ABSTRACT
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
The present study was designed to determine the levels of cardiac troponin T (cTnT) in cord blood of neonates exposed in utero to tocolytic therapy by beta-sympathomimetics. cTnT in 40 neonates after acute tocolysis (0.24 +/- 0.05 microg/l) was significantly higher (p < 0.05) in comparison with the control group (0.05 +/- 0.01 microg/l). The maximal values were reached in about the 3rd day of therapy (0.39 +/- 0.11 microg/l). cTnT in 30 neonates after long-term tocolysis was 0.12 +/- 0.03 microg/l. No correlation was found between cTnT and CK and its isoenzyme CK-MB or ECG. CK, unlike cTnT, significantly correlated with gestational age (r = 0.57, p < 0.05) and birth weight (r = 0.55, p < 0.05). It is possible to conclude that acute tocolytic therapy by beta-sympathomimetics increases the cTnT levels in cord blood and cardiac troponin T is more useful for the laboratory diagnosis of neonatal myocardial injury than CK-MB.
Subject(s)
Fetal Blood/chemistry , Tocolysis/adverse effects , Troponin T/blood , Adrenergic beta-Agonists/adverse effects , Cardiomyopathies/chemically induced , Creatine Kinase/blood , Electrocardiography , Female , Humans , Infant, Newborn , Isoenzymes/blood , Male , Myocardium/enzymology , Pregnancy , Tocolytic Agents/adverse effectsABSTRACT
Anthracycline derivatives are among the most effective antineoplastic drugs but their therapeutic use is limited by their adverse effects. The cardiac side-effects of antineoplastic drugs were investigated in rabbits in vivo from the viewpoint of release of cardiac troponin T (cTnT) measured by Elecsys Troponin T STAT immunoassay (Boehringer Mannheim, Germany). No increase in cTnT was found following administration of a single dose of daunorubicin (3 mg/kg i.v., n = 4). During development of daunorubicin-induced cardiomyopathy (daunorubicin 3 mg/kg i.v., once a week; maximum nine administrations, n = 7), the levels of cTnT were within the physiological range (i.e. cTnT <0.1 microg/l) at the beginning of the experiment and before and after the 5th administration, but the pathological values of cTnT after the 8th administration in 43% animals (0.22+/-0.08 microg/l) correlated with their premature death. In the control group, the levels of cTnT were always lower than 0.1 microg/l during the experiment. Following administration of a new antineoplastic drug - Oracin [6-[2-(2-hydroxyethyl) aminoethyl]-5,11-dioxo-5,6-dihydro-11H-indeno [1,2-c]-isoquinoline hydrochloride, 10 mg/kg i.v., once weekly, ten administrations, n = 7], there was no increase in cTnT levels. These findings correlated with the PEP: LVET index, histological examination and no animal succumbing to premature death. It is possible to conclude that cTnT is a useful marker for the prediction of experimentally induced anthracycline cardiomyopathy and for the evaluation of cardiotoxic (and, possibly, cardioprotective) effects of new drugs in rabbits.
Subject(s)
Antibiotics, Antineoplastic/adverse effects , Antineoplastic Agents/adverse effects , Biomarkers/analysis , Cardiomyopathies/chemically induced , Cardiomyopathies/metabolism , Daunorubicin/adverse effects , Ethanolamines/adverse effects , Isoquinolines/adverse effects , Myocardium/metabolism , Troponin T/metabolism , Animals , Drug Administration Schedule , Infusions, Intravenous , Male , RabbitsABSTRACT
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.
Subject(s)
Tocolysis/adverse effects , Troponin T/blood , Adult , Apgar Score , Body Weight , Enzyme-Linked Immunosorbent Assay , Female , Fenoterol/adverse effects , Fetal Blood/chemistry , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Trimester, Third , Verapamil/adverse effectsABSTRACT
The measurement of CK-MB remains the test of choice for confirmation or exclusion of AMI and probably will remain the test of choice for routine diagnosis in the near future. Nowadays determination of cardiac troponin T (cTnT) and cardiac troponin I (cTnI) as a method relatively expensive and time-consuming should be restricted to clinical settings that really require their high specificity.
Subject(s)
Biomarkers/blood , Myocardial Infarction/diagnosis , Myocardium/metabolism , Troponin I/blood , Troponin/blood , Creatine Kinase/blood , Humans , Isoenzymes , Troponin TABSTRACT
The present study was designed to evaluate the side-effects of preventive tocolysis by Bricanyl on the foetal myocardium using the new serological marker of myocardial damage-troponin T (TnT). The cardiac troponin T concentration was measured by means of commercial kits (Enzymun-Test System, Boehringer Mannheim, Germany) in the cord blood of 15 neonates. TnT serum concentration of neonates exposed in utero to Bricanyl was not significantly higher (mean 0.12 +/- 0.20 microgram/l) in comparison with the normal cardiac troponin T level but 4 of 15 neonates had an elevated TnT concentration (above 0.1 microgram/l). No correlation was found between TnT and CK or CK-MB.
Subject(s)
Fetal Blood/chemistry , Terbutaline/adverse effects , Tocolysis , Tocolytic Agents/adverse effects , Troponin/blood , Female , Fetal Heart/drug effects , Humans , Infant, Newborn , Male , Pregnancy , Terbutaline/therapeutic use , Tocolytic Agents/therapeutic use , Troponin TABSTRACT
Troponin T (TnT) is recently being considered to be an important diagnostic marker of myocardial damage in adults, but this marker has not yet been used in neonates. The present study was designed to determine the normal level of cardiac TnT in the cord blood of healthy term neonates. Cardiac troponin T concentration in cord blood was measured in 15 healthy term neonates using commercial kit (Enzymun-Test System, Boehringer, Mannheim). TnT serum concentration was 0.05 +/- 0.04 micrograms/l in 10 of 15 babies whereas in the remaining 5 haemolysed samples its concentration was elevated (mean 0.19 +/- 0.07 micrograms/l). It is important to consider that incidental haemolysis of blood samples can mimic pathological elevation of TnT by interfering with the assay.
Subject(s)
Fetal Blood/chemistry , Troponin/blood , Age Factors , Biomarkers , Blood Chemical Analysis , Body Weight , Enzymes/blood , Female , Humans , Infant, Newborn , Male , Reference Values , Troponin TABSTRACT
The ECG changes in children with acute myocarditis have been reported. The individual case-reports were presented in brief, and the detailed descriptions of ECG changes have been made in all 5 patients. Following findings have been reflected: A-V blocks of I-III degrees, polytopic supraventricular and ventricular pseudocontractions, supraventricular tachyarrhythmias and repolarisation changes. Etiologically, the infection with Coxsackie virus from the B group was stated, one cyse of rheumatic carditis, and possible interrelation with varicella infection was discussed in one female patient.
