6 results on '"Meskell S"'
Search Results
2. Methods of weaning preterm babies <30 weeks gestation off CPAP: a multicentre randomised controlled trial
- Author
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Todd, David A., Wright, A., Broom, M., Chauhan, M., Meskell, S., Cameron, C., Perdomi, A. M., Rochefort, M., Jardine, L., Stewart, A., Shadbolt, B., Todd, David A., Wright, A., Broom, M., Chauhan, M., Meskell, S., Cameron, C., Perdomi, A. M., Rochefort, M., Jardine, L., Stewart, A., and Shadbolt, B.
- Abstract
BACKGROUND Controversy exists whether different continuous positive airway pressure (CPAP) weaning methods influence time to wean off CPAP, CPAP duration, oxygen duration, Bronchopulmonary Dysplasia (BPD) or length of admission. AIMS In a multicentre randomised controlled trial, the authors have primarily compared CPAP weaning methods impact on time to wean off CPAP and CPAP duration and secondarily their effect on oxygen duration, BPD and time of admission. METHODS Between April 2006 and October 2009, 177 infants <30 weeks gestational age (GA) who fulfilled stability criteria on CPAP were randomised to one of the three CPAP weaning methods (M). M1: Taken 'OFF' CPAP with the view to stay 'OFF'. M2: Cycled on and off CPAP with incremental time 'OFF'. M3: As with m(2), cycled on and off CPAP but during 'OFF' periods were supported by 2 mm nasal cannula at a flow of 0.5 l/min. RESULTS Based on intention to treat analysis, there was no significant difference in mean GA or birthweight between the groups (27.1 ± 1.4, 26.9 ± 1.6 and 27.3 ± 1.5 (weeks ± 1SD) and 988 ± 247, 987 ± 249 and 1015 ± 257 (grams ± 1SD), respectively). Primary outcomes showed M1 produced a significantly shorter time to wean from CPAP (11.3 ± 0.8, 16.8 ± 1.0, 19.4 ± 1.3 (days ± 1SE) p<0.0001, respectively) and CPAP duration (24.4 ± 0.1, 38.6 ± 0.1, 30.5 ± 0.1 (days ± 1SE) p<0.0001, respectively). All the secondary outcomes were significantly shorter with M1, (oxygen duration: 24.1 ± 1.5, 45.8 ± 2.2, 34.1 ± 2.0 (days ± 1SE) p<0.0001, BPD: 7/56 (12.5%), 29/69 (42%), 10/52 (19%) p=0.011 and length of admission: 58.5 ± 0.1, 73.8 ± 0.1 69.5 ± 0.1 (days ± 1SE) p<0.0001, respectively). CONCLUSION Method 1 significantly shortens CPAP weaning time, CPAP duration, oxygen duration, BPD and admission time.
- Published
- 2012
3. Normative blood pressure data in non-ventilated premature neonates from 28-36 weeks gestation.
- Author
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Kent AL, Meskell S, Falk MC, and Shadbolt B
- Published
- 2009
- Full Text
- View/download PDF
4. Are renal volumes measured by magnetic resonance imaging and three-dimensional ultrasound in the term neonate comparable?
- Author
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Kent AL, Jyoti R, Robertson C, Gonsalves L, Meskell S, Shadbolt B, and Falk MC
- Subjects
- Female, Gestational Age, Humans, Image Interpretation, Computer-Assisted, Infant, Newborn, Male, Organ Size, Predictive Value of Tests, Reproducibility of Results, Ultrasonography, Imaging, Three-Dimensional, Infant, Premature, Kidney anatomy & histology, Kidney diagnostic imaging, Magnetic Resonance Imaging
- Abstract
Renal volume, but not renal length, has been shown to be positively correlated with renal function. Three-dimensional (3D) ultrasound and magnetic resonance imaging (MRI) are two modalities used to assess renal volume. The aim of our study was to determine whether 3D ultrasound measurements of renal volume in the neonate are comparable to those of MRI measurements. Preterm and term neonates had an MRI and 3D ultrasound to determine renal volume at the same time as they had an MRI brain scan for other clinical conditions. The preterm neonates were all term corrected age, and the term neonates were 1-4 weeks of age. None of the kidneys examined were abnormal. There were no significant differences in the weight or length of the preterm and term infants at the time of their MRI scan. The left renal length was significantly longer according to MRI measurements than according to 3D ultrasound measurements (p=0.02). Renal volumes of both the left and right kidney were greater when measured by MRI than by 3D ultrasound (p<0.0001, respectively). Total volumes of the kidneys were greater when measured by MRI than by 3D ultrasound (p=0.008). Renal volume in neonates was significantly less when evaluated by 3D ultrasound than by MRI. These results demonstrate that MRI and 3D ultrasound renal volumes are not comparable in the neonatal population and, therefore, the same radiological modality should be used if repeat volume measurements are to be performed.
- Published
- 2010
- Full Text
- View/download PDF
5. Do maternal- or pregnancy-associated disease states affect blood pressure in the early neonatal period?
- Author
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Kent AL, Shadbolt B, Hu E, Meskell S, Falk MC, and Dahlstrom JE
- Subjects
- Analysis of Variance, Case-Control Studies, Cohort Studies, Female, Gestational Age, Humans, Hypertension complications, Infant, Newborn, Infant, Newborn, Diseases epidemiology, Intensive Care Units, Neonatal, Pregnancy, Pregnancy Complications etiology, Prenatal Exposure Delayed Effects epidemiology, Risk Factors, Blood Pressure physiology, Hypertension epidemiology, Placenta physiopathology, Pregnancy Complications epidemiology
- Abstract
Background: Placental vascular changes associated with maternal disease states may affect fetal vascular development. There is evidence suggesting that being born prematurely is associated with a higher blood pressure (BP) in later life., Aim: To determine whether maternal disease state affects BP in the early neonatal period., Methods: Cohort study of neonates admitted to neonatal intensive care unit with exposure to maternal hypertension and diabetes. Inclusion criteria were neonates greater than 27 weeks gestation not ventilated or requiring inotropes for more than 24 h, materna l hypertension (pregnancy induced or essential) or diabetes of any kind requiring treatment, and spontaneous delivery. Exclusion criteria included chromosomal or congenital anomaly and illicit maternal drug use. Oscillometric BP measurements taken until discharge on days 1, 2, 3, 4, 7, 14, 21 and 28. Placental histopathology was performed., Results: One hundred and ninety infants enrolled, 104 in the control and 86 in the study group. Sixty-five infants were born between 28-31 weeks and 125 infants between 32-41 weeks gestation. Those born between 28-31 weeks with a history of diabetes had a statistically higher systolic, mean and diastolic BP throughout the first 28 days of life (P = 0.001; P = 0.007; P = 0.02). Those born between 32-41 weeks gestation with placental pathology associated with altered uteroplacental perfusion had a higher systolic BP (P = 0.005)., Conclusions: Maternal- or pregnancy-associated disease states appear to influence BP in the early neonatal period. Diabetes and altered placental perfusion were associated with higher BP readings. Clinical significance of these statistically elevated BPs in the early neonatal period is unknown.
- Published
- 2009
- Full Text
- View/download PDF
6. Does extreme prematurity affect kidney volume at term corrected age?
- Author
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Kent AL, Jyoti R, Robertson C, Gonsalves L, Meskell S, Shadbolt B, and Falk MC
- Subjects
- Cardiovascular Agents therapeutic use, Cardiovascular Diseases prevention & control, Case-Control Studies, Female, Gestational Age, Humans, Indomethacin therapeutic use, Infant, Newborn, Infant, Newborn, Diseases prevention & control, Kidney diagnostic imaging, Magnetic Resonance Imaging, Male, Organ Size, Radiography, Infant, Extremely Low Birth Weight growth & development, Infant, Premature growth & development, Kidney growth & development
- Abstract
Objective: Extreme prematurity exposes the neonate to a number of potential renal insults that may result in a reduced number of glomeruli and/or renal size. This may predispose these individuals to cardiovascular disease later in life. The objective was to determine using magnetic resonance imaging (MRI) whether extreme prematurity results in decreased renal volume., Methods: Neonates <29 weeks' gestation and term infants undergoing MRI of the brain were enrolled in the study. An MRI was performed at term corrected age in the premature neonate and within the first 4 weeks of life in the term neonate., Results: Seventeen preterm infants and 13 term infants had MRIs performed. There was no significant difference in weight and length at the time of MRI (p = 0.76 and 0.11, respectively). There was no significant difference in total renal volume or total kidney volume to weight ratio between the preterm and term neonates (p = 0.83 and 0.6, respectively)., Conclusions: At term corrected age, extremely premature neonates have the same renal volume as term infants. It is unclear whether renal volume is a good indicator of glomerular number.
- Published
- 2009
- Full Text
- View/download PDF
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