1/36. Nasal colonization of infants with group B streptococcus associated with intrauterine pressure transducers.The rate of nasal colonization with group B streptococcus in infants cultured at the time of discharge from the nursery rose significantly during a four-month interval. Investigation of this trend resulted in detection of group B streptococci in the domes of two intrauterine pressure transducers (IPTs). Subsequent routine sterilization of IPT domes after each maternal use was associated with a decline in infant group B streptococcal colonization to the usual endemic rate in the nursery. Retrospective evaluation demonstrated that colonization in infants born to IPT-monitored women had increased significantly during the study interval and that no increase in colonization occurred in infants born to non-IPT-monitored women. From epidemiologic evidence it appears that use of contaminated IPTs during labor was a nosocomial source of group B streptococcal colonization.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/36. Negative extrathoracic pressure in infants with cystic fibrosis and respiratory failure.Respiratory support using negative extrathoracic pressure or high-frequency chest wall oscillation was used to treat 3 infants with cystic fibrosis and respiratory failure who had not responded to maximal medical therapy. Beneficial clinical effects were noted in all three cases. Pulmonary function testing was performed in 2 cases, and measures of compliance increased.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/36. Massive air embolism in a neonate with respiratory distress.The occurrence of massive air embolism in a neonate during treatment with intermittent positive-pressure respiration and positive end expiratory pressure is reported as a note of caution. It is possible that this complication may indeed be more common. Careful post-mortem examinations (including radiological examinations) are advocated in order that the true incidence of this devastating event shall be known.- - - - - - - - - - ranking = 0.4keywords = pressure (Clic here for more details about this article) |
4/36. Serious complications after umbilical artery catheterization for neonatal monitoring.Umbilical artery catheterization in critically ill neonates caused major complications, including five deaths, in 15 of 165 infants with respiratory distress syndrome who underwent autopsy at the UCLA Hospital during the past eight years. Arterial occlusion leading to visceral infarction occurred in 12 patients, and vascular perforation caused hemoperitoneum in three patients. Repeated catheter manipulation and protracted catheter use were common factors identified in patients in whom complications developed. Restricted indications for catheter use, routine roentgenographic confirmation of catheter tip location below the kidneys, low-dosage heparin sodium infusion, use of cannulas with decreased thrombogenicity, avoidance of catheter manipulation, and vigilance to remove catheters when no longer required should reduce the incidence of this iatrogenic neonatal complication while still permitting arterial pressure and blood gas monitoring when clinically indicated.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
5/36. Pulmonary pseudocysts in the newborn infant.Five neonates who developed a pulmonary pseudocyst are reported. All infants had clinical hyaline membrane disease and were treated with continuous distending airway pressure. The pseudocysts developed between 39 hours and 7 days of age. In all but one pulmonary interstitial emphysema preceded or occurred together with the development of the pseudocyst. All babies went on to complete clinical recovery without surgical intervention. Radiologic documentation of the spontaneous resolution of the pseudocyst was obtained in three infants and occurred over three days, five days, and three months, respectively.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
6/36. Increased hypoxemia in neonates secondary to the use of continuous positive airway pressure.Five neonates are presented who, while receiving continuous transpulmonary pressure, developed increased systemic arterial hypoxemia, which was relieved when this therapeutic modality was decreased or discontinued. Three of the five had chest radiographs consistent with hyaline membrane disease: the other two had atypical radiographs. None had evidence of air leaks. Levels of positive airway pressure utilized when the hypoxemia was noted ranged from 5 to 15 cm H2O. Calculated shunt fractions (Qs/Qt) improved from a mean of 73% to 37% when the continuous positive airway pressure was lowered. The site of shunting in these infants could have been in the lung or through anatomic extrapulmonary shunts. Improvement in total cardiac output may also have contributed to the improved oxygenation. This paradoxical effect of continuous transpulmonary pressure appears to be mediated through changes in the pulmonary vascular resistance brought about by the continuous transpulmonary pressure.- - - - - - - - - - ranking = 1.8keywords = pressure (Clic here for more details about this article) |
7/36. Successful treatment with CPAP of two infants with bronchomalacia.Two children with severe bronchial collapse secondary to bronchomalacia improved dramatically after institution of continuous positive airway pressure (CPAP). Treatment was discontinued after 14 weeks without reappearance of symptoms. Repeated bronchoscopy revealed a diminution in the bronchial collapsibility. It is suggested that CPAP should be given if generalised bronchomalacia is present to tide the children over a bad period while the bronchus is becoming more stable.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
8/36. Pulmonary interstitial emphysema requiring lobectomy. Complications of assisted ventilation.An infant with hyaline membrane disease treated with intermittent positive pressure ventilation developed pulmonary interstitial emphysema localised to one lobe after collapse of the affected lobe. The development of tension and further symptoms necessitated lobectomy, after which the infant became totally asymptomatic. microscopy of the resected lobe showed the unusual feature of giant cells lining the air-containing cysts. The presence of these multinucleate cells suggested the cysts may have represented greatly dilated lymphatic channels resulting from rupture of gases into the pulmonary lymphatics.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
9/36. Congenital perforated cornea in Peter's anomaly.A male infant was born with a perforated left cornea associated with bilateral central corneal defects caused by mesodermal dysgenesis. Smears and culture of the perforated cornea revealed no infectious agents, and there was no evidence of systemic infection in the child or mother at birth. Histopathologic material excised during keratoplasty was compatible with persistent hyperplastic vitreous, possibly causing a forward displacement of the lens/iris diaphragm with pressure on the corneal endothelium and possible dissolution of the cornea leading to perforation. The relationship of increased intraocular pressure in this case was unknown.- - - - - - - - - - ranking = 0.4keywords = pressure (Clic here for more details about this article) |
10/36. Systemic air embolism in the respiratory distress syndrome of the newborn.Details of 25 cases of neonatal systemic air embolism, including three of our patients, are reviewed. This rare complication of respiratory distress syndrome (RDS) was observed in 21 premature infants and 4 fullterm newborns, of whom 23 required intermittent positive pressure ventilation (IPPV). In 21 of these patients air embolism was preceded by pulmonary interstitial emphysema, pneumomediastinum, pneumothorax and/or pneumopericardium. Air embolism occurred between 3 and 288 hours after delivery. The outcome was lethal in 24 cases, only one patient survived. Two main pathogenic mechanisms are discussed; entrance of air from ruptured alveoli into the lung capillaries and introduction of air via catheters in umbilical vessels.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
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