We report three cases of transient myocardial hypertrophy, diagnosed by echocardiography, occurring between the second and seventh days of life in neonates with initially normal ventricular myocardial wall thickness. The three term neonates had perinatal injury with acute fetal distress. In all three cases electrocardiographic and biologic signs of myocardial ischemia were present. The first echocardiographic results showed abnormalities in systolic or diastolic left ventricular function, without hypertrophy of the walls. The hypertrophic cardiomyopathy (HCM) occurred between days 2 and 7 and affected first the interventricular septum and the free wall of the right ventricle. The left ventricular posterior wall subsequently became abnormal, resulting in severe overall myocardial hypertrophy, which finally disappeared in all three cases between 1 and 5 months of life. Such observations of early severe and transient HCM have not been previously reported. We believe it is a consequence of myocardial ischemia due to acute fetal distress. The prognosis of this type of HCM is good, in contrast to that of other primitive HCM occurring in neonates.

Acute Disease↗

PubMedDate not supplied

Electron microscopic studies of endotracheal tubes used in neonates: do microbes adhere to the polymer?

Fourteen neonates intubated at birth for 1-16 days had a microbiological follow up. After removal, tubes were examined using electron microscopy. Tubes became covered with a slimy accretion from the third day in place, independently of bacterial colonization, which was, in all but one cases, restricted to the rough areas of the tubes. Only Candida albicans and the corresponding slimy coat were found on smooth areas of tube. Cocci were noticed on 3 tubes. They were associated with the slimy accretion. Transmission micrographs elicited a thick material that was lying between cocci and polymer. These results showed that, on neonates' endotracheal tubes, accretion occurred independently of microbial colonization and that when colonization occurred, cocci adhered preferentially to a biological coat of human origin rather than the medical devices.

Bacterial Adhesion↗

PubMedDate not supplied

[Comparison of capillary and venous blood cultures in experimental bacteremia in chickens].

In order to evaluate bacteraemia in chickens previously inoculated intravenously with 10(4)-10(6) Escherichia coli K12, a comparative study of the sensitivity of 500 microliters or 50 microliters venous blood cultures and 50 microliters capillary blood cultures was carried out. Results of 206 blood cultures performed on 20 different chickens were negative in 147 cases and positive in 59. After 30 minutes, the sensitivity of capillary blood cultures was comparable to that of 500 microliters venous blood cultures and significantly higher than that of 50 microliters venous blood cultures. This greater sensitivity of capillary blood cultures in cases of prolonged bacteraemia may be due to capillary sequestration of bacteria. Micro-blood cultures appear to be of major interest in the diagnosis of septicaemia in neonates, and the capillary trapping hypothesis will require confirmation by means of a quantitative study.

Animals↗

PubMedDate not supplied

Effects of indomethacin on cerebral hemodynamics at rest and during endotracheal suctioning in preterm neonates.

The effect of therapeutic doses of indomethacin versus placebo (saline) on cerebral hemodynamics was studied in nine mechanically ventilated preterm infants. Recordings were made at rest and during endotracheal suctioning. Indomethacin at a dose of 0.2 mg/kg body weight was infused over 5 min. Compared to placebo, there was a significant decrease in Doppler mean frequency in the anterior cerebral artery within minutes of starting the indomethacin infusion during the resting period after the first (p less than 0.01), second (p less than 0.001) and third (p less than 0.025) doses. This effect has persisted during endotracheal suctioning. Thus, indomethacin alters cerebral hemodynamics by decreasing Doppler mean frequency. In view of these findings, and particularly because of the alteration in the resting cerebral hemodynamics, the recommendation of prophylactic treatment with indomethacin remains questionable.

Blood Flow Velocity↗