59 results on '"Luis Arruza"'
Search Results
2. Interferencia entre NIRS cerebral y bilirrubina conjugada en neonatos de extremado bajo peso
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María José Rodríguez, Araceli Corredera, José Martínez-Orgado, and Luis Arruza
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Pediatrics ,RJ1-570 - Published
- 2021
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3. Interference between cerebral NIRS and conjugated bilirubin in extremely low birth weight neonates
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María José Rodríguez, Araceli Corredera, José Martínez-Orgado, and Luis Arruza
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Pediatrics ,RJ1-570 - Published
- 2021
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4. Cannabidiol Reduces Inflammatory Lung Damage After Meconium Aspiration in Newborn Piglets
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Luis Arruza, Lorena Barata, Eva Vierge, Maria José Rodríguez, Aaron Del Pozo, William Hind, and José Martínez-Orgado
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meconium aspiration syndrome (MAS) ,cannabidiol ,inflammation ,piglet ,translational research ,Pediatrics ,RJ1-570 - Abstract
AimTo assess the effects of cannabidiol (CBD) on lung damage in a piglet model of meconium aspiration syndrome (MAS).Materials and MethodsMeconium aspiration syndrome was modelled in newborn piglets via intratracheal instillation of 20% meconium in saline collected from healthy newborn humans. Piglets were treated i.v. with 5 mg/kg CBD (MAS + CBD) or Vehicle (MAS + VEH) 30 min after MAS induction and monitored for 6 h. Ventilated piglets without meconium instillation served as controls (CTL). Ventilatory and haemodynamic monitoring, histological and biochemical studies assessed the effects of treatment.ResultsPost-insult administration of CBD reduced MAS-induced deterioration of gas exchange, improving respiratory acidosis (final pH 7.38 ± 0.02, 7.22 ± 0.03 and 7.33 ± 0.03 and final pCO2 39.8 ± 1.3, 60.4 ± 3.8 and 45.7 ± 3.1 mmHg for CTL, MAS + VEH and MAS + CBD, respectively, p < 0.05). These beneficial effects were obtained despite the less aggressive ventilatory settings required for CBD-treated animals (final minute volume 230 ± 30, 348 ± 33 and 253 ± 24 mL/kg/min and final Oxygenation Index 1.64 ± 0.04, 12.57 ± 3.10 and 7.42 ± 2.07 mmHg for CTL, MAS + VEH and MAS + CBD, respectively, p < 0.05). CBD’s beneficial effects on gas exchange were associated with reduced histological lung damage, reduced leucocyte infiltration and oedema (histopathological score 1.6 ± 0.3, 8.6 ± 1.4 and 4.6 ± 0.7 points for CTL, MAS + VEH and MAS + CBD, respectively, p < 0.05), as well as reduced TNFα production (0.04 ± 0.01, 0.34 ± 0.06 and 0.12 ± 0.02 A.U. for CTL, MAS + VEH and MAS + CBD, respectively, p < 0.05). Moreover, CBD improved blood pressure stability (final mean blood pressure 74.5 ± 0.2, 62.2 ± 6.2, and 78.67 ± 4.1 mmHg for CTL, MAS + VEH and MAS + CBD, respectively, p < 0.05).ConclusionCannabidiol reduces histologic lung damage and inflammation in a piglet model of MAS. This translates into improved gas exchange and blood pressure stability.
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- 2022
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5. Diastolic Dysfunction in Neonates With Hypoxic-Ischemic Encephalopathy During Therapeutic Hypothermia: A Tissue Doppler Study
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Maria Jose Rodriguez, Jose Martinez-Orgado, Araceli Corredera, Irene Serrano, and Luis Arruza
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diastolic dysfunction ,hypoxic-ischemic encephalopathy ,therapeutic hypothermia ,tissue Doppler ,newborn ,targeted neonatal echocardiography ,Pediatrics ,RJ1-570 - Abstract
Diastolic dysfunction often complicates myocardial ischemia with increased mortality rates. However, less is known about diastolic function after perinatal asphyxia in neonates with hypoxic-ischemic encephalopathy (HIE) during therapeutic hypothermia (TH) and rewarming.AimThe aim of this study was to assess diastolic function with tissue Doppler imaging (TDI) in neonates with moderate–severe HIE during TH and rewarming.MethodNewborns at >36 weeks' gestation with moderate–severe HIE treated with TH were evaluated with targeted neonatal echocardiography (TNE), including TDI, within 24 h of TH initiation (T1), at 48–72 h of treatment (T2), and after rewarming (T3). These retrospective data were collected and compared with a control group of healthy babies at >36 weeks' gestation that was prospectively evaluated following the same protocol.ResultsA total of 21 patients with HIE + TH and 15 controls were included in the study. Myocardial relaxation before the onset of biventricular filling was prolonged in the HIE + TH group during TH with significantly longer isovolumic relaxation time (IVRT') in the left ventricle (LV), the septum, and the right ventricle (RV). This was associated with slower RV early diastolic velocity (e') and prolonged filling on T1. Total isovolumic time (t-IVT; isovolumic contraction time [IVCT'] + IVRT') and myocardial performance index (MPI') were globally increased in asphyxiated neonates. All these differences persisted after correction for heart rate (HR) and normalized after rewarming. TDI parameters assessing late diastole (a' velocity or e'/a' and E/e' ratios) did not differ between groups.ConclusionTDI evaluation in our study demonstrated a pattern of early diastolic dysfunction during TH that normalized after rewarming, whereas late diastole seemed to be preserved. Our data also suggest a possible involvement of impaired twist/untwist motion and dyssynchrony. More studies are needed to investigate the impact and therapeutic implication of diastolic dysfunction in these babies, as well as to clarify the role of TH in these findings.
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- 2022
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6. Extremely Preterm Infant Admissions Within the SafeBoosC-III Consortium During the COVID-19 Lockdown
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Marie Isabel Rasmussen, Mathias Lühr Hansen, Gerhard Pichler, Eugene Dempsey, Adelina Pellicer, Afif EL-Khuffash, Shashidhar A, Salvador Piris-Borregas, Miguel Alsina, Merih Cetinkaya, Lina Chalak, Hilal Özkan, Mariana Baserga, Jan Sirc, Hans Fuchs, Ebru Ergenekon, Luis Arruza, Amit Mathur, Martin Stocker, Olalla Otero Vaccarello, Tomasz Szczapa, Kosmas Sarafidis, Barbara Królak-Olejnik, Asli Memisoglu, Hallvard Reigstad, Elżbieta Rafińska-Ważny, Eleftheria Hatzidaki, Zhang Peng, Despoina Gkentzi, Renaud Viellevoye, Julie De Buyst, Emmanuele Mastretta, Ping Wang, Gitte Holst Hahn, Lars Bender, Luc Cornette, Jakub Tkaczyk, Ruth del Rio, Monica Fumagalli, Evangelia Papathoma, Maria Wilinska, Gunnar Naulaers, Iwona Sadowska-Krawczenko, Chantal Lecart, María Luz Couce, Siv Fredly, Anne Marie Heuchan, Tanja Karen, and Gorm Greisen
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extremely preterm ,COVID-19 ,randomized clinical trial ,pandemic ,observational study ,neonatal intensive care unit admission ,Pediatrics ,RJ1-570 - Abstract
Objective: To evaluate if the number of admitted extremely preterm (EP) infants (born before 28 weeks of gestational age) differed in the neonatal intensive care units (NICUs) of the SafeBoosC-III consortium during the global lockdown when compared to the corresponding time period in 2019.Design: This is a retrospective, observational study. Forty-six out of 79 NICUs (58%) from 17 countries participated. Principal investigators were asked to report the following information: (1) Total number of EP infant admissions to their NICU in the 3 months where the lockdown restrictions were most rigorous during the first phase of the COVID-19 pandemic, (2) Similar EP infant admissions in the corresponding 3 months of 2019, (3) the level of local restrictions during the lockdown period, and (4) the local impact of the COVID-19 lockdown on the everyday life of a pregnant woman.Results: The number of EP infant admissions during the first wave of the COVID-19 pandemic was 428 compared to 457 in the corresponding 3 months in 2019 (−6.6%, 95% CI −18.2 to +7.1%, p = 0.33). There were no statistically significant differences within individual geographic regions and no significant association between the level of lockdown restrictions and difference in the number of EP infant admissions. A post-hoc analysis based on data from the 46 NICUs found a decrease of 10.3%in the total number of NICU admissions (n = 7,499 in 2020 vs. n = 8,362 in 2019).Conclusion: This ad hoc study did not confirm previous reports of a major reduction in the number of extremely pretermbirths during the first phase of the COVID-19 pandemic.Clinical Trial Registration:ClinicalTrial.gov, identifier: NCT04527601 (registered August 26, 2020), https://clinicaltrials.gov/ct2/show/NCT04527601.
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- 2021
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7. Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain
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Belén Fernández Colomer, Manuel Sánchez-Luna, Concepción de Alba Romero, Ana Alarcón, Ana Baña Souto, Fátima Camba Longueira, María Cernada, Zenaida Galve Pradell, María González López, M. Cruz López Herrera, Carmen Ribes Bautista, Laura Sánchez García, Elena Zamora Flores, Adelina Pellicer, Clara Alonso Díaz, Cristina Herraiz Perea, Dolores Sabina Romero Ramírez, Isabel de las Cuevas Terán, Isabel Pescador Chamorro, José Luis Fernández Trisac, Luis Arruza Gómez, Luis Miguel Cardo Fernández, Mª Jesús García García, Marta Nicolás López, Miryam Hortelano López, Mónica Riaza Gómez, Natalio Hernández González, Raquel González Sánchez, Sílvia Zambudio Sert, Susana Larrosa Capacés, and Vanesa Matías del Pozo
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coronavirus disease 2019 ,SARS-CoV-2 infection ,neonates ,epidemiology–descriptive ,hospital-acquired infection ,community-acquired infection ,Pediatrics ,RJ1-570 - Abstract
Objective: Coronavirus disease 2019 (COVID-19) cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to increase worldwide. Although some data from pediatric series are available, more evidence is required, especially in neonates, a group with specific characteristics that deserve special attention. This study aimed to describe general and clinical characteristics, management, and treatment of postnatal-acquired (community and nosocomial/hospital-acquired) COVID-19 neonatal cases in Spain.Methods: This was a national prospective epidemiological study that included cases from a National Registry supported by the Spanish Society of Neonatology. Neonates with postnatal SARS-CoV-2 infection were included in this study. General data and infection-related information (mode and source of transmission, age at diagnosis, clinical manifestations, need for hospitalization, admission unit, treatment administered, and complementary studies performed, hospital stay associated with the infection) were collected.Results: A total of 40 cases, 26 community-acquired and 14 nosocomial were registered. Ten were preterm newborns (2 community-acquired and 8 nosocomial COVID-19 cases). Mothers (in both groups) and healthcare workers (in nosocomial cases) were the main source of infection. Hospital admission was required in 22 community-acquired cases [18 admitted to the neonatal intermediate care unit (NIMCU) and 4 to the neonatal intensive care unit (NICU)]. Among nosocomial COVID-19 cases (n = 14), previously admitted for other reasons, 4 were admitted to the NIMCU and 10 to the NICU. Ten asymptomatic patients were registered (5 in each group). In the remaining cases, clinical manifestations were generally mild in both groups, including upper respiratory airways infection, febrile syndrome or acute gastroenteritis with good overall health. In both groups, most severe cases occurred in preterm neonates or neonates with concomitant pathologies. Most of the cases did not require respiratory support. Hydroxychloroquine was administered to 4 patients in the community-acquired group and to 2 patients in the nosocomial group. Follow-up after hospital discharge was performed in most patients.Conclusions: This is the largest series of COVID-19 neonatal cases in Spain published to date. Although clinical manifestations were generally mild, prevention, treatment, and management in this group are essential.
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- 2020
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8. Exploring clinical, echocardiographic and molecular biomarkers to predict bronchopulmonary dysplasia.
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Maria Alvarez-Fuente, Laura Moreno, Paloma Lopez-Ortego, Luis Arruza, Alejandro Avila-Alvarez, Marta Muro, Enrique Gutierrez, Carlos Zozaya, Gema Sanchez-Helguera, Dolores Elorza, Andrea Martinez-Ramas, Gema Villar, Carlos Labrandero, Lucia Martinez, Teresa Casado, Irene Cuadrado, and Maria Jesus Del Cerro
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Medicine ,Science - Abstract
INTRODUCTION:Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease in childhood, related to prematurity, and the most common cause of pulmonary hypertension (PH) secondary to pulmonary disease in children. Moderate and severe BPD have a worse outcome and relate more frequently with PH. The prediction of moderate or severe BPD development in extremely premature newborns is vital to implement preventive strategies. Starting with the hypothesis that molecular biomarkers were better than clinical and echocardiographic factors, this study aims to explore the ability of clinical, echocardiographic and analytical variables to predict moderate or severe BPD in a cohort of extremely preterm infants. PATIENTS AND METHODS:We designed a prospective longitudinal study, in which we followed a cohort of preterm newborns (gestational age
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- 2019
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9. The Impact of Postnatal Systemic Steroids on the Growth of Preterm Infants: A Multicenter Cohort Study
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Carlos Zozaya, Alejandro Avila-Alvarez, Fermín García-Muñoz Rodrigo, María L. Couce, Luis Arruza, Cristina Fernandez-Perez, Abdón Castro, María Teresa Cuesta, Beatriz Vacas, Máximo Vento, and Miguel Saenz de Pipaón
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bronchopulmonary dysplasia ,preterm infant ,steroids ,growth ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Postnatal steroids, often used to prevent and treat bronchopulmonary dysplasia, may influence the growth of preterm infants, although data are scarce in the literature. This is a multicenter cohort study including surviving preterm infants n = 17,621) from the Spanish Neonatal Network SEN1500 database, without major congenital malformations. Linear regression models were adjusted for postnatal steroids, respiratory severity course (invasive mechanical ventilation at 28 days), progression to moderate−severe bronchopulmonary dysplasia (O2 at 36 weeks), length of stay, sex, gestational age and z-scores at birth. A subgroup analysis depending on the timing of administration, ventilation status at 28 days and moderate−severe BPD diagnosis was also performed. Overall, systemic postnatal steroids were not independently associated with poorer weight gain (0.1; 95% CI: −0.05 to 0.2 g/kg/day), linear growth (0; 95% CI: −0.03 to 0.01 cm/week) or head circumference growth (−0.01; 95% CI: −0.02 to 0 cm/week). Patients who received steroids after 28 days or who were not O2 dependent at 36 weeks after having received steroids gained more weight (0.22; 95% CI: 0.04 to 0.4 and 0.2; 95% CI: 0.004 to 0.5 g/kg/day, respectively). Globally, systemic postnatal steroids had no significant adjusted effect on postnatal growth.
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- 2019
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10. Parainfluenza 3 Respiratory Infection Associated with Pericardial Effusion in a Very Low Birthweight Infant
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Cristina Aranda Cazón, Luis Arruza Gómez, Gloria Herranz Carrillo, Cristina González Menchén, Zarife Daoud Pérez, José Antonio Martínez-Orgado, and José Tomás Ramos Amador
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Infectious and parasitic diseases ,RC109-216 - Abstract
Parainfluenza 3 virus is a frequent cause of respiratory infections in the pediatric population although it is uncommonly diagnosed in neonates, being usually reported as neonatal intensive care unit microepidemics. We report a case of parainfluenza 3 respiratory infection associated with pericardial effusion in a very low birthweight infant.
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- 2017
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11. Analysis of microsamples by miniaturized magnetic-based pipette tip microextraction: determination of free cortisol in serum and urine from very low birth weight preterm newborns
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José Grau, María Moreno-Guzmán, Luis Arruza, Miguel Ángel López, Alberto Escarpa, and Alberto Chisvert
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Electrochemistry ,Environmental Chemistry ,Biochemistry ,Spectroscopy ,Analytical Chemistry - Abstract
Miniaturized magnetic-based pipette tip microextraction is presented as a sample preparation approach for microsamples of serum and urine from newborns.
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- 2023
12. On the Move-Sensitive Fluorescent Aptassay on Board Catalytic Micromotors for the Determination of Interleukin-6 in Ultra-Low Serum Volumes for Neonatal Sepsis Diagnostics
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José Gordón, Luis Arruza, María Dolores Ibáñez, María Moreno-Guzmán, Miguel Ángel López, and Alberto Escarpa
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Fluid Flow and Transfer Processes ,Interleukin-6 ,Sepsis ,Process Chemistry and Technology ,Infant, Newborn ,Humans ,Infant ,Bioengineering ,Neonatal Sepsis ,Instrumentation - Abstract
A graphene oxide/nickel/platinum nanoparticle micromotor (MM)-based fluorescent aptassay is proposed to determine interleukin-6 (IL-6) in serum samples from low-birth-weight infants (gestational age of less than 32 weeks and birthweight below 1000 g) with sepsis suspicion. In this kind of patients, IL-6 has demonstrated good sensitivity and specificity for the diagnosis of sepsis, both for early and late onset sepsis. The approach was based on the adsorption of the aptamer for IL-6 tagged with 6-FAM as a fluorescent label (Apt
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- 2022
13. Cerebral Oximetry Monitoring in Extremely Preterm Infants
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Mathias L. Hansen, Adelina Pellicer, Simon Hyttel-Sørensen, Ebru Ergenekon, Tomasz Szczapa, Cornelia Hagmann, Gunnar Naulaers, Jonathan Mintzer, Monica Fumagalli, Gabriel Dimitriou, Eugene Dempsey, Jakub Tkaczyk, Guoqiang Cheng, Siv Fredly, Anne M. Heuchan, Gerhard Pichler, Hans Fuchs, Saudamini Nesargi, Gitte H. Hahn, Salvador Piris-Borregas, Jan Širc, Miguel Alsina-Casanova, Martin Stocker, Hilal Ozkan, Kosmas Sarafidis, Andrew O. Hopper, Tanja Karen, Beata Rzepecka-Weglarz, Serife S. Oguz, Luis Arruza, Asli C. Memisoglu, Ruth del Rio Florentino, Mariana Baserga, Pierre Maton, Anita C. Truttmann, Isabel de las Cuevas, Peter Agergaard, Pamela Zafra, Lars Bender, Ryszard Lauterbach, Chantal Lecart, Julie de Buyst, Afif El-Khuffash, Anna Curley, Olalla O. Vaccarello, Jan Miletin, Evangelia Papathoma, Zachary Vesoulis, Giovanni Vento, Luc Cornette, Laura S. Lopez, Beril Yasa, Anja Klamer, Massimo Agosti, Olivier Baud, Emmanuele Mastretta, Merih Cetinkaya, Karen McCall, Shujuan Zeng, Eleftheria Hatzidaki, Agata Bargiel, Sylwia Marciniak, Xiaoyan Gao, Lin Huijia, Lina Chalak, Ling Yang, Shashidhar A. Rao, Xin Xu, Begoña L. Gonzalez, Maria Wilinska, Zhaoqing Yin, Iwona Sadowska-Krawczenko, Itziar Serrano-Viñuales, Barbara Krolak-Olejnik, Marta M. Ybarra, Catalina Morales-Betancourt, Peter Korček, Marta Teresa-Palacio, Fabio Mosca, Anja Hergenhan, Nilgun Koksal, Konstantia Tsoni, Munaf M. Kadri, Claudia Knöpfli, Elzbieta Rafinska-Wazny, Mustafa S. Akin, Tone Nordvik, Zhang Peng, Sinem G. Kersin, Liesbeth Thewissen, Ana Alarcon, David Healy, Berndt Urlesberger, Münevver Baş, Jana Baumgartner, Eleni Skylogianni, Veronika Karadyova, Eva Valverde, Elena Bergon-Sendin, Jachym Kucera, Silvia Pisoni, Le Wang, Anne Smits, Rebeca Sanchez-Salmador, Marie I. Rasmussen, Markus H. Olsen, Aksel K. Jensen, Christian Gluud, Janus C. Jakobsen, and Gorm Greisen
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Infant, Newborn ,Complications of Pregnancy ,Infant ,Infant, Premature, Diseases/diagnosis ,General Medicine ,Bronchopulmonary Dysplasia/etiology ,Brain Injuries/diagnostic imaging ,Neonatal Sepsis/etiology ,Oximetry/methods ,Pediatrics ,Enterocolitis, Necrotizing/etiology ,Retinopathy of Prematurity/etiology ,Cerebrovascular Circulation ,Infant, Extremely Premature ,Humans ,Obstetrics/Gynecology ,Neonatology ,Cerebrum ,Ultrasonography - Abstract
Background: The use of cerebral oximetry monitoring in the care of extremely preterm infants is increasing. However, evidence that its use improves clinical outcomes is lacking.Methods: In this randomized, phase 3 trial conducted at 70 sites in 17 countries, we assigned extremely preterm infants (gestational age, Results: A total of 1601 infants underwent randomization and 1579 (98.6%) were evaluated for the primary outcome. At 36 weeks' postmenstrual age, death or severe brain injury had occurred in 272 of 772 infants (35.2%) in the cerebral oximetry group, as compared with 274 of 807 infants (34.0%) in the usual-care group (relative risk with cerebral oximetry, 1.03; 95% confidence interval, 0.90 to 1.18; P = 0.64). The incidence of serious adverse events did not differ between the two groups.Conclusions: In extremely preterm infants, treatment guided by cerebral oximetry monitoring for the first 72 hours after birth was not associated with a lower incidence of death or severe brain injury at 36 weeks' postmenstrual age than usual care. (Funded by the Elsass Foundation and others; SafeBoosC-III ClinicalTrials.gov number, NCT03770741.). Background The use of cerebral oximetry monitoring in the care of extremely preterm infants is increasing. However, evidence that its use improves clinical outcomes is lacking. Methods In this randomized, phase 3 trial conducted at 70 sites in 17 countries, we assigned extremely preterm infants (gestational age
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- 2023
14. Ecocardiografía funcional en neonatología
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Gómez, Luis Arruza and Sánchez, Araceli Corredera
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- 2014
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15. Interferencia entre NIRS cerebral y bilirrubina conjugada en neonatos de extremado bajo peso
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Araceli Corredera, José Martínez-Orgado, M.J. Rodríguez, and Luis Arruza
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business.industry ,Pediatrics, Perinatology and Child Health ,Medicine ,business ,Pediatrics ,RJ1-570 - Published
- 2021
16. Interference between cerebral NIRS and conjugated bilirubin in extremely low birth weight neonates
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Araceli Corredera, Luis Arruza, M.J. Rodríguez, and José Martínez-Orgado
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medicine.medical_specialty ,Low birth weight ,Endocrinology ,business.industry ,Management of Technology and Innovation ,Internal medicine ,Conjugated bilirubin ,medicine ,medicine.symptom ,Interference (genetic) ,business ,Pediatrics ,RJ1-570 - Published
- 2021
17. OFF-ON on-the-fly aptassay for rapid and accurate determination of procalcitonin in very low birth weight infants with sepsis suspicion
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José M. Gordón Pidal, Luis Arruza, María Moreno-Guzmán, Miguel Ángel López, and Alberto Escarpa Miguel
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Materials Chemistry ,Metals and Alloys ,Electrical and Electronic Engineering ,Condensed Matter Physics ,Instrumentation ,Surfaces, Coatings and Films ,Electronic, Optical and Magnetic Materials - Published
- 2023
18. Cerebral blood flow velocity and oxygenation correlate predominantly with right ventricular function in cooled neonates with moderate-severe hypoxic-ischemic encephalopathy
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Luis Arruza, M.J. Rodríguez, José Martínez-Orgado, and Araceli Corredera
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medicine.medical_specialty ,Vena Cava, Superior ,Ventricular Dysfunction, Right ,Hemodynamics ,Context (language use) ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Asphyxia Neonatorum ,Ejection fraction ,business.industry ,Infant, Newborn ,Stroke Volume ,Oxygenation ,Stroke volume ,Hypothermia ,Transcranial Doppler ,Cerebral blood flow ,Cerebrovascular Circulation ,Hypoxia-Ischemia, Brain ,Pediatrics, Perinatology and Child Health ,Ventricular Function, Right ,cardiovascular system ,Cardiology ,medicine.symptom ,business ,Blood Flow Velocity - Abstract
The relationship between right ventricular (RV) function and cerebral blood flow (CBF) velocity and cerebral oxygenation was assessed in neonates with hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia (TH). Echocardiographic, transcranial Doppler, and hemodynamic data from 37 neonates with moderate-severe HIE + TH were reviewed. Twenty healthy newborns served as controls. Cardiac dysfunction in HIE + TH was characterized by a predominant RV dysfunction, with concomitantly reduced CBF velocity. A significant correlation was found between CBF velocity and tricuspid annular plane systolic excursion (TAPSE), RV output (RVO), and stroke volume (SVRV), as well as with left ventricular output and stroke volume. Brain oxygenation (rSO2) correlated significantly with RVO, SVRV, TAPSE, ejection fraction, and fractional shortening, whereas cerebral fractional tissue oxygen extraction (FTOEc) correlated with RVO, SVRV, RV myocardial performance index, and superior vena cava flow. CBF velocity and cerebral NIRS correlations were stronger with parameters of right ventricular performance. Conclusion: CBF velocity and brain oxygenation correlate predominantly with RV function in HIE + TH. This suggests a preferential contribution of RV performance to cerebral hemodynamics in this context.
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- 2020
19. Atención integral del neonato con encefalopatía hipóxico-isquémica en España
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C. Santana, C. Tapia, I. Centelles, B. Arias, J. Diez-Delgado, V. Alzina, A. Orizaola, E. Tapia, M.D. Elorza, M.J. García, R.P. Arias, M.D. Blanco, G. Romera, G. Arca, S. Martínez-Nadal, J.M. Lloreda-García, C. Ruiz, A. Cuñarro, J. Beceiro, J. Jiménez, Alejandro Avila-Alvarez, M. Baca, M. Benito, T. González, A. Aguirre, E. Piñán, E.P. Gutiérrez, A. Pavón, D. Hernández, M. Domingo, S. Caserío, A. de la Morena, M. Baquero, A. García-Alix, M.T. Moral, M.L. Millán, M.E. Vázquez, A. Pantoja, I. Tofé, S. Romero, M. Losada, A. Euba, B. García, I. Güemes, E. Valverde, P.R. Balliu, S. Aparici, P.A. Crespo, P.J. Jiménez, L. Castañón, W. Coroleu, Nuria Herranz-Rubia, S. Rite, E. Sole, F. Mar, E. Jiménez, M.A. López-Vílchez, F. Jiménez, Luis Arruza, N. Balado, A.R. Barrio, R. Montero, M. Albújar, L. Martínez, C. Vega-del-Val, I. Esteban, C. Muñóz, A.E. Jerez, J.C. Tejedor, A. Concheiro-Guisán, F. Cabañas, E. Torres, E. González, B. Loureiro, M.D. Esquivel, A. Lavilla, J.A. Hurtado, A. Alberola, B. Reyes, J.M. Ceballos, E.M. Fernández, M.P. Ventura, Alfredo García-Alix, R. López, I. Benavente-Fernández, J. Estañ, L. Castells, J.L. Alcaráz, H. Boix, I. Echániz, María L. Couce, R. Porta, and Juan Arnaez
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Asphyxia ,03 medical and health sciences ,0302 clinical medicine ,Hypoxia-ischaemia ,030225 pediatrics ,Pediatrics, Perinatology and Child Health ,Therapeutic hypothermia ,Newborn ,Prognosis ,Pediatrics ,Biomarkers ,RJ1-570 - Abstract
Resumen: Introducción: Apenas conocemos cómo es la asistencia de los recién nacidos (RN) con encefalopatía hipóxico-isquémica (EHI) en hipotermia terapéutica (HT), especialmente si existen protocolos asistenciales, la neuromonitorización que se realiza o cómo es la aproximación al pronóstico neurológico. Este conocimiento permite detectar e implementar áreas de mejora asistencial. Método: Estudio transversal de los 57 hospitales españoles que realizaban HT en 2015, mediante cuestionario sobre: 1) la disponibilidad de protocolos y de recursos tecnológicos; 2) el uso de herramientas de neuromonitorización; 3) los conocimientos de los profesionales; 4) la información pronóstica que se da los padres, y 5) el informe al alta y del plan de seguimiento. Resultados: El 95% utiliza enfriamiento corporal-total servocontrolado y dispone de protocolos específicos de actuación. El 70% utiliza sedación y el 68% deja al paciente a dieta absoluta. La monitorización con electroencefalografía integrada por amplitud se utiliza en más del 80% de los centros, aunque solo en el 50% la enfermera es capaz de interpretarlo. La saturación de oxígeno cerebral es escasamente monitorizada (16%). Entre los estudios diagnóstico-pronósticos, la neuroimagen es universal, pero los neurobiomarcadores apenas se utilizan (29%). Solo el 21% ofrece información pronóstica antes de las 72 h de vida; sin presencia de la enfermera en el 70%. El seguimiento lo realiza el neuropediatra (84%), con una duración desigual entre centros. Conclusiones: La asistencia del RN con EHI en España es adecuada, con áreas de mejora en: neuromonitorización, sedación, marco temporal de la información pronóstica, trabajo en equipo y estandarización de la duración del seguimiento. Abstract: Introduction: There is not much information about the care of infants with hypoxic-ischaemic encephalopathy (HIE) treated with therapeutic hypothermia (TH) in Spain. This includes whether protocols are routinely used, the type of neuro-monitoring performed, and how information on the neurological prognosis is presented to families. The answers to these would allow to detect and implement areas of improvement. Method: A cross-sectional analysis was performed on the responses to structured questionnaires sent to all the Spanish neonatal units that were performing TH in June 2015. Questions were divided into 5 sections: 1) the availability of protocols and technological resources, 2) the use of neuro-monitoring tools, 3) the knowledge and training of the professionals; 4) the prognostic information given to the parents; and 5) the discharge report and the follow-up plan. Results: Most centres (95%) use servo controlled whole-body cooling methods and have specific management protocols. Sedation is used in 70% of centres, and in 68% of them the onset of enteral feeding is delayed until the end of the cooling period. Amplitude-integrated electroencephalography monitoring is used in more than 80% of the centres, although only in 50% are nurses able to interpret it. Cerebral oxygen saturation is not often monitored (16%). As regards diagnostic-prognostic studies, neuroimaging is universal, but brain damage biomarkers are hardly used (29%). Prognostic information is offered within the first 72 posnatal hours in 21% of the centres, and is given without the presence of the nurse in 70% of the centres. Follow-up is performed by a neuro-paediatrician (84%), with an uneven duration between centres. Conclusions: The care of infants with HIE treated with TH in Spain is generally adequate, although there are areas for improvement in neuromonitoring, sedation, prognostic information, teamwork, and duration of follow-up.
- Published
- 2020
20. Polymer-Based Micromotor Fluorescence Immunoassay for On-the-Move Sensitive Procalcitonin Determination in Very Low Birth Weight Infants’ Plasma
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Alberto Escarpa, María Moreno-Guzmán, Miguel Ángel López, Luis Arruza, and Águeda Molinero-Fernández
- Subjects
Fluid Flow and Transfer Processes ,chemistry.chemical_classification ,Chromatography ,medicine.diagnostic_test ,Process Chemistry and Technology ,010401 analytical chemistry ,Bioengineering ,02 engineering and technology ,Polymer ,Fluorescence immunoassay ,021001 nanoscience & nanotechnology ,Immunofluorescence ,01 natural sciences ,Procalcitonin ,0104 chemical sciences ,Specific antibody ,chemistry ,Immunoassay ,Micromotor ,medicine ,0210 nano-technology ,Instrumentation - Abstract
A new fluorescence micromotor-based immunoassay (FMIm) has been developed for procalcitonin (PCT) determination as an early sepsis diagnostic analytical tool. The micromotors combine the high binding capacity of the specific antibodies onto their polymeric polypyrrole outer layer (PPy layer), with their magnetic guidance (Ni layer) and self-propulsion by catalytic generation of oxygen bubbles (PtNP inner layer) to actively recognize the PCT antigen. This FMIm allowed a sensitive (LOD = 0.07 ng mL-1) and direct PCT determination in clinical samples from very low-birth-weight infants (VLBWI) with sepsis suspicion, using small volumes of sample (25 μL) in a clinically relevant range of concentrations (0.5-150 ng mL-1). The good agreement between PCT levels obtained by our micromotor-based method and routine immunofluorescence hospital determination demonstrates the feasibility for the analysis in VLBWI samples and its potential as a point-of-care diagnostic tool for sepsis.
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- 2020
21. Addition to On the Move-Sensitive Fluorescent Aptassay on Board Catalytic Micromotors for the Determination of Interleukin-6 in Ultra-Low Serum Volumes for Neonatal Sepsis Diagnostics
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José Gordón, Luis Arruza, María Dolores Ibáñez, María Moreno-Guzmán, Miguel Ángel López, and Alberto Escarpa
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Fluid Flow and Transfer Processes ,Process Chemistry and Technology ,Bioengineering ,Instrumentation - Published
- 2023
22. Dexmedetomidine affects cerebral activity in preterm infants
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Cristina Cortes-Ledesma, Luis Arruza, Angela Sainz-Villamayor, and José Martínez-Orgado
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Pediatrics, Perinatology and Child Health ,Obstetrics and Gynecology ,General Medicine - Abstract
The use of dexmedetomidine (DEX) has been extended in preterm newborns, but the effects on cerebral activity and their relationship with haemodynamic changes has not been studied.We retrospectively studied the effects of DEX administered to 10 preterm newborns, assessing amplitude-integrated EEG (aEEG) parameters, brain regional SO2(brSO2), heart rate, non-invasive mean blood pressure (MBP), transcutaneous oxygen saturation (SpO2), venous pCO2 and haemoglobin (Hb) values, in two 6-hour periods: one starting 6 hours before the beginning of DEX perfusion and the other 6 hours afterwards.DEX infusion led to brSO2decrease not associated to heart rate, MBP, SpO2, Hb or pCO2 variation, which suggests that brSO2decrease could be related to local vasoconstriction. DEX infusion led to prolongation of interburst interval and reduction of cycling. Such effects, not been described so far, should be considered in the assessment of aEEG traces after DEX administration to avoid misinterpretations regarding patient’s prognosis. More studies are needed to assess the safety of DEX use in the newborn.
- Published
- 2021
23. Successful delivery room management of electromechanical dissociation and heart block: is electrocardiogram useless?
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Cristina, Cortes, Eva, Vierge, Enrique, Criado, Jose, Martinez-Orgado, and Luis, Arruza
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Electrocardiography ,Clinical Research Article ,Heart Block ,Pregnancy ,Delivery Rooms ,Pediatrics, Perinatology and Child Health ,Infant, Newborn ,Humans ,Arrhythmias, Cardiac ,Female ,Heart Arrest - Abstract
Background Although electrocardiogram (ECG) can detect heart rate (HR) faster compared to pulse oximetry, it remains unknown if routine use of ECG for delivery room (DR) resuscitation reduces the time to stabilization in preterm infants. Methods Neonates 100 b.p.m., time to stabilization, or use of resuscitation interventions such as PPV for preterm infants
- Published
- 2022
24. Neuroprotection by cannabidiol and hypothermia in a piglet model of newborn hypoxic-ischemic brain damage
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Lorena Barata, Esther Aleo, Ana Gutiérrez-Rodríguez, Eva Vierge, Maria-José Rodríguez, María Ceprián, José Martínez-Orgado, Enrique Criado, William H Hind, Carlos Vargas, Elena Sobrino, and Luis Arruza
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0301 basic medicine ,Swine ,Encephalopathy ,Excitotoxicity ,Apoptosis ,Hypothermia ,Brain damage ,Pharmacology ,medicine.disease_cause ,Neuroprotection ,Asphyxia ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Hypothermia, Induced ,medicine ,Animals ,Cannabidiol ,Neuroinflammation ,Inflammation ,business.industry ,Hemodynamics ,Brain ,medicine.disease ,Disease Models, Animal ,Neuroprotective Agents ,030104 developmental biology ,Animals, Newborn ,Brain Injuries ,Hypoxia-Ischemia, Brain ,Respiratory Physiological Phenomena ,Drug Therapy, Combination ,Microglia ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Oxidative stress ,medicine.drug - Abstract
Objective Hypothermia, the gold standard after a hypoxic-ischemic insult, is not beneficial in all treated newborns. Cannabidiol is neuroprotective in animal models of newborn hypoxic-ischemic encephalopathy. This study compared the relative efficacies of cannabidiol and hypothermia in newborn hypoxic-ischemic piglets and assessed whether addition of cannabidiol augments hypothermic neuroprotection. Methods One day-old HI (carotid clamp and FiO2 10% for 20 min) piglets were randomized to vehicle or cannabidiol 1 mg/kg i.v. u.i.d. for three doses after being submitted to normothermia or 48 h-long hypothermia with a subsequent rewarming period of 6 h. Non-manipulated piglets (naive) served as controls. Hemodynamic or respiratory parameters as well as brain activity (aEEG amplitude) were monitored throughout the experiment. Following termination, brains were obtained for histological (TUNEL staining, apoptosis; immunohistochemistry for Iba-1, microglia), biochemical (protein carbonylation, oxidative stress; and TNFα concentration, neuroinflammation) or proton magnetic resonance spectroscopy (Lac/NAA: metabolic derangement; Glu/NAA: excitotoxicity). Results HI led to sustained depressed brain activity and increased microglial activation, which was significantly improved by cannabidiol alone or with hypothermia but not by hypothermia alone. Hypoxic-ischemic-induced increases in Lac/NAA, Glu/NAA, TNFα or apoptosis were not reversed by either hypothermia or cannabidiol alone, but combination of the therapies did. No treatment modified the effects of HI on oxidative stress or astroglial activation. Cannabidiol treatment was well tolerated. Conclusions cannabidiol administration after hypoxia-ischemia in piglets offers some neuroprotective effects but the combination of cannabidiol and hypothermia shows some additive effect leading to more complete neuroprotection than cannabidiol or hypothermia alone.
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- 2019
25. The Effect of Morbidity and Sex on Postnatal Growth of Very Preterm Infants: A Multicenter Cohort Study
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Beatriz Vacas, Carlos Zozaya, Cristina Fernández-Pérez, Fermín García-Muñoz Rodrigo, Alejandro Avila-Alvarez, Abdón Castro, Luis Arruza, María Teresa Cuesta, María L. Couce, Miguel Saenz de Pipaon, and Máximo Vento Torres
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Male ,medicine.medical_specialty ,Databases, Factual ,Patent ductus arteriosus ,Sex of newborn ,Gestational Age ,Comorbidity ,Infant, Premature, Diseases ,Growth ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,Necrotizing enterocolitis ,030225 pediatrics ,Ductus arteriosus ,Linear regression ,medicine ,Humans ,030212 general & internal medicine ,Retrospective Studies ,Sex Characteristics ,Obstetrics ,business.industry ,Body Weight ,Infant, Newborn ,Infant ,Gestational age ,Late-onset sepsis ,medicine.disease ,Bronchopulmonary dysplasia ,Body Height ,medicine.anatomical_structure ,Spain ,Infant, Extremely Premature ,Multivariate Analysis ,Preterm infant ,Pediatrics, Perinatology and Child Health ,Linear Models ,Female ,Morbidity ,medicine.symptom ,business ,Head ,Weight gain ,Developmental Biology ,Cohort study - Abstract
Background: Extrauterine growth restriction is common in the preterm infant, and it is associated with poor neurodevelopment. Nutrition plays an important role in postnatal growth, but growth is also influenced by other factors like co-morbidity, and, also, there might be sex differences. Methods: This is a cohort study including preterm infants < 32 weeks at birth (n = 21,825) from the Spanish Neonatal Network database. The effect of sex and morbidity (patent ductus arteriosus, bronchopulmonary dysplasia, necrotizing enterocolitis and late-onset sepsis) on weight gain as well as linear and head growth from birth to discharge/death was assessed with linear regression models adjusted by gestational age and Z-scores at birth. Results: The 4 selected morbidities had an independent effect on all 6 growth parameters studied, which was greater in the case of necrotizing enterocolitis: changes in weight, length and head Z-scores were –0.60 (95% CI: –0.66 to –0.55), –0.62 (95% CI: –0.70 to –0.54) and –0.63 (95% CI: –0.71 to –0.56), respectively. Weight gain and linear growth were overall more affected than head growth. Girls lost slightly more weight Z-scores (–0.03; 95% CI: –0.06 to –0.002) than boys after adjustment by morbidity. There were no significant gender differences regarding linear and head growth velocity (cm/week), although girls lost more head Z-scores (–0.14; 95% CI: –0.18 to –0.10). Conclusions: Main co-morbidities associated with prematurity have an impact on postnatal growth. Head growth is less affected than length and weight. Girls are at slightly higher risk of postnatal weight and head restriction after adjustment by morbidity.
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- 2019
26. Preventing bronchopulmonary dysplasia: new tools for an old challenge
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María Álvarez-Fuente, Bernard Thébaud, Alejandro Avila-Alvarez, Irwin K.M. Reiss, Luis Arruza, Dolores Elorza, Elisa Proença, Laura Moreno, Manuel Ramirez Orellana, Paloma Lopez, Liesbeth Duijts, Patrizia Zaramella, Jane A. Mitchell, María Jesús del Cerro, Gustavo Rocha, Hercília Guimarães, Santiago Rueda, Eugenio Baraldi, Álvaro Gimeno-Díaz de Atauri, and Pediatrics
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medicine.medical_specialty ,MEDLINE ,Disease ,Pediatrics ,behavioral disciplines and activities ,Infant, Newborn, Diseases ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,mental disorders ,medicine ,Humans ,Intensive care medicine ,Bronchopulmonary Dysplasia ,business.industry ,Infant, Newborn ,Infant ,Gestational age ,Perinatology and Child Health ,Omics ,medicine.disease ,Clinical trial ,Low birth weight ,Bronchopulmonary dysplasia ,Lung disease ,Pediatrics, Perinatology and Child Health ,medicine.symptom ,business ,Infant, Premature ,030217 neurology & neurosurgery - Abstract
Bronchopulmonary dysplasia (BPD) is the most prevalent chronic lung disease in infants and presents as a consequence of preterm birth. Due to the lack of effective preventive and treatment strategies, BPD currently represents a major therapeutic challenge that requires continued research efforts at the basic, translational, and clinical levels. However, not all very low birth weight premature babies develop BPD, which suggests that in addition to known gestational age and intrauterine and extrauterine risk factors, other unknown factors must be involved in this disease's development. One of the main goals in BPD research is the early prediction of very low birth weight infants who are at risk of developing BPD in order to initiate the adequate preventive strategies. Other benefits of determining the risk of BPD include providing prognostic information and stratifying infants for clinical trial enrollment. In this article, we describe new opportunities to address BPD's complex pathophysiology by identifying prognostic biomarkers and develop novel, complex in vitro human lung models in order to develop effective therapies. These therapies for protecting the immature lung from injury can be developed by taking advantage of recent scientific progress in -omics, 3D organoids, and regenerative medicine.
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- 2018
27. Off-label mesenchymal stromal cell treatment in two infants with severe bronchopulmonary dysplasia: clinical course and biomarkers profile
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María Álvarez-Fuente, Paloma López-Ortego, Carlos Labrandero, Luis Arruza, Laura Moreno, África González, Gustavo J. Melen, Manuel Ramírez-Orellana, and María Jesús del Cerro
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Oncology ,Cancer Research ,medicine.medical_specialty ,Stromal cell ,Immunology ,Disease ,Lung injury ,Mesenchymal Stem Cell Transplantation ,Off-label use ,behavioral disciplines and activities ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Internal medicine ,mental disorders ,Humans ,Immunology and Allergy ,Medicine ,Lung ,Genetics (clinical) ,Bronchopulmonary Dysplasia ,Transplantation ,business.industry ,Mesenchymal stem cell ,Infant, Newborn ,Infant ,Mesenchymal Stem Cells ,Cell Biology ,medicine.disease ,Trachea ,030228 respiratory system ,Bronchopulmonary dysplasia ,Tolerability ,Premature birth ,Cytokines ,Administration, Intravenous ,Female ,business ,Biomarkers ,Infant, Premature - Abstract
Background Bronchopulmonary dysplasia (BPD) is the most prevalent sequelae of premature birth, for which therapeutic options are currently limited. Mesenchymal stromal cells (MSCs) are a potential therapy for prevention or reversal of BPD. Series of cases We report on two infants with severe BPD in whom off-label treatment with repeated intravenous doses of allogeneic bone marrow–derived MSCs were administered. We analyzed the temporal profile of serum and tracheal cytokines and growth factors as well as safety, tolerability and clinical response. The administration of repeated intravenous doses of MSCs in two human babies with severe and advanced BPD was feasible and safe and was associated with a decrease of pro-inflammatory molecules and lung injury biomarkers. Both patients were at very advanced stages of BPD with very severe lung fibrosis and did not survive the disease. Conclusions MSCs are a promising therapy for BPD, but they should be administered in early stages of the disease.
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- 2018
28. Congenital Cutaneous Candidiasis With Systemic Dissemination in a Preterm Infant
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José Martínez-Orgado, Luis Arruza, Macarena García, Isabel Miras, José Tomás Ramos, Eva Vierge, and Enrique Criado
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Microbiology (medical) ,medicine.medical_specialty ,Antifungal Agents ,Candidiasis, Cutaneous ,Congenital cutaneous candidiasis ,Erythematous rash ,Desquamation ,Cerebrospinal fluid ,medicine ,Humans ,Skin ,business.industry ,Infant, Newborn ,medicine.disease ,Dermatology ,Low birth weight ,Infectious Diseases ,Treatment Outcome ,Infant, Extremely Low Birth Weight ,Pediatrics, Perinatology and Child Health ,Female ,medicine.symptom ,Presentation (obstetrics) ,Skin lesion ,business ,Prolonged treatment - Abstract
Congenital cutaneous candidiasis is an infrequent invasive fungal infection that usually appears in the first days of life. Extremely low birth weight infants are the most frequently affected. Classic presentation includes diffuse extensive erythematous rash with papules, plaques, pustules and vesicles, which later undergoes desquamation. Systemic dissemination is common in extremely low birth weight infants. Blood, urine and cerebrospinal fluid evaluation should be included in the initial assessment. Early and prolonged treatment has been associated with decreased mortality. We report the case of congenital cutaneous candidiasis in a preterm infant. Early skin lesion recognition allowed establishing adequate treatment in the first hours of life.
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- 2021
29. Polymer-Based Micromotor Fluorescence Immunoassay for
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Águeda, Molinero-Fernández, María, Moreno-Guzmán, Luis, Arruza, Miguel Ángel, López, and Alberto, Escarpa
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Immunoassay ,Polymers ,Infant, Newborn ,Fluorescent Antibody Technique ,Humans ,Infant, Very Low Birth Weight ,Pyrroles ,Procalcitonin - Abstract
A new fluorescence micromotor-based immunoassay (FMIm) has been developed for procalcitonin (PCT) determination as an early sepsis diagnostic analytical tool. The micromotors combine the high binding capacity of the specific antibodies onto their polymeric polypyrrole outer layer (PPy layer), with their magnetic guidance (Ni layer) and self-propulsion by catalytic generation of oxygen bubbles (PtNP inner layer) to actively recognize the PCT antigen. This FMIm allowed a sensitive (LOD = 0.07 ng mL
- Published
- 2020
30. The Impact of Postnatal Systemic Steroids on the Growth of Preterm Infants: A Multicenter Cohort Study
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Cristina Fernández-Pérez, María Teresa Cuesta, María L. Couce, Miguel Saenz de Pipaon, Abdón Castro, Máximo Vento, Beatriz Vacas, Fermín García-Muñoz Rodrigo, Luis Arruza, Alejandro Avila-Alvarez, and Carlos Zozaya
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,medicine.medical_treatment ,growth ,Subgroup analysis ,lcsh:TX341-641 ,Gestational Age ,Article ,preterm infant ,03 medical and health sciences ,0302 clinical medicine ,Adrenal Cortex Hormones ,030225 pediatrics ,bronchopulmonary dysplasia ,medicine ,Body Size ,Humans ,Respiratory system ,Mechanical ventilation ,030219 obstetrics & reproductive medicine ,Nutrition and Dietetics ,business.industry ,Infant, Newborn ,Gestational age ,medicine.disease ,Respiration, Artificial ,Bronchopulmonary dysplasia ,Female ,medicine.symptom ,business ,Linear growth ,Weight gain ,lcsh:Nutrition. Foods and food supply ,Infant, Premature ,Food Science ,Cohort study ,steroids - Abstract
Postnatal steroids, often used to prevent and treat bronchopulmonary dysplasia, may influence the growth of preterm infants, although data are scarce in the literature. This is a multicenter cohort study including surviving preterm infants <, 32 weeks at birth (n = 17,621) from the Spanish Neonatal Network SEN1500 database, without major congenital malformations. Linear regression models were adjusted for postnatal steroids, respiratory severity course (invasive mechanical ventilation at 28 days), progression to moderate&ndash, severe bronchopulmonary dysplasia (O2 at 36 weeks), length of stay, sex, gestational age and z-scores at birth. A subgroup analysis depending on the timing of administration, ventilation status at 28 days and moderate&ndash, severe BPD diagnosis was also performed. Overall, systemic postnatal steroids were not independently associated with poorer weight gain (0.1, 95% CI: &minus, 0.05 to 0.2 g/kg/day), linear growth (0, 0.03 to 0.01 cm/week) or head circumference growth (&minus, 0.01, 0.02 to 0 cm/week). Patients who received steroids after 28 days or who were not O2 dependent at 36 weeks after having received steroids gained more weight (0.22, 95% CI: 0.04 to 0.4 and 0.2, 95% CI: 0.004 to 0.5 g/kg/day, respectively). Globally, systemic postnatal steroids had no significant adjusted effect on postnatal growth.
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- 2019
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31. 3-lead electrocardiogram is more reliable than pulse oximetry to detect bradycardia during stabilisation at birth of very preterm infants
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Enrique Criado, Beatriz Iglesias, Luis Arruza, Jose Martínez-Orgado, Esther Aleo, and María José Rodríguez
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Bradycardia ,Resuscitation ,Infant, Premature, Diseases ,030204 cardiovascular system & hematology ,Sensitivity and Specificity ,Electrocardiography ,03 medical and health sciences ,0302 clinical medicine ,Heart Rate ,Predictive Value of Tests ,030225 pediatrics ,Heart rate ,Humans ,Medicine ,Oximetry ,Prospective Studies ,Lead (electronics) ,Monitoring, Physiologic ,medicine.diagnostic_test ,business.industry ,Delivery room ,Infant, Newborn ,Reproducibility of Results ,Obstetrics and Gynecology ,General Medicine ,Very preterm ,Pulse oximetry ,Anesthesia ,Pediatrics, Perinatology and Child Health ,medicine.symptom ,business ,Infant, Premature ,Neonatal resuscitation - Abstract
ObjectivesCurrent neonatal resuscitation guidelines suggest the use of ECG in the delivery room (DR) to assess heart rate (HR). However, reliability of ECG compared with pulse oximetry (PO) in a situation of bradycardia has not been specifically investigated. The objective of the present study was to compare HR monitoring using ECG or PO in a situation of bradycardia (HR Study designVideo recordings of resuscitations of infants ResultsA total of 29 episodes of bradycardia registered by the ECG in 39 video recordings were included in the analysis (n=29). PO did not detect the start of these events in 20 cases (69%). PO detected the start and the end of bradycardia later than the ECG (median (IQR): 5 s (0–10) and 5 s (0–7.5), respectively). A decline in PO accuracy was observed as bradycardia progressed so that by the end of the episode PO offered significantly lower HR readings than ECG.ConclusionsPO detects the start and recovery of bradycardia events slower and less accurately than ECG during stabilisation at birth of very preterm infants. ECG use in this scenario may contribute to an earlier initiation of resuscitation manoeuvres and to avoid unnecessary prolongation of resuscitation efforts after recovery.
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- 2017
32. Parainfluenza 3 Respiratory Infection Associated with Pericardial Effusion in a Very Low Birthweight Infant
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Gloria Herranz Carrillo, José Martínez-Orgado, Zarife Daoud Pérez, Cristina Aranda Cazón, Luis Arruza Gómez, José Tomás Ramos Amador, and Cristina González Menchén
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Pediatrics ,medicine.medical_specialty ,Neonatal intensive care unit ,business.industry ,viruses ,Respiratory infection ,Case Report ,General Medicine ,030204 cardiovascular system & hematology ,Parainfluenza 3 virus ,medicine.disease ,Pericardial effusion ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Medicine ,lcsh:RC109-216 ,Respiratory system ,business ,Pediatric population ,Parainfluenza-3 - Abstract
Parainfluenza 3 virus is a frequent cause of respiratory infections in the pediatric population although it is uncommonly diagnosed in neonates, being usually reported as neonatal intensive care unit microepidemics. We report a case of parainfluenza 3 respiratory infection associated with pericardial effusion in a very low birthweight infant.
- Published
- 2017
33. Toward Early Diagnosis of Late-Onset Sepsis in Preterm Neonates: Dual Magnetoimmunosensor for Simultaneous Procalcitonin and C-Reactive Protein Determination in Diagnosed Clinical Samples
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Alberto Escarpa, María Moreno-Guzmán, Miguel Ángel López, Águeda Molinero-Fernández, and Luis Arruza
- Subjects
medicine.medical_specialty ,medicine.drug_class ,Antibiotics ,Bioengineering ,02 engineering and technology ,Biosensing Techniques ,01 natural sciences ,Gastroenterology ,Procalcitonin ,Sepsis ,Immunoenzyme Techniques ,Antibiotic resistance ,Late phase ,Internal medicine ,medicine ,Humans ,Instrumentation ,Electrodes ,Fluid Flow and Transfer Processes ,Late onset sepsis ,biology ,business.industry ,Process Chemistry and Technology ,010401 analytical chemistry ,C-reactive protein ,Infant, Newborn ,Electrochemical Techniques ,021001 nanoscience & nanotechnology ,medicine.disease ,0104 chemical sciences ,Low birth weight ,C-Reactive Protein ,Early Diagnosis ,biology.protein ,medicine.symptom ,0210 nano-technology ,business - Abstract
Early diagnosis of sepsis, combining blood cultures and inflammation biomarkers, continues to be a challenge, especially in very low birth weight (VLBW) infants because of limited availability of blood samples. Traditional diagnostic procedures are cumbersome, not fast enough, and require relatively large volumes of sample. Empiric use of antibiotics, before diagnostic confirmation, is required to decrease mortality, leading to potential antibiotic resistance and side effects in VLBW infants. To solve such a serious problem, a dual magnetoimmunosensor is proposed for simultaneous assessment of two of the most important sepsis biomarkers: procalcitonin (PCT for early phase) and C-reactive protein (CRP for late phase). This "sample-to-result" approach exhibited excellent sensitivity, selectivity, precision, and stability using low sample volumes (
- Published
- 2019
34. Cohort study showed that growth rate increment has not been enough to prevent growth retardation of preterm infants and raised concerns about unbalanced growth
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Cristina Fernández-Pérez, Luis Arruza, Máximo Vento, María Teresa Cuesta, Fermín García-Muñoz Rodrigo, Abdón Castro, Miguel Saenz de Pipaon, María L. Couce, Carlos Zozaya, Beatriz Vacas, and Alejandro Avila-Alvarez
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Weight Gain ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Child Development ,030225 pediatrics ,medicine ,Humans ,030212 general & internal medicine ,Growth rate ,Postnatal growth ,Growth Disorders ,business.industry ,Head growth ,Postmenstrual Age ,Infant, Newborn ,General Medicine ,Pediatrics, Perinatology and Child Health ,Female ,medicine.symptom ,business ,Complication ,Linear growth ,Weight gain ,Head ,Infant, Premature ,Cohort study - Abstract
Aim: We describe the postnatal weight gain, linear and head growth trends of surviving preterm infants from 2005 to 2017. Methods: Multicentre cohort study, including surviving preterm infants
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- 2019
35. Exploring clinical, echocardiographic and molecular biomarkers to predict bronchopulmonary dysplasia
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Gema Villar, Enrique Gutierrez, Marta Muro, Paloma López-Ortego, Carlos Labrandero, Alejandro Avila-Alvarez, Teresa Casado, Laura Moreno, Gema Sanchez-Helguera, Carlos Zozaya, Luis Arruza, Andrea Martínez-Ramas, María Álvarez-Fuente, Dolores Elorza, Irene Cuadrado, María Jesús del Cerro, Lucia Martinez, Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF), and Instituto de Salud Carlos III
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Male ,Pulmonology ,Epidemiology ,Physiology ,Infant, Premature, Diseases ,Biochemistry ,Families ,0302 clinical medicine ,Pregnancy ,Risk Factors ,Medicine and Health Sciences ,Medicine ,Birth Weight ,Longitudinal Studies ,Prospective Studies ,Children ,Bronchopulmonary Dysplasia ,Multidisciplinary ,Pulmonary Hypertension ,Follow up studies ,Prognosis ,Chemistry ,Physiological Parameters ,Echocardiography ,Infant, Extremely Premature ,Physical Sciences ,Female ,Infants ,Research Article ,Chemical Elements ,medicine.medical_specialty ,Science ,Gestational Age ,Risk Assessment ,03 medical and health sciences ,030225 pediatrics ,Humans ,business.industry ,Body Weight ,Chemical Compounds ,Infant, Newborn ,Biology and Life Sciences ,Neonates ,Infant, Low Birth Weight ,medicine.disease ,Molecular biomarkers ,Uric Acid ,Oxygen ,030228 respiratory system ,Bronchopulmonary dysplasia ,Age Groups ,Spain ,Family medicine ,Medical Risk Factors ,People and Places ,Population Groupings ,business ,Acids ,Biomarkers ,Developmental Biology ,Follow-Up Studies - Abstract
INTRODUCTION: Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease in childhood, related to prematurity, and the most common cause of pulmonary hypertension (PH) secondary to pulmonary disease in children. Moderate and severe BPD have a worse outcome and relate more frequently with PH. The prediction of moderate or severe BPD development in extremely premature newborns is vital to implement preventive strategies. Starting with the hypothesis that molecular biomarkers were better than clinical and echocardiographic factors, this study aims to explore the ability of clinical, echocardiographic and analytical variables to predict moderate or severe BPD in a cohort of extremely preterm infants. PATIENTS AND METHODS: We designed a prospective longitudinal study, in which we followed a cohort of preterm newborns (gestational age
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- 2019
36. Presentación de masa mediastínica gigante en un varón de 15 años con síndrome de Klinefelter
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Luján, Esther Aleo, López, Celia Gil, Esteban, Santiago Rueda, Gómez, Luis Arruza, Rodríguez, Olga Pérez, and Moreno, Francisco Valverde
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- 2004
- Full Text
- View/download PDF
37. Pulse oximetry versus electrocardiogram for heart rate assessment during resuscitation of the preterm infant
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Enrique Criado, G. Herranz, Esther Aleo, M.J. Rodríguez, J. Martínez Orgado, M. Moro, Luis Arruza, and B. Iglesias
- Subjects
medicine.medical_specialty ,Resuscitation ,Reanimación ,Pretérmino ,Pulsioximetría ,030204 cardiovascular system & hematology ,Pediatrics ,RJ1-570 ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Management of Technology and Innovation ,Internal medicine ,Heart rate ,Medicine ,Prospective cohort study ,Neonato ,medicine.diagnostic_test ,business.industry ,Auscultation ,Frecuencia cardíaca ,Pulse oximetry ,Heart Rate Determination ,Cardiology ,Electrocardiograma ,business ,Electrocardiography ,Neonatal resuscitation - Abstract
Background: Heart rate (HR) assessment is essential during neonatal resuscitation, and it is usually done by auscultation or pulse oximetry (PO). The aim of the present study was to determine whether HR assessment with ECG is as fast and reliable as PO during preterm resuscitation. Material and methods: Thirty-nine preterm (
- Published
- 2016
38. Pulsioximetría frente al monitor de electrocardiograma para la determinación de la frecuencia cardíaca durante la reanimación del recién nacido pretérmino
- Author
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Enrique Criado, Luis Arruza, Esther Aleo, J. Martínez Orgado, B. Iglesias, M. Moro, G. Herranz, and M.J. Rodríguez
- Subjects
03 medical and health sciences ,0302 clinical medicine ,Preterm ,030225 pediatrics ,Resuscitation ,Pediatrics, Perinatology and Child Health ,Heart rate ,Pulse oximeter ,030204 cardiovascular system & hematology ,Newborn ,Pediatrics ,RJ1-570 ,Electrocardiogram - Abstract
Resumen: Introducción: La medición de frecuencia cardíaca (FC) es esencial durante la reanimación neonatal y se realiza habitualmente mediante auscultación o pulsioximetría (PO). El objetivo de este estudio es analizar si durante la reanimación del recién nacido prematuro la medición de la FC mediante ECG es tan precoz y fiable como la PO. Material y métodos: Se realizó video-grabación de la reanimación de 39 recién nacidos prematuros (
- Published
- 2016
39. Adverse drug reactions in neonates: a prospective study
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Ana Belén Rivas, Emilio Vargas, Antonio Portolés, Luis Arruza, Jorge Diz, and Enrique Pacheco
- Subjects
Male ,Drug ,Pediatrics ,medicine.medical_specialty ,Drug-Related Side Effects and Adverse Reactions ,media_common.quotation_subject ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Informed consent ,030225 pediatrics ,Pharmacovigilance ,Adverse Drug Reaction Reporting Systems ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Medical prescription ,Prospective cohort study ,media_common ,business.industry ,Incidence ,Incidence (epidemiology) ,Infant, Newborn ,Hospitalization ,Caffeine citrate ,Pediatrics, Perinatology and Child Health ,Female ,business ,Follow-Up Studies ,medicine.drug ,Cohort study - Abstract
AimTo investigate the frequency and characteristics of adverse drug reactions (ADRs) in hospitalised neonates to obtain a better understanding of and improvement in neonatal healthcare.MethodologyA prospective cohort study. Data were collected on 313 neonates and 2166 drug prescriptions. Clinical characteristics of patients, drugs administered and ADRs were prospectively recorded and analysed. Informed consent was obtained in all cases.Results116 different ADRs were detected. 17% of the neonates experienced at least one of these ADRs. Systemic antimicrobials and caffeine citrate were the drugs that most commonly caused ADRs. According to the ADR Severity Assessment Scale, 41% were mild, 42% were moderate and 17% were severe. Of the ADRs identified, 11% were classified as ‘certain’ by the Naranjo method and 20% were classified as ‘defined’ by the Karch and Lasagna modified algorithm. Most of the ADRs detected were related to feed intolerance, phlebitis and tachycardia. Most were acute (73%) and lasted between 1 and 7 days (39%). After the occurrence of an ADR, it was necessary to initiate specific treatment in 44 cases, discontinue the drugs involved in 30 cases, and reduce the drug dose in another 30 cases. An association was shown between the number of drugs prescribed and ADR onset.ConclusionsThere is a high incidence of ADRs in hospitalised newborns, which increases with the number of prescriptions.
- Published
- 2016
40. On-the-fly rapid immunoassay for neonatal sepsis diagnosis: C-reactive protein accurate determination using magnetic graphene-based micromotors
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Luis Arruza, Águeda Molinero-Fernández, Alberto Escarpa, and Miguel Ángel López
- Subjects
Materials science ,Biomedical Engineering ,Biophysics ,Biosensing Techniques ,02 engineering and technology ,Carbon nanotube ,Spectrum Analysis, Raman ,Electrosynthesis ,01 natural sciences ,law.invention ,law ,Electrochemistry ,medicine ,Humans ,Electrodes ,Immunoassay ,Neonatal sepsis ,medicine.diagnostic_test ,Nanotubes, Carbon ,Graphene ,010401 analytical chemistry ,Infant, Newborn ,Reproducibility of Results ,General Medicine ,Carbon black ,021001 nanoscience & nanotechnology ,medicine.disease ,0104 chemical sciences ,C-Reactive Protein ,Surface modification ,Graphite ,Neonatal Sepsis ,0210 nano-technology ,Biosensor ,Biotechnology ,Biomedical engineering - Abstract
Based on the exceptional and new opened biosensing possibilities of self-propelled micromotors, a micromotor-based immunoassay (MIm) has smartly been designed for C-reactive protein (CRP) determination in plasma of preterm infants with sepsis suspicion. The design of the micromotors involved the electrosynthesis of a carbon-based outer layer (for antibody functionalization), an intermediate Ni layer (for magnetic guidance and stopped flow operations) and PtNPs inner catalytic layer (for catalytic bubble propulsion). Micromotors biofunctionalization on the outer layer (using carbon black (CB), reduced graphene oxide (rGO) and multi-walled carbon nanotubes (MWCNTs), and biocompatible propulsion capabilities, were carefully studied. Magnetic rGO/Ni/PtNPs micromotors exhibited the most efficient and reproducible (CV = 9%) anti-CRP functionalization, controlled stopped-flow operations as well as efficient bubble propulsion (1% H2O2, 1,5% NaCh, speed 140 μm s-1). Analytical performance of MIm was excellent, allowing the direct (without dilution), sensitive (LOD = 0.80 μg/mL), and accurate CRP determination (Er = 1%) in hardly available preterm babies’ plasma samples with suspected sepsis using very low volumes ( Overall, the results obtained allowed the fast and reliable sepsis diagnostics in preterm babies’ individuals with suspected sepsis, not only proving the usefulness of the approach as its potential utilization as point-of-care device for clinical analysis but drawing new horizons in extremely low sample volumes-based diagnostics.
- Published
- 2020
41. Successful exchange transfusion in extremely preterm infant after symptomatic lipid overdose
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B Iglesias, M J Rodríguez-Castaño, and Luis Arruza
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Male ,Fat Emulsions, Intravenous ,Parenteral Nutrition ,medicine.medical_treatment ,Iatrogenic Disease ,Exchange Transfusion, Whole Blood ,Exchange transfusion ,03 medical and health sciences ,Lethargy ,0302 clinical medicine ,030225 pediatrics ,medicine ,Humans ,030212 general & internal medicine ,Continuous positive airway pressure ,Infant Nutritional Physiological Phenomena ,Mechanical ventilation ,Continuous Positive Airway Pressure ,business.industry ,Infant, Newborn ,Gestational age ,Apnea ,Metabolic acidosis ,medicine.disease ,Extremely Preterm Infant ,Dietary Fats ,Treatment Outcome ,Anesthesia ,Infant, Extremely Premature ,Pediatrics, Perinatology and Child Health ,Equipment Failure ,medicine.symptom ,business ,Acidosis - Abstract
Background Complications of intravenous lipid administration are relatively uncommon. However, inadvertent rapid infusion of intravenous fat emulsion (IVFE) is an inherent risk when fats are infused separately from the dextrose-amino acid solution. Case report Extremely preterm infant, born at 25 weeks and 6 days of gestational age weighing 920 g, who inadvertently received a massive overdose of IVFE due to a device failure. He developed lethargy, apnea, metabolic acidosis and hemodynamic instability requiring mechanical ventilation and inotropic support. Despite discontinuation of IVFE and supportive care, clinical course and metabolic acidosis worsened, so a double-volume exchange transfusion was performed. The procedure was well tolerated, without complications. Serum triglyceride concentration as well as other laboratory data normalized immediately after the exchange transfusion. The patient was extubated to continuous positive airway pressure and inotropic support was discontinued 24 hours after the procedure. He was discharged home at 40 weeks of corrected age with normal magnetic resonance imaging and neurological examination. Conclusion In cases of profound, symptomatic hypertriglyceridemia due to lipid overdose, double-volume exchange transfusion should be considered, even in extremely preterm infants.
- Published
- 2018
42. Hypoxic–ischemic brain damage induces distant inflammatory lung injury in newborn piglets
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José Martínez-Orgado, Luis Arruza, Hector Lafuente, Natalia Escribano, Nagat Mohammed, Francisco J. Alvarez-Diaz, M. Ruth Pazos, and Martín Santos
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Male ,0301 basic medicine ,Pathology ,medicine.medical_specialty ,Swine ,Oxygenation index ,Interleukin-1beta ,Encephalopathy ,Ischemia ,Brain damage ,Lung injury ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Animals ,Hypoxia ,Lung ,Inflammation ,business.industry ,Brain ,Lung Injury ,respiratory system ,Hypoxia (medical) ,medicine.disease ,respiratory tract diseases ,Disease Models, Animal ,030104 developmental biology ,medicine.anatomical_structure ,Animals, Newborn ,Hypoxia-Ischemia, Brain ,Pediatrics, Perinatology and Child Health ,medicine.symptom ,business ,Bronchoalveolar Lavage Fluid ,Infiltration (medical) ,030217 neurology & neurosurgery - Abstract
We aimed to investigate whether neonatal hypoxic–ischemic (HI) brain injury induces inflammatory lung damage. Thus, hypoxic (HYP, FiO2 10% for 30 min), ischemic (ISC, bilateral carotid flow interruption for 30 min), or HI event was performed in 1–2-d-old piglets. Dynamic compliance (Cdyn), oxygenation index (OI), and extravascular lung water (EVLW) were monitored for 6 h. Then, histologic damage was assessed in brain and lung (lung injury severity score). Total protein content (TPC) was determined in broncoalveolar lavage fluid (BALF), and IL-1β concentration was measured in lung and brain tissues and blood. Piglets without hypoxia or ischemia served as controls (SHM). HI-induced brain damage was associated with decreased Cdyn, increased OI and EVLW, and histologic lung damage (interstitial leukocyte infiltration, congestive hyperemia, and interstitial edema). BALF TPC was increased, suggesting inflammatory damage. In agreement, tissue IL-1β concentration increased in the brain and lung, in correspondence with increased IL-1β serum concentration. Neither HYP nor ISC alone led to brain or lung damage. HI brain damage in newborn piglets led to inflammatory lung damage, suggesting an additional mechanism accounting for the development of lung dysfunction after neonatal HI encephalopathy.
- Published
- 2015
43. The economic impact of prematurity and bronchopulmonary dysplasia
- Author
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Alba Torrent, Marta Muro, Luis Arruza, Carlos Zozaya, María Jesús del Cerro, Carmen González-Armengod, Alejandro Avila, Paloma López-Ortego, Jose Luis Gavilan, and María Álvarez-Fuente
- Subjects
Palivizumab ,Male ,Pediatrics ,medicine.medical_specialty ,Databases, Factual ,medicine.medical_treatment ,Birth weight ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Oxygen therapy ,medicine ,Humans ,030212 general & internal medicine ,Bronchopulmonary Dysplasia ,Mechanical ventilation ,business.industry ,Incidence (epidemiology) ,Incidence ,Infant, Newborn ,Gestational age ,Infant ,Health Care Costs ,medicine.disease ,Bronchopulmonary dysplasia ,Premature birth ,Spain ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,business ,Infant, Premature ,medicine.drug ,Follow-Up Studies - Abstract
Bronchopulmonary dysplasia (BPD) is one of the most serious chronic lung diseases in infancy and one of the most important sequels of premature birth (prevalence of 15-50%). Our objective was to estimate the cost of BPD of one preterm baby, with no other major prematurity-related complications, during the first 2 years of life in Spain. Data from the Spanish Ministry of Health regarding costs of diagnosis-related group of preterm birth, hospital admissions and visits, palivizumab administration, and oxygen therapy in the year 2013 were analyzed. In 2013, 2628 preterm babies were born with a weight under 1500 g; 50.9% were males. The need for respiratory support was 2.5% needed only oxygen therapy, 39.5% required conventional mechanical ventilation, and 14.9% required high-frequency ventilation. The incidence of BPD was of 34.9%. The cost of the first 2 years of life of a preterm baby with BPD and no other major prematurity-related complications ranged between 45,049.81 € and 118,760.43 €, in Spain, depending on birth weight and gestational age. If the baby required home oxygen therapy or developed pulmonary hypertension, this cost could add up to 181,742.43 €.Prematurity and BPD have an elevated cost, even for public health care systems. This cost will probably increase in the coming years if the incidence and survival of preterm babies keeps rising. The development of new therapies and preventive strategies to decrease the incidence of BPD and other morbidities associated with prematurity should be a priority. What is known: • Bronchopulmonary dysplasia (BPD) is a serious chronic lung disease related with premature birth. • BPD is an increasing disease due to the up-rise in the number of premature births. What is new: • The economic cost of preterm birth and BPD has never before been estimated in Spain nor published with European data. • Preterm babies with BPD and a good clinical outcome carry also an important economic and social burden.
- Published
- 2017
44. Cannabidiol reduces lung injury induced by hypoxic-ischemic brain damage in newborn piglets
- Author
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Luis Arruza, Nagat Mohammed, Natalia Escribano, Hector Lafuente, William H Hind, María Ruth Pazos, Francisco J. Alvarez-Diaz, Martín Santos, and José Martínez-Orgado
- Subjects
0301 basic medicine ,Male ,Pathology ,medicine.medical_specialty ,Swine ,Interleukin-1beta ,Inflammation ,Brain damage ,Pulmonary compliance ,Lung injury ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Animals ,Cannabidiol ,Hypoxia ,Lung ,medicine.diagnostic_test ,business.industry ,Hemodynamics ,Brain ,Lung Injury ,respiratory system ,digestive system diseases ,respiratory tract diseases ,Oxygen ,Disease Models, Animal ,Oxidative Stress ,030104 developmental biology ,medicine.anatomical_structure ,Bronchoalveolar lavage ,Animals, Newborn ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Hypoxia-Ischemia, Brain ,medicine.symptom ,business ,Bronchoalveolar Lavage Fluid ,030217 neurology & neurosurgery ,Oxidative stress ,medicine.drug - Abstract
Brain hypoxic–ischemic (HI) damage induces distant inflammatory lung damage in newborn pigs. We aimed to investigate the effects of cannabidiol (CBD) on lung damage in this scenario. Newborn piglets received intravenous vehicle, CBD, or CBD+WAY100635 (5-HT1A receptor antagonist) after HI brain damage (carotid flow interruption and FiO2 0.10 for 30 min). Total lung compliance (TLC), oxygenation index (OI), and extravascular lung water content (EVLW) were monitored for 6 h. Histological damage, interleukin (IL)-1β concentration, and oxidative stress were assessed in brain and lung tissue. Total protein content was determined in bronchoalveolar lavage fluid (BALF). CBD prevented HI-induced deleterious effects on TLC and OI and reduced lung histological damage, modulating inflammation (decreased leukocyte infiltration and IL-1 concentration) and reducing protein content in BALF and EVLW. These effects were related to CBD-induced anti-inflammatory changes in the brain. HI did not increase oxidative stress in the lungs. In the lungs, WAY100635 blunted the beneficial effects of CBD on histological damage, IL-1 concentration, and EVLW. CBD reduced brain HI-induced distant lung damage, with 5-HT1A receptor involvement in these effects. Whether the effects of CBD on the lungs were due to the anti-inflammatory effects on the brain or due to the direct effects on the lungs remains to be elucidated.
- Published
- 2017
45. Ecocardiografía funcional en cuidados intensivos neonatales: experiencia en una unidad española a lo largo de un año
- Author
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Araceli Corredera, B. Llorente, M.J. Rodríguez, M. Moro, Luis Arruza, and P. Arévalo
- Subjects
Point-of-care ultrasound ,Pediatrics, Perinatology and Child Health ,Intensive care unit ,Functional echocardiography ,Newborn ,Pediatrics ,RJ1-570 - Abstract
Resumen: Introducción: Numerosas publicaciones destacan la utilidad de la ecocardiografía funcional (EcoFn) en neonatología. No existen datos sobre su uso en unidades españolas. Objetivo: Evaluar la frecuencia de uso, pacientes, indicaciones, mediciones y repercusión sobre el tratamiento de la EcoFn en un año en una unidad de cuidados intensivos neonatales (UCIN) española. Métodos: Estudio descriptivo retrospectivo en pacientes ingresados en UCIN en un año. Variables: edad gestacional, peso, diagnóstico principal, días de vida en el momento del estudio, indicación, parámetros medidos y modificaciones del tratamiento. Resultados: Se realizaron 168 ecografías en 50 pacientes, con una media ± desviación estándar de 3,4 ± 2,83 por paciente. Las indicaciones más frecuentes fueron la valoración del ductus (58,3%) seguida de la inestabilidad hemodinámica (22,2%). El resultado de la ecografía modificó el tratamiento en 62 casos (36,9%). En un 17,4% se inició tratamiento con ibuprofeno y en un 1,2% de los casos se adelantó el fin de este. En un 10,8% de los casos, la ecografía modificó el soporte hemodinámico. Los parámetros principales valorados fueron: valoración de presencia/repercusión del ductus 100%; función miocárdica: fracción de eyección/acortamiento 23,8%, gasto ventrículo del izquierdo 24,4%, gasto del ventrículo derecho 21,4%; flujo sistémico 42,3%; signos de hipertensión pulmonar 7,7%. Conclusiones: La EcoFn es utilizada frecuentemente en UCIN y en muchos casos guía el tratamiento de los pacientes. La valoración del ductus y de la inestabilidad hemodinámica son las indicaciones más frecuentes. Queda por determinar si el uso de la EcoFn modifica la evolución de los pacientes de UCIN. Abstract: Introduction: Several publications highlight the usefulness of functional echocardiography (FnECHO) in neonatal intensive care. Data is lacking on its use in units neonatal in Spain. Objectives: To evaluate frequency of use, patient characteristics, indications, measurements, and impact on patient management of FnECHO in a neonatal intensive care unit (NICU) in Spain over a 1 year period. Methods: A retrospective study conducted in NICU patients during 1 year. Variables: gestational age, birthweight, admission criteria, days of life at examination, indication for FnECHO, parameters assessed, and treatment modifications. Results: 168 echocardiographic studies were performed in 50 patients (mean 3,4. SD 2,83). The most frequent indication was patent ductus (PDA) assessment (58.3%), followed by hemodynamic instability (22.2%). The results of FnECHO modified treatment in 62 cases (36.9%). In 17.4% of them treatment with ibuprofen was initiated, and in 1.2% it was discontinued. In 10.8% of the cases, the results of FnECHO modified hemodynamic support. Echocardiographic evaluation included: assessment of presence/hemodynamic significance of PDA (100%); myocardiac function: ejection fraction/shortening fraction (EF/SF) 23.8%, left ventricular output 24.4%, right ventricular output 21.4%, systemic blood flow 42.3%; and signs of pulmonary hypertension 7.7%. Conclusions: FnECHO is frequently used in the NICU, and in many cases it guides treatment. PDA assessment and hemodynamic instability are the most frequent indications. It still needs to be elucidated if the use of FnECHO modifies patient outcomes.
- Published
- 2014
46. Functional echocardiography in neonatal intensive care: 1-Year experience in a unit in Spain
- Author
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Araceli Corredera, P. Arévalo, Luis Arruza, M. Moro, M.J. Rodríguez, and B. Llorente
- Subjects
Pediatrics ,medicine.medical_specialty ,Neonatal intensive care unit ,Ejection fraction ,business.industry ,Hemodynamics ,Gestational age ,Ecografía en el punto de la asistencia ,Retrospective cohort study ,Fractional shortening ,medicine.disease ,Pulmonary hypertension ,RJ1-570 ,Ecocardiografía funcional ,Recién nacido ,Management of Technology and Innovation ,Intensive care ,medicine ,business ,Cuidados intensivos neonatales - Abstract
Introduction: Several publications highlight the usefulness of functional echocardiography (FnECHO) in neonatal intensive care. Data are lacking on its use in neonatal units in Spain. Objectives: To evaluate frequency of use, patient characteristics, indications, measurements, and impact on patient management of FnECHO in a neonatal intensive care unit (NICU) in Spain over a 1-year period. Methods: A retrospective study conducted in NICU patients during 1 year. Variables: gestational age, birthweight, admission criteria, days of life at examination, indication for FnECHO, parameters assessed, and treatment modifications. Results: 168 echocardiographic studies were performed in 50 patients (mean 3.4; SD 2.83). The most frequent indication was patent ductus (PDA) assessment (58.3%), followed by haemodynamic instability (22.2%). The results of FnECHO modified treatment in 62 cases (36.9%). In 17.4% of them treatment with ibuprofen was initiated, and in 1.2% it was discontinued. In 10.8% of the cases, the results of FnECHO modified haemodynamic support. Echocardiographic evaluation included: assessment of presence/haemodynamic significance of PDA (100%); myocardiac function: ejection fraction/shortening fraction (EF/SF) 23.8%, left ventricular output 24.4%, right ventricular output 21.4%, systemic blood flow 42.3%; and signs of pulmonary hypertension 7.7%. Conclusions: FnECHO is frequently used in the NICU, and in many cases it guides treatment. PDA assessment and haemodynamic instability are the most frequent indications. It still needs to be elucidated if the use of FnECHO modifies patient outcomes. Resumen: Introducción: Numerosas publicaciones destacan la utilidad de la ecocardiografía funcional (EcoFn) en neonatología. No existen datos sobre su uso en unidades españolas. Objetivo: Evaluar la frecuencia de uso, pacientes, indicaciones, mediciones y repercusión sobre el tratamiento de la EcoFn en un año en una unidad de cuidados intensivos neonatales (UCIN) española. Métodos: Estudio descriptivo retrospectivo en pacientes ingresados en UCIN en un año. Variables: edad gestacional, peso, diagnóstico principal, días de vida en el momento del estudio, indicación, parámetros medidos y modificaciones del tratamiento. Resultados: Se realizaron 168 ecografías en 50 pacientes, con una media ± desviación estándar de 3,4 ± 2,83 por paciente. Las indicaciones más frecuentes fueron la valoración del ductus (58,3%) seguida de la inestabilidad hemodinámica (22,2%). El resultado de la ecografía modificó el tratamiento en 62 casos (36,9%). En un 17,4% se inició tratamiento con ibuprofeno y en un 1,2% de los casos se adelantó el fin de este. En un 10,8% de los casos, la ecografía modificó el soporte hemodinámico. Los parámetros principales valorados fueron: valoración de presencia/repercusión del ductus 100%; función miocárdica: fracción de eyección/acortamiento 23,8%, gasto ventrículo del izquierdo 24,4%, gasto del ventrículo derecho 21,4%; flujo sistémico 42,3%; signos de hipertensión pulmonar 7,7%. Conclusiones: La EcoFn es utilizada frecuentemente en UCIN y en muchos casos guía el tratamiento de los pacientes. La valoración del ductus y de la inestabilidad hemodinámica son las indicaciones más frecuentes. Queda por determinar si el uso de la EcoFn modifica la evolución de los pacientes de UCIN.
- Published
- 2014
47. Ecocardiografía funcional en neonatología
- Author
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Araceli Corredera Sánchez and Luis Arruza Gómez
- Subjects
business.industry ,Pediatrics, Perinatology and Child Health ,Medicine ,business - Published
- 2014
48. Circulating endothelial progenitor cells are reduced in rat oxygen-induced retinopathy despite a retinal SDF-1/CXCR4 and VEGF proangiogenic response
- Author
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Raquel Fernández-Durango, Arturo Fernández-Cruz, Amanda Villalvilla, Santiago Redondo, M. Moro, and Luis Arruza
- Subjects
Vascular Endothelial Growth Factor A ,Receptors, CXCR4 ,Stromal cell ,Angiogenesis ,Bone Marrow Cells ,Real-Time Polymerase Chain Reaction ,General Biochemistry, Genetics and Molecular Biology ,Rats, Sprague-Dawley ,Neovascularization ,Andrology ,chemistry.chemical_compound ,Retinal Diseases ,Glial Fibrillary Acidic Protein ,medicine ,Animals ,General Pharmacology, Toxicology and Pharmaceutics ,Progenitor cell ,Retina ,Neovascularization, Pathologic ,business.industry ,Endothelial Cells ,Retinal Vessels ,Retinal ,General Medicine ,Flow Cytometry ,medicine.disease ,Immunohistochemistry ,Chemokine CXCL12 ,eye diseases ,Rats ,Oxygen ,Vascular endothelial growth factor ,medicine.anatomical_structure ,chemistry ,Immunology ,cardiovascular system ,sense organs ,medicine.symptom ,business ,Retinopathy - Abstract
Aims The purpose of this study is to investigate circulating endothelial progenitor cells (EPCs) and the signaling pathways involved in their recruitment in the ischemic retina of the 50/10 rat model of oxygen-induced retinopathy (OIR). Main methods Within 12 h after birth, litters of Sprague–Dawley rats and their mothers were exposed to alternating oxygen concentrations, followed by a room air exposition, to induce OIR. Retinopathy was quantified by ADPase stain in flat-mounted retinas and pre-ILM nuclei count in retinal sections. Semiquantitative real-time PCR and immunofluorescence were assessed in retinas to study stromal cell-derived factor 1 (SDF-1), its receptor CXCR4 and vascular endothelial growth factor (VEGF) expression. Circulating EPCs were evaluated by flow cytometry in peripheral blood. Key findings Our results showed increased immunolabelling of SDF-1 in endothelial cells and strong expression of CXCR4 in Muller cells in OIR retinas as compared to control retinas. We found increased levels of CXCR4 and VEGF mRNA in OIR retinas, especially during the vascular attenuation stage. The number of circulating EPCs was decreased in OIR rats as compared to control rats. Significance The decrease in circulating EPCs could be implied in vessel growth arrest during normal retinal development in OIR rats, while pro-angionenic signals released by Muller cells in the hypoxic retina could drive pathological neovascularization in the ischemic retina. These data warrant further studies to investigate new therapeutic approaches for ROP.
- Published
- 2012
49. Preterm Resuscitation With Low Oxygen Causes Less Oxidative Stress, Inflammation, and Chronic Lung Disease
- Author
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Gema Villar, Manuel Moro, J Escobar, Alessandro Arduini, Máximo Vento, Isabel Izquierdo, Juan Sastre, Raquel Escrig, Miguel Asensi, Luis Arruza, and L. Jackson Roberts
- Subjects
Male ,medicine.medical_specialty ,Resuscitation ,Isoprostane ,Infant, Premature, Diseases ,medicine.disease_cause ,Gastroenterology ,chemistry.chemical_compound ,Isofuran ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Bronchopulmonary Dysplasia ,Oxygen saturation (medicine) ,Inflammation ,business.industry ,Infant, Newborn ,Oxygen Inhalation Therapy ,Glutathione ,medicine.disease ,Oxygen ,Oxidative Stress ,Bronchopulmonary dysplasia ,chemistry ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Glutathione disulfide ,Female ,business ,Infant, Premature ,Oxidative stress - Abstract
OBJECTIVE: The goal was to reduce adverse pulmonary adverse outcomes, oxidative stress, and inflammation in neonates of 24 to 28 weeks of gestation initially resuscitated with fractions of inspired oxygen of 30% or 90%. METHODS: Randomized assignment to receive 30% (N = 37) or 90% (N = 41) oxygen was performed. Targeted oxygen saturation values were 75% at 5 minutes and 85% at 10 minutes. Blood oxidized glutathione (GSSG)/reduced glutathione ratio and urinary o-tyrosine, 8-oxo-dihydroxyguanosine, and isoprostane levels, isofuran elimination, and plasma interleukin 8 and tumor necrosis factor α levels were determined. RESULTS: The low-oxygen group needed fewer days of oxygen supplementation (6 vs 22 days; P < .01) and fewer days of mechanical ventilation (13 vs 27 days; P < .01) and had a lower incidence of bronchopulmonary dysplasia at discharge (15.4% vs 31.7%; P < .05). GSSG/reduced glutathione × 100 ratios at day 1 and 3 were significantly higher in the high-oxygen group (day 1: high-oxygen group: 13.36 ± 5.25; low-oxygen group: 8.46 ± 3.87; P < .01; day 3: high-oxygen group: 8.87 ± 4.40; low-oxygen group: 6.97 ± 3.11; P < .05). Urinary markers of oxidative stress were increased significantly in the high-oxygen group, compared with the low-oxygen group, in the first week after birth. GSSG levels on day 3 and urinary isofuran, o-tyrosine, and 8-hydroxy-2′-deoxyguanosine levels on day 7 were correlated significantly with development of chronic lung disease. CONCLUSIONS: Resuscitation of preterm neonates with 30% oxygen causes less oxidative stress, inflammation, need for oxygen, and risk of bronchopulmonary dysplasia.
- Published
- 2009
50. Häufig unerwünschte Arzneimittelwirkungen bei Neugeborenen
- Author
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A Belén Rivas, E Pacheco, and Luis Arruza
- Published
- 2016
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