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  • 1
    Online-Ressource
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    Effect of fluconazole prophylaxis on Candida fluconazole susceptibility in premature infants
    Oxford University Press (OUP) ; 2018
    In:  Journal of Antimicrobial Chemotherapy Vol. 73, No. 12 ( 2018-12-01), p. 3482-3487
    Details
    In: Journal of Antimicrobial Chemotherapy, Oxford University Press (OUP), Vol. 73, No. 12 ( 2018-12-01), p. 3482-3487
    Kurzfassung: Extremely premature infants are at high risk of developing invasive candidiasis; fluconazole prophylaxis is safe and effective for reducing invasive candidiasis in this population but further study is needed. We sought to better understand the effect of prophylactic fluconazole on a selection of fluconazole-resistant Candida species. Methods We evaluated the susceptibility to fluconazole of Candida isolates from premature infants ( 〈 750 g birth weight) enrolled in a multicentre, randomized, placebo-controlled trial of fluconazole prophylaxis. Candida species were isolated through surveillance cultures at baseline (study day 0–7), period 1 (study day 8–28) and period 2 (study day 29–49). Fluconazole MICs were determined for all Candida isolates. Results Three hundred and sixty-one infants received fluconazole (n = 188) or placebo (n = 173). After the baseline period, Candida colonization was significantly lower in the fluconazole group compared with placebo during periods 1 (5% versus 27%; P  〈  0.001) and 2 (3% versus 27%; P  〈  0.001). After the baseline period, two infants (1%) were colonized with at least one fluconazole-resistant Candida in each group. Median fluconazole MIC was similar in both treatment groups at baseline and period 1. However, in period 2, median MIC was higher in the fluconazole group compared with placebo (1.00 versus 0.50 mg/L, P = 0.01). There was no emergence of resistance observed and no patients developed invasive candidiasis with a resistant Candida isolate. Conclusions Fluconazole prophylaxis decreased Candida albicans and ‘non-albicans’ Candida colonization and was associated with a slightly higher fluconazole MIC for colonizing Candida isolates.
    Materialart: Online-Ressource
    ISSN: 0305-7453 , 1460-2091
    URL: Article
    DOI: 10.1093/jac/dky353
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2018
    ZDB Id: 1467478-6
    SSG: 15,3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
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    Complications Associated With Surgically Placed Central Venous Catheters In Low Birth Weight Neonates
    Springer Science and Business Media LLC ; 1999
    In:  Journal of Perinatology Vol. 19, No. 2 ( 1999-03-01), p. 106-109
    Details
    In: Journal of Perinatology, Springer Science and Business Media LLC, Vol. 19, No. 2 ( 1999-03-01), p. 106-109
    Materialart: Online-Ressource
    ISSN: 0743-8346 , 1476-5543
    URL: Article
    DOI: 10.1038/sj.jp.7200137
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 1999
    ZDB Id: 2007668-X
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
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    Lung resistance and elastance in spontaneously breathing preterm infants: effects of breathing pattern and demographics
    American Physiological Society ; 2000
    In:  Journal of Applied Physiology Vol. 88, No. 3 ( 2000-03-01), p. 997-1005
    Details
    In: Journal of Applied Physiology, American Physiological Society, Vol. 88, No. 3 ( 2000-03-01), p. 997-1005
    Kurzfassung: Reported values of lung resistance (Rl) and elastance (El) in spontaneously breathing preterm neonates vary widely. We hypothesized that this variability in lung properties can be largely explained by both inter- and intrasubject variability in breathing pattern and demographics. Thirty-three neonates receiving nasal continuous positive airway pressure [weight 606–1,792 g, gestational age (GA) of 25–33 wk, 2–49 days old] were studied. Transpulmonary pressure was measured by esophageal manometry and airway flow by face mask pneumotachography. Breath-to-breath changes in Rl and El in each infant were estimated by Fourier analysis of impedance (Z) and by multiple linear regression (MLR). Rl MLR (Rl MLR = 0.85 × Rl Z −0.43; r 2 = 0.95) and El MLR (El MLR = 0.97 × El Z + 8.4; r 2 = 0.98) were highly correlated to Rl Z and El Z , respectively. Both Rl(mean ± SD; Rl Z = 70 ± 38, Rl MLR = 59 ± 36 cmH 2 O ⋅ s ⋅ l −1 ) and El (El Z = 434 ± 212, El MLR = 436 ± 210 cmH 2 O/l) exhibited wide intra- and intersubject variability. Regardless of computation method, Rl was found to decrease as a function of weight, age, respiratory rate (RR), and tidal volume (Vt) whereas it increased as a function of RR ⋅ Vt and inspiratory-to-expiratory time ratio (Ti/Te). El decreased with increasing weight, age, Vt and female gender and increased as RR and Ti/Te increased. We conclude that accounting for the effects of breathing pattern variability and demographic parameters on estimates of Rland El is essential if they are to be of clinical value. Multivariate statistical models of Rl and Elmay facilitate the interpretation of lung mechanics measurements in spontaneously breathing infants.
    Materialart: Online-Ressource
    ISSN: 8750-7587 , 1522-1601
    URL: Article
    DOI: 10.1152/jappl.2000.88.3.997
    RVK:
    WA 15000
    RVK:
    XA 52094
    Sprache: Englisch
    Verlag: American Physiological Society
    Publikationsdatum: 2000
    ZDB Id: 1404365-8
    SSG: 12
    SSG: 31
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
    Online-Ressource
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    Detecting lung overdistention in newborns treated with high-frequency oscillatory ventilation
    American Physiological Society ; 2000
    In:  Journal of Applied Physiology Vol. 89, No. 1 ( 2000-07-01), p. 364-372
    Details
    In: Journal of Applied Physiology, American Physiological Society, Vol. 89, No. 1 ( 2000-07-01), p. 364-372
    Kurzfassung: Positive airway pressure (Paw) during high-frequency oscillatory ventilation (HFOV) increases lung volume and can lead to lung overdistention with potentially serious adverse effects. To date, no method is available to monitor changes in lung volume (ΔVl) in HFOV-treated infants to avoid overdistention. In five newborn piglets (6–15 days old, 2.2–4.2 kg), we investigated the use of direct current-coupled respiratory inductive plethysmography (RIP) for this purpose by evaluating it against whole body plethysmography. Animals were instrumented, fitted with RIP bands, paralyzed, sedated, and placed in the plethysmograph. RIP and plethysmography were simultaneously calibrated, and HFOV was instituted at varying Paw settings before (6–14 cmH 2 O) and after (10–24 cmH 2 O) repeated warm saline lung lavage to induce experimental surfactant deficiency. Estimates of ΔVl from both methods were in good agreement, both transiently and in the steady state. Maximal changes in lung volume (ΔVl max ) from all piglets were highly correlated with ΔVl measured by RIP (in ml) = 1.01 × changes measured by whole body plethysmography − 0.35; r 2 = 0.95. Accuracy of RIP was unchanged after lavage. Effective respiratory system compliance (Ceff) decreased after lavage, yet it exhibited similar sigmoidal dependence on ΔVl max pre- and postlavage. A decrease in Ceff (relative to the previous Paw setting) as ΔVl max was methodically increased from low to high Paw provided a quantitative method for detecting lung overdistention. We conclude that RIP offers a noninvasive and clinically applicable method for accurately estimating lung recruitment during HFOV. Consequently, RIP allows the detection of lung overdistention and selection of optimal HFOV from derived Ceff data.
    Materialart: Online-Ressource
    ISSN: 8750-7587 , 1522-1601
    URL: Article
    DOI: 10.1152/jappl.2000.89.1.364
    RVK:
    WA 15000
    RVK:
    XA 52094
    Sprache: Englisch
    Verlag: American Physiological Society
    Publikationsdatum: 2000
    ZDB Id: 1404365-8
    SSG: 12
    SSG: 31
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
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    Work of Breathing During Constant- and Variable-Flow Nasal Continuous Positive Airway Pressure in Preterm Neonates
    American Academy of Pediatrics (AAP) ; 2001
    In:  Pediatrics Vol. 108, No. 3 ( 2001-09-01), p. 682-685
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 108, No. 3 ( 2001-09-01), p. 682-685
    Kurzfassung: Constant-flow nasal continuous positive airway pressure (NCPAP) often is used in preterm neonates to recruit and maintain lung volume. Physical model studies indicate that a variable-flow NCPAP device provides more stable volume recruitment with less imposed work of breathing (WOB). Although superior lung recruitment with variable-flow NCPAP has been demonstrated in preterm neonates, corroborating WOB data are lacking. Objective. To measure and compare WOB associated with the use of variable-flow versus constant-flow NCPAP in preterm neonates. Methods. Twenty-four preterm infants who were receiving constant-flow NCPAP (means, SD) and had birth weight of 1024 ± 253 g, gestational age of 28 ± 1.7 weeks, age of 14 ± 13 days, and Fio2 of 0.3 ± 0.1 were studied. Variable-flow and constant-flow NCPAP were applied in random order. We measured changes in lung volume and tidal ventilation (VT) by DC-coupled/calibrated respiratory inductance plethysmography as well as esophageal pressures at NCPAP of 8, 6, 4, and 0 cm H2O. Inspiratory WOB (WOBI) and lung compliance were calculated from the esophageal pressure and VT data using standard methods. WOB was divided by VT to standardize the results. Results. WOBI decreased at all CPAP levels with variable-flow NCPAP, with a maximal decrease at 4 cm H2O. WOBI increased at all CPAP levels with constant-flow CPAP. Lung compliance increased at all NCPAP levels with variable-flow, with a relative decrease at 8 cm H2O, whereas it increased only at 8 cm H2O with constant-flow NCPAP. Compared with constant-flow NCPAP, WOBI was 13% to 29% lower with variable-flow NCPAP. Conclusion. WOBI is decreased with variable-flow NCPAP compared with constant-flow NCPAP. The increase in WOBI with constant-flow NCPAP indicates the presence of appreciable imposed WOB with this device. Our study, performed in neonates with little lung disease, indicates the possibility of lung overdistention at CPAP of 6 to 8 cm H2O with the variable-flow device. Further study is necessary to determine the efficacy of variable-flow NCPAP in neonates with significant lung disease and its use over extended periods of time.continuous-flow and variable-flow NCPAP, work of breathing, premature neonates, lung compliance.
    Materialart: Online-Ressource
    ISSN: 1098-4275 , 0031-4005
    URL: Article
    DOI: 10.1542/peds.108.3.682
    Sprache: Englisch
    Verlag: American Academy of Pediatrics (AAP)
    Publikationsdatum: 2001
    ZDB Id: 1477004-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
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    Lung Recruitment and Breathing Pattern During Variable Versus Continuous Flow Nasal Continuous Positive Airway Pressure in Premature Infants: An Evaluation of Three Devices
    American Academy of Pediatrics (AAP) ; 2001
    In:  Pediatrics Vol. 107, No. 2 ( 2001-02-01), p. 304-308
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 107, No. 2 ( 2001-02-01), p. 304-308
    Kurzfassung: To determine whether lung volume changes and breathing pattern parameters differ among 3 devices for delivery of nasal continuous positive airway pressure (CPAP) in premature infants. Methods. Thirty-two premature infants receiving nasal CPAP for apnea or mild respiratory distress were enrolled. Birth weight was (mean ± standard deviation) 1081 ± 316 g, gestational age 29 ± 2 weeks, age at study 13 ± 12 days, and fraction of inspired oxygen (Fio2) at study .29 ± .1. Three devices, applied in random order, were studied in each infant: continuous flow nasal CPAP via CPAP prongs, continuous flow nasal CPAP via modified nasal cannula, and variable flow nasal CPAP. After lung recruitment to standardize volume history, changes in lung volume (ΔVL) were assessed at nasal CPAP of 8, 6, 4, and 0 cm H2O using calibrated direct current-coupled respiratory inductance plethysmography. Results. ΔVL was significantly greater overall with the variable flow device compared with both the nasal cannula and CPAP prongs. However, ΔVL was not different between the cannula and the prongs. Respiratory rate, tidal volume, thoraco-abdominal asynchrony, and Fio2 were greater with the modified cannula than for either of the other 2 devices. Conclusion. Compared with 2 continuous flow devices, the variable flow nasal CPAP device leads to greater lung recruitment. Although a nasal cannula is able to recruit lung volume, it does so at the cost of increased respiratory effort and Fio2.
    Materialart: Online-Ressource
    ISSN: 1098-4275 , 0031-4005
    URL: Article
    DOI: 10.1542/peds.107.2.304
    Sprache: Englisch
    Verlag: American Academy of Pediatrics (AAP)
    Publikationsdatum: 2001
    ZDB Id: 1477004-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
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    Sickle cell disorders in females: Screening of sickle hemoglobinopathy be part of Antenatal and Intensive care?
    Medknow ; 2016
    In:  Journal of Integrated Health Sciences Vol. 4, No. 2 ( 2016), p. 31-
    Details
    In: Journal of Integrated Health Sciences, Medknow, Vol. 4, No. 2 ( 2016), p. 31-
    Materialart: Online-Ressource
    ISSN: 2347-6486
    URL: Article
    DOI: 10.4103/2347-6486.240199
    Sprache: Englisch
    Verlag: Medknow
    Publikationsdatum: 2016
    ZDB Id: 3038453-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
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    Secular changes in the outcomes to eighteen to twenty-four months of age of extremely low birth weight infants, with adjustment for changes in risk factors and severity of illness
    Elsevier BV ; 1995
    In:  The Journal of Pediatrics Vol. 126, No. 1 ( 1995-1), p. 75-87
    Details
    In: The Journal of Pediatrics, Elsevier BV, Vol. 126, No. 1 ( 1995-1), p. 75-87
    Materialart: Online-Ressource
    ISSN: 0022-3476
    URL: Article
    DOI: 10.1016/S0022-3476(95)70507-4
    Sprache: Englisch
    Verlag: Elsevier BV
    Publikationsdatum: 1995
    ZDB Id: 2005245-5
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
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    Study Protocol: IMPETUS: Implementing a uniform stroke care pathway in medical colleges of India: IMPETUS Stroke
    Medknow ; 2022
    In:  Annals of Indian Academy of Neurology Vol. 25, No. 4 ( 2022), p. 640-
    Details
    In: Annals of Indian Academy of Neurology, Medknow, Vol. 25, No. 4 ( 2022), p. 640-
    Materialart: Online-Ressource
    ISSN: 0972-2327
    URL: Article
    DOI: 10.4103/aian.aian_1033_21
    Sprache: Englisch
    Verlag: Medknow
    Publikationsdatum: 2022
    ZDB Id: 2240174-X
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
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    Surfactant Replacement in Neonates With Early Chronic Lung Disease
    American Academy of Pediatrics (AAP) ; 1995
    In:  Pediatrics Vol. 95, No. 6 ( 1995-06-01), p. 851-854
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 95, No. 6 ( 1995-06-01), p. 851-854
    Kurzfassung: Objective. To study the effect of a single dose of exogenous bovine surfactant on oxygen and ventilatory requirements of neonates with early chronic lung disease. Study design. Prospective pilot study. Setting. Three regional neonatal intensive care units. Methods. Infants 7 to 30 days old with birth weights less than 1500 g were eligible if they required a fraction of inspired oxygen (FIO2) of more than 0.4, had stable ventilatory requirements for 24 hours before study entry, and showed diffuse haziness on chest radiographs. Those with patent ductus arteriosus or active infection or those receiving steroid therapy were excluded. After treatment with the surfactant, differences in FIO2 and the ventilator efficiency index were analyzed using the Wilcoxon signed rank test. Results. Ten patients were recruited. Median values (range): birth weight, 693 g (530 to 1100 g); gestation, 25 weeks (24 to 27 weeks); and postnatal age at study entry, 13 days (9 to 30 days). The FIO2 decreased significantly between 0 and 1 hour after surfactant administration, from a median (range) of 0.67 (0.47 to 0.88) to 0.39 (0.28 to 0.63). This effect was sustained for 24 hours (median FIO2, 0.36). Although the FIO2 subsequently increased to 0.49 (range, 0.35 to 0.88) at 72 hours, it was significantly lower than that entry before the study. There was a trend toward an increase in the ventilator efficiency index at 24 and 48 hours. Conclusions. A single dose of surfactant is effective in reducing oxygen requirements in neonates with early chronic lung disease. Surfactant replacement may be useful adjunctive therapy in these neonates.
    Materialart: Online-Ressource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.95.6.851
    Sprache: Englisch
    Verlag: American Academy of Pediatrics (AAP)
    Publikationsdatum: 1995
    ZDB Id: 1477004-0
    Standort Signatur Einschränkungen Verfügbarkeit
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