PROPER LOCALIZATION OF UMBILICAL ARTERIAL AND VENOUS CATHETERS BY LATERAL ROENTGENOGRAMS

PEDIATRICS ◽  
1969 ◽  
Vol 43 (1) ◽  
pp. 34-39
Author(s):  
David H. Baker ◽  
Walter E. Berdon ◽  
L. Stanley James
Keyword(s):  
Portal Vein ◽  
Ductus Arteriosus ◽  
Pulmonary Arteries ◽  
Newborn Infants ◽  
Acid Base ◽  
Sick Newborn ◽  
Venous Catheterization ◽  
Lateral Film ◽  
Acid Base Status ◽  
Lateral Roentgenograms

Widespread use of umbilical arterial and venous catheters to monitor the acid-base status of sick newborn infants has made proper placement of such catheters mandatory. Clinical assessment of their placement is poor. Radiographic localization is simple with anteroposterior and most important lateral films of the chest and abdomen. The venous and arterial course is totally different since the vein ascends anteriorly, while the artery descends to join the pelvic arteries before a posterior ascent into the aorta. The lateral film is optimal to identify inadvertent venous catheterization of a mesenteric vein or a wedged portal vein site. The lateral arterial view allows correction should the catheter slip into the ductus arteriosus and pulmonary arteries. The arterial catheter placement is felt to be best situated either in the chest below the ductus or in the abdomen below the major arteries to avoid either irritation of their ostia or injection of highly alkaline agents into the kidneys or intestines.

scholarly journals 991 CAPILLARY VENOUS HEMATOCRIT DIFFERENCE IN NEWBORN INFANTS: RELATION TO BLOOD VOLUME, PERIPHERAL BLOOD FLOW, AND ACID BASE STATUS

1978 ◽  
Vol 12 ◽  
pp. 529-529
Author(s):  
Otwin Linderkamp ◽  
Hans T Versmold ◽  
Irmela Strohhacker ◽  
Karin Messow-Zahn ◽  
Klaus P Riegel ◽  
...  
Keyword(s):  
Blood Flow ◽  
Blood Volume ◽  
Peripheral Blood ◽  
Newborn Infants ◽  
Peripheral Blood Flow ◽  
Acid Base ◽  
Acid Base Status

Severe pulmonary hypertension and arterial adventitial changes in newborn calves at 4,300 m

1987 ◽  
Vol 62 (2) ◽  
pp. 821-830 ◽  
Author(s):  
K. R. Stenmark ◽  
J. Fasules ◽  
D. M. Hyde ◽  
N. F. Voelkel ◽  
J. Henson ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Cellular Proliferation ◽  
Rapid Development ◽  
Ductus Arteriosus ◽  
Pulmonary Arteries ◽  
Newborn Infants ◽  
Severe Pulmonary Hypertension ◽  
Luminal Diameter ◽  
Pulmonary Arterial ◽  
Newborn Calves

Some human newborns have a syndrome characterized by irreversible pulmonary hypertension and severe hypoxemia and by medial hypertrophy and adventitial thickening of pulmonary arteries. We considered that newborn calves made severely hypoxic might reproduce features of the human disease. When 2-day-old calves were placed at 4,300 m simulated altitude, pulmonary arterial pressure was increased and could be reversed by 100% O2. However, after 2 wk at 4,300 m, pulmonary arterial pressures were suprasystemic and there was right-to-left shunting probably through the foramen ovale and a patent but restrictive ductus arteriosus. Suprasystemic pulmonary pressure and hypoxemia persisted with 100% O2 breathing. Morphometrical examination of the lung arteries showed a markedly thickened adventitia with cellular proliferation and collagen and elastin deposition. There was increased medial thickness and distal muscularization of the pulmonary arteries associated with decreased luminal diameter. The rapid development of severe pulmonary hypertension and poor responsiveness to O2 was associated with increased arterial wall thickness, particularly involving the adventitia. Thus the pulmonary arterial circulation in these calves, which were placed at high altitude for 2 wk, exhibited features resembling persistent pulmonary hypertension in newborn infants.

THE EFFECT OF HYPOXIA AND STATUS OF DUCTUS ARTERIOSUS ON ACID BASE BALNCE IN NEWBORN INFANTS

1965 ◽  
Vol 20 (4) ◽  
pp. 590-592
Author(s):  
Arthur J. Moss ◽  
George C. Emmanouilides ◽  
Forrest H. Adams ◽  
Katok Chuang
Keyword(s):  
Ductus Arteriosus ◽  
Newborn Infants ◽  
Acid Base

The Change of Fibrin Split Products and Plasmin-Inhibitor in the Newborn Infant

1975 ◽  
Author(s):  
Shigenori Suzuki
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Newborn Infants ◽  
Acid Base ◽  
Newborn Period ◽  
Coagulation Abnormalities ◽  
Acid Base Status ◽  
Plasmin Inhibitor

It is very important for an newborn to keep a certain balance of its bloodcoagulation and fibrinolytic system in order to maintain extrauterine life.We have tried a follow up of coagulation abnormalities, fibrin split products and plasmininhibitors in severe asphyxia and respiratory distress syndrome. An other factor which is very dangerous for the fetus is acidosis.The following results were obtained from 102 newborns:1. A great number of FDP positive cases occurs in newborn who died from IRDS (80 μg/ml— 160μg/ml).2. The plasminogen levels of cases who died from IRDS and severe asphyxia are lower than that of normal newborn infants.3. α1-antitrypsin and antithrombin levels are relatively lower in the newborn period while the value of α1-macroglobulin maintains a normal level.4. Correlation was seen between the coagulation abnormalities and acid base status (below actual pH 7.1).The results shows the possibility that DIC is of great importants to RDS and FDP and are associated with hemorrhage and thrombosis.

Unsuspected Pulmonary Vascular Abnormalities Associated With Diaphragmatic Hernia

PEDIATRICS ◽  
1976 ◽  
Vol 58 (6) ◽  
pp. 902-906
Author(s):  
Richard L. Naeye ◽  
Stephen J. Shochat ◽  
Victor Whitman ◽  
M. Jeffrey Maisels
Keyword(s):  
Ductus Arteriosus ◽  
Pulmonary Arteries ◽  
Newborn Infants ◽  
Blood Gases ◽  
Pulmonary Vasculature ◽  
Vascular Abnormalities ◽  
Mediastinal Shift ◽  
Lung Expansion ◽  
Ventilatory Insufficiency ◽  
Diaphragmatic Hernias

The pulmonary vasculature of 12 newborn infants who died with unilateral diaphragmatic hernias was studied. Four developed severe ventilatory insufficiency after birth and promptly died. Their lungs were both hypoplastic and airless due to compression by displaced abdominal viscera and mediastinal shift. Corrective surgery permitted lung expansion and adequate ventilation for one to two hours in five infants. Subsequently, ventilatory insufficiency supervened and they died. Postoperative blood gases revealed a right-to-left ductus arteriosus shunt in one infant. Ten of the infants with hernias had a significantly greater mass of muscle in pulmonary arteries than did matched controls. This may partially explain the fetal-type circulatory pattern with right-to-left shunting which occurs in these infants.

The effect of hypoxia and status of ductus arteriosus on acid-base balance in newborn infants

1964 ◽  
Vol 65 (6) ◽  
pp. 819-823 ◽  
Author(s):  
Arthur J. Moss ◽  
George C. Emmanouilides ◽  
Forrest H. Adams ◽  
Katok Chuang
Keyword(s):  
Ductus Arteriosus ◽  
Newborn Infants ◽  
Acid Base Balance ◽  
Acid Base ◽  
Base Balance

Bovine Surfactant (Surfactant TA) Therapy in Immature Baboons with Hyaline Membrane Disease

PEDIATRICS ◽  
1985 ◽  
Vol 75 (6) ◽  
pp. 1132-1142 ◽  
Author(s):  
D. Vidyasagar ◽  
H. Maeta ◽  
T. N.K. Raju ◽  
E. John ◽  
R. Bhat ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Hyaline Membrane Disease ◽  
Treated Group ◽  
Blood Gas ◽  
Acid Base ◽  
Hyaline Membrane ◽  
Acid Base Status ◽  
Arterial Po2 ◽  
Patent Ductus

As a prelude to clinical trials with a bovine surfactant (surfactant TA), in human infants with hyaline membrane disease, pulmonary and hemodynamic changes following its instillation in premature baboons were investigated. Baboons, delivered by cesarean section at 141 ± 3.5 days (mean ± SD, 77% gestation), were provided with intensive care. At 2 hours of age in one group (n = 10), 100 mg/kg of surfactant TA (reconstituted bovine surfactant, Tokyo Tanabe Co., Tokyo) was instilled into the lungs. Sequential measurements and monitoring of pulmonary and hemodynamic variables were carried out in these ten baboons and in a control group of five baboons for 16 hours, at which time the experiments were electively terminated. At birth, the pulmonary compliance, findings of chest radiographs, ratio of arterial Po2 to alveolar Po2, and respirator variables needed to maintain normal blood gas and acid base status were identical in both groups and indicative of severe hyaline membrane disease. Following surfactant instillation, the treated group demonstrated a rapid increase in Po2 with significantly improved ratio of arterial Po2 to alveolar Po2 (from a mean ± SD pretreatment value of 0.21 ± 0.11 to 0.45 ± 0.11 by 16 hours). Pulmonary compliance improved similarly (from pretreatment value of 0.18 ± 0.06 mL/cm H2O/kg to 0.27 ± 0.09 mL/cm H2O/kg). Significant reduction in respirator support variables could be achieved in all treated animals; however, in the control animals, the pulmonary status worsened as evidenced by increasing mean airway pressure and respirator variables to keep normal blood gas and acid base status, thus worsening compliance. At autopsy, pulmonary pressure-volume curves were significantly different with large hysteresis obtained in the surfactant-treated group. Although no deleterious effect on hemodynamics was noted in surfactant TA-treated animals, a large patent ductus arteriosus was demonstrated by aortography. Increased lung blood flow, probably due to a large patent ductus arteriosus flow, was demonstrated by radiolabeled microsphere technique. The physiologic significance and clinical relevance of these findings in premature baboons treated with surfactant TA are discussed.

Immunologic Studies of Antithrombin III Heparin Cofactor in the Newborn

1978 ◽  
Vol 39 (03) ◽  
pp. 624-630 ◽  
Author(s):  
W E Hathaway ◽  
L L Neumann ◽  
C A Borden ◽  
L J Jacobson
Keyword(s):  
Gestational Age ◽  
Antithrombin Iii ◽  
Newborn Infants ◽  
Term Infant ◽  
Sick Newborn ◽  
At Iii ◽  
Thrombotic Complications ◽  
Low Levels ◽  
Collection Methods ◽  
Made In

SummarySerial quantitative immunoelectrophoretic (IE) measurements of antithrombin III heparin cofactor (AT III) were made in groups of well and sick newborn infants classified by gestational age. Collection methods (venous vs. capillary) did not influence the results; serum IE measurements were comparable to AT III activity by a clotting method. AT III is gestational age-dependent, increasing from 28.7% of normal adult values at 28-32 weeks to 50.9% at 37-40 weeks, and shows a gradual increase to term infant levels (57.4%) by 3-4 weeks of age. Infants with the respiratory distress syndrome (RDS) show lower levels of AT III in the 33-36 week group, 22% vs. 44% and in the 37-40 week group, 33.6% vs. 50.9%, than prematures without RDS. Infants of 28-32 week gestational age had only slight differences, RDS = 24%, non-RDS = 28.7%. The lowest levels of AT III were seen in patients with RDS complicated by disseminated intravascular coagulation and those with necrotizing enterocolitis. Crossed IE on representative infants displayed a consistent pattern which was identical to adult controls except for appropriate decreases in the amplitude of the peaks. The thrombotic complications seen in the sick preterm infant may be related to the low levels of AT III.

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