Blood Pressure Increases, Birth Weight-Dependent Stability Boundary, and Intraventricular Hemorrhage

PEDIATRICS ◽  
1990 ◽  
Vol 85 (5) ◽  
pp. 727-732
Author(s):  
Edward H. Perry ◽  
Henrietta S. Bada ◽  
John D. Ray ◽  
Sheldon B. Korones ◽  
Kris Arheart ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intensive Care ◽  
Birth Weight ◽  
Intraventricular Hemorrhage ◽  
Stability Boundary ◽  
Stable Region ◽  
Low Birth Weight Infant ◽  
Motor Activities ◽  
The Stability ◽  
Transcutaneous Po2

The blood pressure (BP) and transcutaneous Po2, (TcPo2) changes associated with intensive care procedures were evaluated to determine whether responses differ between babies with and without periventricular-intraventricular hemorrhage (PV-IVH). Fifty-three inborn babies ≤1500 g were studied using a microcomputer-based monitoring system. With almost any procedure including a seemingly benign one such as a diaper change, peak systolic BP increased and TcPo2 decreased. However, responses to interventions did not differ between babies with PV-IVH and those without PV-IVH. Neither did these responses differ between those with birth weight ≤1000 g and >1000 g. When each baby's record was scanned for the highest peak systolic BP before diagnosis of PV-IVH or within 48 hours in those with no PV-IVH and their BP points plotted against birth weight, a stable region was evident wherein PV-IVH occurred at a lower incidence (13%). When peak systolic BP was beyond this stable region, the incidence of PV-IVH was significantly higher, 70% (P < .0001). The stability boundary for the maximum systolic BP is birth weight-dependent; the limit for the highest tolerable peak systolic BP is lower for the low-birth-weight infant. In over 70% of instances the highest peak systolic BP was associated with motor activities either induced by nursery procedures or spontaneous. We speculate that decreasing the frequency of intensive care interventions may decrease episodic BP increases to levels beyond the birth weight-dependent stability boundary where PV-IVH is likely to occur.

Blood Pressure and Intraventricular Hemorrhage in Premature Infants

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 1006-1007
Author(s):  
EDWARD H. PERRY ◽  
HENRIETTA S. BADA ◽  
JOHN D. DAY ◽  
SHELDON B. KORONES ◽  
KRISTOPHER L. ARHEART ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Birth Weight ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Stability Boundary ◽  
Mean Blood Pressure ◽  
Pressure Increase ◽  
Blood Pressure Increase ◽  
The Mean

In Reply.— We appreciate the interest and comments of Drs Puccio and Soliani regarding our article "Blood Pressure Increase, Birth Weight Dependent Stability Boundary and Intraventricular Hemorrhage."1 In response, we address the following points: 1. Although mean blood pressure (BP) values greater than 100 mm Hg were observed in some of our patients, these were quite rare. The mean BP was found to be less than 60 mm Hg 99% of the time. Thus, unless one is recording BPs through long periods and sampling quite often, the brief spikes likely would not be observed.

Holding the Very Low Birth Weight Infant: Skin-to-Skin Techniques

2005 ◽  
Vol 24 (1) ◽  
pp. 7-14 ◽  
Author(s):  
Theresa Kledzik
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Intensive Care Units ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Neonatal Intensive Care Units ◽  
Low Birth Weight Infant ◽  
Skin To Skin

Skin-to-skin holding has been reported as a valuable intervention for preterm infants for over a decade. However, many neonatal intensive care units are not practicing this therapy and cite lack of protocols and techniques as a barrier. This article describes in detail the nursing considerations and techniques involved to successfully implement skin-to-skin holding for very low birth weight, technology-dependent infants. NICU protocols can be derived from this article.

Mathematical Analysis of Stability of a Spinning Disk Under Rotating, Arbitrarily Large Damping Forces

1996 ◽  
Vol 118 (4) ◽  
pp. 657-662 ◽  
Author(s):  
F. Y. Huang ◽  
C. D. Mote
Keyword(s):  
Periodic Solution ◽  
Parameter Space ◽  
Perturbation Technique ◽  
Stability Boundary ◽  
Rotating Disk ◽  
Stable Region ◽  
Damping Force ◽  
Analysis Of Stability ◽  
The Stability ◽  
Nontrivial Periodic Solution

Stability of a rotating disk under rotating, arbitrarily large damping forces is investigated analytically. Points possibly residing on the stability boundary are located exactly in parameter space based on the criterion that at least one nontrivial periodic solution is necessary at every boundary point. A perturbation technique and the Galerkin method are used to predict whether these points of periodic solution reside on the stability boundary, and to identify the stable region in parameter space. A nontrivial periodic solution is shown to exist only when the damping does not generate forces with respect to that solution. Instability occurs when the wave speed of a mode in the uncoupled disk, when observed on the disk, is exceeded by the rotation speed of the damping force relative to the disk. The instability is independent of the magnitude of the force and the type of positive-definite damping operator in the applied region. For a single dashpot, nontrivial periodic solutions exist at the points where the uncoupled disk has repeated eigenfrequencies on a frame rotating with the dashpot and the dashpot neither damps nor energizes these modes substantially around these points.

INTENSIVE CARE AND THE VERY-LOW-BIRTH-WEIGHT INFANT

The Lancet ◽  
1979 ◽  
Vol 314 (8136) ◽  
pp. 254-255 ◽  
Author(s):  
E.O.R. Reynolds ◽  
AnnL. Stewart ◽  
T.H. Hughes-Davies ◽  
P.M. Dunn ◽  
B.D. Speidel ◽  
...  
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infant

Cardiovascular and Catecholamine Changes After Administration of Pancuronium in Distressed Neonates

PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 284-287
Author(s):  
Luis A. Cabal ◽  
Bijan Siassi ◽  
Raul Artal ◽  
Felipe Gonzalez ◽  
Joan Hodgman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Birth Weight ◽  
Intravenous Injection ◽  
Gestational Age ◽  
Sympathetic Activity ◽  
Intraventricular Hemorrhage ◽  
Myocardial Dysfunction ◽  
Newborn Infants ◽  
Blood Pressures

Heart rate, blood pressure, transcutaneous gases, and catecholamine changes following intravenous injection of pancuronium were evaluated in seven ill newborn infants (birth weight: 1,280 to 4,500 g; gestational age, 29 to 42 weeks). Each infant was monitored continuously for 30 minutes before and 50 minutes after infusion of the paralyzing agent. There were no significant changes in transcutaneous gases, whereas significant increases in heart rate; systolic, diastolic, and mean blood pressures; and blood norepinephrine and epinephrine levels were found. The increase in heart rate lasted for 30 minutes, and the increase in blood pressure persisted for 50 minutes after administration of the drug. Because of the potential relationship between increased blood pressure and intraventricular hemorrhage and myocardial dysfunction, heart rate and blood pressure must be monitored during infusion of pancuronium in distressed newborns. These data suggest that pancuronium stimulates sympathetic activity in distressed newborns.

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