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  • 1
    Electronic Resource
    Electronic Resource
    Effects of dobutamine on left ventricular performance in newborns as determined by systolic time intervals (1987)
    Springer
    European journal of pediatrics 146 (1987), S. 135-139 
    Details
    ISSN: 1432-1076
    Keywords: Newborns ; Dobutamine ; Systolic time intervals ; Echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To evaluate the effects of dobutamine on myocardial function in newborns, left ventricular systolic time intervals (STI) — normalized pre-ejection period (PEPI), normalized left ventricular ejection time (LVETI) and pre-ejection period to left ventricular ejection time ratio (PEP/LVET) — were assessed by echocardiography in 18 newborns treated with dobutamine for clinically diagnosed heart failure. Examinations were performed prior to and 30 min after starting dobutamine infusion (7.5 or 10 μg/kg per min). Patients were assigned to two groups according to their PEP/LVET prior to dobutamine administration: group I (n=9) with pre-treatment PEP/LVET ≤ 0.35 and group II (n=9) with pre-treatment PEP/LVET 〉 0.35. While there was no change of STI in group I, dobutamine infusion resulted in a significant decrease in PEPI (from 102±4.8 to 87.8±4.2; mean ± SEM;P〈0.01) and of PEP/LVET (from 0.56±0.05 to 0.45±0.05; mean ±SEM;P〈0.01) and in a significant increase of LVETI (from 237.6±5.6 to 253.3±5.2; mean ±SEM;P〈0.01) in group II. Heart rate increased significantly in both groups. Left ventricular end-diastolic dimension, also assessed by echocardiography, did not change in the eight studies performed. An increase in mean arterial pressure was found in three out of five newborns of group II and in one out of four patients in group I. It is concluded that dobutamine can improve cardiac performance in newborns with impaired left venfricular function. This effect is probably due to an improvement in myocardial contractility.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02343218
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  • 2
    Electronic Resource
    Electronic Resource
    Physical performance in long-term survivors of acute leukaemia in childhood (1998)
    Springer
    European journal of pediatrics 157 (1998), S. 464-467 
    Details
    ISSN: 1432-1076
    Keywords: Key words Childhood cancer ; Leukaemia ; Late effects ; Anthracyclines Exercise testing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to assess the physical performance in long-term survivors of acute leukaemia in childhood and to evaluate the effects of anthracycline therapy. Electrocardiography, echocardiography and spiroergometry were carried out on 56 patients aged 9–28 years, of whom 44 patients had been treated with 15–483 mg/m2 doxorubicin (or equivalent). Acute leukaemia had been diagnosed 1.5–16 years earlier. Of the patients 75% reached normal maximal oxygen uptake, 69% normal oxygen uptake at the anaerobic threshold and 95% normal maximal work rate. Of the patients 75% achieved adequate values for maximal heart rate and 78% normal blood lactate concentration. No difference was seen between patients treated with and without anthracyclines. Conclusion The results of this study provide little evidence for cardiopulmonary impairment in long-term survivors of ALL. Both the cardiac function, as evaluated by ECG and echocardiography, and the physical performance in spiroergometry are normal in a large number of these patients. Anthracycline treatment does not appear to have a negative effect on these parameters.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050854
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  • 3
    Electronic Resource
    Electronic Resource
    Congenital sinus bradycardia combined with congenital total atrioventricular block (1977)
    Springer
    European journal of pediatrics 125 (1977), S. 219-224 
    Details
    ISSN: 1432-1076
    Keywords: Congenital Sinus bradycardia ; Sick-Sinus-Syndrome ; Total atrioventricular block ; Bundle of His EG
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sinus bradycardia and total atrioventricular block were found at the age of seven months in a boy who is now 161/2 years old. According to Yaters (1929) criteria, these are likely to be congenital disorders. While the frequency of the ventricular impulse generator in the upper bundle of His only slowed in accordance with age during the period of observation, the sinus node activity deteriorated considerably. Finally potentials could only be sporadically demonstrated. Under heavy stress and with a simultaneous slight increase in ventricular frequency, a re-occurence of regular but slow sinus node activity came about. The cause of this binodal disorder of rhythm is unknown. There is no indication of family affliction or of myocarditis in early childhood. Congenital heart disease could also be excluded.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00480600
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  • 4
    Electronic Resource
    Electronic Resource
    Changes of the cardiovascular system during the perinatal period (1987)
    Springer
    European journal of pediatrics 146 (1987), S. 545-549 
    Details
    ISSN: 1432-1076
    Keywords: Cardiovascular system ; Newborn ; Myocardial performance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract After describing the particular features of the fetal circulation, changes in the pattern of blood flow at the time of birth and during early neonatal life are explained. From animal studies it is wellknown that during the first hours and weeks after birth newborns are characterized by an extremely high cardiac output due to high metabolic demands. In order to meet this marked volume loading, already under resting conditions the neonatal heart appears to be operating nearly at its full capacity without reserves in contractility, preload and afterload. Consequently the newborn heart has less ability to cope with additional acute afterload and/or preload stress. Few investigations on cardiac output and myocardial performance in healthy human newborns provide presumptive evidence that the postnatal human heart performs probably as well as the heart of other species. These observations may influence the therapeutic approach in clinical situations with additional alterations in loading conditions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02467350
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  • 5
    Electronic Resource
    Electronic Resource
    Effects of dopamine infusion on plasma catecholamines in preterm and term newborn infants (1991)
    Springer
    European journal of pediatrics 150 (1991), S. 503-506 
    Details
    ISSN: 1432-1076
    Keywords: Dopamine infusion ; Newborn infants ; Plasma catecholamines ; Noradrenaline ; Adrenaline
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Newborn infants (21 preterm and 13 term) received dopamine infusions at a low (2.5–3.4 μg/kg per min) and/or high (5–10 μg/kg per min) infusion rate and changes in plasma catecholamines were monitored. The mean baseline values for dopamine, noradrenaline and adrenaline were between 240 and 560, 125 and 144 and 62 and 82 pg/ml, respectively. During low-rate infusion of dopamine, there was a significant increase in plasma dopamine (20–100fold), noradrenaline (three- to five-fold) and adrenaline (threefold). Administration of dopamine at the high rate resulted in an even larger increase in the plasma catecholamines (dopamine, 100–300fold; noradrenaline, seven- to eightfold; adrenaline, four- to sixfold). In a double-log plot, there was a highly significant correlation between the plasma concentrations of dopamine and noradrenaline (r=0.77;P〈0.001). In conclusion, infusion of dopamine in term and preterm newborn infants is accompanied by an enhanced sympatho-adrenal tone which may contribute to the cardiovascular effects of dopamine in these patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01958433
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  • 6
    Electronic Resource
    Electronic Resource
    Hemodynamic effects of dobutamine in children with cardiovascular failure (1982)
    Springer
    European journal of pediatrics 139 (1982), S. 4-7 
    Details
    ISSN: 1432-1076
    Keywords: Children ; Dobutamine ; Hemodynamics ; Improvement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effect of dobutamine, a synthetic catecholamine, was studied in 12 patients aged one day to 14 years with low cardiac output syndromes. After initial stabilization of the patients dobutamine was administered by continuous infusion in a dosage of 7.5 or 10 μg/kg/min. Heart rate, cardiac output (using thermodilution technique and/or pulse contour method), mean systemic and mean pulmonary artery pressures were determined before and after the dobutamine infusion. Systemic and pulmonary vascular resistances, cardiac index and stroke volume index were calculated. Cardiac output and cardiac index increased significantly in every patient, whereas the heart rate changed only slightly, suggesting that the increase in cardiac output was mainly due to the alteration of stroke volume. The mean arterial pressure increased significantly, but the mean pulmonary artery pressure was unchanged. No side effects were observed during the dobutamine infusion. Dobutamine is a potent inotropic drug with limited chronotropic and peripheral vascular effects in newborns, infants and chidren.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00442069
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  • 7
    Electronic Resource
    Electronic Resource
    Evaluation of pediatric intensive care in Europe (1987)
    Springer
    Intensive care medicine 13 (1987), S. 65-70 
    Details
    ISSN: 1432-1238
    Keywords: Scoring systems ; CCS ; TISS ; APS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract There are no reports analyzing the results of pediatric intensive care in Europe. We evaluated quantitatively the severity of illness and the amount of care required for 714 consecutively admitted patients. We used simultaneously the Clinical Classification System (CCS) the Acute Physiology Score (APS) and the Therapeutic Intervention Scoring System (TISS). Overall mortality at 1 month was 15%. The mortality rate was higher for CCS Class IV patients (32.3%) than for CCS III (4.5%) and CCS II (3.2%). The difference was significant between CCS IV and CCS III and II respectively (p〈0.001) but no difference was observed between CCS III and CCS II. The patients were also classified among 7 major organ system failures: cardio vascular, respiratory, neurologic, gastro intestinal, renal, metabolic, hematologic. Three of them were primarily involved: respiratory (44.9%) cardio-vascular (20.7%), neurologic (18.8%). Among these 3 groups the highest mortality was observed in cardio-vascular patients (p〈0.01 v.s. respiratory, p〈0.05 v.s. neurologic). The death rate was 22% among the 264 neonates, 9.7% among the 247 infants (p〈0.01) and 12.6% among the 198 children. APS and TISS scores increased significantly with the CCS classes. However the overall mortality rate was 8% for the patients with an APS〈35 and 62.5% for the patients with an APS〉35 which probably represent the real class IV patients. Some discrepancies among the different institutions participating in the study suggest the need for further studies before the use of such score for interinstitutional comparisons and for evaluation of efficacy of therapy in multicenter studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00263562
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  • 8
    Electronic Resource
    Electronic Resource
    Hemodynamic monitoring in childhood (1989)
    Springer
    Intensive care medicine 15 (1989), S. S27 
    Details
    ISSN: 1432-1238
    Keywords: Hemodynamic monitoring ; Childhood ; Oxygen delivery ; Cardiac output ; Oxygen utilization ; Mixed venous oxygen saturation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hemodynamic monitoring is indicated in children with impending or manifest cardiocirculatory failure. Since cardiocirculatory failure is characterized by an imbalance between oxygen delivery and oxygen demand due to perfusion failure, the parameters monitored should aid in the assessment of these oxygen variables. Oxygen delivery depends on oxygen content and cardiac output. Cardiac output is determined by heart rate and stroke volume; stroke volume by preload, afterload and contractility. Since the direct measurement of oxygen consumption routinely is almost impossible, global oxygen utilization represented by mixed venous oxygen saturation may be used to quantify the relationship between oxygen delivery and oxygen consumption. Justification of invasive hemodynamic monitoring depends among other things on an optimal balance between usefulness of information and complications associated with the techniques used. In future, the development of further noninvasive techniques and the scientific evaluation of recommended monitoring techniques are prospects in cardiovascular monitoring in childhood.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00260880
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  • 9
    Electronic Resource
    Electronic Resource
    The effect of nifedipine alone or combined with low dose acetylsalicylic acid on endotoxin-induced pulmonary hypertension in the piglet (1988)
    Springer
    Intensive care medicine 14 (1988), S. 595-601 
    Details
    ISSN: 1432-1238
    Keywords: Endotoxin ; Pulmonary hypertension ; Nifedipine ; ASA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cardiovascular responses to the calcium antagonist nifedipine, alone and combined with low dose acetylsalicylic acid (ASA), were evaluated in a piglet model of endotoxin-induced pulmonary hypertension. All animals were anesthetized, paralyzed and mechanically ventilated. Cardiac output (CO), pulmonary artery pressure (PAP), aortic blood pressure (SAP), pulmonary capillary wedge pressure (PCWP), right strial pressure (RAPM) and arterial blood gases were measured before and after induction of pulmonary hypertension by E. coli endotoxin and after treatment. Results of treated groups were compared to a control group of piglets subjected to the same dose (0.15 μg/kg i.v.) of endotoxin. Control animals responded to a bolus injection of endotoxin within 15 min with an increase in mean PAP by 110%. Pulmonary vascular resistance (PVR) increased by 144%. Mean arterial pressure did not change significantly from baseline values. In animals treated with a single dose of 1 mg/kg ASA prior to endotoxin, the initial pulmonary response was not quantitatively different from control values, whereas ASA 20 mg/kg abolished the pulmonary vascular reaction. The increase of systemic vascular resistance (SVR) produced by endotoxin was aggravated by high dose ASA. In piglets treated with nifedipine (4 μg/kg/min) over 30 min after the application of endotoxin with and without additional infusion of nifedipine 60 min prior to endotoxin the PVR could be attenuated. The combination of nifedipine and low dose ASA showed synergistic effects compared to control. The increase of mean PAP was significantly reduced, the PVR remained in base-line range due to a marked elevation of cardiac output.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00256762
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  • 10
    Electronic Resource
    Electronic Resource
    Intravenöses Humanimmunglobulin zur Prophylaxe der Amnioninfektion beim vorzeitigen Blasensprung (1989)
    Springer
    Archives of gynecology and obstetrics 245 (1989), S. 211-213 
    Details
    ISSN: 1432-0711
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zusammenfassung Mit einer prospektiven randomisierten kontrollierten Studie prüfen wir bei Patientinnen mit vorzeitigem Blasensprung in der 25.–35. SSW den Effekt einer Immunglobulinprophylaxe der aszendierenden Amnioninfektion. Die erste Zwischenauswertung mit 15 Patientinnen zeigt, daß die i.v. Gabe eines IgG-, IgA- und IgM-haltigen Immunglobulinpräparates innerhalb von 24–48 h nach dem Blasensprung zu einer deutlichen Reduzierung der infektiösen Morbidität beim Feten führt und läßt einen Trend zur Schwangerschaftsverlängerung erkennen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02417239
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