Arch Dis Child Fetal Neonatal Ed
January 2025
Objective: To determine survival and neurodevelopmental outcomes in the Hypotension in Preterm (HIP) trial.
Design: Prospective follow-up of infants enrolled in randomised controlled trial.
Participants: 58 infants born before 28 weeks of gestation with low mean arterial blood pressure.
Objective: To test the potential utility of applying machine learning methods to regional cerebral (rcSO) and peripheral oxygen saturation (SpO) signals to detect brain injury in extremely preterm infants.
Study Design: A subset of infants enrolled in the Management of Hypotension in Preterm infants (HIP) trial were analysed ( = 46). All eligible infants were <28 weeks' gestational age and had continuous rcSO measurements performed over the first 72 h and cranial ultrasounds performed during the first week after birth.
Semin Fetal Neonatal Med
October 2022
Neonatal care is becoming increasingly complex with large amounts of rich, routinely recorded physiological, diagnostic and outcome data. Artificial intelligence (AI) has the potential to harness this vast quantity and range of information and become a powerful tool to support clinical decision making, personalised care, precise prognostics, and enhance patient safety. Current AI approaches in neonatal medicine include tools for disease prediction and risk stratification, neurological diagnostic support and novel image recognition technologies.
View Article and Find Full Text PDFBackground: The impact of the permissive hypotension approach in clinically well infants on regional cerebral oxygen saturation (rScO) and autoregulatory capacity (CAR) remains unknown.
Methods: Prospective cohort study of blinded rScO measurements within a randomized controlled trial of management of hypotension (HIP trial) in extremely preterm infants. rScO, mean arterial blood pressure, duration of cerebral hypoxia, and transfer function (TF) gain inversely proportional to CAR, were compared between hypotensive infants randomized to receive dopamine or placebo and between hypotensive and non-hypotensive infants, and related to early intraventricular hemorrhage or death.
Arch Dis Child Fetal Neonatal Ed
July 2021
Objective: To determine whether restricting the use of inotrope after diagnosis of low blood pressure (BP) in the first 72 hours of life affects survival without significant brain injury at 36 weeks of postmenstrual age (PMA) in infants born before 28 weeks of gestation.
Design: Double-blind, placebo-controlled randomised trial. Caregivers were masked to group assignment.
Hemodynamic support in neonatal intensive care is directed at maintaining cardiovascular wellbeing. At present, monitoring of vital signs plays an essential role in augmenting care in a reactive manner. By applying machine learning techniques, a model can be trained to learn patterns in time series data, allowing the detection of adverse outcomes before they become clinically apparent.
View Article and Find Full Text PDFBackground: Much controversy exists about the optimal management of a patent ductus arteriosus (PDA) in preterm infants, especially in those born at a gestational age (GA) less than 28 weeks. No causal relationship has been proven between a (haemodynamically significant) PDA and neonatal complications related to pulmonary hyperperfusion and/or systemic hypoperfusion. Although studies show conflicting results, a common understanding is that medical or surgical treatment of a PDA does not seem to reduce the risk of major neonatal morbidities and mortality.
View Article and Find Full Text PDFIn many preterm infants, the ductus arteriosus remains patent beyond the first few days of life. This prolonged patency is associated with numerous adverse outcomes, but the extent to which these adverse outcomes are attributable to the hemodynamic consequences of ductal patency, if at all, has not been established. Different treatment strategies have failed to improve short-term outcomes, with a paucity of data on the correct diagnostic and pathophysiological assessment of the patent ductus arteriosus (PDA) in association with long-term outcomes.
View Article and Find Full Text PDFEchocardiography and near-infrared spectroscopy have significantly changed our view on hemodynamic transition of the extreme preterm infant. Instead of focusing on maintaining an arbitrary target value of blood pressure, we aim for circulatory well-being by a comprehensive holistic assessment of markers of cardiovascular instability. Most of these clinical and biochemical indices are influenced by transition itself and remain poor discriminators to identify patients with a potential need for therapeutic intervention.
View Article and Find Full Text PDFObjective: To develop new quantitative features for the Perfusion Index signal recorded continuously over the first 24 hours of life in a cohort of extremely low gestational age newborns and to assess the association of these features with normal and adverse short-term outcome.
Study Design: A cohort study of extremely low gestational age newborns. Adverse outcome was defined as early mortality before 72 hours of life, acquired severe periventricular-intraventricular hemorrhage, or severe cystic leukomalacia.
J Am Soc Echocardiogr
September 2008
Background: In young patients (aged <12 years) with Duchenne muscular dystrophy (DMD), cardiac systolic function is generally described to be within the normal range. Recent studies have suggested the presence of subclinical dysfunction in these young patients using cardiac magnetic resonance imaging, tissue Doppler measurements, and myocardial velocity gradients. The aim of this study was to further assess regional myocardial function in a young group of patients with DMD using myocardial velocity and deformation imaging.
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