UMBILICAL VESSEL ANGIOCARDIOGRAPHY IN THE NEWBORN INFANT

PEDIATRICS ◽  
1963 ◽  
Vol 31 (6) ◽  
pp. 946-951
Author(s):  
Samuel O. Sapin ◽  
Leonard M. Linde ◽  
George C. Emmanouilides

Angiocardiography from an umbilical vessel approach was performed in 10 critically sick newborn infants. The umbilical vein route was successfully employed up to the eighth day of life, while the umbilical artery was safely used as late as age 5 days. This approach has advantages over other methods of catheterization and angiocardiography. Angiocardiographic quality was satisfactory for accurate interpretation.

2020 ◽  
Author(s):  
Sumeda Nandadasa ◽  
Jason M. Szafron ◽  
Vai Pathak ◽  
Sae-Il Murtada ◽  
Caroline M. Kraft ◽  
...  

AbstractThe umbilical artery lumen occludes rapidly at birth, preventing blood loss, whereas the umbilical vein remains patent, providing the newborn with a placental infusion. Here, we identify differential arterial-venous proteoglycan dynamics as a determinant of these contrasting vascular responses. We show that the umbilical artery, unlike the vein, has an inner layer enriched in the hydrated proteoglycan aggrecan, external to which lie contraction-primed smooth muscle cells (SMC). At birth, SMC contraction drives inner layer buckling and centripetal displacement to occlude the arterial lumen, a mechanism elicited by biomechanical and computational analysis. Vascular dimorphism arises from spatially regulated proteoglycan expression and breakdown in umbilical vessels. Mice lacking aggrecan or the metalloprotease ADAMTS1, which degrades proteoglycans, demonstrated their opposing roles in umbilical cord arterial-venous dimorphism and contrasting effects on SMC differentiation. Umbilical vessel dimorphism is conserved in mammals, suggesting that their differential proteoglycan dynamics were a positive selection step in mammalian evolution.


2018 ◽  
Vol 41 (7) ◽  
pp. 393-399 ◽  
Author(s):  
Jenny Peng ◽  
Niels Rochow ◽  
Mohammadhossein Dabaghi ◽  
Radenka Bozanovic ◽  
Jan Jansen ◽  
...  

Introduction: A lung assist device, which acts as an artificial placenta, can provide additional gas exchange for preterm and term newborns with respiratory failure. The concept of the lung assist device requires a large bore access via umbilical vessels to allow pumpless extracorporeal blood flow rates up to 30 mL/kg/min. After birth, constricted umbilical vessels need to be reopened for vascular access. The objective is to study the impact of umbilical vessel expansion on vessel integrity for achieving large bore access. Methods: Umbilical cords from healthy term deliveries were cannulated and dilatated with percutaneous transluminal angioplasty catheters in 1 mm increments from 4 to 8 mm for umbilical artery and from 4 to 15 mm for umbilical vein, n = 6 per expansion diameter. Paraffin-embedded transverse sections of dilated and control samples were HE & Van Gieson stained. Effects of dilatation, shown by splitting, were measured. Results: Umbilical vessel expansion led to concentric splitting, shown by areas devoid of extracellular matrix and nuclei in the tunica intima and media. No radial splitting was observed. Results suggest an expansion threshold of umbilical artery at 6 mm and umbilical vein at 7 mm, while maximal splitting was observed above this threshold (3.6 ± 0.8%, p = 0.043 for umbilical artery 7 mm and 6.3 ± 1.8%, p = 0.048 for umbilical vein 8 mm). Endothelial cell sloughing was present in all dilated samples but not in the control samples. Conclusion: The suggested thresholds for safe expansions are similar to in utero umbilical vessel diameters and demonstrate a proof of concept for attaining large bore access for the lung assist device.


PEDIATRICS ◽  
1950 ◽  
Vol 6 (2) ◽  
pp. 254-261
Author(s):  
LAWRENCE B. SLOBODY ◽  
GEORGE D. ROOK ◽  
MORRISON LEVBARG ◽  
MADELAINE MORCY

The circulation time with fluorescein has been determined in 90 normal newborn infants immediately after birth. The umbilical vein-to-lip time was determined in 45 newborn infants. The mean circulation time was 4.8 ± 0.7 sec. with a range of 3.1 to 7.0 sec. The ductus venosus-to-lip time was determined in 45 newborn infants. The mean circulation time was 4.4 ± 0.6 sec. with a range of 3.3 to 5.8 sec. Polyethylene tubing 0.047 internal diameter and 5% fluorescein 0.1 ml. in 5% sodium bicarbonate solution are recommended for the determination of circulation time in the newborn infant immediately after birth. This determination is simple and accurate and may aid in the differential diagnosis of cyanosis of the newborn infant.


eLife ◽  
2020 ◽  
Vol 9 ◽  
Author(s):  
Sumeda Nandadasa ◽  
Jason M Szafron ◽  
Vai Pathak ◽  
Sae-Il Murtada ◽  
Caroline M Kraft ◽  
...  

The umbilical artery lumen closes rapidly at birth, preventing neonatal blood loss, whereas the umbilical vein remains patent longer. Here, analysis of umbilical cords from humans and other mammals identified differential arterial-venous proteoglycan dynamics as a determinant of these contrasting vascular responses. The umbilical artery, but not the vein, has an inner layer enriched in the hydrated proteoglycan aggrecan, external to which lie contraction-primed smooth muscle cells (SMC). At birth, SMC contraction drives inner layer buckling and centripetal displacement to occlude the arterial lumen, a mechanism revealed by biomechanical observations and confirmed by computational analyses. This vascular dimorphism arises from spatially regulated proteoglycan expression and breakdown. Mice lacking aggrecan or the metalloprotease ADAMTS1, which degrades proteoglycans, demonstrate their opposing roles in umbilical vascular dimorphism, including effects on SMC differentiation. Umbilical vessel dimorphism is conserved in mammals, suggesting that differential proteoglycan dynamics and inner layer buckling were positively selected during evolution.


PEDIATRICS ◽  
1975 ◽  
Vol 56 (3) ◽  
pp. 374-379
Author(s):  
Boyd W. Goetzman ◽  
Robert C. Stadalnik ◽  
Hugo G. Bogren ◽  
Willard J. Blankenship ◽  
Richard M. Ikeda ◽  
...  

Catheterization of the aorta via the umbilical artery provides a convenient route for monitoring arterial blood pressure, for obtaining blood specimens for measurement of blood gas tensions and chemistries, and for the infusion of fluids and pharmacologic preparations in sick newborn infants. Use of this technique may be accompanied by a number of complications of which thrombotic phenomena are the most common. Twenty-three of 98 (24%) newborn infants undergoing umbilical artery catheterization were found to have thrombotic complications determined by aortography. No correlation was present between the duration of time that the umbilical artery catheters were in place and the occurrence of thrombotic complications. From paired aortographic or aortographic and autopsy studies in 24 patients, it was concluded that if a thrombotic complication did not occur early, none was likely to occur subsequently. One patient was considered to have died as a direct result of a thrombotic complication. Aortography is a safe, simple, and reliable technique for the early detection of thrombotic complications of umbilical artery catheters. Umbilical artery catheterization is not without risk and careful selection of patients for this procedure is indicated.


PEDIATRICS ◽  
1972 ◽  
Vol 49 (3) ◽  
pp. 470-471
Author(s):  
William F. Powers ◽  
William H. Tooley

In his recent editorial, Dr. Cook1 mentions bacterial contamination as one of the complications of umbilical artery catheterization, and refers to a report by Krauss, et al.2 who grew bacteria from 6 of 11 (55%) umbilical artery catheters. Balagtas, et al.3 have also published similar findings with umbilical vein catheters, 52% of which had bacterial colonization on removal. These reports stress the significant risk of generalized infection with umbilical vessel catheters. On the other hand, Casalino and Lipsitz4 report a 5% incidence of bacterial contamination.


Blood ◽  
1990 ◽  
Vol 75 (12) ◽  
pp. 2417-2426 ◽  
Author(s):  
L Fina ◽  
HV Molgaard ◽  
D Robertson ◽  
NJ Bradley ◽  
P Monaghan ◽  
...  

Abstract All seven of a set of CD34 monoclonal antibodies that recognize epitopes on an approximately 110 Kd glycoprotein on human hemopoietic progenitor cells also bind to vascular endothelium. Capillaries of most tissues are CD34 positive, as are umbilical artery and, to a lesser extent, vein, but the endothelium of most large vessels and the endothelium of placental sinuses are not. Angioblastoma cells and parafollicular mesenchymal cells in fetal skin are also CD34 positive, as are some stromal elements. An approximately 110 Kd protein can be identified by Western blot analysis with CD34 antibodies in detergent extracts of freshly isolated umbilical vessel endothelial cells, and CD34 mRNA is present in cultured umbilical vein cells as well as other tissues rich in vascular endothelium (breast, placenta). These data indicate that the binding of CD34 antibodies to vascular endothelium is to the CD34 gene product, and not to crossreactive epitopes. Despite the presence of CD34 mRNA in cultured, proliferating endothelial cells, the latter do not bind CD34 antibodies. In addition, CD34 antigen cannot be upregulated by growth factors. We conclude that under these conditions, CD34 protein is downregulated or processed into another form that is unreactive with CD34 antibodies. Electron microscopy of umbilical artery, breast, and kidney capillary vessels reveals that in all three sites, CD34 molecules are concentrated on membrane processes, many of which interdigitate between adjacent endothelial cells. However, well-established endothelial cell contacts with tight junctions are CD34 negative. CD34 may function as an adhesion molecule on both endothelial cells and hematopoietic progenitors.


Blood ◽  
1990 ◽  
Vol 75 (12) ◽  
pp. 2417-2426 ◽  
Author(s):  
L Fina ◽  
HV Molgaard ◽  
D Robertson ◽  
NJ Bradley ◽  
P Monaghan ◽  
...  

All seven of a set of CD34 monoclonal antibodies that recognize epitopes on an approximately 110 Kd glycoprotein on human hemopoietic progenitor cells also bind to vascular endothelium. Capillaries of most tissues are CD34 positive, as are umbilical artery and, to a lesser extent, vein, but the endothelium of most large vessels and the endothelium of placental sinuses are not. Angioblastoma cells and parafollicular mesenchymal cells in fetal skin are also CD34 positive, as are some stromal elements. An approximately 110 Kd protein can be identified by Western blot analysis with CD34 antibodies in detergent extracts of freshly isolated umbilical vessel endothelial cells, and CD34 mRNA is present in cultured umbilical vein cells as well as other tissues rich in vascular endothelium (breast, placenta). These data indicate that the binding of CD34 antibodies to vascular endothelium is to the CD34 gene product, and not to crossreactive epitopes. Despite the presence of CD34 mRNA in cultured, proliferating endothelial cells, the latter do not bind CD34 antibodies. In addition, CD34 antigen cannot be upregulated by growth factors. We conclude that under these conditions, CD34 protein is downregulated or processed into another form that is unreactive with CD34 antibodies. Electron microscopy of umbilical artery, breast, and kidney capillary vessels reveals that in all three sites, CD34 molecules are concentrated on membrane processes, many of which interdigitate between adjacent endothelial cells. However, well-established endothelial cell contacts with tight junctions are CD34 negative. CD34 may function as an adhesion molecule on both endothelial cells and hematopoietic progenitors.


PEDIATRICS ◽  
1960 ◽  
Vol 26 (4) ◽  
pp. 657-660
Author(s):  
Philip J. Lipsitz ◽  
JoAnn M. Cornet

A study was done to investigate the routine use of blood obtained from the umbilical vein for blood cultures in newborn infants. It was found that 45% of such samples will be contaminated with the same organisms as are found on the umbilical stump. The pathogenesis of the bacteremia indicated by positive cultures from samples of blood obtained from the umbilical vein is discussed. Positive cultures from the blood samples obtained at the start of exchange transfusions do not necessarily indicate either bacteremia or septicemia.


Sign in / Sign up

Export Citation Format

Share Document