Search PubMed⌕ Search

Biomedical subjects

D Vidyasagar

Publications and source records attributed to D Vidyasagar.

At least 91 records · Page 5Linked to original sources
PubMed1983

Low cerebral perfusion pressure: an indicator of poor prognosis in asphyxiated term infants.

To establish the value of monitoring cerebral perfusion pressure (CPP) as an index for outcome in acutely ill neonates, blood pressure and intracranial pressure (ICP) were monitored in 44 sick newborn infants. ICP was measured via the fontanel using a noninvasive technique. The results indicate that CPP was similar in preterm hyaline membrane disease infants with intracranial bleed and in those without bleed. In term asphyxiated infants, CPP correlated with outcome; 86% of those with low CPP either died or developed cerebral palsy and 75% of those with normal CPP were neurologically normal. We feel that low CPP in asphyxiated term infants must be viewed with concern.

Asphyxia Neonatorum↗
PubMed1983

Intracranial pressure and cardiac output remain stable during high frequency oscillation.

In 6 anesthetized and paralyzed adult cats, intracranial pressure (ICP) and cardiovascular variables were studied during high frequency oscillation (HFO). Over 2 h of HFO, cardiac output, right heart pressures, and blood gases remained stable, and were not different from control period values. Good ventilation and oxygenation were achieved. ICP was 5.7 mm Hg during the control period, and remained within +/- 1.25 mm Hg throughout HFO. Further, respiration-induced ICP waveforms were abolished during HFO. We believe that high frequency ventilation (HFV) does not alter cardiovascular and ICP dynamics for the duration tested in healthy anesthetized animals.

Animals↗
PubMed1983

Colloid osmotic pressure in infants with hyaline membrane disease.

Colloid osmotic pressure (COP) was measured serially in 81 critically ill neonates with hyaline membrane disease (HMD) during the first five days of life, and these changes were correlated with the birth weight, gestational age, serum protein level, clinical status, and outcome. Colloid osmotic pressure correlated better with the total protein level (n = 81; r = 0.54) than with birth weight (r = 0.23) and gestational age (r = 0.31; n = 81). Seventy-one of 81 neonates survived. Among the survivors, COP increased significantly by day 5, whereas changes in the total protein level were not significant during the same period. Colloid osmotic pressure decreased significantly in nine of ten nonsurvivors (mean +/- SE, 11 +/- 0.5 to 8 +/- 0.55 mm Hg), whereas the total protein level did not show a similar change. Thus, COP cannot be accurately predicted by measuring serum protein during acute illness. Serial measurement of COP was a better prognostic indicator than the total protein level in infants with HMD.

Birth Weight↗
PubMed1982

Development of sucking in term infants from birth to four hours postbirth.

The development of sucking response was investigated in 30 clinically normal infants from 1 or 5 minutes postbirth until their first feeding 4 hours later. Maximum sucking pressures were measured with a research nipple attached to a portable electronic suckometer. Mean suction (negative pressure) began at 5 Torr at birth, peaked at 103 Torr at 90 minutes, and decreased thereafter to 65 Torr at 4 hours. Expression (positive pressure) began at 12 Torr, rose to 29, and decreased to 25. Mean expression pressures correlated with feeding scale scores, r = +.44(24); p less than .025, but suction pressures did not, r = +.26(24); p less than .1. Normative data were gathered on 10 additional stabilized newborns who had been fed twice successfully. Suction pressures were 96 Torr on Day 1, and 103 Torr on Day 2; expression pressures were 25 and 24 Torr, respectively. These pressures approximate those recorded in newborns between 1 and 2 hours postbirth.

Biomechanical Phenomena↗
PubMed1982

Age-related difference in cerebral perfusion pressure response to acute hypoxia in neonatal puppies.

Acute hypoxia is known to increase cerebral blood flow and intracranial pressure in the fetus and newborn. The combined effects of these changes on cerebral perfusion pressure are unknown. We investigated cerebral perfusion pressure changes in newborn puppies of two age groups (group I, mean age 28 days, group II, mean age 11 days) during acute, severe hypoxia. The results indicate that (1) in both groups the intracranial pressure increases within seconds following the onset of hypoxia; (2) the mean arterial blood pressure drops almost precipitantly in older animals, whereas in group II, the blood pressure is maintained near baseline values up to 4 min, and (3) because of differences in blood pressure responses the cerebral perfusion pressure falls dramatically in group I, whereas in younger animals normotensive response to hypoxia helps maintain the cerebral perfusion pressure for a longer period. We conclude that in young animals early normotensive response to hypoxia assures adequate transmural pressure for the perfusion of brain which may be a built-in protective factor.

Acute Disease↗
PubMed1982

Tobramycin and gentamicin are equally safe for neonates: results of a double-blind randomized trial with quantitative assessment of renal function.

The frequent use of aminoglycosides in neonates led us to compare tobramycin and gentamicin because some studies in adults and animals suggested a safety advantage for tobramycin. In a randomized, double-blind comparison, 50 infants < or = 3 days old received either tobramycin or gentamicin, 2.5 mg/kg/12 hr, for a mean of 8 days. The groups were similar for gestational age, birth weight, underlying disease, Apgar score, clinical condition, renal function, and concurrent use of other drugs. Trough and postdose serum concentrations of both drugs were similar in each weight group. Renal status at onset, during or up to 2 wk after therapy was also similar, as judged by urinalysis, serum creatinine, fractional excretion of Na, urine N-acetyl-beta-glucosaminidase, and urine to serum creatinine ratio. Nephrotoxicity occurred in four infants (13%) receiving tobramycin and three infants (15%) receiving gentamicin. No otoxicity, as measured by auditory brainstem response, was noted in either group. Tobramycin offered no safety advantages over gentamicin in neonates, and the choice between the agents should be based on other considerations, such as susceptibility of the pathogen and cost.

Bacterial Infections↗
PubMed1982

Absorption of oral neomycin in premature infants with suspected necrotizing enterocolitis.

The oral absorption of neomycin was studied in 2 premature infants (32 weeks of gestation) with suspected necrotizing enterocolitis. 1 infant received 50 mg and the other 100 mg of neomycin sulfate/kg/day in 4 divided doses for approximately 7 days. Plasma neomycin levels were determined by a micro, sensitive and specific high-performance liquid chromatographic assay developed in our laboratory. Plasma levels as high as 2.9 and 4.5 micrograms/ml were observed in these 2 infants. A urinary recovery study for 1 infant revealed that at least 3.7% of the oral dose was absorbed. The significant and persistent plasma levels of neomycin in these patients suggest the need for extreme caution in using this potentially toxic antibiotic for prolonged treatment in neonates.

Chromatography, High Pressure Liquid↗
PubMed1981

Cerebral perfusion pressure and abnormal intracranial pressure wave forms: their relation to outcome in birth asphyxia.

Intracranial pressure (ICP) studies were carried out in 14 infants with severe birth asphyxia and brain damage. A markedly low cerebral perfusion pressure (CPP) was noted in infants who died and in 1 infant who survived with cerebral palsy. The long-term ICP tracing revealed negative waves and plateau waves in 2 infants. Cushing response was noted in 2 infants who had elevated ICP. The value and significance of evaluated CPP and of abnormal waveforms are discussed.

Asphyxia Neonatorum↗
PubMed1981

Critical care problems in neonates. Colloid osmotic pressure in healthy and sick neonates.

Clinical usefulness of colloid osmotic pressure (COP) measurements in adults has been well established. However, data in healthy and sick neonates are sparse. The present study established the COP changes in healthy term and preterm infants and in critically ill neonates. COP in healthy term (16.9 +/- 1.9 mm Hg) and preterm (15.4 +/- 1.3) infants was significantly lower than adults (21.6 +/- 3.6). Even in sick neonates, COP correlated with gestational age (n = 78, r = 0.63, p less than 0.001 , birth weight (r = 0.58, p less than 0.001) and total protein (n = 71, r = 0.58, p less than 0.001). Critically ill preterm infants with hyaline membrane disease had the lowest COP (11.5 +/- 1.2). Administration of 10% albumin failed to increase the COP significantly. In critically ill preterm infants who survived, the COP increased during the first postnatal week, whereas in nonsurvivors COP decreased significantly to less than 10 mm Hg.

Blood Proteins↗