Biomedical subjects

B H Su

Publications and source records attributed to B H Su.

23 records · Page 2Linked to original sources

PubMedDate not supplied

Partial liquid ventilation in normal rabbits: comparison of three kinds of perfluorocarbon.

Perfluorocarbon liquids have been used in liquid ventilation studies and considered an effective technique of gas exchange with less barotrauma when compared with gas ventilation. We compared the effects of partial liquid ventilation (PLV) using 3 kinds of perfluorocarbon liquids (Fluorinert FC 43, FC 77 and FC 84) available in Taiwan in normal rabbits. We were able to achieve adequate oxygenation and ventilation during a 2-hour-duration of PLV using FC 43, FC 77 or FC 84. There was no significant difference in hemodynamic status or laboratory findings between control group and PLV groups. There were also no significant differences before LV and after 2 hours of PLV among PLV groups. Histological study of lung tissue revealed intact and well expanded alveoli, and no significant pathological change after 2 hours of PLV. These results show that PLV using FC 43, FC 77 or FC 84 is an effective technique for maintaining adequate pulmonary gas exchange in normal rabbits.

Animals↗

PubMedDate not supplied

Persistent pulmonary hypertension of the newborn: echocardiographic assessment.

Twenty seven newborn infants with persistent hypoxemia in the first 3 days after birth were enrolled for hemodynamic assessment using echocardiography. Measurements included pulmonary arterial pressure (peak velocity of tricuspid regurgitation (TR), patent ductus arteriosus (PDA) flow pattern, interatrial shunting flow pattern and pulmonary flow velocity ratio (the time to peak velocity/right ventricle ejection time ratio (TPV/RVET)) and left ventricular ejection fraction. The estimated systolic pulmonary arterial pressure and the systemic arterial pressure determined via an indwelling arterial line were recorded at the time of echocardiographic examination, and pulmonary arterial pressure/systemic arterial pressure was calculated. Nineteen infants (70.4%) had a TR sufficient to estimate systolic pulmonary arterial pressure. The median value of pulmonary arterial pressure/systemic arterial pressure was 1.02 (range, 0.68 to 1.78). Twenty two infants (81.5%) had a PDA and flow patterns indicating pulmonary arterial pressure above or approaching systemic arterial pressure. All infants had a foramen ovale and flow patterns were bi-directional or pure right-to-left. TPV/RVET had a wide range of values (0.23 to 0.55), and only 44.5% of infants had high pulmonary arterial pressure as reflected by low TPV/RVET ratio. Eleven infants (40.7%) had an ejection fraction below the normal range. Results of 17 survivors were compared with 8 deceased infants (2 infants of birth weight less than 1000 gm were excluded who died of massive pulmonary hemorrhage). There were no significant differences for any parameter of pulmonary arterial pressure, but ejection fraction was significantly lower in deceased infants. This study has demonstrated that it is possible to evaluate pulmonary arterial pressure noninvasively by using echocardiography in most newborn infants with clinical evidence of persistent pulmonary hypertension of the newborn (PPHN). Ejection fraction is an echocardiographic parameter which can significantly predict mortality.

Echocardiography, Doppler↗

PubMedDate not supplied

Glucose-insulin infusion for the early treatment of non-oliguric hyperkalemia in extremely-low-birth-weight infants.

In order to investigate the status of non-oliguric hyperkalemia and to evaluate glucose-insulin infusion treatment among extremely-low-birth-weight (ELBW) infants, 161 infants weighting less than 1000 gm at birth were enrolled for this study. They were divided into two groups: a hyperkalemic group and a non-hyperkalemic group. Hyperkalemia was defined here as a serum potassium level of greater than 6 mEq/L in a non-hemolyzed arterial blood sample. A glucose-insulin infusion was administered to the patients when hyperkalemia was detected in them during the first few days after birth. The infusion was discontinued when the serum potassium levels had been less than 6 mEq/L and stabilized for 6 hours. The incidence of non-oliguric hyperkalemia among ELBW infants in this study was 58% (93/161). The mean gestational age of neonates was 25.7 +/- 1.8 weeks (hyperkalemic) and 26.6 +/- 1.7 weeks (non-hyperkalemic). The mean rate of increases in serum potassium levels was 0.32 +/- 0.29 mEq/L/hr (hyperkalemic) and 0.13 +/- 0.12 mEq/L/hr (non-hyperkalemic). The incidence of severe intraventricular hemorrhage (IVH) was 19% (18/93) (hyperkalemic) and 4.4% (3/68) (non-hyperkalemic). The incidence of cardiac arrhythmia was 12% (11/93) (hyperkalemic) and 0% (non-hyperkalemic) respectively. Neonates with fewer weeks of gestation at birth and faster increases in serum potassium levels were associated with a more prominent tendency toward hyperkalemia. Hyperkalemia markedly increases the risk of severe IVH and arrhythmia for ELBW infants. A higher glucose infusion rate should be maintained to prevent hypoglycemia following insulin treatment.

Case-Control Studies↗

PubMedDate not supplied

A survey on the treatment strategy of patent ductus arteriosus in very low-birth-weight infants.

This study is a retrospective analysis of the clinical data of 67 very low birth weight infants (VLBWI) with symptomatic patent ductus arteriosus (PDA); all were admitted to four neonatal intensive care units (NICU) from January 1, 1996 through December 31, 1996. The mean gestational age was 27.9 +/- 2.4 weeks, the mean birth weight was 1078 +/- 193 g. Fifty-six infants (83.6%) had RDS, and 53 infants (79%) received artificial surfactant. The NICU at a regional hospital used CVD score > or =3 as the sole criteria and the remaining three NICUs used color Doppler echocardiogram to confirm a symptomatic PDA and to treat it; sometimes LA/AO > or = 1.3 was used as the criteria for indomethacin treatment. Two of these three hospitals sometimes used the pulsed Doppler echocardiogram as well as color Doppler examination as the treatment criteria. Seven infants (10.5%) had contraindication for indomethacin treatment; four of them closed after conservative treatment, and another three were subjected to surgical ligation. Of the remaining 60 infants, 3 were treated with oral indomethacin and 57 were treated with intravenous indomethacin. The mean age when initial treatment given was 3.8 +/- 1.5 days (range, 8 hours approximately 20 days). Among them 10 (16.7%) were within 24 hours after birth, 25 (41.7%) were between 24 and 48 hours, and 25 (41.7%) were beyond 48 hours. The dosage of indomethacin was 0.2 mg/kg per dose intravenously every 12 to 24 hours for three doses as a full course, if not contraindicated. The mean dose of indomethacin was 2.8 +/- 1.5; 10 infants (16.7%) received 1 dose, 15 (25%) received 2 doses, 27 (45%) received 3 doses, 3 (5%) received 4 doses and 5 (8.3%) received 6 doses. Among them, 51 infants (85%) PDA closed (including 2 treated with oral indomethacin), 9 (15%) failed to close and 6 of them received surgical ligation (including 1 treated with oral indomethacin). The complications associated with indomethacin treatment were hypoglycemia (52%), decreased urine output (42%) and gastrointestinal hemorrhage (32%). The infants with RDS had an earlier mean age of initial treatment than non-RDS infants (3.3 +/- 2.5 vs. 7.6 +/- 5.6 days; p < 0.05), and also had a higher closure rate (89% vs. 57%; p < 0.05). There was a closure rate of 85% in this multicenter retrospective analysis. Even though the infants received only one or two doses, they still had a good chance of ductal closure (21/25, 84%). To minimize the complications associated with indomethacin treatment in VLBWI, the protocol of indomethacin treatment should be re-evaluated.

Ductus Arteriosus, Patent↗

PubMedDate not supplied

Effect of erythromycin on feeding intolerance in very low birth weight infants: a preliminary observation.

To investigate the effect of erythromycin on feeding intolerance in very low birth weight infants, from February 1997 to December 1997 twenty infants weighing less than 1500 g, with prolonged intolerance of enteral feeding, were enrolled in this study. The protocol for erythromycin treatment was: a loading dose of 30 mg/kg/day, divided into three portions given every eight hours intravenously for 1 hour over a three day period; then a maintenance dose of 3-5 mg/kg intravenously for one hour once a day was given until full feeding was well established. The assessment of erythromycin effect was the daily net orogastric balance (volume of orogastric tube feeding minus volume of orogastric aspirates). The mean gestational age was 27.1 +/- 2.0 weeks (mean +/- SD) and the mean birth weight was 1025 +/- 196 g. The mean age when erythromycin started was 19.5 +/- 14 days; the mean days after the initiation of erythromycin when orogastric tube feeding could be started and full feeding established were 2.4 +/- 1.1 days and 15.1 +/- 2.2 days, respectively. At the beginning of erythromycin treatment, the net balance of tube aspirates was -4.8 +/- 4.1 ml. The net balance rose significantly to 30.6 +/- 15.3 ml, 92.6 +/- 25.4 ml and 125.3 +/- 18.1 ml at 7, 14 and 21 days after erythromycin treatment, respectively. In conclusion, erythromycin treatment is a safe method to improve intolerance of enteral feeding in very low birth weight infants. It is suggested that the effect of erythromycin on gastrointestinal motility in these infants should be further investigated in the context of a randomized, controlled trial before widespread clinical implementation of this treatment.

Anti-Bacterial Agents↗