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J Krauel

Publications and source records attributed to J Krauel.

11 recordsLinked to original sources
PubMed1999

[High-frequency oscillatory ventilation as salvage strategy in the newborn infant. Spanish multicenter study. I].

OBJECTIVE: The aim of this study was to evaluate the results of high frequency ventilation (HFV) used as a rescue strategy in newborn infants with severe lung disease who either failed conventional mechanical ventilation (CMV) or had an air block. PATIENTS AND METHODS: From April 1995 to June 1998, 241 infants with severe lung disease and managed according to a common protocol of HFV used as a rescue strategy were prospectively evaluated in the nine participating level III Spanish Neonatal Intensive Care Units. The most frequent diagnoses were respiratory distress syndrome (119), meconium aspiration (24), pneumonia (19) and congenital diaphragm hernia (18). RESULTS: Mean +/- SD gestational age and birth weight were 32.0 +/- 5.5 weeks and 1,187 +/- 1,071 g, respectively. All babies were previously manages with CMV for a mean of 59 hours. HFV was started at a mean postnatal age of 82 hrs, with a mean oxygenation index (OI) of 28.3 +/- 15.3 and an a/A DO2 of 0.10 +/- 0.08. Initial mean HFV settings were: mean airway pressure 12.8 +/- 3.4 mbar, frequency 8.3 +/- 1.4 Hz, amplitude 53 +/- 20 percent, tidal volume 2.2 +/- 0.7 ml/kg and FiO2 0.88 +/- 0.2. At two hours of HFV there was a significant increase in the mean PaO2 (from 48 to 80 mmHg), with a concomitant decrease in FiO2 (from 0.88 to 0.79), PaCO2 (from 60 to 46 mmHg) and OI (from 28 to 18). Mean a/A DO2 increased from 0.10 to 0.19; these changes remained similar thereafter. HFV was suspended after a mean of 95 hrs because of improvement in 70%, death in 19% and failure to improve the clinical condition in the remaining 19%. Intrahospital death rate was 32%. The following complications were observed: pneumothorax (10%), interstitial emphysema (4%), intraventricular hemorrhage grades III and IV (14.5%) and bronchopulmonary dysplasia (35%). CONCLUSIONS: HFV is an effective rescue strategy that improves pulmonary gas exchange within two hours of its initiation.

Female↗
PubMed1987

[Simultaneous determination of total and immature neutrophil C-reactive protein in normal, diseased, and infected newborn infants].

C. reactive protein and immature neutrophils/total neutrophils ratio are measured in 146 newborns. Three groups are considered: 37 healthy, 90 pathologic non infected and 19 bacteriologically confirmed infected newborns. Pathologies other than infection do not alter CRP nor I/T. Levels lower than 20 mg/l for CRP and 0.18 for I/T are considered normal. Both tests are considered very useful for neonatal infection diagnosis (p less than 0.001). CRP shows a higher sensitivity than I/T in neonatal infection diagnosis even in its initial period (84% versus 63%).

Bacterial Infections↗
PubMed1982

[Perinatal histories of 22 newborns with malformations of the central nervous system].

The authors reviewed the perinatal histories of 22 newborns malformations of the central nervous system, among 9,323 consecutive births in the last five years, with particular emphasis on the incidence and types of malformations, as well as the most important findings of the parents anamnesis. Prenatal ultrasonography is stressed out as an important tool in the precocious diagnosis of such a kind of malformations.

Adult↗
PubMed1980

[Pulmonary edema associated with Pseudomonas neonatal sepsis (author's transl)].

Four newborn babies at term, with massive pulmonary haemorrhage associated with fulminant septicemia due to pseudomonas, are presented. The neonates died in the first day of life. The haematocrit and the proteic contents of the pulmonary effluent showed the existence of a pulmonary lesional edema. The histological findings in the four cases support this hypothesis. A revision of the etiopathogenic possibilities of the noncardiogenic pulmonary edema in the neonate is presented.

Female↗
PubMed1980

[Persistance of fetal circulation. a case associated to maternal indomethacin administration (author's transl)].

The case of a neonate born to a mother who was treated with indomethacin in the antenatal period is presented. Newborn presented, immediately after birth, severe respiratory distress syndrome, with cyanosis that remain unmodified by oxigenotherapy and mechanical ventilation. Clinical picture and analitic and radiographic findings, suggested persistent fetal circulation syndrome. It has been recently demonstrated that indomethacin is able to affect hemodynamic changes in neonatal period avoiding arteriolar dilatation and consequently, the fall of pulmonary vascular resistences. Administration of tolazoline was followed of rapidly improvement of the patient.

Female↗
PubMed1979

Ventilator modifications for intermittent mandatory ventilation.

A Loosko MK2 ventilator has been modified to provide IMV in newborns. IMV rate can be varied from 3-60/min. The minimum inspiration period can be theoretically as low as 0.1 sec. This modification in neonatal mechanical ventilation has been shown to be economically feasible.

Humans↗
PubMedDate not supplied

Clinical and immunological spectrum of partial DiGeorge syndrome.

We present four cases of DiGeorge syndrome diagnosed at our center. Onset occurred during the neonatal period and was associated with severe congenital heart disease. In case 1, the patient had heart disease and absence of thymus. Total T-lymphocytes were 34%; total T4-lymphocytes were 27%. Stimulation test with phytohemagglutinin (PHA), concanavalin A (conA) and pokeweed mitogen were negative. Microdeletion was found in the chromosome 22q11 region. The second case involved heart disease, microstomia, round and rotated ears and branchial cyst. Total T-lymphocytes were 38% and total T4-lymphocytes 27%. Thymus was absent. Microdeletion in the chromosome 22q11 region. Case 3 showed heart disease, renal malformation, absence of thymus and parathyroid gland. The patient died 5 days postsurgery. Microdeletion was seen at chromosome 22q11. In the fourth case there was heart disease, microretrognathia, hypertelorism, short neck, absence of thymus and parathyroid glands. Total T-lymphocytes were 22%, total T4-lymphocytes 15%, and total T lymphocytes for pokeweed mitogen were negative. Microdeletion was found at chromosome 22q11. At the age of 13 days the patient died. The cases were recorded during a 2-year period, between 1997 and 1998. The prevalence of DiGeorge syndrome in the number of admissions for congenital heart disease among the neonates at our hospital was 3.14%. Presentation in the form of repeated infections is rare, since most cases of DiGeorge syndrome are partial, and functional cellular immunity is preserved.

Adult↗
PubMedDate not supplied

[Fetal alcohol syndrome (author's transl)].

A case of fetal alcohol syndrome is reported in a intrauterine growth retarded female newborn with dysmorphic features and congenital cardiopathy whose mother suffered from a chronic ethylism during pregnancy. Authors compare this case findings with the reported revisions of other authors.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

[Neonatal listeriosis. Apropos of 53 cases].

53 cases of neonatal listeriosis were seen during the last five years at the Intensive Care Unit for newborn infants (Pr Minkowski) and the Neonatal Center (P. Varangot) of the Port-Royal Maternity Hospital. The significant decline in mortality to 22 p. 100, when compared with previous years, was attributed to improvements in the diagnosis during the first hours of life and the contribution of artificial ventilation. The most frequent initial clinical sign was respiratory distress (58 p. 100) whereas meningitis was relatively rare (11 p. 100). Discoloration of the amniotic fluid and a fever in the mother at the time of delivery, were also important diagnostic clues. The macroscopic examination of the placenta and particularly placental smears containing listeria monocytogenes (15 of the specimens) as well as the hematological alterations, particularly an increase of the fibrinogen level above 3-4 g/1 during the first 48 hous of life (72 p. 100 of the cases) contributed to an early diagnosis.

Female↗