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  • American Academy of Pediatrics (AAP)  (2)
  • 2005-2009  (2)
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  • American Academy of Pediatrics (AAP)  (2)
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  • 2005-2009  (2)
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  • 1
    Online Resource
    Online Resource
    Carbon Monoxide is a Significant Mediator of Cardiovascular Status Following Preterm Birth
    American Academy of Pediatrics (AAP) ; 2009
    In:  Pediatrics Vol. 124, No. 1 ( 2009-07-01), p. 277-284
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 124, No. 1 ( 2009-07-01), p. 277-284
    Abstract: OBJECTIVE: With male gender as a strong predictor of cardiovascular instability, we hypothesized that gender-specific differences in circulating carbon monoxide levels contributed to dysregulated microvascular function in preterm male infants. METHODS: Infants born at 24 to 34 weeks of gestation (N = 84) were studied in a regional tertiary neonatal unit. Carboxyhemoglobin levels were measured through spectrophotometry in umbilical arterial blood and at 24, 72, and 120 hours after birth. Microvascular blood flow was determined through laser Doppler flowmetry. RESULTS: Carboxyhemoglobin levels demonstrated a strong inverse relationship with gestational age (r = −0.636; P & lt; .001) and were higher in boys (P = .032). Repeated-measures analysis of variance showed a significant decrease in arterial carboxyhemoglobin levels over time (P & lt; .001), with significant between-subjects effects for gestational age (P = .011) and gender (P = .025). Positive correlations with microvascular blood flow at 24 hours of age (r = 0.495; P & lt; .001) and 120 hours of age (r = 0.548; P & lt; .001) were observed. With controlling for gestational age, carboxyhemoglobin levels at 72 hours were greater for infants who died in the first week of life (P = .035). CONCLUSIONS: The gestational age- and gender-specific differences in carboxyhemoglobin levels and the relationship with dysregulated microvascular blood flow, a state related to greater illness severity and hypotension, are novel findings not confined solely to sick preterm infants. Both inducible heme oxygenase-dependent and non–heme oxygenase-dependent pathways may initially play a central role in carbon monoxide production, inducing pathophysiologic processes in a gender-specific manner.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2008-0877
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2009
    detail.hit.zdb_id: 1477004-0
    detail.hit.zdb_id: 207677-9
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Continuous Positive Airway Pressure Therapy for Infants With Respiratory Distress in Non–Tertiary Care Centers: A Randomized, Controlled Trial
    American Academy of Pediatrics (AAP) ; 2007
    In:  Pediatrics Vol. 120, No. 3 ( 2007-09-01), p. 509-518
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 120, No. 3 ( 2007-09-01), p. 509-518
    Abstract: OBJECTIVE. Our objective was to determine whether continuous positive airway pressure therapy would safely reduce the need for up-transfer of infants with respiratory distress from nontertiary centers. METHODS. We randomly assigned 300 infants at & gt;30 weeks of gestation with respiratory distress to receive either Hudson prong bubble continuous positive airway pressure therapy or headbox oxygen treatment (standard care). The primary end point was “up-transfer or treatment failure.” Secondary end points included death, length of nursery stay, time receiving oxygen therapy, cost of care, and other measures of morbidity. RESULTS. Of 151 infants who received continuous positive airway pressure therapy, 35 either were up-transferred or experienced treatment failure, as did 60 of the 149 infants given headbox oxygen treatment. There was no difference in the length of stay or the duration of oxygen treatment. For every 6 infants treated with continuous positive airway pressure therapy, there was an estimated cost saving of $10000. Pneumothorax was identified for 14 infants in the continuous positive airway pressure group and 5 in the headbox group. There was no difference in any other measure of morbidity or death. CONCLUSIONS. Hudson prong bubble continuous positive airway pressure therapy reduces the need for up-transfer of infants with respiratory distress in nontertiary centers. There is a clinically relevant but not statistically significant increase in the risk of pneumothorax. There are significant benefits associated with continuous positive airway pressure use in larger nontertiary centers.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2007-0775
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2007
    detail.hit.zdb_id: 1477004-0
    detail.hit.zdb_id: 207677-9
    Location Call Number Limitation Availability
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    Online Resource
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