1/17. High-frequency oscillation for persistent fetal circulation after repair of congenital diaphragmatic hernia.A female neonate who had been diagnosed as having congenital diaphragmatic hernia by ultrasonography was delivered by cesarean section. After the hernia was repaired, she developed hypoxemia and hypercapnia, probably due to persistent fetal circulation (PFC). Neither conventional mechanical ventilation (CMV) nor manual ventilation improved the respiratory status. High-frequency oscillation (HFO) successfully improved pulmonary gas exchange, but we failed to wean the patient from HFO by using intermittent HFO. The patient was again placed on CMV for weaning and was extubated on the 12th ICU day. We conclude that HFO can be an alternative respiratory modality in patients with respiratory failure due to PFC after the repair of congenital diaphragmatic hernia.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
2/17. Perforating gastric ulceration during tolazoline therapy for persistent foetal circulation.Gastric ulcerations were observed in an infant with persistent foetal circulation treated with tolazoline. The first symptoms were noted 14 hours after institution of therapy, and free air in the abdomen was visualised 34 hours later. It is suggested that the ulcerations may have been a side effect of tolazoline. The concomitant use of cimetidine may prevent this complication.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
3/17. pregnancy and delivery after bone marrow transplantation (BMT) for severe aplastic anemia (SAA). A case report.A 23 years old multiple pretransfused female with severe aplastic anemia (SAA) underwent bone marrow transplantation (BMT). cyclophosphamide (200 mg/kg) was used for conditioning, donor buffy coat cells were given as rejection prophylaxis. Seven months after BMT regular menses started in the absence of exogenous hormonal manipulation and 21 months after BMT the patient became pregnant. pregnancy was complicated by mumps in the 14th week. It was terminated at term by cesarean section. The normally developed newborn girl (3,450 gm) presented with a "persistent fetal circulation syndrome". After surgical correction of the patent ductus arteriosus Botalli the girl baby recovered quickly.- - - - - - - - - - ranking = 0.2keywords = circulation (Clic here for more details about this article) |
4/17. Severe fetomaternal hemorrhage. A report of four cases.Four cases of severe fetomaternal hemorrhage (FMH) presented with severe anemia and signs of circulatory failure. One of the patients developed the syndrome of persistent fetal circulation. The diagnosis of FMH was confirmed in all using Kleihauer-Betke tests, which demonstrated abundant fetal erythrocytes in the maternal circulation. Three infants survived after prompt volume replacement and correction of anemia. The only fatality was related to an underlying chromosomal disorder. The majority of reported neonatal deaths due to FMH have occurred when shock was the presenting manifestation.- - - - - - - - - - ranking = 0.4keywords = circulation (Clic here for more details about this article) |
5/17. Misalignment of lung vessels: a syndrome causing persistent neonatal pulmonary hypertension.The cases of two female infants with persistent neonatal pulmonary hypertension are described. Combinations of pulmonary parenchymal lesions were present, including underdevelopment of alveoli and interstitial fibrosis as well as misalignment of lung vessels. As a result of the misalignment, the pulmonary veins joined the pulmonary arteries, rather than following a course away from them. One of the infants had additional congenital malformations. This syndrome should be considered in the evaluation of infants with persistent fetal circulation.- - - - - - - - - - ranking = 0.2keywords = circulation (Clic here for more details about this article) |
6/17. False diagnosis of persistent fetal circulation caused by misplacement of umbilical artery catheter.We have described two cases in which persistent fetal circulation was mistakenly diagnosed because umbilical artery catheters were placed in too high a position. In one case, repeated doses of tolazoline were given unnecessarily. While high placement of umbilical artery catheters is commonly accepted, misplacement may not always be apparent on routine AP chest films taken to confirm catheter positioning.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
7/17. Transcutaneous estimation of oxygen tension in unusual clinical situations.Transcutaneous oxygen monitoring has been used successfully in the assessment of trend in tissue oxygenation in neonates and children. This study highlights the application of transcutaneous oxygen monitoring in three unusual clinical situations: dual channel oxygen monitoring in persistent foetal circulation, hyperoxia test in the differentiation of cardiac or pulmonary central cyanosis and the effect of endotracheal intubation on tissue oxygenation. Its usefulness and potential application in these situations are discussed.- - - - - - - - - - ranking = 0.2keywords = circulation (Clic here for more details about this article) |
8/17. Congenital alveolar capillary dysplasia: a developmental vascular anomaly causing persistent pulmonary hypertension of the newborn.The clinical course and histologic findings are presented of an infant with an unusual form of pulmonary dysplasia. Characteristic sonographic findings and progressive hypoxemia led to the diagnosis of persistence of the fetal circulation. The patient expired despite ventilatory and pharmacologic intervention. Postmortem findings of severe pulmonary capillary hypoplasia, despite normal anatomical and biochemical parenchymal maturation, were observed. It is suggested that factors controlling pulmonary capillary maturation may be significantly different from those involved in airway and pulmonary parenchymal development.- - - - - - - - - - ranking = 0.2keywords = circulation (Clic here for more details about this article) |
9/17. Persistent fetal circulation in neonates postoperatively: the value of manual ventilation.Three critically ill infants who had persistent fetal circulation postoperatively, refractile to tolazoline and 100% oxygen with mechanical ventilation including continuous positive airway pressure, responded favourably to prolonged manual hyperventilation. Two infants had undergone repair of a diaphragmatic hernia and the third had correction of a tracheoesophageal fistula. Normal respiratory function was documented in two survivors. The third died 14 days postoperatively. The use of this simple technique indicated that perseverance can be rewarded in the treatment of persistent fetal circulation unresponsive to the usual medical management.- - - - - - - - - - ranking = 1.2keywords = circulation (Clic here for more details about this article) |
10/17. beta-hemolytic streptococcal infection appearing as persistent fetal circulation.Sixty neonates who were transferred to a neonatal intensive care unit during a four-year period had diagnoses of persistent fetal circulation (PFC). Six of these 60 neonates had beta-hemolytic streptococcal infection. The clinical appearance of these six neonates included respiratory distress, cyanosis, and/or apnea. The chest roentgenograms showed mild to moderate lung disease. All six neonates had progressive acidosis with hypoxemia. The diagnosis of PFC was made by cardiac catheterization or contrast echoangiography. The neonates were treated with mechanical ventilation, antibodies, and supportive therapy, including tolazoline hydrochloride. mortality was high; only one of the six neonates survived. Streptococcal infection should be added to the growing list of conditions associated with PFC.- - - - - - - - - - ranking = 1keywords = circulation (Clic here for more details about this article) |
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