Tag Archives: Hemodynamics

PDA shunts and extubation

Following on from my recent post about PEEP levels and PDA shunts, this new article from Perth. The authors prospectively enrolled very immature infants (< 28 weeks) before a planned early extubation and did echocardiograms before and after. The mean … Continue reading

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PEEP and ductal shunts

I never thought that modest increase in PEEP would have a real effect on ductal shunting. As the size of the ductal shunt depends on the pressure gradient across the PDA and the resistance of the vessel, in order to … Continue reading

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Back Home

Back from Helsinki. The meeting was excellent, with a very high quality faculty, even though I diluted that down a little. I have put my presentation on this website, under ‘presentations from our group’ (link here). I presented on my … Continue reading

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What we don’t know about neonatal endocrinology #1, the adrenals.

I once wrote a paper with the last author of this article, when we were both working in Edmonton, so I will have to be nice, I guess. Seriously, we do need to know a lot more about adrenal responses … Continue reading

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Hypotension

A new study from the NICHD neonatal network Batton B, Li L, Newman NS, Das A, Watterberg KL, Yoder BA, et al. Use of Antihypotensive Therapies in Extremely Preterm Infants. Pediatrics. 2013 May 6.,This prospective cohort study was specifically designed … Continue reading

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Acidosis and the preterm, effects on heart and lungs

Noori S, Wu T-W, Seri I. pH Effects on Cardiac Function and Systemic Vascular Resistance in Preterm Infants. The Journal of pediatrics. 2013;162(5):958-63.e1. This study examined the effects of pH on ventricular outputs and calculated vascular resistance. There was little … Continue reading

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Oh No; not renal dose dopamine again!

This is the sort of thing that really irritates me: If you report ‘we did X, and Y happened’ the obvious question should be, ‘what would have happened if you didn’t do X?’ That is called having controls! It is … Continue reading

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How long is a piece of string? When is a PDA hemodynamically significant?

The answer to the first question is traditionally ‘twice as long as half a piece of string’ which is supposed to be funny. Equally difficult is the second question, when is a patent ductus arteriosus (PDA)  hemodynamically significant? We could … Continue reading

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New agents for hemodynamic support; how to evaluate them?

I have only ever prescribed a vasopressin infusion once for a baby. An infant was dying of septic shock and I done everything that I thought might help, without any evident benefit. So I decided to try vasopressin, based on … Continue reading

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Assessing perfusion in the sick preterm baby

I often give talks where I present my ‘data’, (notice the quotation marks, what I actually present are my prejudices, and uncontrolled observational information, along with systematic reviews of other people’s data) which suggest strongly that there is no need … Continue reading

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