A5053228757- Neonatal Respiratory Health Research
- Congenital Heart Disease Studies
- Neuroscience of respiration and sleep
- Neonatal and fetal brain pathology
- Congenital Diaphragmatic Hernia Studies
- Cardiovascular Conditions and Treatments
- Cardiac Arrest and Resuscitation
- Mechanical Circulatory Support Devices
- Ultrasound in Clinical Applications
- Hemodynamic Monitoring and Therapy
- Infant Development and Preterm Care
- Respiratory Support and Mechanisms
- Pulmonary Hypertension Research and Treatments
- Phonocardiography and Auscultation Techniques
- Cardiac Arrhythmias and Treatments
- Preterm Birth and Chorioamnionitis
- Cardiovascular Function and Risk Factors
- Renal function and acid-base balance
- Traumatic Brain Injury and Neurovascular Disturbances
- Non-Invasive Vital Sign Monitoring
- Cardiac, Anesthesia and Surgical Outcomes
- Prenatal Screening and Diagnostics
- Cardiovascular Syncope and Autonomic Disorders
- Transplantation: Methods and Outcomes
- Cardiovascular Issues in Pregnancy
The University of Sydney
2015-2024
Royal North Shore Hospital
2015-2024
King Edward Memorial Hospital
2023
The University of Western Australia
2022
John Hunter Children's Hospital
2022
University of Newcastle Australia
2022
Mater Mothers' Hospital
2022
Mater Research
2022
The University of Queensland
2022
National Health and Medical Research Council
2022
<h3>OBJECTIVES</h3> To document the incidence, timing, degree, and associations of systemic hypoperfusion in preterm infant to explore temporal relation between low blood flow development intraventricular haemorrhage (IVH). <h3>STUDY DESIGN</h3> 126 babies born before 30 weeks9 gestation (mean 27 weeks, mean body weight 991 g) were studied with Doppler echocardiography cerebral ultrasound at 5, 12, 24, 48 hours age. Superior vena cava (SVC) was assessed by as primary measure returning from...
Key points Delayed cord clamping improves circulatory stability in preterm infants at birth, but the underlying reason is not known. In a new lamb study we investigated whether delayed until ventilation had been initiated improved pulmonary, cardiovascular and cerebral haemodynamic stability. We demonstrated that prior to markedly function by increasing pulmonary blood flow before clamped, thus further stabilising transition. These results show delaying after onset leads smoother transition...
The preferred timing of umbilical-cord clamping in preterm infants is unclear.We randomly assigned fetuses from women who were expected to deliver before 30 weeks gestation either immediate the umbilical cord (≤10 seconds after delivery) or delayed (≥60 delivery). primary composite outcome was death major morbidity (defined as severe brain injury on postnatal ultrasonography, retinopathy prematurity, necrotizing enterocolitis, late-onset sepsis) by 36 postmenstrual age. Analyses performed an...
<h3>Objective</h3> Failure of closure the patent ductus arteriosus (PDA) may be associated with harm. Early cardiac ultrasound-targeted treatment a large PDA result in reduction adverse outcomes and need for later no increase effects. <h3>Study design</h3> Multicentre, double-blind, placebo-controlled randomised trial. <h3>Setting</h3> Three neonatal intensive care units Australia. <h3>Patients interventions</h3> Eligible infants born <29 weeks were screened received indomethacin or...
Ventricular outputs cannot be used to assess systemic blood flow in preterm infants because they are confounded by shunts through the ductus arteriosus and atrial septum. However, measurements superior vena cava (SVC) can returning from upper body brain.To describe a Doppler echocardiographic technique that measures SVC, test its reproducibility, establish normal ranges.SVC was assessed together with right ventricular output or ductal shunting. Normal range established 14 born after 36...
Objectives. To determine hemodynamic and antecedent risk factors for early late periventricular/intraventricular hemorrhage (P/IVH) in premature infants. Methods. Two prospective cohort studies of 126 (1995–1996) 128 (1998–1999) infants born &lt;30 weeks’ gestation. Head ultrasounds were performed at &lt;6 hours age, 7 28 days age. P/IVH was classified as (present on initial scan) (developed subsequently). Echocardiographic measurement the superior vena cava (SVC) flow &lt;6, 10,...
One hundred and twenty ventilated preterm infants, birthweight < 1500 g, were examined within the first 36 hours with colour Doppler echocardiography, to determine cardiorespiratory influences on right (RVO) left ventricular output (LVO). Forty nine of these infants had three further daily scans. Measurements included (LV) ejection fraction, determination RVO LVO, ductal interatrial shunt direction, velocity diameter. Infants grouped by respiratory disease severity: mild, mean FIO2 in 24...
AIM: To establish if there is an association between early cardiovascular adaptation and intraventricular haemorrhage (IVH). METHODS: One hundred seventeen ventilated preterm infants (mean gestational age 27 weeks, mean birthweight 993 g) were studied echocardiographically within the first 36 hours. Measurements included right (RVO) left ventricular outputs (LVO), ductus arteriosus (PDA) atrial shunt diameter using colour Doppler pulsed direction velocity of both shunts. Clinical variables...
Background As measurement of arterial oxygen saturation (SpO2) is common in the delivery room, target SpO2 ranges allow clinicians to titrate therapy for preterm infants order achieve levels similar those seen normal term first minutes life. However, influence onset ventilation and timing cord clamping on systemic cerebral oxygenation not known. Aim We investigated whether initiation ventilation, prior to, or after umbilical clamping, altered lambs. Methods Systemic blood-flows, pressures...
Aims Preterm infants can be inadvertently exposed to high tidal volumes (VT) in the delivery room, causing lung inflammation and injury, but little is known about their effects on brain. The aim of this study was compare an initial 15 min VT resuscitation strategy a less injurious cerebral haemodynamics, injury. Methods lambs at 126 d gestation were surgically instrumented prior receiving with either: 1) High targeting 10–12 mL/kg for first (n = 6) or 2) protective (Prot VT), consisting...
Umbilical cord milking (UCM) at birth may benefit preterm infants, but the physiological effects of UCM are unknown. We compared two strategies with immediate umbilical clamping (UCC) and physiological-based (PBCC) in lambs.At 126 days' gestational age, fetal lambs were exteriorised, intubated instrumented to measure umbilical, pulmonary cerebral blood flows arterial pressures. Lambs received either (1) without placental refill (UCMwoPR); (2) (UCMwPR); (3) PBCC, whereby ventilation commenced...
IntroductionEndotracheal (ET) epinephrine administration is an option during neonatal resuscitation, if the preferred intravenous (IV) route unavailable.ObjectivesWe assessed whether endotracheal achieved return of spontaneous circulation (ROSC), and maintained physiological stability after ROSC, at standard higher dose, in severely asphyxiated newborn lambs.MethodsNear-term fetal lambs were until asystole. Resuscitation was commenced with ventilation chest compressions. Lambs randomly...
OBJECTIVE. The goal was to report the 1- and 3-year outcomes of preterm infants with low systemic blood flow in first day effect dobutamine versus dopamine for treatment flow. METHODS. A cohort 128 born at &lt;30 weeks gestation underwent echocardiographic measurement superior vena cava 3, 10, 24 hours age. Forty-two (&lt;41 mL/kg per minute) were assigned randomly or dopamine. Surviving blinded neurodevelopmental assessments corrected ages 1 3 years. RESULTS. Seventy-six 87...