Pure phenotypic neonatal IP presentation in a myofibrillar myopathy is extremely rare and not reported in the literature. Along with other common causes of neonatal IP, neuromuscular causes should also be investigated.
Background and Aims:
Mechanical ventilation in prone position was associated with a reduction in mortality and increase in arterial oxygenation in acute respiratory distress syndrome (ARDS) patients. However, physiological effects of prone position in COVID ARDS patients are unknown.
Material and Methods:
In this prospective observational study, data of n = 47 consecutive real time RT- PCR confirmed SARS-CoV-2-infected patients with severe ARDS were included. Respiratory mechanics and oxygenation data of recruited patients were collected before and after prone position.
Results:
Median (Interquartile range, IQR) age of the recruited patients was 60 (50–67) years and median (IQR) PaO2/FiO2 ratio of 61.2 (54–80) mm Hg with application of median (IQR) positive end expiratory pressure (PEEP) of 12 (10–14) cm H2O before initiation of prone position. Out of those patients, 36 (77%) were prone responders at 16 hours after prone session, evident by increase of PaO2 by at least 20 mm Hg or by 20% as compared to baseline, and 73% patients were sustained responders (after returning to supine position). Plateau airway pressure (p < 0.0001), peak airway pressure (p < 0.0001), and driving pressure (p < 0.0001) were significantly reduced in prone position, and static compliance (p = 0.001), PaO2/FiO2 ratio (p < 0.0001), PaO2 (p = 0.0002), and SpO2 (p = 0.0004) were increased at 4 hours and 16 hours since prone position and also after returning to supine position.
Conclusion:
In SARS-CoV-2-infected patients, mechanical ventilation in prone position is associated with improvement in lung compliance and oxygenation in almost three-fourth of the patients and persisted in supine position in more than 70% of the patients.
Background: A large number of newborns are affected by congenital heart diseases, which accounts for a high proportion of infant mortality worldwide. But there are regional variations in the prevalence and distribution pattern of congenital heart diseases. We evaluated the incidence, risk factors and diagnostic clues for congenital heart disease in newborns in our neonatal intensive care unit. Methods: A prospective observational study was conducted in the neonatal intensive care unit of Vydehi institute of medical sciences between January 2013 to December 2016. Congenital heart disease was suspected if clinical and confirmed by 2D echocardiography and doppler and colour flow imaging. Data was collected on a predesigned proforma containing information regarding gender, gestational age and weight at birth, family history, and associated malformations. Results: Out of 1974 babies screened for CHDs, 126 babies had CHDs (4.6%) of which 71(56%) were males. Most of neonates presented with Respiratory distress (52.3%), murmurs (49.5%), abnormal chest X ray (27.7%), followed by cyanosis (18.2%) in Cyanotic CHDs(100% of the cases). Conclusion: The incidence of CHD in newborns at the neonatal intensive care unit was higher than that in all live births.VSD was the most common congenital heart defect detected while Tetralogy of Fallot was commonest among the cyanotic heart defects.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.