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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric radiology 8 (1979), S. 139-145 
    ISSN: 1432-1998
    Keywords: Respiratory distress syndrome ; Intermittent positive pressure ventilation ; Pulmonary interstitial emphysema ; Systemic air embolism ; Umbilical catheters
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract 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.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 157 (1998), S. 724-730 
    ISSN: 1432-1076
    Keywords: Key words Opiate-exposed infants ; Drug withdrawal ; Clinical and neurodevelopmental outcome ; Griffiths Developmental Scale ; Prevention
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To study the developmental effects of prenatal exposure to opiates, a prospective follow up study of 34 drug-exposed (opiates and nicotine) and 42 reference infants (nicotine exposure only) was conducted from January 1992 to September 1995. At the time of delivery, 12 of 34 mothers used opiates without medical control. Twenty-two mothers participated in a methadone maintenance programme. At 1 year, the average Griffiths Developmental Quotient (DQ) was lower in the drug-exposed group (mean: 100.5 vs. references 107.9; P 〈 0.001). This difference was mainly due to lower subscales “locomotor” (mean 100.8 vs. 111.4; P 〈 0.05) and “intellectual performance” (mean 100.8 vs. 108.5; P 〈 0.05) in the drug-exposed group. Severe developmental retardation mean DQ (−2 SD) was diagnosed in 2 drug-exposed infants. Mild developmental retardation (mean DQ: 1 SD– 〉 2 SD) was found in 7 drug-exposed and in 3 reference infants (P 〈 0.05). Neurological abnormalities were found more frequently in the drug-exposed group (11 vs. 3 infants; P 〈 0.01). Among the opiate-exposed infants, the subscales “hearing and speech” and “intellectual performance” were lower in the uncontrolled drug-using than in the methadone group. The 17 fostered infants showed no difference in developmental outcome compared with the 10 infants living with their biological parents (mean DQ: 100.0 versus 101.3). Conclusions At 1 year infants prenatally exposed to opiates are at risk for mild psychomotor developmental impairment.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 151 (1992), S. 596-600 
    ISSN: 1432-1076
    Keywords: Respiratory distress syndrome ; Surfactant protein A
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Surfactant-associated protein (SP-A) was measured in tracheal aspirates of ventilated infants with (n=51) and without (n=21) respiratory distress syndrome (RDS). SP-A concentrations in samples collected after birth were significantly lower in RDS than in infants ventilated for other reasons than RDS (median 0.03 vs. 1.60 μg/ml). As a biochemical test to diagnose RDS early after birth, the sensitivity of measuring SP-A in tracheal aspirates was 87% and specificity 81%. SP-A content in tracheal aspirates of infants with RDS was monitored during the first 7 days of life. A significant (P〈0.001) increase within the first 4 days was found in those infants who survived, whereas no such change was found in those infants who died.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 131 (1979), S. 219-228 
    ISSN: 1432-1076
    Keywords: Neonatal lung ; Respiratory distress syndrome ; Phospholipids, pulmonary ; Surfactant, artificial ; Surfactant, substitution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A mixture of synthetic phospholipids containing 90% Dipalmitoylphosphatidylcholine and 10% Dipalmitoylphosphatidylglycerol was tested for its suitability as surfactant substitute. Different methods of preparation were employed. The substance was studied by chromatography, Wilhelmy balance, and in rabbits after tracheal instillation during mechanical ventilation. When prepared as suspension of multilamellar liposomes in NaCl, the phospholipid samples displayed the essential surfactant features of adsorption from the subphase, spreading to a monolayer and lowering the surface tension to 3.7 dyn/cm at compression. For a dose of 2.55 μg/cm2, the stability index was 1.83±0.29. Samples prepared with ultrasound were not surface-active. Sonication also destroyed the surface-tension-lowering ability of previously active samples. No signs of local toxicity were found in the treated animals. When radioactive DPPC/DPPG was instillated into the trachea of the ventilated rabbit, autohistoradiography demonstrated radioactive material in the alveoli covering the alveolar wall with a thin layer. Provided that proper techniques of preparation and administration are employed, the phospholipids tested are a promising surfactant substitute worthy of clinical study.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1076
    Keywords: Artificial surfactant ; Lung phospholipids ; Premature rabbit fetus ; Respiratory distress syndrome ; Surfactant substitution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sixty-eight rabbit fetuses of 27 days gestation were tracheotomised, artificially ventilated, and their lung mechanics studied in a body-enclosing plethysmograph. The animals were treated by tracheal instillation of natural surfactant concentrate or large unilamellar vesicles containing dipalmitoyl-phosphatidylcholine: egg phosphatidylglycerol, 9∶1. Both preparations were highly surface active in terms of film adsorption and surface tension-lowering potential. Before treatment, the lung mechanics were analysed to indicate the presence of respiratory distress syndrome (RDS). Controls received 0.15 M saline. Differences were found between the in vitro and in vivo activities of both preparations in some animals. In 30 preterm animals with partial lung maturity and without respiratory distress syndrome, no significant effect could be achieved with either the natural or the artificial surfactant. In 38 animals with severe RDS, the tidal volume and compliance increased markedly within 15 min of substitution of both preparations. Compliance increased to 178% of the initial value in ventilated, control animals, to 391% in animals treated with natural, and to 344% in animals treated with artificial surfactant.
    Type of Medium: Electronic Resource
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