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- Farooqi, Aijaz, et al.
(författare)
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Mental health and social competencies of 10- to 12-year-old children born at 23 to 25 weeks of gestation in the 1990s : a Swedish national prospective follow-up study.
- 2007
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 120:1, s. 118-133
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Tidskriftsartikel (refereegranskat)abstract
- Abstract OBJECTIVE: We investigated a national cohort of extremely immature children with respect to behavioral and emotional problems and social competencies, from the perspectives of parents, teachers, and children themselves. METHODS: We examined 11-year-old children who were born before 26 completed weeks of gestation in Sweden between 1990 and 1992. All had been evaluated at a corrected age of 36 months. At 11 years of age, 86 of 89 survivors were studied and compared with an equal number of control subjects, matched with respect to age and gender. Behavioral and emotional problems, social competencies, and adaptive functioning at school were evaluated with standardized, well-validated instruments, including parent and teacher report questionnaires and a child self-report, administered by mail. RESULTS: Compared with control subjects, parents of extremely immature children reported significantly more problems with internalizing behaviors (anxiety/depression, withdrawn, and somatic problems) and attention, thought, and social problems. Teachers reported a similar pattern. Reports from children showed a trend toward increased depression symptoms compared with control subjects. Multivariate analysis of covariance of parent-reported behavioral problems revealed no interactions, but significant main effects emerged for group status (extremely immature versus control), family function, social risk, and presence of a chronic medical condition, with all effect sizes being medium and accounting for 8% to 12% of the variance. Multivariate analysis of covariance of teacher-reported behavioral problems showed significant effects for group status and gender but not for the covariates mentioned above. According to the teachers' ratings, extremely immature children were less well adjusted to the school environment than were control subjects. However, a majority of extremely immature children (85%) were functioning in mainstream schools without major adjustment problems. CONCLUSIONS: Despite favorable outcomes for many children born at the limit of viability, these children are at risk for mental health problems, with poorer school results.
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- Jennische, Margareta, et al.
(författare)
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School level at 10 years of age in children who required neonatal intensive care in 1980-1989
- 2006
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 95:12, s. 1586-1593
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Tidskriftsartikel (refereegranskat)abstract
- School level at age 10 was studied in two cohorts of children who had required neonatal intensive care (NIC): cohort 1, children born 1980-1985 (n=310); and cohort 2, children born 1986-1989 (n=245); and two control groups. More than 80% of all NIC children of both cohorts attended the appropriate mainstream grade 3 or 4; 12.9% of cohort 1 and 6.8% of cohort 2 were in mainstream grade 2. Six per cent of both cohorts received special education. Among very preterm children (23-31 gestational weeks), 73.5% of cohort 1 and 80.3% of cohort 2 attended grades 3 and 4, while 22.9% and 12.1%, respectively, were in grade 2. Assistance (remedial teaching, personal assistant or special teaching group) was given to 42.4% of cohort 1 in the mainstream (grades 2, 3 and 4) and to 38.2% of cohort 2 in the mainstream. In cohort 2, more very preterm girls than matched controls received assistance (p < 0.05); no corresponding difference was found in very preterm boys. Most children with congenital malformations received assistance in mainstream education or received special education. Conclusion: Most NIC children are in mainstream school classes at age 10. Twelve to 23% of very preterm children are 1 y behind. Many NIC children in the school mainstream need assistance at school, but the proportion of children in mainstream education increases markedly with time.
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- Rehncrona, S., et al.
(författare)
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Apnea : Phrenic Nerve Stimulation
- 2009
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Ingår i: Textbook of Stereotactic and functional neurosurgery. - Heidelberg : Sringer Verlag. - 9783540707790 ; , s. 2991-2997
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Rieger-Fackeldey, Esther, et al.
(författare)
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Bronchopulmonary C-fibers modulate the breathing pattern in surfactant-depleted juvenile cats
- 2008
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Ingår i: Respiratory Physiology & Neurobiology. - : Elsevier BV. - 1569-9048 .- 1878-1519. ; 160:3, s. 341-349
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the influence of nonmyelinated C-fibers on the breathing pattern by cooling the vagal nerves to temperatures at which myelinated nerve transmission from pulmonary stretch receptors is blocked (+7 degrees C) and further at which nonmyelinated fiber input is blocked (0 degrees C), in anaesthetized spontaneously breathing juvenile cats with normal (L(N)), surfactant-depleted (L(D)) and surfactant-treated (L(T)) lungs. In L(N), vagal cooling from +7 to 0 degrees C decreased respiratory frequency (f(R); -8%; p < 0.01), and increased tidal volume (V(T); +40%; p < 0.01). In the presence of shallow fast breathing in L(D), f(R) decreased (+38 to +7 degrees C: -26%; p < 0.015 and +7 to 0 degrees C: -24%; p < 0.001) and V(T) increased (+37%; p < 0.049 and +88%; p < 0.016). In L(T), f(R) decreased (+7 to 0 degrees C: -21%; p < 0.001), whereas V(T) remained the same at 0 degrees C (+12%; NS). These findings show for the first time that the activity of bronchopulmonary C-fibers have a prominent role in modulating the breathing pattern in juvenile cats with surfactant-depleted lungs.
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- Rieger-Fackeldey, Esther, et al.
(författare)
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Inhibition of breathing after Surfactant Depletion is Achieved at a Higher Arterial PCO2 during Ventilation with Liquid than with Gas
- 2005
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Ingår i: Respiratory Research. - : Springer Science and Business Media LLC. - 1465-9921 .- 1465-993X. ; 6, s. 24-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundInhibition of phrenic nerve activity (PNA) can be achieved when alveolar ventilation is adequate and when stretching of lung tissue stimulates mechanoreceptors to inhibit inspiratory activity. During mechanical ventilation under different lung conditions, inhibition of PNA can provide a physiological setting at which ventilatory parameters can be compared and related to arterial blood gases and pH.ObjectiveTo study lung mechanics and gas exchange at inhibition of PNA during controlled gas ventilation (GV) and during partial liquid ventilation (PLV) before and after lung lavage.MethodsNine anaesthetised, mechanically ventilated young cats (age 3.8 ± 0.5 months, weight 2.3 ± 0.1 kg) (mean ± SD) were studied with stepwise increases in peak inspiratory pressure (PIP) until total inhibition of PNA was attained before lavage (with GV) and after lavage (GV and PLV). Tidal volume (Vt), PIP, oesophageal pressure and arterial blood gases were measured at inhibition of PNA. One way repeated measures analysis of variance and Student Newman Keuls-tests were used for statistical analysis.ResultsDuring GV, inhibition of PNA occurred at lower PIP, transpulmonary pressure (Ptp) and Vt before than after lung lavage. After lavage, inhibition of inspiratory activity was achieved at the same PIP, Ptp and Vt during GV and PLV, but occurred at a higher PaCO2 during PLV. After lavage compliance at inhibition was almost the same during GV and PLV and resistance was lower during GV than during PLV.ConclusionInhibition of inspiratory activity occurs at a higher PaCO2 during PLV than during GV in cats with surfactant-depleted lungs. This could indicate that PLV induces better recruitment of mechanoreceptors than GV.
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- Sedin, Gunnar, et al.
(författare)
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Kuvösvård
- 2008
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Ingår i: Neonatologi. - Lund : Studentlitteratur. - 9789144046433 ; , s. 439-439
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Bokkapitel (populärvet., debatt m.m.)
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- Sindelar, Richard, et al.
(författare)
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Maintained inspiratory activity during proportional assist ventilation in surfactant-depleted cats early after surfactant instillation : phrenic nerve and pulmonary stretch receptor activity.
- 2006
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Ingår i: Respir Res. - 1465-993X. ; 7, s. 38-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Inspiratory activity is a prerequisite for successful application of patient triggered ventilation such as proportional assist ventilation (PAV). It has recently been reported that surfactant instillation increases the activity of slowly adapting pulmonary stretch receptors (PSRs) followed by a shorter inspiratory time (Sindelar et al, J Appl Physiol, 2005 [Epub ahead of print]). Changes in lung mechanics, as observed in preterm infants with respiratory distress syndrome and after surfactant treatment, might therefore influence the inspiratory activity when applying PAV early after surfactant treatment. OBJECTIVE: To investigate the regulation of breathing and ventilatory response in surfactant-depleted young cats during PAV and during continuous positive airway pressure (CPAP) early after surfactant instillation in relation to phrenic nerve activity (PNA) and the activity of PSRs. METHODS: Seven anesthetized, endotracheally intubated young cats were exposed to periods of CPAP and PAV with the same end-expiratory pressure (0.2-0.5 kPa) before and after lung lavage and after surfactant instillation. PAV was set to compensate for 75% of the lung elastic recoil. RESULTS: Tidal volume and respiratory rate were higher with lower PaCO2 and higher PaO2 during PAV than during CPAP both before and after surfactant instillation (p < 0.05; both conditions). As an indicator of breathing effort, esophageal deflection pressure and PNA were lower during PAV than during CPAP in both conditions (p < 0.02). Peak PSR activity was higher and occurred earlier during PAV than during CPAP (p < 0.01), and correlated linearly with PNA duration in all conditions studied (p < 0.001). The inspiratory time decreased as tidal volume increased when CPAP was changed to PAV, with the highest correlation observed after surfactant instillation (r = -0.769). No apneic periods could be observed. CONCLUSION: PSR activity and the control of breathing are maintained during PAV in surfactant-depleted cats early after surfactant instillation, with a higher ventilatory response and a lower breathing effort than during CPAP.
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- Ågren, Johan, et al.
(författare)
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Vätskebalans
- 2008
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Ingår i: Neonatologi. - Lund : Studentlitteratur. - 9789144046433 ; , s. 159-165
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Bokkapitel (populärvet., debatt m.m.)
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