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Biomedical subjects

I M Hiatt

Publications and source records attributed to I M Hiatt.

39 records · Page 3Linked to original sources

Compliance measurement in respiratory distress syndrome: the prediction of outcome.

Dynamic compliance (Cdyn) measurements within the first three days of life predicted survival in 60 preterm infants suffering from respiratory distress syndrome. Cdyn was measured in 47 survivors at 2.3 +/- 1.4 days of life and in 13 nonsurvivors on 2.7 +/- 1.7 days. All nonsurvivors died from respiratory failure within the first two weeks of life. Mean Cdyn of the survivors was 0.83 +/- 0.33 ml/cm H2O and of the nonsurvivors 0.35 +/- 0.19 ml/cm H2O (p less than 0.001). Cdyn values below 0.45 ml/cm H2O predicted 11 of 13 deaths in infants, and Cdyn measurements above this value predicted 45 of 47 survivals, with a specificity of 81% and a sensitivity of 89%. Eleven of the survivors, who subsequently developed bronchopulmonary dysplasia (BPD), had a mean Cdyn of 0.56 +/- 0.23 ml/cm H2O. When these infants were matched with infants of comparable weight without evidence of BPD, the BPD group had a significantly lower Cdyn (p less than 0.05). Cdyn measurements during the first three days of life are useful in predicting outcome of respiratory failure secondary to respiratory distress syndrome.

Airway Resistance↗

Ventilatory response to inspired carbon dioxide in premature infants recovering from intraventricular hemorrhage.

We examined the ventilatory response to inhaled carbon dioxide with a computerized waveform analyzer in two groups of premature infants. Twenty-seven infants suffered from periventricular-intraventricular hemorrhage (IVH) during the first week of life and comprised the study group (birth weight 1.2 +/- 0.2 kg, gestational age 29 +/- 2 weeks). The control group consisted of 15 infants without IVH (birth weight 1.4 +/- 0.3 kg, gestational age 30 +/- 2 weeks). Study infants were evaluated at a postnatal age of 9 +/- 2 weeks and control infants at 7 +/- 3 weeks. No differences were found in the slope or position of the ventilatory response curve, baseline PACO2, increase in minute ventilation, VT/Ttot, and Ti/Ttot between the two groups. Subgroups with unresolved apnea (10 IVH and eight control infants) demonstrated a rightward shift of the ventilatory response curve compared to those infants without apnea. A previous IVH did not reduce the ventilatory response to CO2 in this group of infants.

Apnea↗

The incidence of gastroesophageal reflux in preterm infants.

We observed an increased incidence of gastroesophageal reflux (GER) in a group of preterm infants. Seventy-five infants (birth weight 1117 +/- 242 gm, gestational age 30 +/- 3 weeks) were tested within 1 week before hospital discharge (37 to 38 weeks postconceptional age). All of the infants had a two-channel pneumocardiogram and a 1-hour esophageal pH study (Tuttle test). Home monitors were used for all infants after hospital discharge and their use was maintained until standard discontinuation criteria were achieved. The Tuttle test was abnormal in 47 (63%) of the infants. Of the 47 infants with GER, 22 (47%) had evidence of obstructive apnea during the periods of reflux and 32 (68%) had an abnormal PCG result. Thirty-eight (81%) of the infants with GER had episodes of either obstructive or central apnea. The diagnosis of GER is important in premature infants because of the high association with recurrent or obstructive apnea.

Apnea↗