54 research outputs found
Assessment of radiant temperature in a closed incubator
In closed incubators, radiative heat loss (R) which is assessed from the mean radiant temperature [Formula: see text] accounts for 40â60% of the neonateâs total heat loss. In the absence of a benchmark method to calculate [Formula: see text]âoften considered to be the same as the air incubator temperatureâerrors could have a considerable impact on the thermal management of neonates. We compared [Formula: see text] using two conventional methods (measurement with a black-globe thermometer and a radiative âview factorâ approach) and two methods based on nude thermal manikins (a simple, schematic design from Wheldon and a multisegment, anthropometric device developed in our laboratory). By taking the [Formula: see text] estimations for each method, we calculated metabolic heat production values by partitional calorimetry and then compared them with the values calculated from [Formula: see text] and [Formula: see text] measured in 13 preterm neonates. Comparisons between the calculated and measured metabolic heat production values showed that the two conventional methods and Wheldonâs manikin underestimated R, whereas when using the anthropomorphic thermal manikin, the simulated versus clinical difference was not statistically significant. In conclusion, there is a need for a safety standard for measuring [Formula: see text] in a closed incubator. This standard should also make available estimating equations for all avenues of the neonateâs heat exchange considering the metabolic heat production and the modifying influence of the thermal insulation provided by the diaper and by the mattress. Although thermal manikins appear to be particularly appropriate for measuring [Formula: see text], the current lack of standardized procedures limits their widespread use
Lower hypoxic ventilatory response in smokers compared to non-smokers during abstinence from cigarettes
Quels modes d'inhumation au temps des grandes mortalitĂ©s mĂ©diĂ©vales et modernes ? Essai de typo-chronologie des structures dâenfouissement des victimes dâĂ©pidĂ©mies
International audienc
Quels modes d'inhumation au temps des grandes mortalitĂ©s mĂ©diĂ©vales et modernes ? Essai de typo-chronologie des structures dâenfouissement des victimes dâĂ©pidĂ©mies
International audienc
Does the incubator control mode influence outcomes of low-birth-weight neonates during the first days of life and at hospital discharge?
Involvement of autonomic nervous activity changes in gastroesophageal reflux in neonates during sleep and wakefulness.
BACKGROUND: It has been suggested that disturbed activity of the autonomic nervous system is one of the factors involved in gastroesophageal reflux (GER) in adults. We sought to establish whether transient ANS dysfunction (as assessed by heart rate variability) is associated with the occurrence of GER events in neonates during sleep and wakefulness. METHODS: Nineteen neonates with suspected GER underwent simultaneous, synchronized 12-hour polysomnography and esophageal multichannel impedance-pH monitoring. We compared changes in HRV parameters during three types of periods (control and prior to and during reflux) with respect to the vigilance state. RESULTS: The vigilance state influenced the distribution of GER events (P<0.001), with 53.4% observed during wakefulness, 37.6% observed during active sleep and only 9% observed during quiet sleep. A significant increase in the sympathovagal ratio (+32%, P=0.013) was observed in the period immediately prior to reflux (due to a 15% reduction in parasympathetic activity (P=0.017)), relative to the control period. This phenomenon was observed during both wakefulness and active sleep. CONCLUSION: Our results showed that GER events were preceded by a vigilance-state-independent decrease in parasympathetic tone. This suggests that a pre-reflux change in ANS activity is one of the factors contributing to the mechanism of reflux in neonates
Influence of radiofrequency electromagnetic fields exposure on sleep patterns in preterm neonates
International audienceThe study objective was to assess the influence of radiofrequency electromagnetic fields (RF-EMF) exposure on sleep patterns in preterm newborns. We hypothesized that an increase in RF-EMF exposure levels would alter infants' sleep structure parameters.Materials and methodsIndividual, continuous measurements of RF-EMF levels were performed in 29 hospitalized preterm newborns throughout the first 21 days after birth. The last day, overnight sleep structure was recorded by polysomnography. Relationships between both chronic (three-week period) and acute (polysomnographic period) RF-EMF levels with sleep parameters were computed.ResultsAt median levels, the main chronic effect was an increase in indeterminate sleep with RF-EMF exposure. At the highest exposure levels found in our study, an increase in RF-EMF levels increased sleep fragmentation. No significant relationship was found between acute RF-EMF levels and sleep parameters.ConclusionsDespite no consolidated disruption in sleep structure, this study is the first to show that some sleep parameters seem to have a certain sensitivity to chronic - but not acute - RF-EMF exposure in preterm newborns. Further studies are needed to confirm our results and examine possible mid- to long-term, sleep-related cardiorespiratory and neurodevelopmental outcomes
Heart Rate Variability in Sleeping Preterm Neonates Exposed to Cool and Warm Thermal Conditions
<div><p>Sudden infant death syndrome (SIDS) remains the main cause of postneonatal infant death. Thermal stress is a major risk factor and makes infants more vulnerable to SIDS. Although it has been suggested that thermal stress could lead to SIDS by disrupting autonomic functions, clinical and physiopathological data on this hypothesis are scarce. We evaluated the influence of ambient temperature on autonomic nervous activity during sleep in thirty-four preterm neonates (mean ± SD gestational age: 31.4±1.5 weeks, postmenstrual age: 36.2±0.9 weeks). Heart rate variability was assessed as a function of the sleep stage at three different ambient temperatures (thermoneutrality and warm and cool thermal conditions). An elevated ambient temperature was associated with a higher basal heart rate and lower short- and long-term variability in all sleep stages, together with higher sympathetic activity and lower parasympathetic activity. Our study results showed that modification of the ambient temperature led to significant changes in autonomic nervous system control in sleeping preterm neonates. The latter changes are very similar to those observed in infants at risk of SIDS. Our findings may provide greater insight into the thermally-induced disease mechanisms related to SIDS and may help improve prevention strategies.</p></div
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