No abstract

There is a significant increase in myocardial performance following transfusion, which is related to the severity of the anemia.

Refractory pneumothoraces with bronchopleural fistula (BPF) pose a significant challenge in managing critically sick and ventilated neonates. We report a case of the term female neonate being treated with extracorporeal membrane oxygenation (ECMO) support for meconium aspiration and presumed sepsis, with a significant air leak refractory to pleural drainage that was managed using endobronchial application of cyanoacrylate (enbucrilate) glue to seal the leak.

Aim:We investigated myocardial contractility as measured by Echocardiographic parameters of Tissue Doppler Imaging (TDI), Myocardial Performance Index (MPI), Ejection Fraction (EF) and Biochemical markers in VLBW infants before and after red cell transfusion.Method:Prospective, observational study on VLBW infants of < 34 weeks gestation and >2 weeks of age. Blood sampling and echocardiogram performed in 12 hours before and between 3 to 7 days after transfusion. Infants with congenital heart lesions were excluded. Data was analysed using paired t-test, Wilcoxon signed rank and Kendall's Tau to compare the differences and to see correlation between pre and post values.Results: 74 pre and post transfusion (Pst) studies were performed on 28 infants. Pre-transfusion (Prt) haematocrit (Hct) ranged between 0.20% and 0.29%.Significant improvement in each biochemical and echocardiographic parameters were seen after transfusion: Methods: Piglets (n=7, age 1-2 days) were anaesthetized with propofol and randomized to normovolaemia-hypovolaemia or hypovolaemianormovolaemia. Hypovolaemia was induced by removal of ⅓ of the estimated blood volume. Normovolaemia was re-established by re-infusing the removed blood volume. A resting period of 30 minutes was interpolated after removal and reinfusion of the blood volume to enable recovery of cerebral autoregulation. CA-capacity was estimated from changes in cortical flux (laser-Doppler probe) to induced rises in ABP by inflation of a thoracic aorta balloon for 30 seconds. Subsequently, CAcapacity was calculated as %ΔCVR/%ΔABP (i.e. percentage of full autoregulatory capacity), where CVR was estimated as ABP/Doppler flux.Results: A total of 104 and 94 rises in ABP were analyzed during normo-and hypovolaemia, respectively. Hypovolaemia reduced mean ABP from 54±4 to 39±5 mmHg (P=0.02) and CAcapacity from 62±9 to 37±8% (P=0.05) (mean ±SEM). CA-capacity was 56±3 at ABP above 40 mmHg compared to 33± 3 below 40 mmHg (P=0.00005). Analysis of variance demonstrated an interaction between hypovolaemia and ABP such

Background: Tissue Doppler echocardiography assesses the long axis function of both ventricles which is difficult to evaluate by conventional echocardiography. This is readily available and can be used as a bedside tool to evaluate myocardial function.