D Müller.

At least 55 records · Page 3Linked to original sources
PubMed1986

[Glucose tolerance in intensive care premature infants with a birth weight below 1,500 g in the first 5 days].

UNLABELLED: Plasma insulin and blood glucose values were studied in 11 stressed premature infants with birth weight below 1 500 g during the first five days after birth under increasing fluid and glucose infusion rates. The group 11 small premature neonates was subdivided; group A consisted of 6 stressed premature infants with respiratory distress syndrome (RDS stage III-IV) and/or intraventricular haemorrhage (IVH stage III-IV), and group B of 5 slightly stressed premature infants with RDS (stage I-II and/or IVH (stage I-II). During the first two days there was no difference in caloric and fluid intake in both groups. From the third day on caloric intake was much higher in group B than in group A (day 5: group A: 61.33 +/- 13.01 kcal/kg BW; group B: 78.2 +/- 18.49 kcal/kg BW). Plasma insulin values increased in both groups during the first five days after birth (group A: day 1: mean plasma insulin values 8.18 +/- 7.59 microU/ml; day 4: 27.22 +/- 32.85 microU/ml; group B: day 1: mean plasma insulin values 4.34 +/- 2.62; day 4: 11.18 +/- 8.38). Blood glucose and plasma insulin values were significantly higher in group A than in group B. CONCLUSION: Impaired glucose utilisation in severely stressed premature infants with parenteral nutrition might be due to stress induced peripheral insulin resistance.

Birth Weight↗
PubMed1986

[Neurologic, psychologic and logopedic follow-up of 6 to 8-year-old former premature infants with a birth weight below 1,501 g].

The purpose of the present study was to find out if formerly premature babies (birth weight less than or equal to 1,501 g) show differences in their neurological, psychological and linguistic development of school-age when compared to children without perinatal problems. Discrete neurological dysfunctions (clumsy child syndromes, discrete hemi-syndromes) and left-handedness were found significantly more frequently in the premature group. The test psychological investigation of the intellectual development and the development of language did not reveal significant differences between the two groups. Also with regard to the cognitive partial functions (attention, visual differentiation, serial memory performance and visuomotor coordination) the prematures were significantly behind only in serial memory performance. On the other hand the results of the psychological investigations were significantly worse in children of lower social classes independent of birth weight.

Attention Deficit Disorder with Hyperactivity↗
PubMed1985

[Diagnosis and therapy of fetal kidney and urinary tract malformations].

Of 23 patients with abnormal prenatal sonographic findings 17 also showed malformations of the kidneys and urinary tract in the postpartal period. Although even minor abnormalities could be detected by antenatal ultrasound, the identification of the abnormal findings was not possible in every case. Diagnostic problems arose in 8 foetuses showing mild dilatation of the collecting system, since it was not possible to distinguish between functional dilatation and dilatation from vesicoureteral reflux or minimal ureteral obstruction. Difficulties in identification of large malformations also occurred in 3 other patients, if the first sonographic examination was performed in a late stage of pregnancy, so that no follow-up of the sonographic picture was possible. In one of these children a huge right-sided multicystic kidney resulted in compression of the contralateral ureter with hydronephrosis, damaging the other kidney. Early delivery should, therefore, be considered in all children showing large cystic abdominal masses and no identifiable normal kidney, so that adequate obstetric treatment of these patients can be initiated in time.

Female↗
PubMed1985

[Mycotic thrombosis as a rare complication of Shaw's central silastic catheter in long-term parenteral feeding in a premature infant].

A 26 days old very-low-birthweight infant with an indwelling silastic-catheter and suddenly occurring symptoms of pulmonary hypoperfusion is reported. At post-mortem examination a mycotic-thrombus originating from the right atrium was found obturating the tricuspid valve. Despite of the very low incidence of complications with central silastic-catheters one should consider thromboembolic occlusion within the heart or the great vessels in any case of an unexplained sudden deterioration with profound hypoxemia.

Cardiomegaly↗
PubMed1985

[Congenital central hypoventilation syndrome--loss of chemosensitivity in respiratory control].

This report describes an infant with congenital central hypoventilation. There is no response to 4% CO2-breathing in sleep and in awake state. Hypoxia, behavioral and "behavioral like" inputs increase ventilation, but not to normal levels. Drugs such as theophylline, naloxone, acetazolamide, methylprogesterone, thyroxine and nicethamide have no effect on the respiratory control. Despite the insertion of a phrenic nerve pacemaker intermittent positive pressure ventilation must be provided in addition.

Carbon Dioxide↗
PubMed1984

[Mortality and morbidity of newborn infants in intensive care (birth weight less than 1,501 grams)].

A comparative analysis of the mortality and morbidity of premature infants with a birthweight below 1.501 g, born in the years 1974, 1978 and 1981, is given. The mortality rate has remained unchanged in the years 1974 (when a neonatal intensive care unit was installed at the University Children's Hospital Graz) and 1981 with 33% and 32% respectively. The total number of admissions rose from 36 (1974) to 67 (1978) and 91 (1981). Simultaneously the number of patients, who needed neonatal intensive care increased. Whilst in 1974 only 2 of 24 surviving infants needed artificial ventilation, in 1978 19 of 38 patients had respirator therapy. Despite the increasing severity of neonatal affections the number of severe handicaps caused by perinatal complications remained constantly low with altogether 5 cases in the years 1978 and 1981. Two children had a spastic tetraplegia, two others had a posthaemorrhagic hydrocephalus and one child was blind due to bilateral septic abscesses of the vitreous body. Only two of these children had long time artificial ventilation. Approximately 80% of the surviving children exhibited normal psychomotor development and showed no neurological sequelae. This rate was unchanged in the investigated periods.

Child↗
PubMed1983

[Percutaneous-peripheral vena cava catheterization in intensive care of premature and newborn infants. Comparison of Shaw's silastic catheter with the customary polyvinyl catheter].

Central venous catheters inserted via peripheral veins are commonly used in neonatal intensive care. Handling of two commonly available catheters made of different materials were compared during application in 85 neonates under intensive care. Polyvinylchloride and silicone rubber were used as catheter material. Advantages of silicone rubber catheter were detected especially in very low birth weight premature infants. Successful puncture of the peripheral veins and correct positioning could be performed in a higher proportion of these babies than when using polyvinylchloride-catheters. The insertion of polyvinyl-catheters needs shorter time of manipulation and during infusion we found a significantly lower incidence of mechanical problems with the catheter.

Catheterization↗
PubMed1983

Intracranial haemorrhage in the term neonate diagnosed by computerised tomography--perinatal history, symptoms and outcome.

An intracranial haemorrhage was diagnosed by computerised tomography in 35 term neonates. Subarachnoid haemorrhage was found in 23, intracerebral haemorrhage in 9 and subdural haematoma in 3 patients. Perinatal risk factors indicating trauma or hypoxic events were evaluated in more than 50%. Clinical symptoms were independent of the site of the bleeding. An additional hypoxic-ischaemic brain injury seemed to be the cause of the observed clinical symptoms in many cases. The outcome was significantly better in patients with subarachnoid haemorrhage than in intracerebral haemorrhage or subdural haematoma. Respiratory arrest, increased muscle tone and seizures were frequently associated with an unfavourable outcome.

Asphyxia Neonatorum↗
PubMed1980

Artificial ventilation in severe IRDS using inspiratory plateau, prolonged expiratory time and low frequency.

57 preterm and 1 term infant suffering from severe idiopathic respiratory distress syndrome with respiratory insufficiency were mechanically ventilated with an inspiratory-time of at least 1.5 sec and an inspiratory:expiratory ratio of always less than 1:2. Consequently the respiratory frequencies were below 14/min (low frequency ventilation). The infants were allowed to breathe spontaneously during the expiratory phase of the respirator. Applying these conditions we achieved satisfactory oxygenation and control of PCO2 elevation in our patients. 34 infants (59%) survived. None showed radiological evidence of bronchopulmonary dysplasia. This fact together with a relatively low incidence of pneumothorax (6.8%) suggests that this method if compared with conventional ventilation is less likely to cause persistent lung damage.

Carbon Dioxide↗
PubMed1980

[Ductus ligation in idiopathic respiratory distress syndrome of the premature infant].

In a 13-month period, ligation of the persistent ductus was carried out in 23 prematurely born babies with severe respiratory distress syndrome who were all respirator-dependent. Mean gestational age was 30.6 weeks (26-36 weeks), mean birth weight 1490 g (850-3090 g) with 3 patients under 1000 g. Signs of cardiac failure by large left to right shunt via ductus were seen at the end of the first week of life, radiologic signs as pulmonary edema were seen 1 to 2 days earlier. Mean age at operation was 13.5 days (4-27 days), mean duration of artificial ventilation 22 days (8-59 days). Indomethacin was used orally 12 of these patients without effect to close the ductus. One patient died of cerebral hemorrhage on his 17th day of life, 10 days postoperatively, one 3 1/2 months later at home with porencephaly and hydrocephalus. Four patients show radiologic signs of bronchopulmonary dysplasia. In the following 6 months up to December 1979, another 15 patients with IRDS underwent ductus ligation. Gestational age and birth weights were about the same as in the first group. Out of this second group which has not been followed up for a longer period. 3 babies died. Early mortality in both groups is 10.5% (4 out of 38 patients).

Birth Weight↗
PubMed1979

[Prenatal diagnosis by ultrasound of a very large heart (author's transl)].

Ultrasound diagnosis enabled identification of a congenitally very large heart. Due to this finding, no obstetric intervention was performed despite a foetal emergency situation. Hence, unnecessary surgery was avoided. The principal signs enabling clarification of the case by ultrasound were a vena umbilicalis of 2 cm thickness and the highly dilated heart which occupied 75% of the cross-sectional area of the thorax, besides the clinical clues, hydramnion and hydrops fetus.

Adult↗
PubMed1979

[Septic arthritis and osteomyelitis as a complication of neonatal intensive care (author's transl)].

In a prematurely born infant of a diabetic mother a purulent arthritis with osteomyelitis of the elbow occurred 18 days after an enterobacter aerogenes-septicemia was proved. Enterobacter (aerobacter) aerogenes is a nosocomial gramnegative germ, that is more and more regarded responsible for infection of the newborn in intensive care units. In accordance with the literature recording a high rate functional loss after septic arthritis also our patient suffered from a mobility deficiency in his right elbow a year after the onset of the disease.

Anti-Bacterial Agents↗
PubMed1979

[Indomethacin in IRDS with PDA phenomenon (author's transl)].

16 premature babies (all needing artificial ventilation, 15 suffering from idiopathic respiratory distress syndrome and one from severe apneic spells) received a single or double dose of indomethacin once the symptoms of an open ductus arteriosus further complicated their disease. Within 24 hours four patients showed closure of their duct, three other patients a very distinct improvement of their hemodynamic situation. There was no change of the ductus dependent symptoms in 8 other babies. One baby presented with a marked a worsening of its clinical situation and finally required surgical closure of its duct. There is quite a discrepancy found in the results reported from different centers. Starting from our results possible reasons for this discrepancy are discussed.

Apnea↗