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  • 1
    Electronic Resource
    Electronic Resource
    Comparison of C-reactive protein and white blood cell count with differential in neonates at risk for septicaemia (1995)
    Springer
    European journal of pediatrics 154 (1995), S. 138-144 
    Details
    ISSN: 1432-1076
    Keywords: C-reactive protein Septicaemia ; Neonates ; White blood cell count parameters
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We prospectively compared the diagnostic value of C-reactive protein (CRP) and white blood cell counts for detection of neonatal septicaemia. Sensitivity and specifity in receiver operating characteristics, and positive and negative predictive value of CRP and white blood cell count were compared in 195 critically ill preterm and term newborns clinically suspected of infection. Blood cultures were positive in 33 cases. During the first 3 days after birth CRP elevation (sensitivity 75%, specifity 86%), leukopenia (67%/90%), neutropenia (78%/80%) and immature to total neutrophil count (I/T) ratio (78%/73%) were good diagnostic parameters, as opposed to band forms with absolute count (84%/66%) or percentage (79%/71%), thrombocytopenia (65%/57%) and toxic granulations (44%/94%). Beyond 3 days of age elevated CRP (88%/87%) was the best parameter. Increased total (84%/66%) or percentage band count (79%/71%) were also useful. Leukocytosis (74%/56%), increased neutrophils (67%/65%), I/T ratio (79%/47%), thrombocytopenia (65%/57%) and toxic granulations had a low specifity. The positive predictive value of CRP was 32% before and 37% after 3 days of age, that of leukopenia was 37% in the first 3 days.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01991918
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  • 2
    Electronic Resource
    Electronic Resource
    Comparison of C-reactive protein and white blood cell count with differential in neonates at risk for septicaemia (1995)
    Springer
    European journal of pediatrics 154 (1995), S. 138-144 
    Details
    ISSN: 1432-1076
    Keywords: Key words C-reactive protein ; Septicaemia ; Neonates ; White blood cell count parameters
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We prospectively compared the diagnostic value of C-reactive protein (CRP) and white blood cell counts for detection of neonatal septicaemia. Sensitivity and specifity in receiver operating characteristics, and positive and negative predictive value of CRP and white blood cell count were compared in 195 critically ill preterm and term newborns clinically suspected of infection. Blood cultures were positive in 33 cases. During the first 3 days after birth CRP elevation (sensitivity 75%, specifity 86%), leukopenia (67%/ 90%), neutropenia (78%/80%) and immature to total neutrophil count (I/T) ratio (78%/73%) were good diagnostic parameters, as opposed to band forms with absolute count (84%/66%) or percentage (79%/ 71%), thrombocytopenia (65%/57%) and toxic granulations (44%/94%). Beyond 3 days of age elevated CRP (88%/87%) was the best parameter. Increased total (84%/66%) or percentage band count (79%/71%) were also useful. Leukocytosis (74%/ 56%), increased neutrophils (67%/ 65%), I/T ratio (79%/47%), thrombocytopenia (65%/57%) and toxic granulations had a low specifity. The positive predictive value of CRP was 32% before and 37% after 3 days of age, that of leukopenia was 37% in the first 3 days.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050264
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Can near infrared spectroscopy of the liver monitor tissue oxygenation? (2000)
    Springer
    European journal of pediatrics 159 (2000), S. 549-549 
    Details
    ISSN: 1432-1076
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051334
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  • 4
    Electronic Resource
    Electronic Resource
    Diagnostic potential of neutrophil elastase inhibitor complex in the routine care of critically ill newborn infants (2000)
    Springer
    European journal of pediatrics 159 (2000), S. 659-662 
    Details
    ISSN: 1432-1076
    Keywords: Key words Infant ; Newborn ; Sepsis ; Diagnosis ; Neutrophil-elastase ; C-reactive protein
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract It has been suggested that determination of the neutrophil elastase α1-proteinase inhibitor complex (E-α1PI) improves the diagnosis of bacterial infection in newborns. We evaluated the use of E-α1PI measurements in 143 newborns, consecutively admitted to a tertiary intensive care unit, employing a new random access assay and a sampling procedure that minimises post-collection artefacts. The 95% range for non-infected newborns was 20–110 μg/l up to the 5th day of life and 20–85 μg/l thereafter. The sensitivity as to the diagnosis of culture-proven bloodstream infection was 80% for E-α1PI, 86% for the immature to total neutrophil ratio, 64% for C-reactive protein and 37% for the total white blood cell count. The corresponding specificity amounted to 97%, 85%, 85% and 86%, respectively. E-α1PI increases preceded elevations of C-reactive protein by 18 h. Like C-reactive protein, E-α1PI levels did not distinguish between bloodstream infection and non-bacterial inflammatory responses. Results of E-α1PI became available within 1 h of collection and usually 2–3 h before manual leucocyte counts. Conclusion Determination of neutrophil elastase α1-proteinase inhibitor levels yields diagnostic advantages comparable to those of manual differential counts but provide faster turnaround times.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00008402
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  • 5
    Electronic Resource
    Electronic Resource
    Influence of nutrition on urinary oxalate and calcium in preterm and term infants (1997)
    Springer
    Pediatric nephrology 11 (1997), S. 687-690 
    Details
    ISSN: 1432-198X
    Keywords: Key words: Oxalate ; Calcium ; Preterm infants ; Term infants ; Gestational age ; Nutritional factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract.   Few data for normal urinary oxalate (Ox) and calcium (Ca) excretion related both to gestational age and nutritional factors have been reported in preterm or term infants. We therefore determined the molar Ox and Ca to creatinine (Cr) ratios in spot urines from 64 preterm and 37 term infants aged 1–60 days, either fed formula or human milk (HM). Only vitamin D was supplemented; renal or metabolic diseases were excluded. Urinary Ox/Cr ratio was higher in preterm than in term infants, both when formula fed (1st month 253 vs. 180 mmol/mol and 2nd month 306 vs. 212 mmol/mol; P〈0.05) or HM fed (206 vs. 169 mmol/mol and 283* vs. 232 mmol/mol; * P〈0.05). Ox/Cr was also higher in formula- than HM-fed preterm infants. The ratio increased during the first 2 months of life irrespective of nutrition. Urinary Ca/Cr ratio was comparable in all groups during the 1st month of life, except for a lower (P〈0.05) value in term infants fed HM (0.10 mol/mol). It increased in all groups during the 2nd month of life, being highest in HM-fed preterm infants (1.86 mol/mol). In conclusion, urinary Ox and Ca excretion is influenced by both gestational age and nutrient intake in preterm and term infants.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004670050366
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  • 6
    Electronic Resource
    Electronic Resource
    Dexamethasone therapy and cortisol excretion in severe pediatric head injury (1987)
    Springer
    Child's nervous system 3 (1987), S. 103-105 
    Details
    ISSN: 1433-0350
    Keywords: Head injury ; Children ; Dexamethasone ; Endogenous cortisol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Glucocorticoids are used in an attempt to reduce brain edema secondary to head injury. Nevertheless, their usefulness remains uncertain and contradictory. In a randomized study of 24 children with severe head injury, urinary free cortisol was measured by radioimmunoassay. Twelve patients (group 1) received dexamethasone and 12 (group 2) did not. All patients were treated with a standardized regimen. In group 1 there was complete suppression of endogenous cortisol production. In group 2 free cortisol was up to 20-fold higher than under basal conditions and reached maximum values on days 1–3. Since the excretion of cortisol in urine reflects the production rate closely and is not influenced by liver function and barbiturates, the results in group 2 show that the endogenous production of steroids is an adequate reaction to severe head injury. Exogenous glucocorticoids are thus unlikely to have any more beneficial effects than endogenous cortisol.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00271134
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  • 7
    Electronic Resource
    Electronic Resource
    Automatic selection of tidal volume, respiratory frequency and minute ventilation in intubated ICU patients as startup procedure for closed-loop controlled ventilation (1994)
    Springer
    Journal of clinical monitoring and computing 11 (1994), S. 19-30 
    Details
    ISSN: 1573-2614
    Keywords: adult ; child ; closed-loop controlled ventilation ; feedback ; human ; initial settings ; respiration-artificial ; computer ; mechanical ventilation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract Objective: Before a patient can be connected to a mechanical ventilator, the controls of the apparatus need to be set up appropriately. Today, this is done by the intensive care professional. With the advent of closed loop controlled mechanical ventilation, methods will be needed to select appropriate startup settings automatically. The objective of our study was to test such a computerized method which could eventually be used as a start-up procedure (first 5–10 minutes of ventilation) for closed-loop controlled ventilation. Design: Prospective Study. Settings: ICU's in two adult and one children's hospital. Patients: 25 critically ill adult patients (age≥15 y) and 17 critically ill children selected at random were studied. Interventions: To simulate ‘initial connection’, the patients were disconnected from their ventilator and transiently connected to a modified Hamilton AMADEUS ventilator for maximally one minute. During that time they were ventilated with a fixed and standardized breath pattern (Test Breaths) based on pressure controlled synchronized intermittent mandatory ventilation (PCSIMV). Measurements and main results: Measurements of airway flow, airway pressure and instantaneous CO2 concentration using a mainstream CO2 analyzer were made at the mouth during application of the Test-Breaths. Test-Breaths were analyzed in terms of tidal volume, expiratory time constant and series dead space. Using this data an initial ventilation pattern consisting of respiratory frequency and tidal volume was calculated. This ventilation pattern was compared to the one measured prior to the onset of the study using a two-tailed paired t-test. Additionally, it was compared to a conventional method for setting up ventilators. The computer-proposed ventilation pattern did not differ significantly from the actual pattern (p〉0.05), while the conventional method did. However the scatter was large and in 6 cases deviations in the minute ventilation of more than 50% were observed. Conclusions: The analysis of standardized Test Breaths allows automatic determination of an initial ventilation pattern for intubated ICU patients. While this pattern does not seem to be superior to the one chosen by the conventional method, it is derived fully automatically and without need for manual patient data entry such as weight or height. This makes the method potentially useful as a startup procedure for closed-loop controlled ventilation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01132840
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  • 8
    Electronic Resource
    Electronic Resource
    Transcutaneous carbon dioxide and oxygen tension in newborn infants: Reliability of a combined monitor of oxygen tension and carbon dioxide tension (1988)
    Springer
    Journal of clinical monitoring and computing 4 (1988), S. 103-106 
    Details
    ISSN: 1573-2614
    Keywords: Monitoring: carbon dioxide ; oxygen ; Anesthesia, pediatric ; Oxygen: tension, arterial ; Carbon dioxide: tension, arterial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract We evaluated a new combined sensor for monitoring transcutaneous carbon dioxide tension (PtcCO2) and oxygen tension (PtcO2) in 20 critically ill newborn infants. Arterial oxygen tension (PaO2) ranged from 16 to 126 torr and arterial carbon dioxide tension (PaCO2) from 14 to 72 torr. Linear correlation analysis (100 paired values) of PtcO2 versus PaO2 showed anr value of 0.75 with a regression equation of PtcO2=8.59+0.905 (PaO2), while PtcCO2 versus PaCO2 revealed a correlation coefficient ofr=0.89 with an equation of PtcCO2=2.53+1.06 (PaCO2). The bias between PaO2 and PtcO2 was −2.8 with a precision of ±16.0 torr (range, −87 to +48 torr). The bias between PaCO2 and PtcCO2 was −5.1 with a precision of ±7.3 torr (range, −34 to +8 torr). The transcutaneous sensor detected 83% of hypoxia (PaO2 〈45 torr), 75% of hyperoxia (PaO2 〉90 torr), 45% of hypocapnia (PaCO2 〈35 torr), and 96% of hypercapnia (PaCO2 〉45 torr). We conclude that the reliability of the combined transcutaneousPo 2 andPCo 2 monitor in sick neonates is good for detecting hypercapnia, fair for hypoxia and hyperoxia, but poor for hypocapnia. It is an improvement in that it spares available skin surface and requires less handling, but it appears to be slightly less accurate than the single electrodes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01641810
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