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Semin Respir Crit Care Med
Division of Neurosciences Critical Care, Departments of Neurology and Anesthesia and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Published: December 2017
Spontaneous intracerebral hemorrhage (ICH) is the most common cause of intraventricular hemorrhage (IVH) in adults. Complicating approximately 40% of ICH cases, IVH adds to the morbidity and mortality of this often fatal form of stroke. It is also a severity factor that complicates subarachnoid hemorrhage and traumatic brain injury, along with other less common causes of intracranial bleeding. Medical and surgical interventions to date have focused on limiting ICH and IVH expansion, controlling intracranial pressure, and relieving obstructive hydrocephalus. The placement of an external ventricular drain (EVD) can achieve the latter two goals but has not demonstrated improvement in clinical outcomes beyond mortality reduction. More recently, intraventricular fibrinolysis, utilizing the EVD, has gained interest as a safe and potentially effective method to maintain catheter patency and facilitate hematoma removal. A recent phase III clinical trial evaluating the efficacy of intraventricular alteplase versus intraventricular saline showed a mortality benefit, but failed to meet the primary endpoint of significant functional improvement. However, planned subgroup analysis focusing on patients with IVH volume > 20 mL, and those with IVH removal > 85% suggest that significant functional benefits may be attainable with this therapy. The practice of intraventricular fibrinolysis for spontaneous IVH is not the standard of care; however, based on 20 years of experience, it meets thresholds as a safe intervention, and in those patients with a high burden of intraventricular blood, aggressive clearance may lead to improved quality of life in survivors of this morbid syndrome.
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http://dx.doi.org/10.1055/s-0037-1607991 | DOI Listing |
Resusc Plus
March 2025
Department of Neonatology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Objective: To provide an updated review of the clinical profile and outcomes of delivery room chest compression (DR-CC) in China.
Method: Retrospective analysis of prospectively collected data from 23 neonatal intensive care units in Jiangsu, China (2019-2021). Antepartum, delivery room, and postpartum variables in DR-CC-receiving and no-DR-CC groups were compared using uni- and multivariate analyses.
Front Pediatr
February 2025
Department of Neonatology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Background: With advances in perinatal medicine, there has been a rise in the preterm birth rate, especially the rate of very low birth weight (VLBW) and extremely low birth weight infants. Studies have shown that maternal age during pregnancy and at the time of delivery is associated with pregnancy complications and poor neonatal outcomes. Little is known about the effect of maternal age on the outcome of very low birth weight infants.
View Article and Find Full Text PDFInt J Mol Sci
February 2025
Neurobiology, Research Unit, Hospital Universitari Son Espases, Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain.
Pediatric stroke, a significant cause of long-term neurological deficits in children, often arises from disruptions within neurovascular unit (NVU) components. The NVU, a dynamic ensemble of astrocytes, endothelial cells, pericytes, and microglia, is vital for maintaining cerebral homeostasis and regulating vascular brain development. Its structural integrity, particularly at the blood-brain barrier (BBB), depends on intercellular junctions and the basement membrane, which together restrict paracellular transport and shield the brain from systemic insults.
View Article and Find Full Text PDFJ Pediatr (Rio J)
March 2025
Hospital das Clínicas de Ribeirão Preto da Universidade de São Paulo, Departamento de Pediatria, Divisão de Terapia Intensiva Neonatal, Ribeirão Preto, SP, Brazil.
Objective: This systematic review aimed to analyze, in neonates, the effects of high-frequency oscillatory ventilation (HFOV) with volume-targeted (VT) compared with conventional HFOV.
Sources: The authors searched PubMed, EMBASE, Cochrane, and ClinicalTrials.gov from inception until August 4th, 2024, to identify studies comparing HFOV with and without VT in neonates under 44 weeks corrected age.
J Magn Reson Imaging
March 2025
Department of Radiology, Central Hospital of Dalian University of Technology, Dalian, People's Republic of China.
Unlabelled: Four-dimensional flow cardiovascular magnetic resonance (4D Flow cardiac MRI) is an advanced non-invasive imaging technology, and its derived kinetic energy (KE) blood flow parameters have been confirmed as a potential biomarkers for assessing ventricular hemodynamics. This review synthesizes details on the methodology, clinical significance, and current status of studies focused on quantifying KE parameters of the ventricle using 4D Flow cardiac MRI, providing an objective foundation for further exploration of the value of KE in cardiac diseases.
Study Type: retrospective.
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