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

It is described the surgical interruption of Patent Ductus Arteriosus in ten premature newborn patients with cardiac insufficiency and/or respiratory distress syndrome. The authors mention the technical factors that they consider important to have good results with these fragile infants, as the use of local anesthesia; to perform the procedure in the neonatal intensive care unit, the extrapleural dissection of the ductus, etc. The post-operative care problems are analyzed and this experience is compared with reports from other authors.
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PMID:[Ligation of the ductus arteriosus in premature infants. Surgical considerations]. 724 84

Six very preterm (< 32 weeks' gestation) infants who developed late-onset respiratory distress were each matched for sex and gestation with 2 control preterm infants. Radiologically and biochemically the diagnosis of rickets and rachitic respiratory distress seemed clear and the pattern conformed with other reports of the syndrome. The control infants were of similar gastational ages but there was a significantly higher incidence of pre-eclampsia in the pregnancies of index cases. Also significant was a prolonged illness of several weeks' duration in the index cases; this illness was either heart failure due to patent ductus arteriosus or prolonged ventilation in the early weeks of life for apnoeic attacks. Awareness of these 2 aetiological factors shows the necessity of monitoring such infants for evidence of rickets. The use of water-soluble antirachitic prophylaxis such as 1 alpha-hydroxy-vitamin D or 1,25-dihydroxy-vitamin D is sometimes indicated.
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PMID:Aetiological factors in rickets of prematurity. 743 31

In a 13-month period, ligation of the persistent ductus was carried out in 23 prematurely born babies with severe respiratory distress syndrome who were all respirator-dependent. Mean gestational age was 30.6 weeks (26-36 weeks), mean birth weight 1490 g (850-3090 g) with 3 patients under 1000 g. Signs of cardiac failure by large left to right shunt via ductus were seen at the end of the first week of life, radiologic signs as pulmonary edema were seen 1 to 2 days earlier. Mean age at operation was 13.5 days (4-27 days), mean duration of artificial ventilation 22 days (8-59 days). Indomethacin was used orally 12 of these patients without effect to close the ductus. One patient died of cerebral hemorrhage on his 17th day of life, 10 days postoperatively, one 3 1/2 months later at home with porencephaly and hydrocephalus. Four patients show radiologic signs of bronchopulmonary dysplasia. In the following 6 months up to December 1979, another 15 patients with IRDS underwent ductus ligation. Gestational age and birth weights were about the same as in the first group. Out of this second group which has not been followed up for a longer period. 3 babies died. Early mortality in both groups is 10.5% (4 out of 38 patients).
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PMID:[Ductus ligation in idiopathic respiratory distress syndrome of the premature infant]. 744 Feb 30

Patent ductus arteriosus was diagnosed in 239 neonates of low birth weight (less than 2500 g) referred to the Hospital for Sick Children in a 21/2-year period. The respiratory distress syndrome was present in 77% of the group and congestive heart failure in 50%. Spontaneous closure of the defect was more frequent in those without congestive heart failure. In 48 patients whose heart failure could not be controlled by other medical therapy indomethacin was given, and in 20 (42%) it was judged successful. Surgical ligation of the ductus was performed at a median age of 30 days in 33 infants who either failed to respond to indomethacin or in whom its use was contraindicated; there were no intraoperative deaths, but 11 (33%) of the infants died 4 days to 6 months after the operation.
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PMID:Patent ductus arteriosus in infants of low birth weight. 744 79

A further case of pyruvate carboxylase deficiency, French type, with a particular clinical presentation and evolution is described. The initial neonatal symptoms started with respiratory distress, severe metabolic acidosis and a tendency to hypoglycemia. However, the clinical course was not rapidly deteriorating. At the age of 6 months he presented acute neurological symptoms, respiratory difficulty, lactic acidosis and hyperammonemia. Amino and organic acid abnormalities strongly suggested pyruvate carboxylase deficiency, which was confirmed by enzymatic studies in cultured fibroblasts and liver necropsy. Progressive deterioration and bronchopneumonia with cardiac failure and renal insufficiency led to death. Anatomic-pathologic studies revealed periventricular cysts and diffuse hypomyelination. Prenatal diagnosis of a further sibling was performed. The neonatal clinical presentation, biochemical abnormalities, and the presence of periventricular cysts suggested a French phenotype. However, the clinical course was less severe, suggesting a residual enzymatic activity and a possible milder mutation.
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PMID:An atypical French form of pyruvate carboxylase deficiency. 750 91

A cross-sectional echocardiographic study of 50 black Zimbabwean children with clinical human immunodeficiency virus (HIV) infection was carried out. The median age was 9 months. Seventy per cent had chronic cough, 60% respiratory distress and 40% cyanosis. Sixty per cent had pericardial effusion and 48% right ventricular hypertrophy (RVH) and dilation. However, the clinical diagnosis of heart failure was difficult as most of these children (80%) had hepatomegaly. These findings suggest that respiratory disease plays a role in the causation of RVH in these children. As cardiac causes of RVH were absent, this was presumed to be due to cor pulmonale. HIV-infected children presenting with respiratory distress may have clinically unapparent cor pulmonale. Early and appropriate management may by beneficial.
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PMID:Cor pulmonale in children with human immunodeficiency virus infection. 767 13

Tracheal agenesis is a rare congenital malformation that usually is fatal. This report describes our experience in two such cases. In both cases, the diagnosis was suspected at birth, because the patients had respiratory distress without an audible cry and were difficult to intubate. A gastrostomy and banding of the abdominal esophagus provided effective initial stabilization, in conjugation with respiratory management. The first patient also had complex cardiac malformations, and the infant died of cardiac failure 1 week after birth. The second infant, who had tracheal agenesis with a proximal tracheoesophageal fistula and a bronchoesophageal fistula, was managed successfully. At 9 months of age, a tracheotomy was performed, a long T tube was inserted to maintain the airway patency beyond the proximal tracheoesophageal fistula, and the patient was discharged. At 3 years of age, esophageal reconstruction was performed with a colonic interposition graft. The patient is thriving and developing normally at 4 years of age. Diagnosis at birth and maintenance of airway patency are essential for successful management of tracheal agenesis. Initial surgical interventions are palliative but lifesaving. Subsequent management focuses on improving the quality of life and allowing swallowing and speech.
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PMID:Surgical management of tracheal agenesis. 796 64

A 17-year-old male with mitochondrial myopathy was transferred to our hospital because of respiratory distress and a rapidly deteriorating level of consciousness. He had a markedly increased cardiac output with low systemic vascular resistance and decreased arteriovenous oxygen difference. Severe lactic acidosis, rhabdomyolysis and acute renal failure were also present. He was treated in the intensive care unit with continuous hemofiltration and hemodialysis. This case demonstrates that cardiac failure in mitochondrial encephalomyopathy may be caused by myocardial abnormalities as well as by reduced systemic vascular resistance secondary to disturbed oxidative metabolism.
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PMID:High-output heart failure in mitochondrial myopathy: a fulminant form with severe lactic acidosis and rhabdomyolysis. 801 76

Despite the use of exogenous surfactants, the incidence of bronchopulmonary dysplasia (BPD) has not decreased as much as expected. Of 208 newborns involved in trials with Exosurf at our center, 51 had BPD. Among these newborns, 8 were found retrospectively to have secondary worsening of respiratory distress syndrome after initial improvement with surfactant treatment. Oxygen requirements decreased from 89 +/- 15% to 58 +/- 16% (mean +/- SD), respectively, before and 48 h after surfactant, and then reached a plateau of 34 +/- 10% before dramatic deterioration at 22 +/- 9 days of life. The patients had signs of cardiac failure and increased oxygen requirements of up to 76 +/- 19% within 6 h. A patent foramen ovale (PFO) was demonstrated at echocardiography with a left to right shunt at Doppler. No other cause of worsening was found. Five infants had significant improvement when treated with digoxin and furosemide. This retrospective study raises questions about the relationship between PFO and BPD that should be explored in a prospective study.
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PMID:Patent foramen ovale with left to right shunt in bronchopulmonary dysplasia: coincidental or associated complication? 803 24

Thanatogenesis of pulmonary tuberculosis has been studied on autopsy material gained in tuberculosis hospitals of Moscow from 1972 to 1992. The leading cause of lethal outcomes was progressive fibrous-cavernous tuberculosis (71.6% in 1992). Disseminated tuberculosis mortality rose two-fold (14.2% in 1992). Death rate for infiltrative tuberculosis reaches now 5.56%. Tuberculous patients die of the progressive disease in 54.94%, of respiratory distress and cardiac insufficiency in 32.72%. Progressive tuberculosis proved to combine with nontuberculous diseases in 71.87% of the cases.
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PMID:[Thanatogenesis of pulmonary tuberculosis based on statistics from tuberculosis hospitals in Moscow]. 817 Aug 99


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