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Biomedical subjects

A Erenberg

Publications and source records attributed to A Erenberg.

51 records · Page 3Linked to original sources
PubMed1978

Epidural anesthesia with bupivacaine for Cesarean section: neonatal blood levels and neurobehavioral responses.

A recent study found no neurobehavioral change in infants whose mothers received bupivacaine epidural anesthesia (112 +/- 7 mg) for labor and vaginal delivery. The present study was undertaken to examine the possibility that the larger doses of bupivicaine necessary for cesarean section might cause neurobehavioral changes in the neonate. Ten infants delivered by cesarean section with bupivacaine epidural anesthesia (168 +/- 7 mg) was assessed by Scanlon's neonatal neurobehavioral examination. They were compared in a prospective randomized study with a control group of ten infants delivered with tetracaine spinal anesthesia. In the experimental group bupivacaine was detectable in umbilical arterial blood (.17 +/- .07 microgram/ml), umbilical venous blood (.21 +/- .09 microgram/ml), and neonatal blood samples at 4 hours of age (.04 +/- .04 microgram/ml). By 24 hours of age bupivacaine was no longer detectable in newborn blood samples. Infants in the experimental group were indistinguishable from control infants in terms of their motor organization, responsiveness to external stimuli, and habituation to repetitive stimuli. Detectable neurobehavioral effects were absent despite the fact that 1.5 times the dose of bupivacaine used for labor and vaginal delivery was employed in this study.

Adult↗
PubMed1978

Arginine vasopressin response to an osmotic stimulus in the fetal sheep.

Baseline plasma osmolality (pOsm) and plasma arginine vasopressin (pAVP) were measured in chronically catheterized fetal sheep. Mean baseline pAVP in fetuses from 101-120 days was 1.9 +/- 0.46 muU/ml (mean +/- SEM) with a pOsm of 293 +/- 1.8 mOsm/kg. In fetuses of 121-141 days of gestation, mean pAVP was significantly lower, 0.77 +/- 0.19 muU/ml (P less than 0.05), with a similar pOsm (293 +/- 1.9 mOsm/kg). The logarithmic baseline pAVP values were linearly correlated with pOsm for both groups. Hypertonic saline infusion resulted in a similar increase in the log pAVP corrected for the rise in pOsm in the 101-120-day fetuses and in 121-141-day fetuses. The slope of this response was similar to that of the steady state relationship. The data indicates that the fetal osmoreceptor system for control of arginine vasopressin secretion is fully functional in the last trimester of pregnancy.

Animals↗
PubMed1975

Umbilical blood flow and glucose uptake in lamb fetus following single umbilical artery ligation.

Umbilical blood flow (UBF) and fetal glucose uptake were measured in 5 lamb fetuses 4-20 days following single umbilical artery ligation (SUAL). The ligation was performed at 108-119 days gestation (sheep pregnancy = 145-150 days), and the blood flow and glucose uptake studies were performed as chronic preparation at 120-137 days of gestation. In comparison with 9 control subjects at matched gestation, the SUAL fetuses had significantly lower UBF (mean plus or minus SEM, 735 plus or minus 70 vs. 475 plus or minus 24 ml/min, p less than 0.01) and fetal glucose uptake (2190 plus or minus 1.6 vs. 14.8 plus or minus 1.9 mg/min, p less than 0.05). When the values were expressed per kilogram fetal weight, the UBF decreased with increasing gestational age in SUAL fetuses. In the control fetuses, the UBF increased with increasing gestational age. The fetal glucose uptake (FGU), when expressed per kilogram fetal weight, was essentially similar to that of the control subjects. The glucose gradients across the placenta were similar in both groups of fetuses. These data suggest that in lamb fetuses with placental vascular insufficiency induced by SUAL, the reduction of UBF and FGU may account for growth retardation in utero. It was also suggested that placental transfer of substrate other than glucose may also be impaired as a result o

Animals↗
PubMedDate not supplied

Mechanical ventilation of the neonate during magnetic resonance imaging.

Minimum deadspace manifolds have shown promise as a means for assuring effective ventilation of the ventilator-dependent patient undergoing magnetic resonance (MR) imaging. The use of these manifolds in the neonatal patient requires some modification. Six neonatal patients were studied utilizing a modified neonatal ventilator tubing. The results of this study demonstrate no significant difference in pre-study and post-study parameters for heart rate, respiratory rate, transcutaneous oxygen and carbon dioxide levels, oxygen saturation and end-tidal carbon dioxide levels, when utilizing the minimum deadspace manifold and single limb ventilator tubing.

Humans↗
PubMedDate not supplied

Evaluation of a percutaneously placed 27-gauge central venous catheter in neonates weighing less than 1200 grams.

A percutaneous 27-gauge OD central venous catheter was inserted at 4 +/- 3 (SD) days of age and left in place for up to 2 weeks in 20 neonates with birth weights less than 1200 g and greater than 24 h of age. Parenteral nutritional solutions and medications were administered through these catheters. Twenty neonates matched for birth weight and gestational age served as paired controls. In vitro studies demonstrate that the maximum infusion rate for parenteral nutrition solutions is about 20 ml/hr. Packed red blood cells could not be infused through these catheters. In vivo results demonstrate a significant (p less than 0.05) reduction in number of peripheral iv catheters inserted during study (2 +/- 1 vs 7 +/- 4, SD) with no difference in cost per day of iv access ($79.42 +/- 113.51 vs $43.91 +/- 15.99, SD). Two-dimensional ultrasound assessment of catheter thrombosis was unsuccessful. Moreover, there was no correlation between angiographic and electron microscopic evaluation of catheter tip thrombosis. Electron microscopy of catheter tips revealed 33% with complete, partial and no occlusion, respectively, and 39% with sheath thrombosis. In summary, percutaneous insertion of a 27-gauge OD Vialon central venous catheter is a feasible alternative in providing venous access in very low birth weight infants.

Birth Weight↗