Search PubMed⌕ Search

Biomedical subjects

P Morville

Publications and source records attributed to P Morville.

At least 19 recordsLinked to original sources
PubMed2001

[Posterior fossa hemorrhage in newborns following vaccum extractor delivery].

AIM: To emphasize the risk of posterior fossa hemorrhage in newborns following vacuum extraction. PATIENTS AND METHODS: Over a period of 26 months (September 1996-December 1998), seven patients who underwent delivery with the vacuum extractor had symptoms of brain stem compression, related to posterior fossa hemorrhage. They were referred to the neonatal intensive care unit. Some parameters had been analyzed: gestational period, delivery circumstances, gestational age, parameters of newborn, indications of vacuum extraction and other paraclinical investigations (biological and radiological). RESULTS: Ultrasound scan revealed intracranial hemorrhage in five cases of seven; mean time of diagnosis was 10 hours of age. All patients presented symptoms of brain stem compression. Mean period of follow-up was 22 months: six of seven patients had a normal neurodevelopment. One patient had a cerebellar ataxia, another one a palsy of the IIIrd cranial nerve. CONCLUSION: Analyses of posterior fossa by ultrasound scan should be made for newborns delivered by vacuum extractor, especially if they had symptoms of brain stem compression.

Brain Stem↗
PubMed1999

[Recombinant human erythropoietin in premature infants. Evaluation of a one year experience].

UNLABELLED: Recently, recombinant human erythropoietin (rhEPO) has been claimed to diminish red blood cell transfusions in premature infants. After a year of experience, we investigated whether early rhEPO treatment would reduce the need for transfusion. PATIENTS AND METHODS: Fifty premature infants of gestational age < or = 32 weeks admitted to our NICU in 1997, received rhEPO 750 UI/kg/week from day 3 to 5 for six weeks. They were compared with 50 untreated controls admitted in 1996. RESULTS: The treatment and control groups did not differ for gestational age, weight at birth, CRIB score, and blood losses. We were not able to detect any difference in the number of transfused infants, and in the number of transfusions per infant until discharge. However, treated infants received significantly fewer transfusions per infant between day 16 and day 45 (0.42 +/- 0.67 vs. 0.8 +/- 0.99). Infants with a birth weight between 1,000-1,250 g received fewer transfusions in the EPO group. CONCLUSION: rhEPO treatment can be useful, but in association with other procedures: conservative transfusion criteria, minimization of phlebotomy losses and early iron supplementation.

Erythrocyte Transfusion↗
PubMed1998

[Vancomycin and cardiac arrest in the infant].

BACKGROUND: Different adverse effects induced by vancomycin bolus infusion are described, but cardiac arrest seems rare, in children as in adults. CASE REPORT: Two infants, 5 and 12 months old, were admitted after cardiac arrest, following vancomycin bolus infusion in excessive dose. They recovered after prompt resuscitation and their short term follow-up was normal. CONCLUSION: Two mechanisms are invoked: anaphylactic shock and direct cardiovascular toxicity. Both are dose- and infusion rate-dependent, and probably intersubject dependent. Usually, cardiac arrest is promptly reversed by adequate resuscitation. The rules of prescription are: adequate dilution and slow rate of infusion. If any adverse effect occurred, preventive antihistaminic drug therapy should be advised.

Anaphylaxis↗
PubMed1994

Echocardiographic investigation of inhaled nitric oxide in newborn babies with severe hypoxaemia.

Nitric oxide inhalation can benefit newborn babies with right-to-left extrapulmonary shunt (EPS). Using doppler ultrasound, we compared the effects of nitric oxide on systemic oxygenation and mean pulmonary-blood-flow velocity (MPBFV) in severely hypoxic babies with or without EPS. With a median (interquartile range) dose of 20 (32) parts per million, oxygenation index decreased significantly in both groups (EPS, 49 [19] vs 11 [9]; non-EPS, 40 [11] vs 20 [13]). The decrease was significantly greater in the EPS group. MPBFV increased significantly in the EPS group (18 [4] vs 29 [8] m/s) only. Nitric oxide may improve systemic oxygenation in neonates with severe hypoxaemia secondary to EPS by increasing pulmonary blood flow, and in those without EPS by improving ventilation-perfusion matching.

Administration, Inhalation↗
PubMed1992

[Neonatal heart transplantation. First results].

Two 5- and 17-days old neonates with hypoplastic left heart syndrome respectively underwent orthotopic heart transplantation. The donor-recipient weight ratio was +58 percent and +88 percent; ischemic time was 144 and 167 min. The immunosuppressive protocol included thymoglobulin during the induction period and a classical 3-drug therapy, with a rapid tapering off of prednisone over 3 weeks. No infectious complication was observed; each infant experimented one episode of acute rejection, successfully treated with prednisolone. Forty-three months and 10 months later, the 2 children are doing well, with normal renal function and normal growth. No late rejection episode was observed. Heart transplantation in neonates is feasible, the short-term and mid-term results are good. Despite important ethical problems, heart transplantation represents a great hope for neonates with inoperable congenital heart defects.

Graft Rejection↗
PubMed1990

Pulmonary vascular effects of exogenous atrial natriuretic peptide in sheep fetuses.

In the adult, atrial natriuretic peptide (ANP) regulates renal and cardiovascular function when blood volume is expanded, when atrial pressure is increased, and when arterial oxygen content is decreased. In late gestation fetal sheep, plasma ANP concentrations are higher than in pregnant adults; however, ANP function in the fetus is unclear. To assess the possible role of ANP in mediating changes in pulmonary blood flow, we studied six chronically cannulated fetal sheep at 132-134 d gestation (term 145 d). We infused ANP in doses of 4.0 +/- 0.48, 16.0 +/- 1.9, and 64.0 +/- 7.7 ng/kg/min, and vehicle into all fetuses. ANP increased hematocrit, which suggests that blood volume decreased. Pulmonary blood flow, measured by the radionuclide-labeled microsphere technique, increased in response to the 4.0, 16.0, and 64.0 ng/kg/min dose ANP infusions from a control value of 126.5 +/- 32.2 to 141.8 +/- 26.9 to 170.4 +/- 37.2 to 300.8 +/- 84.8 mL/min/100 g (p less than 0.05), respectively, and calculated pulmonary vascular resistance decreased from a control value of 0.45 +/- 0.08 to 0.42 +/- 0.08 to 0.43 +/- 0.09 to 0.21 +/- 0.04 (p less than 0.05) mm Hg/mL/min/kg, respectively. Pulmonary blood flow decreased to 54.5 +/- 6.0 mL/min/100 g and calculated pulmonary vascular resistance increased to 0.81 +/- 0.09 mm Hg/mL/min/kg during the recovery period. Mean pulmonary and carotid arterial blood pressures, venous blood pressure, and heart rate did not change significantly. Thus, ANP may play a role in maintaining right ventricular output in the fetus by increasing pulmonary blood flow through its ability to decrease pulmonary vascular resistance.

Animals↗
PubMed1987

Sonographic diagnosis of lissencephaly.

Lissencephaly, a developmental malformation characterized by absence of sulci, may be suggested in dysmorphic or epileptic infants. Real time ultrasonographic findings correlated with typical electroencephalographic abnormalities establish the diagnosis.

Brain↗
PubMed1986

[Endocardial fibroelastosis: prenatal manifestation of aortic valve stenosis].

A diagnosis of fibroelastosis was made in a 33-week-old fetus, based on the echocardiographic features of a marked impairment of left ventricular contractility and hyperechogenicity of the endocardium. Fibroelastosis was associated with an aortic stenosis. There was no evidence of hydrops fetalis. Prenatal detection of this severe congenital heart disease allowed its early management in an intensive care unit. Heart failure due to closure of the ductus required the use of prostaglandin, then a surgical aortic valvulotomy was performed. There was no postoperative problem, and one year after surgery the infant is doing well. His left ventricular contractility is normal, and echocardiographic features of fibroelastosis are no more present. Prenatal diagnosis, use of prostaglandin and increasing safety of neonatal cardiac surgery have improved the prognosis of this serious association.

Aortic Valve Stenosis↗