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Biomedical subjects

R Ariagno

Publications and source records attributed to R Ariagno.

12 recordsLinked to original sources
PubMed1999

Effects of prone and supine position on sleep characteristics in preterm infants.

The purpose of this study was to address the influence of sleep position on sleep characteristics in preterm infants. We studied 16 infants at a mean post-conceptional age of 36.5 weeks. Infants were successfully recorded with videopolysomnograph in the supine and prone position. Between the two positions, there were no significant differences in percentage of active sleep and quiet sleep (QS), the occurrence of arousal, and the incidence of apnea. The first QS after the feeding was longer in the prone position. The sleep position could affect sleep characteristics but not respiratory characteristics in preterm infants.

Arousal↗
PubMed1998

Aerosolized albuterol improves airway reactivity in infants with acute respiratory failure from respiratory syncytial virus.

The objective of this investigation was to measure the bronchodilator effect of aerosolized albuterol on infants with respiratory syncytial virus (RSV)-induced respiratory failure. Infants who required intubation and mechanical ventilator support for RSV disease were eligible for this prospective, nonrandomized study. Pulmonary function tests, including respiratory mechanics by least mean square analysis, small airway function by rapid thoraco-abdominal compression, and functional residual capacity by nitrogen washout were performed before and 20 min after inhalation of 20-40 breaths of undiluted (0.5%) albuterol solution via a small-volume nebulizer. Analysis of maximum expiratory flow at functional residual capacity (V'maxFRC) before and after albuterol administration was performed using a t-test for paired comparisons. A two-tailed P-value of less than 0.05 was considered statistically significant. Twenty-five infants (mean +/-SD postconceptional age = 45 +/- 5 weeks) were enrolled. Thirteen of the 25 infants had a prior history of prematurity and/or cardiorespiratory disease. After aerosolized albuterol, mean V'maxFRC increased significantly from 48 +/- 46 ml/sec to 65 +/- 59 ml/sec (P = 0.03); however, only three patients had an increase into the normal range. Three patients had a substantial (40-50%) decrease in V'maxFRC. These findings suggest that during the acute phase of severe RSV respiratory infection some of this group of very young infants had airway reactivity that improved in response to inhaled albuterol.

Acute Disease↗
PubMed1998

Safety, tolerance and pharmacokinetics of a humanized monoclonal antibody to respiratory syncytial virus in premature infants and infants with bronchopulmonary dysplasia. MEDI-493 Study Group.

BACKGROUND: Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infection in infants. MEDI-493 (palivizumab) is a humanized monoclonal antibody to the fusion protein of RSV and is active in animal models for prevention of pulmonary RSV replication. OBJECTIVE: To describe the safety, tolerance, immunogenicity and pharmacokinetics of repeat intravenous doses of MEDI-493 in premature infants or infants with bronchopulmonary dysplasia. DESIGN: Phase I/II multicenter, randomized, double blind, placebo-controlled, dose escalation trial. PATIENT POPULATION: Infants born prematurely (< or = 35 weeks of gestation) who were < or = 6 months of age and infants with bronchopulmonary dysplasia who were < or = 24 months of age were eligible for study participation. STUDY AGENTS: Participants received 3, 10 or 15 mg/kg MEDI-493 or 0.9% saline intravenously every 30 days for up to five doses. RESULTS: MEDI-493 was safe and well-tolerated and did not induce a specific anti-MEDI-493 response. The mean half-life of 20 days was comparable with that of other immunoglobulin G preparations. Mean trough serum concentrations 30 days after Infusion 1 were 6.8, 36.1 and 60.6 microg/ml for the 3-, 10- and 15-mg/kg dose groups, respectively. After Infusion 2 the trough concentrations were 11.9, 45.2 and 70.7 microg/ml. After subsequent doses the mean trough values ranged from 14 to 18 microg/ml in those given 3 mg/kg and were > 40 microg/ml for patients who received 10 or 15 mg/kg MEDI-493 (46 to 72 microg/ml and 88 to 96 microg/ml, respectively). CONCLUSIONS: MEDI-493 was safe and well-tolerated in this high risk pediatric population. Mean serum concentrations of MEDI-493 that have been shown to produce a 2-log reduction in pulmonary RSV titer in cotton rats were maintained when 10 or 15 mg/kg MEDI-493 was given every 30 days to pediatric patients at high risk for serious RSV disease. Monthly doses of 15 mg/kg maintained concentrations of > 40 microg/ml for the majority of patients.

Antibodies, Monoclonal↗
PubMed1985

The natural history of subependymal germinal matrix hemorrhage.

A prospective study of 377 premature infants (less than or equal to 1500 gm) was undertaken to delineate the natural history of subependymal/intraventricular hemorrhage (S/IVH) and its complications using ultrasound (US) and computed tomography (CT). Low grade (I, II) S/IVH had a low mortality while higher grades (III, IV) still had elevated mortality rates. The addition of intraparenchymal hemorrhage (IPH) to S/IVH incrementally increased the incidence of death and other complications, suggesting IPH hemorrhage should be categorized separately. When a specific day could be identified, S/IVH had its onset in the first 7 days of life with peak incidence occurring on day 3. S/IVH appeared to be an event limited to less than 24 hours in all but 5% of infants in whom progression of hemorrhage was documented over a 24-hour period. The mortality rate of these progressive hemorrhages was high, 50%. The benign phenomenon of late S/IVH was detected in 5% of infants. These hemorrhages were clinically silent and of minor severity. Several complications of S/IVH were detected. Hydrocephalus was a significant complication only for higher grades of S/IVH. When present, severe hydrocephalus had an early onset and reached a maximum at around 3 weeks of age. "Atrophic change" of a cerebral hemisphere was detected in 30% of all S/IVH infants, while this was not seen in nonS/IVH infants. This "atrophic" abnormality had a marked predilection for the left hemisphere, independent of the site of the S/IVH. Periventricular leukomalacia (PVL) was documented by US in 2% of infants and could be detected in the first week of life. PVL presented in the first week of life as an echogenic lesion which developed "cystic" changes at approximately 3-4 weeks of age. This complication should be categorized separately from S/IVH.

Atrophy↗
PubMed1985

Near-miss sudden infant death syndrome in eight infants with sleep apnea-related cardiac arrhythmias.

Eight full-term infants between 3 and 8 weeks of age, who had had 24 to 48 hours of vague problems involving a congested upper airway and/or irritability, had a life-threatening respiratory episode at home, called a near-miss for sudden infant death syndrome event. Polygraphically monitored mixed apneas occurred in clusters during non-rapid eye movement (NREM) sleep with significant cardiac arrhythmias, predominantly sinus arrest. The cardiorespiratory problems continued during sleep in the following 8 to 12 weeks but did not recur after that time, and there were no long-term sequelae when the children were studied again 4 to 7 years later.

Arrhythmias, Cardiac↗
PubMed1981

Sleep parameters and respiratory variables in "near miss' sudden infant death syndrome infants.

Twenty-nine near miss for sudden infant death syndrome and thirty normal infants between the ages of 3 weeks and 6 months were monitored polygraphically for 24 hours. The distribution of sleep and abnormal respiratory events were analyzed for both groups. On the basis of mixed and obstructive apnea, 12-hour nocturnal segments (8 PM to 8 AM) consistently distinguished near miss from normal infant groups between the ages of 3 weeks and 4.5 months. Daytime naps do not provide statistical differences sufficient to differentiate between the two groups. During sleep, abnormal respiratory events are more likely to occur between 1 AM and 6 AM, at least 40 minutes after sleep onset. Respiratory pauses show a significant increase just prior to waking (a strong respiratory stimulus). Any impairment of the arousal threshold during sleep will place near miss infants at increased risk.

Monitoring, Physiologic↗
PubMed1979

Mixed and obstructive sleep apnea and near miss for sudden infant death syndrome: 2. Comparison of near miss and normal control infants by age.

Twenty-nine full-term near miss for sudden infant death syndrome (SIDS) and 30 normal control infants underwent 24-hour polygraphic monitoring. Several types of respiratory events during sleep (eg, central, mixed, and obstructive apnea, periodic breathing) were defined and tabulated. Analysis of these respiratory variables and comparison of groups of near miss and control infants indicated that between 3 weeks and 4 1/2 months of age only one variable was consistently different at a statistically significant level: the number of mixed and obstructive apnea greater than 3 seconds during total sleep time. This study also showed an increase in mixed and obstructive respiratory events during sleep at 6 weeks of age in control as well as in near miss infants.

Female↗
PubMed1976

Abnormal polygraphic findings in near-miss sudden infant death.

Sleep, respiratory, and cardiac data obtained during sleep and wakefulness by continuous 24-hour polygraphic monitoring from twelve infants who were "near misses" for the sudden-infant-death syndrome were compared with similar information obtained from seven low-risk infants. Although the sleep variables studied were of limited value in differentiating between the low and high risk patients, respiratory and cardiac abnormalities were strikingly more common in near-miss infants. High-risk infants demonstrated both obstructive and mixed stopped-breathing episodes (S.B.E.). Bradycardia was seen secondary to S.B.E. but also simultaneously with or independent of S.B.E. Sudden asystole associated with S.B.E. was seen in one case. These results suggest an autonomic-nervous-system dysfunction in high-risk infants.

Apnea↗