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Biomedical subjects

D Vidyasagar

Publications and source records attributed to D Vidyasagar.

At least 127 records · Page 7Linked to original sources
PubMed1979

Simultaneous transcutaneous oxygen tension and tissue pH monitoring in sick neonates.

Our studies show that simultaneous tcPO2 and tpH monitoring is feasible and they indicate a highly significant degree of correlation between arterial PO2 and tcPO2 on the one hand and arterial pH and tpH on the other. We also conclude that tissue pH as measured with tpH electrode is a close approximation of arterial pH in sick neonates.

Blood Gas Analysis↗
PubMed1979

Disposition of indomethacin in preterm infants.

Indomethacin is currently used for the pharmacologic closure of PDA in preterm infants with respiratory distress syndrome. However, the response to the drug has been variable and the disposition of the drug in preterm infants is not well understood. We studied the pharmacokinetics of indomethacin in nine preterm infants with birth weights ranging from 800 to 1,960 gm and gestational ages of 28 to 36 weeks. Three different dose schedules (0.1, 0.25, 0.3 mg/kg dose) were used. The plasma half-life of indomethacin ranged from 11 to 20 hours. Peak levels were achieved within four hours and ranged from 0.027 to 0.310 microgram/ml. The half-life in infants less than 32 weeks' gestation was significantly prolonged compared to that in infants greater than 32 weeks. Protein-binding studies with 14C indomethacin showed that 98% of indomethacin was protein bound. Absorption of orally administered indomethacin appears to be poor and incomplete. No immediate major complications could be correlated to indomethacin therapy in this study.

Birth Weight↗
PubMed1979

Early retransfer: a method of optimal bed utilization of NICU beds.

To facilitate increased utility of Neonatal Intensive Care Unit (NICU) beds, we adopted a policy of early discharge (ED) of infants less than 2000 g to the hospital of their birth after recovery from acute illness and when the infant was breathing room air and taking adequate oral feedings. An inservice teaching program at the primary hospitals preceded such policy. In a 24-month period, 446 infants were referred to the NICU. 111 of 446 died; 335 infants survived. 114 of 335 infants were less than 2000 g at birth; 42% (48 of 114) of them were discharged early to the hospital of their birth (ED); 58% were discharged late (LD) to their homes. 59.7% of the ED and 46.3% of the LD required assisted ventilation. Gestational age, birth weight, and final weight at discharge from hospitals were the same in both groups. None of the ED infants developed complications at the hospital of birth after retransfer. The length of NICU stay for LD was significantly higher 40 +/- 6 (p less than 0.001) than the ED; 20 +/- 2.2 days. In addition, a 15% increase in bed utilization was also noted because of ED. We conclude that ED of infants from the NICU 1) increases utilization of beds; 2) decreases the cost of health care; and 3) increases the participation of primary physicians.

Costs and Cost Analysis↗
PubMed1979

Development of sucking in premature infants from 1 to 7 days post birth.

An ongoing research program to document the development of the sucking response in low- and high-risk newborns is described. Goals are (a) to facilitate early oral feedings, and (b) ultimately to determine whether varying levels of self-regulatory mother-young interaction, uninterrupted by birth, differentially affect life span development. In pilot research, finger sucking opportunities were given twice daily to 2 female and 8 male critically ill premature newborns. A clinical scoring system (range 0--12) measured quality of the sucking response beginning as early as 1 hour of life. The sucking response was present in all 10 newborns. The mean sucking score and standard error of the mean on the first day of life were 6.0 +/- 0.8. Sucking scores did not correlate with birth weight or gestational age, but correlated positively with pH (r = +0.52, p less than .01) and negatively with pCO2 (r = 0.47, p less than .05). Sucking scores generally increased with age and with closely time-related sucking opportunities. Sucking scores were negatively correlated with serum bilirubin levels. Sucking opportunities seemed to facilitate neuromuscular coordination, alert activity, alert inactivity, and deep sleep. A description is given also of a portable electronic suckometer and research nipple developed to quantitatively measure the sucking response of low- and high-risk newborns. The pilot research with this instrument is summarized, as are 3 current studies, 2 of which begin at birth. Sucking is a major component of mother-newborn interaction. Perhaps the isolated transitional newborn is in a nonphysiologic state.

Female↗
PubMed1979

Effects of surrogate mothering on physiologic stabilization in transitional newborns.

This experimental study was conducted to determine whether surrogate mothering during the first hours of life will affect physiologic stabilization in the transitional newborn. Two groups of 8 normal newborns were studied. The treatment was given on cue and consisted of rocking, cuddling, visual and verbal interaction, and non-nutritive sucking to satiety. The control group received routine nursing care. The experimental group's mean axillary temperature correlated with increasing age (r = +.91, p less than .001) and leveled at 2 hours of life at 98.2 degrees F (36.8 degrees C). Control group temperatures fell continuously to 97.4 degrees F (36.3 degrees C) following removal of the newborn from under an infrared heat unit. The experimental group's mean respiratory rate correlated negatively with increasing age (r = -.81, p less than .009). The experimental group's mean heart rate was higher at 3 1/2 hours (p less than .01). The control group's mean heart rate correlated over time (= -.82, p less than .007). Heart murmurs were heard 16 times in 5 controls and 6 times in 3 treated newborns. The frequency difference was significant (p less than .05). Experimental newborns cried an average of 2.1 minutes. This was less (p less than .01) than the controls (38.5 minutes). Electronically measured sucking strength was higher (p less than .001) for the treated newborns (81.5 mm Hg) than for the controls (20.5 mm Hg) prior to the first feeding at 4 hours. The experimental group ingested a mean of 13.75 cc of sterile water at the initial feeding, compared to 5 cc for the controls. Sucking and swallowing difficulty was seen in 6 control and 3 experimental newborns. These data suggest that interaction and soothing by another human facilitates transitional newborn physiologic adaptation.

Adaptation, Physiological↗
PubMed1978

Effects of monitoring high-risk pregnancies and intrapartum FHR monitoring on perinates.

A protocol of chronic antepartum surveillance was initiated at the University of Illinois hospitals in 1973 to assess the impact on perinatal mortality. At the same time, a policy of unselected fetal heart rate (FHR) monitoring was initiated to judge the effect on the intrapartum stillbirth rate. The impact of both programs played a significant role in the decline of perinatal mortality rates for infants weighing more than 1 500 g, from 21.1/1 000 births in 1970--1971 to 14.4/1 000 births in the monitored years 1973 and 1974 (p less than 0.02).

Amniotic Fluid↗
PubMed1978

Clinical significance of monitoring anterior fontanel pressure in sick neonates and infants.

The intracranial pressure was monitored via the anterior fontanel, using a noninvasive technique, in 78 acutely ill, 39 normal term, and 6 normal preterm infants. In normal term and preterm infants the anterior fontanel pressure (AFP) was 10.2 +/- 0.4 and 9.5 +/- 0.8 cm H2O, respectively. Infants with hyaline membrane disease had elevated pressure (13.3 +/- 0.6 cm H2O), which was higher than that of normal preterm infants. Following an episode of intracranial hemorrhage in four infants, the AFP increased to 26.2 +/- 2.5 cm H2O. Elevated pressure was noted in infants with meconium aspiration syndrome (24.1 +/- 1.8 cm H2O); the pressure decreased during the phase of recovery (15.6 +/- 3.5 cm H2O). Elevated pressure was noted in infants with meningitis and hydrocephalus. Repeated measurements helped to diagnose shunt obstruction in an infant with hydrocephalus.

Cerebral Hemorrhage↗
PubMed1977

A simple noninvasive technique of measuring intracranial pressure in the newborn.

A noninvasive approach to measuring intracranial pressure in newborns based on optical principles and devoid of electrical hazards is described. This monitoring technique can be used to detail subtle changes in measurements in ill newborns and to predict hydrocephalus. The mean anterior fontanel pressure in normal infants was 10.14 +/- 0.39 cm H2O. Increased pressure was noted in sick neonates and in infants with hydrocephalus. Good correlation was noted between anterior fontanel pressure and CSF pressure. Pediatrics, 59:957-961, 1977, INTRACRANIAL PRESSURE, ANTERIOR FONTANEL PRESSURE, HYDROCEPHALUS, MONITORING DEVICE.

Humans↗
PubMed1977

Centronuclear myopathy in the newborn period causing severe respiratory distress.

Centronuclear myopathy can be classified into four clinical varieties based on age, severity at onset, and rapidity of progress. In the severe form with involvement of respiratory muscles at birth, the progress is rapid and fatal before 3 years of age. The case described in this report illustrates rapid progression of muscle paralysis and death in a neonate. However, in a majority of cases the disease is either moderately severe or mild with the affected individuals confined to wheel chair by adolescence or early adult life. Diagnosis of the disease is based on appropriate muscle histopathology and electron microscopic studies.

Humans↗
PubMed1977

A new prenatal cardiac diagnostic device for congenital heart disease.

A unique case of congenital heart disease and complete heart block diagnosed by fetal electrocardiogram (ECG) and phonocardiogram recorded initially at 32 weeks gestation is presented. The slow, regular fetal heart rate of approximately 50 beats/min with bizarre QRS and a diamond-shaped murmur beginning with the fetal QRS complex made a diagnosis of complete heart block (CHB) and associated congenital heart disease highly probable. Direct fetal electrocardiograms (FECG) recorded during labor and vaginal delivery at term confirmed the diagnosis of completel atrioventricular block. Cardiac catheterization at 1 day of age showed multiple congenital heart anomalies. The infant developed signs of congestive heart failure and transvenous pacemaker was successfully placed; however, he died at 9 days of age of sepsis and renal failure.

Adult↗