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Biomedical subjects

F J Alvarez Díaz

Publications and source records attributed to F J Alvarez Díaz.

3 recordsLinked to original sources

[Extracorporeal membrane oxygenation (ECMO). II. The development of an experimental model in newborn lambs].

OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) is a technique used for cardiorespiratory support in the treatment of newborns with severe respiratory insufficiency. ECMO has not been used yet in newborns in Spain. The aim of this work was to develop an experimental veno-arterial ECMO model in newborn lambs for training the NICU medical and nursing staff before the clinical application of this technique. MATERIAL AND METHODS: Six newborn lambs were anesthetized, traqueotomized and connected to a neonatal ventilator. The right jugular vein and left carotid artery were cannulated and the catheters were located in the right atrium and aortic arch, respectively. A venous-arterial ECMO was performed during three hours, with an experimental ECMO circuit developed by us. Arterial pH and blood gases, systemic and airway pressures, heart rate, and rectal temperature were monitored. RESULTS: The experimental ECMO circuit developed by use had a very low cost, but was capable of maintaining adequate gas exchange, acid-base balance and a normal rectal temperature. CONCLUSIONS: The development of an experimental ECMO model in newborn lambs may allow the establishment of an initial training program and to maintain the expertise of the NICU staff of a perinatal center planning to start an ECMO program.

Animals↗

[Continuous hemofiltration. Development of an experimental model].

OBJECTIVE: Continuous hemofiltration is an extracorporeal technique used to eliminate water and solutes by convective transport through a hemofilter. The aim of this study was to develop an experimental model of arterio-venous and veno-venous continuous hemofiltration in order to gain experience before its clinical application in human neonates. MATERIALS AND METHODS: Twelve white New Zealand adult rabbits were anesthetized, tracheotomized and connected to a continuous flow neonatal ventilator. Continuous arterio-venous hemofiltration (n = 6) was performed via catheters placed in the carotid artery and jugular vein and veno-venous hemofiltration (n = 6) by a double-lumen catheter located in the inferior vena cava. Heart rate, arterial pressure, pH and blood gases, and the volume of ultra-filtrate were monitored and recorded for a three hour period. RESULTS: In both groups a high rate of ultrafiltration was achieved. The volume of ultrafiltration decreased somewhat during the second hour and remained stable thereafter. No hemodynamic changes were detected. CONCLUSIONS: The development of an experimental model for continuous arterio-venous and veno-venous hemofiltration in rabbits, facilitated the implantation of these techniques in human neonates. The model may be used to train the staff of the Neonatal Intensive Care Unit and to eliminate difficulties with vascular access and the care of extracorporeal lines.

Acute Disease↗

[Severe malformations associated with congenital diaphragmatic hernia: conditioning factors for mortality].

We have retrospectively reviewed the clinical records of 42 newborns with congenital diaphragmatic hernia (CDH) treated in our Neonatal Unit between January 1974 and December 1991. In 20 of the children, the CDH was associated with other malformations, which were major in 11 cases (26.2%). The malformations which occurred most frequently were cardiovascular, followed by chromosomal anomalies and those affecting the central nervous system (CNS). All of the newborns with major malformations are included in the high risk group or those with early diagnosis. Overall mortality was 57.1%. Nine out of the 11 cases with major malformations died (81.8%).

Abnormalities, Multiple↗