ABSTRACT
OBJECTIVE: Superoxide radicals (O2-) are generated during reoxygenation following asphyxia, possibly more when higher concentrations of O2 are used during resuscitation. Superoxide dismutase (SOD) is an antioxidant enzyme, which scavenges O2-. We tested the hypothesis that a single intravenous dose of recombinant human Cu,Zn SOD (rhSOD) could influence microcirculation and biochemical markers of asphyxia in piglets reoxygenated with 21% or 100% O2 after combined cerebral hypoxemia-ischemia-hypercapnia. METHODS: Anesthetized newborn piglets were randomized to asphyxia (n = 40) or control (n = 3). Asphyxia was induced by ventilation with 8% O2, adding CO2, and temporary occlusion of both common carotid arteries. After 20 min, 16 piglets received rhSOD 5 mg/kg intravenously and reoxygenation with 21% O2 (rhSOD, 21%; n = 8) or 100% O2 (rhSOD, 100%; n = 8), and 24 piglets received saline and reoxygenation with 21% O2 (21%, n = 13) or 100% O2 (100%, n = 11). The cortical microcirculation was assessed by laser Doppler flowmetry, and glutamate in the striatum and hypoxanthine in the cortex were measured by in vivo microdialysis. RESULTS AND CONCLUSION: rhSOD peaked in plasma after 5 min. No rhSOD was detected in brain tissue. There were no significant differences between rhSOD and non-rhSOD groups in any measured variable.
Subject(s)
Free Radical Scavengers/administration & dosage , Hypoxia-Ischemia, Brain/therapy , Oxygen Inhalation Therapy , Superoxide Dismutase/administration & dosage , Telencephalon/blood supply , Animals , Animals, Newborn , Blood Flow Velocity , Disease Models, Animal , Free Radical Scavengers/blood , Free Radical Scavengers/metabolism , Humans , Hypoxia-Ischemia, Brain/metabolism , Hypoxia-Ischemia, Brain/physiopathology , Injections, Intravenous , Laser-Doppler Flowmetry , Microcirculation , Random Allocation , Recombinant Proteins/administration & dosage , Recombinant Proteins/blood , Recombinant Proteins/metabolism , Reperfusion , Superoxide Dismutase/blood , Superoxide Dismutase/metabolism , SwineABSTRACT
Instrumental dead space (iDS) is a major part of total dead space in newborns, and thus significantly determines effective alveolar ventilation. Continuous tracheal gas insufflation (CTGI) is a method for reducing the role of iDS, allowing a reduction in respiratory support and secondary lung injury. The literature and authors' experience with the method are reviewed. Major attention is paid to the risks in providing CTGI, optimal equipment and optimal management of CTGI.
Subject(s)
Insufflation , Intubation, Intratracheal , Neonatology , Respiration, Artificial , Respiratory Dead Space/physiology , Respiratory Distress Syndrome, Newborn/physiopathology , Respiratory Distress Syndrome, Newborn/therapy , Humans , Infant, Newborn , Severity of Illness IndexABSTRACT
An unusual case of a primary cutaneous Absidia corymbifera infection in a premature twin successfully treated with low doses of intravenous amphotericin B and topical natamycin is described. Epidemiological and therapeutical aspects of the case are discussed and in vitro antifungal susceptibility data are presented.
Subject(s)
Absidia/isolation & purification , Mucormycosis , Skin Diseases, Infectious , Female , Humans , Infant, Newborn , Mucormycosis/diagnosis , Mucormycosis/drug therapy , Mucormycosis/epidemiology , Obstetric Labor, Premature , Pregnancy , Skin Diseases, Infectious/diagnosis , Skin Diseases, Infectious/drug therapy , Skin Diseases, Infectious/epidemiologyABSTRACT
We studied drug-induced cardiotoxic effects in 22 pregnant women having tocolysis with intravenous fenoterol and verapamil. Because CK-MB is released from the uterus and placenta, we used the determination of cardiac troponin T (cTnT) as it is one of the most sensitive and specific indicators of myocardial necrosis. Cardiac troponin T levels were within physiological range (0.08 +/- 0.01 microgram/l) in all healthy pregnant women tested between 32 and 36 weeks of gestation (control group). In the pregnant women having tocolysis cTnT levels started to increase slightly during the first day of treatment (0.10 +/- 0.03 microgram/l) and were significantly higher (p < 0.05) during the third day (0.35 +/- 0.14 microgram/l) of tocolytic therapy. The cTnT levels in cord blood (0.13 +/- 0.03 microgram/l) did not correspond with maternal cTnT concentrations.
