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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 46 preterm infants with RDS the patency of the ductus arteriosus was established by single film aortography or by clinical diagnosis and confirmation at surgery. The estimated left-to-right shunt through the PDA by aortogram correlated well with the heart size and the clinical diagnosis of heart failure. In 14 infants massive cardiomegaly and heart failure with a PDA occurred before the appearance of a heart murmur. Twelve infants had severe RDS and 34 had mild or moderate RDS. Massive cardiomegaly occurred significantly earlier in infants with severe RDS. It is suggested that ductal ligation is indicated when an infant with massive cardiomegaly requires IPPV and whose aortagram shows that all of the contrast material is in the pulmonary arteries and none in the aortic arch. A heart murmur may or may not be present.
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PMID:Patent ductus arteriosus complicating the respiratory distress syndrome in preterm infants. 12 40

Natural surfactant (Surfactant TA, Survanta, CLSE, SF-RI 1, Curosurf and human surfactant obtained from amniotic fluid) therapy for RDS in very premature infants has been evaluated in 17 controlled clinical trials. Uniformly intratracheal surfactant administration caused a decreased intensity of mechanical ventilation during the first hours (reduced inspiratory pressure, reduced oxygen requirements) as an immediate effect of surfactant administration. Metanalysis reveals barotraumatic pulmonary complications mainly, pneumothorax and pulmonary interstitial emphysema to occur less frequently in surfactant-treated infants in virtually all trials; an increased incidence of survival without bronchopulmonary dysplasia following surfactant treatment was observed in 10 controlled clinical trials. The incidence of other complications of prematurity (intracranial hemorrhage, patent ductus arteriosus and necrotizing enterocolitis) was unchanged following natural surfactant treatment. Dosing of natural surfactant is still under investigation, however recent data indicate that the initial dose should not be less than 100 mg/kg b.w. and retreatment should be given to infants with unsatisfactory response (i.e. fraction of inspired oxygen (FiO2) > 40%). Timing of surfactant treatment still remains controversial. Prophylactic treatment shortly following birth has been compared with rescue-treatment, i.e. surfactant administration to infants suffering from manifest RDS in most studies 4-8 h after birth. Conflicting data from 5 controlled trials may be interpreted as follows: prophylactic treatment seems to be favourable for extremely premature infants (GA < or = 26 weeks) and rescue treatment seems to be adequate for infants of 27-30 weeks of gestation. Intratracheal surfactant instillation in very premature infants did not result in an improved lung function for 24 h to 48 h in all patients. Ten--25% of study infants were reported to be "non-responders", i.e. infants without sustained decrease in oxygen requirements (i.e. FiO2 > 40%). Various factors may be operative including congenital bacterial infections (sepsis or pneumonia), lung hypoplasia and cardiac failure. Inactivation of surface properties of natural surfactant caused by a leakage of proteins across the alveolar-capillary membrane was observed in experimental and clinical studies. Current investigations focus on a combination of postnatal steroids and surfactant treatment to improve lung function and outcome in "non-responders". As long as any controlled clinical studies are being published, this approach remains experimental. Up to now, any controlled clinical trials have been performed to assess different modes of artificial ventilation (e.g. high frequency oscillating ventilation versus conventional ventilation) combined with surfactant therapy. Data obtained from premature animals given natural surfactant indicate any advantage with respect to gas exchange and lung histology to result from high frequency ventilation.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Natural surfactant for neonatal respiratory distress syndrome in very premature infants: a 1992 update. 129 66

Alterations in thyroid function are quite heterogeneous in VLBW preterm neonates. The case of a 1160-g newborn is reported, affected by severe RDS and persistent bradycardia during the first week of life, who later developed symptoms and signs of low-output cardiac failure. ECG showed low QRS. Echocardiography revealed small pericardial effusion. Therapy with L-thyroxine led to rapid improvement of clinical conditions and to normalization of ECG and echocardiographic pattern. Levels of thyroid hormones should be monitored in VLBW infants, since their deficiency may play a role in compromised clinical conditions.
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PMID:[Persistent bradycardia and apnea due to hypothyroidism in a very low-weight newborn infant]. 188 32

A prospective study in 76 newborn with perinatal asphyxia searching for myocardial ischemia was carried out. The disease was found in 51% of the patients. With electrocardiogram, myocardial enzymes, X ray and clinical manifestations the diagnosis was elaborated. No difference in the sex was present, the mean of gestational age was 35 weeks, and with mean birth weight 2,216 g, respiratory distress was present in all the people; only 20.5% developed heart failure and two had heart murmurs; 61.5% showed cardiomegaly. The creatine kinase MB isoenzyme at twelve hours after birth was raised in most of the patients. Respiratory distress syndrome was the principal diagnosis in 38%; hypoxic ischemic encephalopathy and peri-intraventricular hemorrhage was present in 50 and 33% of the patients, respectively. Mortality rate was 33%. Also a comparative study in the infants with and without myocardial ischemia was carried out appearing significative difference in: 1. Cardiomegaly, 2. Hypoxic-ischemic encephalopathy and 3. Creatine kinase MB isoenzyme.
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PMID:[Transient myocardial ischemia in newborn babies with perinatal asphyxia (hypoxic cardiomyopathy)]. 209 33

In the operating room, 66 preterm infants weighing between 710 and 2,700 gm (23 less than 1,000 gm) underwent ligation of a patent ductus arteriosus (PDA). Respiratory distress syndrome was present in 53 patients; the rest had apnea-bradycardia syndrome. PDA ligation was indicated for intractable congestive heart failure in 52 patients or progressive respiratory failure in 14. There were no intraoperative deaths. Fifteen infants died 1 to 120 days postoperatively. Seven deaths resulted from intracranial bleeding, 3 from diffuse coagulopathy, and 1 from respiratory failure. The condition of patients with heart failure improved postoperatively, with the mean left atrium to aorta ratio reduced from 1.56 to 1.02 (p = 0.05). Respiratory function improved in 25 patients extubated by the third postoperative day. Late follow-up (one to five years) of the 51 survivors showed 1 late death. Seventeen survivors had roentgenographic evidence of bronchopulmonary dysplasia. Infants with bronchopulmonary dysplasia required longer postoperative ventilation (mean, 21.5 days compared with 4.75 days). Twenty-four infants were normal. Ligation of PDA in preterm infants has low intraoperative risk and improves the condition of those with heart and respiratory failure. Late follow-up showed good recovery of nearly two-thirds of the patients.
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PMID:Ligation of patent ductus arteriosus in premature infants. 725 56