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Biomedical subjects

C M Rumack

Publications and source records attributed to C M Rumack.

At least 37 records · Page 2Linked to original sources
PubMed1985

Gastrointestinal injury in polycythemic term infants.

Necrotizing enterocolitis is uncommon among term infants. In this group, necrotizing enterocolitis has been associated with two risk factors: polycythemia and umbilical catheterization. During a randomized trial of partial plasma exchange transfusion for treatment of polycythemia, an increased risk of gastrointestinal problems was noted. Eight hyperviscous patients treated with partial plasma exchange transfusion, no symptomatically treated patients, and no control infants developed typical necrotizing enterocolitis (blood in the stools, pneumatosis, and systemic signs). The incidence of necrotizing enterocolitis was significantly greater among patients treated with exchange transfusion compared with patients treated symptomatically or control subjects (P less than .001).

Blood Viscosity↗
PubMed1984

Role of coagulopathy in newborn intracranial hemorrhage.

Fifty newborn infants of less than 33 weeks' gestation were followed prospectively from birth with serial coagulation and real-time ultrasound studies. A significant association of hypocoagulability in the first four hours of life with subsequent onset or progression of intraventricular or other clinical hemorrhages was documented. Abnormalities included lower values for fibrinogen, platelet count, antithrombin III, and factor VIII with higher values for fibrin monomer and longer Laidlaw whole blood clotting times. These abnormalities tended to correct spontaneously in surviving infants. An association between gestational complications and incidence of hypocoagulability and intracranial hemorrhage (ICH) was noted. Babies of preeclamptic mothers had fewer abnormalities and babies born to mothers with premature rupture of membranes and suspected amnionitis manifested more hypocoagulability and more severe intracranial hemorrhages.

Blood Coagulation Disorders↗
PubMed1984

Timing and antecedents of intracranial hemorrhage in the newborn.

Fifty newborn infants of less than 33 weeks' gestation were followed prospectively from birth to evaluate the temporal relationships of various clinical factors to the onset and progression of intracranial hemorrhage (ICH) in an inborn population given maximal support. ICH was diagnosed and followed with bedside ultrasound every eight hours. The incidence of intraventricular hemorrhage was 30% and of any ICH was 40% with onset from less than 2 hours to 8 days of age. Grades 2, 3, and 4 ICH correlated with Apgar scores of less than 5 at five minutes, vaginal delivery, longer labors, and intrapartum hemorrhage. There was a significant correlation between ICH and both blood pressure fluctuations of greater than 100% and rapid colloid infusions. Slow transfusions of packed red cells did not appear to precipitate episodes of ICH. In a setting of optimal care, ICH appears to be more related to prenatal stresses than to specific postnatal complications.

Apgar Score↗
PubMed1983

Role of computed tomography and ultrasound in neonatal brain imaging.

Neonatal brain imaging has had a tremendous impact on neonatal care with the introduction of computed tomography and ultrasound to noninvasive study of the neonatal brain. Improved obstetrical and neonatal care have saved many premature infants, resulting in an increased incidence of central nervous system hemorrhagic and hypoxic brain damage in those very-low-birthweight infants who are at greatest risk for intracranial hemorrhage. The evaluation of the neonatal brain can best be done by an understanding of the relative merits of computed tomography and ultrasound as imaging techniques. This report demonstrates the ability of each modality in specific lesions and recommends a basic approach to neonatal care based on the most likely lesion.

Brain↗
PubMed1981

Detection of neonatal intracranial hemorrhage utilizing real-time and static ultrasound.

Accurate assessment of neonatal brain anatomy and pathology can now be obtained with commercially available ultrasound equipment. Intracranial hemorrhage (ICH) has a 50% to 60% incidence in premature infants under 32 wk gestational age and is felt to be one of the leading causes of neonatal morbidity and mortality. Computerized tomography (CT) has been the standard for detecting ICH; this study demonstrates that ultrasound is equally accurate and sensitive. Real-time examination through the anterior fontanelle resulted in 100% accuracy when compared with CT in a prospective study. Compound axial scans through the parietal bone were not as accurate, with a sensitivity of 91% and a specificity of 85%. If available, good quality real-time, transfontanelle sector ultrasound should be the screening procedure of choice for detecting and following intracranial hemorrhage in the high-risk premature infant.

Cerebral Hemorrhage↗
PubMed1981

Neonatal intracranial hemorrhage and maternal use of aspirin.

A prospective study of 108 infants born at 34 weeks' gestation or earlier or weighing 1500 g or less was carried out to determine the incidence of intracranial hemorrhage and the multiple risk factors that may cause or aggravate this hemorrhage in premature infants. On day 2 post partum, mothers were questioned regarding maternal risk factors, including the use of either aspirin or acetaminophen during the last week of pregnancy. Between days 3 and 7 post partum, computed tomographic scanning was performed on the 108 infants. Of the total, 53 (49%) developed intracranial hemorrhage. The incidence of hemorrhage in the infants whose mothers had ingested aspirin was significantly greater (P less than .05) than that seen in infants whose mothers did not take either aspirin or acetaminophen (control group). The incidence of intracranial hemorrhage among infants whose mothers ingested acetaminophen was not significantly different from that of the control group. This study indicates that aspirin is associated with an increased incidence of intracranial hemorrhage in the authors' population. The use of aspirin in the last 3 months of pregnancy is highly questionable and probably inappropriate.

Acetaminophen↗
PubMed1980

Ultrasound evaluation of cystic intracranial lesions in the neonate.

Ultrasound detected cystic intracranial lesions in 18 infants. Lesions included porencephaly (6 infants), hydranencephaly (1 infant), a quadrigeminal cyst (1 infant), Dandy-Walker syndrome (1 infant), and cavum septi pellucidi and Vergae (9 infants). Cystic lesions of the infant brain can be delineated accurately with ultrasound and distinguished from normal ventricular structures.

Brain Diseases↗
PubMed1980

Ultrasonic evaluation of the neonatal brain.

Ultrasound examination of the infant brain has been performed in selected medical centers for many years. However, the equipment necessary for obtaining satisfactory visualization of the brain has only recently become commercially available. Currently, ultrasonography is an excellent, noninvasive, inexpensive, rapid, and safe imaging modality for the evaluation of hydrocephalus and other pathologic conditions of the neonatal brain. Ventricular size can often be evaluated in infants up to two or three years of age, but a detailed image of the brain parenchyma becomes more difficult to obtain in a term infant after the first two to three months of life. With the use of the water path and high resolution, real-time systems and with the delineation of structures by multiple projections, (axial, coronal, sagittal and occipital), complex abnormalities may be delineated.

Brain↗
PubMed1979

B-mode echoencephalography in the normal and high risk infant.

Commercially available high resolution, contact, gray scale imaging systems can now dependably visualize the normal and abnormal ventricular system as well as some other intracranial structures in all newborns. On 25 normal infants and 41 high risk infants, 135 B-mode echoencephalograms were performed. The technique for obtaining these scans is described. The normal lateral ventricle at the midbody in term infants is 0.9--1.3 cm wide (mean, 1.1 cm). Normal ratio of lateral ventricle to hemisphere is 28% (range, 24%--30%). High risk premature infants have a ratio of 31% (range, 24%--34%). The demonstration of hydrocephalus and cystic intracranial masses is reliable and the correlation with computed tomography is excellent. Postoperative or high risk infants can be repeatedly evaluated without radiation, at a lower cost, and more rapidly with ultrasound than with computed tomography. Ventricular size can be closely monitored and shunt failure detected at any early stage.

Cerebral Hemorrhage↗
PubMed1978

CT detection and course of intracranial hemorrhage in premature infants.

Twenty neonates with a suspected intracranial hemorrhage were studied by computed tomography (CT). The exact site and extent of the hemorrhage in all infants were clearly demonstrated on serial CT scans. In intraventricular hemorrhage, a dense subependymal halo lined the ventricular system and could be recognized for up to 2 weeks. Discrete hemorrhage adjacent to the ventricular system also appeared as discrete nodules rather than as a diffuse hemorrhage. Blood in the ventricular system could be recognized up to 2 weeks when there were blood-cerebrospinal fluid levels. Hydrocephalus was a common sequela and was readily detectable before a measurable change in head size.

Cerebral Hemorrhage↗
PubMed1977

Thick blood syndrome.

Twenty cases of hyperviscosity were studied prospectively to determine the presence and incidence of radiological findings and whether or not exchange transfusion had an appreciable effect on these findings. Serial chest radiographs revealed increased pulmonary vascularity, hyperaeration, and mild, bilateral alveolar infiltrates (perihilar and/or lower lobe). Ten patients were treated with partial plasma exchange transfusions which resulted in improvement of radiological findings. Hyperviscosity is more common than previously recognized. This entity may have profound significance as a potentially treatable cause of central nervous system damage in the neonate.

Blood Viscosity↗
PubMed1976

The decline and early fall of neonatal pulmonary hemorrhage.

Seven years' experience (1965-1972) with neonatal pulmonary hemorrhage at the University of Colorado was reviewed. Pulmonary hemorrhage still occurs frequently as a preterminal event in hyaline membrane disease. As an isolated "pure" entity, however, pulmonary hemorrhage has shown a marked decline. This phenomenon is probably related to advances in neonatal intensive care. The radiographic pattern of "pure" pulmonary hemorrhage in the newborn is most commonly a diffuse alveolar infiltrate. Since pure hemorrhage is now an uncommon entity, the radiologist can reasonably suggest this diagnosis on rare occasions only, in the clinical setting of profound hypoxia.

Hemorrhage↗