Cough as a Risk Factor for Neonatal Intraventricular Hemorrhage

PEDIATRICS ◽  
1990 ◽  
Vol 85 (1) ◽  
pp. 138-138
Author(s):  
JEFFREY PERLMAN
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Arterial Blood Pressure ◽  
Intraventricular Hemorrhage ◽  
Temporal Relationship ◽  
Ventilator Support ◽  
Beneficial Effects ◽  
Arterial Blood ◽  
Close Temporal Relationship

In Reply.— The purpose of the study cited by Dr Argent et al was to elucidate potential mechanisms for the fluctuations in arterial blood pressure observed previously. We agree with the authors that the cough-like Valsalva maneuvers contribute significantly to the circulatory variablility. The data also indicate the close temporal relationship between apneic pauses and stable blood pressure. We support the statement of the authors that ventilator support should be optimized before paralysis. Moreover, other "less noxious" interventions, such as sedation, might have similar beneficial effects regarding stabilization of blood pressure.

Cerebroelectrical Depression Following Surfactant Treatment in Preterm Neonates

PEDIATRICS ◽  
1992 ◽  
Vol 89 (4) ◽  
pp. 643-647 ◽  
Author(s):  
Lena Hellström-Westas ◽  
Nils W. Svenningsen ◽  
Angela H. Bell ◽  
Liselotte Skov ◽  
Gorm Greisen
Keyword(s):  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
Mean Arterial Blood Pressure ◽  
Intraventricular Hemorrhage ◽  
Preterm Neonates ◽  
Cerebral Function ◽  
Surfactant Treatment ◽  
Arterial Blood ◽  
Cerebral Dysfunction ◽  
Almost All

During surfactant treatment of respiratory distress syndrome, 23 premature newborns were investigated with continuous amplitude-integrated electroencephalography (cerebral function monitors). Simultaneously, arterial blood pressure and transcutaneous blood gas values were recorded. A short(<10 minutes) but significant decrease in cerebral activity was seen in almost all neonates immediately after the surfactant instillation, in spite of an improved pulmonary function. In 21 of 23 neonates, a transient fall in mean arterial blood pressure of 9.3 mm Hg (mean) occurred coincidently with the cerebral reaction. Neonates in whom intraventricular hemorrhage developed tended to have lower presurfactant mean arterial blood pressure (P> .05), but they had a significantly lower mean arterial blood pressure after surfactant instillation (P < .05). No other differences were found between neonates in whom intraventricular hemorrhage developed and those without intraventricular hemorrhage. The present findings demonstrate that an acute cerebral dysfunction may occur after surfactant instillation. In some vulnerable neonates with arterial hypotension and severe pulmonary immaturity,the fall in mean arterial blood pressure may increase the risk of cerebral complications and could be related to an unchanged rate of intraventricular hemorrhage after surfactant treatment.

Effect of Pneumothorax-lnduced Systemic Blood Pressure Alterations on the Cerebral Circulation in Newborn Dogs

PEDIATRICS ◽  
1984 ◽  
Vol 74 (3) ◽  
pp. 350-353
Author(s):  
Daniel G. Batton ◽  
Jonathan Hellmann ◽  
Elizabeth E. Nardis
Keyword(s):  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
Premature Infants ◽  
Mean Arterial Blood Pressure ◽  
Cerebral Circulation ◽  
Intraventricular Hemorrhage ◽  
Blood Velocity ◽  
Arterial Blood ◽  
Cerebral Blood Velocity ◽  
Rapid Evacuation

Pneumothorax has been associated with intraventricular hemorrhage in premature infants, although the mechanism for this relationship is not clear. Because alterations in cerebral blood flow are believed to be important in the pathogenesis of intraventricular hemorrhage, the effect of induced pneumothorax and subsequent evacuation on the cerebral circulation in 16 newborn dogs was evaluated. Continuous Doppler ultrasound was used to monitor changes in cerebral blood velocity. Pneumothorax was induced by slow infusion (5 cc/kg/min) or rapid infusion (5 to 10 seconds) of air to reduce mean arterial blood pressure to half of base-line levels. Both methods of pneumothorax induction resulted in significant elevations of central venous pressure and intrapleural pressure, whereas mean arterial blood pressure and cerebral blood velocity decreased significantly. In each group, the pneumothorax was evacuated either by slow withdrawal of air (10 cc/kg/min) or as rapidly as possible. Rapid evacuation of air resulted in an immediate increase in mean arterial blood pressure and cerebral blood velocity to supranormal levels. Slow evacuation led to a more gradual normalization of mean arterial blood pressure and cerebral blood velocity. It is suggested that the precipitous increases in mean arterial blood pressure and cerebral blood velocity following rapid evacuation of a tension pneumothorax may account for the observed association between pneumothorax and intraventricular hemorrhage in premature infants.

Practical aspects of blood pressure management

1991 ◽  
Vol 29 (14) ◽  
pp. 53-55
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Arterial Blood Pressure ◽  
Reduce Blood Pressure ◽  
Important Risk Factor ◽  
Pressure Management ◽  
Blood Pressure Management ◽  
Arterial Blood

Raised arterial blood pressure is an important risk factor for cardiovascular disease. There is now a wide choice of drugs that reduce blood pressure. This article looks at ways of improving therapy and discusses some of the problems of the different drug groups.

Cough as a Risk Factor for Neonatal Intraventricular Hemorrhage

PEDIATRICS ◽  
1990 ◽  
Vol 85 (1) ◽  
pp. 138-138
Author(s):  
A. C. ARGENT ◽  
M. KLEIN ◽  
A. D. ROTHBERG
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Risk Factor ◽  
Cerebral Blood Flow ◽  
Respiratory Distress Syndrome ◽  
Intraventricular Hemorrhage ◽  
Distress Syndrome ◽  
Muscle Paralysis ◽  
Arterial Blood ◽  
Flow Fluctuations

To the Editor.— The recent study by Drs Perlman and Thach1 casts important light on an earlier work by Drs Perlman et al.2,3 Initially, Perlman et al2 showed that the risk of intraventricular hemorrhage in infants with the respiratory distress syndrome correlated with fluctuations in arterial blood pressure and cerebral blood flow. In their second study,3 they found the corollary: muscle paralysis eliminated the pressure and flow fluctuations and markedly reduced the risk of intraventricular hemorrhage.

Mean arterial blood pressure changes in premature infants and those at risk for intraventricular hemorrhage

1990 ◽  
Vol 117 (4) ◽  
pp. 607-614 ◽  
Author(s):  
Henrietta S. Bada ◽  
Sheldon B. Korones ◽  
Edward H. Perry ◽  
Kristopher L. Arheart ◽  
John D. Ray ◽  
...  
Keyword(s):  
Blood Pressure ◽  
At Risk ◽  
Arterial Blood Pressure ◽  
Premature Infants ◽  
Mean Arterial Blood Pressure ◽  
Intraventricular Hemorrhage ◽  
Arterial Blood ◽  
Pressure Changes

Increased Blood Pressure Following Pupillary Dilation with 2.5% Phenylephrine Hydrochloride in Preterm Infants

PEDIATRICS ◽  
1981 ◽  
Vol 68 (2) ◽  
pp. 231-234
Author(s):  
Bonnie J. Lees ◽  
Luis A. Cabal
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Birth Weight ◽  
Arterial Blood Pressure ◽  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Pupillary Dilation ◽  
Phenylephrine Hydrochloride ◽  
Arterial Blood ◽  
Pressure Changes

Heart rate and blood pressure changes following 0.5% tropicamide and 2.5% phenylephrine hydrochloride were evaluated in seven ill preterm infants (birth weight, 910 to 2,060 gm; gestational age, 26 to 36 weeks) during the first day of life. Each infant was monitored continuously for 30 minutes before and for 75 minutes after, instillation of the pupillary dilators. There were no significant changes in the heart rate, whereas a significant increase in systolic, diastolic, and mean arterial blood pressure was found. The increase in arterial blood pressure was detected at two minutes, peaked at eight minutes, and remained at significantly higher levels for 30 minutes after instillation. Because of the potential relationship between increased blood pressure and intraventricular hemorrhage, arterial blood pressure must be monitored during instillation of mydriatic drugs in the preterm infant.

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