Browsing by Author "Kattan Said, Alberto Javier"
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- ItemA risk prediction model for severe intraventricular hemorrhage in very low birth weight infants and the effect of prophylactic indomethacin(2014) Luque, M.; Tapia Illanes, José Luis; Villarroel del Pino, Luis A.; Marshall Rivera, Guillermo; Musante, G.; Carlo, W.; Kattan Said, Alberto Javier
- ItemCongenital diaphragmatic hernia: phosphodiesterase-5 and Arginase inhibitors prevent pulmonary vascular hypoplasia in rat lungs(2022) Toso, Alberto; Aranguiz, Óscar; Cespedes, Carlos; Navarrete, Orieta; Hernández, Cherie; Vio, Carlos P.; Luco Illanes, Matías Fernando; Casanello Toledo, Paola Cecilia; Kattan Said, Alberto JavierBackground Severe pulmonary hypoplasia related to congenital diaphragmatic hernia (CDH) continues to be a potentially fatal condition despite advanced postnatal management strategies. Objective To evaluate the effect of the antenatal sildenafil and 2(S)-amino-6-boronohexanoic acid (ABH-Arginase inhibitor) on lung volume, pulmonary vascular development, and nitric oxide (NO) synthesis in a Nitrofen-induced CDH rat model. Methods Nitrofen-induced CDH rat model was used. Nitrofen was administrated on embryonic day(E) 9,5. At E14, five intervention groups were treated separately: Nitrofen, Nitrofen+Sildenafil, Nitrofen+ABH, Nitrofen+Sildenafil+ABH and Control. At term, offspring's lungs were weighed, some paraffin-embedded for histology, others snap-frozen to analyze eNOS, Arginase I-II expression, and activity. Results In CDH-bearing offsprings, ABH or Sildenafil+ABH preserved the total lung/body-weight index (p < 0.001), preventing pulmonary vascular smooth muscle cell hyperproliferation and improving lung morphometry. Sildenafil+ABH increased 1.7-fold the lung nitrite levels (p < 0.01) without changes in eNOS expression. Sildenafil and ABH improved the number of pulmonary vessels. Conclusion These results suggest that in this CDH rat model, the basal activity of Arginase participates in the lung volume and, together with phosphodiesterase-5, regulates NOS activity in the term fetal lung. The combined treatment (Sildenafil+ABH) could revert some of the pulmonary features in CDH by improving the local NO synthesis and preventing smooth muscle cell hyperproliferation. Impact This study presents Arginase inhibition as a new therapeutic target and the importance of the combined antenatal treatment to improve pulmonary vascular development in a congenital diaphragmatic hernia (CDH) rat model. This study shows that the action of an Arginase inhibitor (ABH) enhances the effects already described for sildenafil in this model. These results reinforce the importance of prenatal treatments' synergy in recovering the hypoplastic lung in the Nitrofen-induced CDH rat model.
- ItemCorticoides postnatal y displasia broncopulmonar: Beneficios versus riesgos(2003) Tapia Illanes, José Luis; Kattan Said, Alberto JavierIn the last decade there has been an important decrease in the neonatal mortality of very low birth weight premature infants. However, bronchopulmonar dysplasia (BPD) is the most frequent chronic sequelae in survivors. Inflammation plays a key role in its pathogenesis and provides the reason why postnatal steroid administration has deserved an important role, not only in research but its increasing use in NICUs. The aim of this article is to review the published evidence of the risks and benefits of steroid therapy in each postnatal age group. With early steroid use (< 72 hours after birth), for each 10 patients treated one case of BPD can be revented, but at the cost of acute complications, such as, intestinal perforation, arterial hypertension and hypertrophic cardiomyopathy. Its late use facilitates extubation and decreases oxygen requirements at 36 weeks (corrected age), but has been associated with growth failure and arterial hipertension. What is of more concern is the observed effect of systemic steroids in neurodevelopment, with a greater risk of developing motor dysfunction and cerebral palsy. It has been estimated that for 30 patients treated with steroids there will be 4 extra cases of cerebral palsy. In summary, there is growing evidence that the long term consequences of postnatal steroid administration outweigh the short term benefits. It therefore should be restricted to carefully selected cases, using lower doses and for shorter durations than currently employed.
- ItemEarly use of combined exogenous surfactant and inhaled nitric oxide reduces treatment failure in persistent pulmonary hypertension of the newborn : a randomized controlled trial(2020) González, A.; Bancalari, A.; Osorio, W.; Luco Illanes, Matías Fernando; González, A.; Pérez Álvarez, Héctor Iván; Kattan Said, Alberto Javier
- ItemEnd of life, death and dying in neonatal intensive care units in Latin America(2012) Fajardo, C. A.; González, S.; Zambosco, G.; Cancela, M. J.; Forero, L. V.; Venegas, M.; Baquero, H.; Lemus Varela, L.; Kattan Said, Alberto Javier; Wormald Langdon, Francisca; Solà, A.; Lantos, J.
- ItemInternational cooperation. Where are we, and where are we heading to?(2017) Kattan Said, Alberto Javier; Kuroiwa, A.; López, R.
- ItemSurvival and morbidity of very low birth weight infants in a South American Neonatal Network(2014) Fernández, R.; D'Apremont, I.; Domínguez, A.; Tapia Illanes, José Luis; Estay Navarrete, Alberto Santiago; González, A.; Quezada, M.; Urzúa Baquedano, María Soledad; Kattan Said, Alberto Javier; Rojas, S; Vignes, S.; Marshall Rivera, Guillermo; Villarroel del Pino, Luis A.
- ItemVasopressin as adjunctive therapy in pulmonary hypertension associated with refractory systemic hypotension in term newborns(2022) Santelices Ruíz, Felipe; Masoli, Daniela; Kattan Said, Alberto Javier; Toso, Alberto; Luco Illanes, Matías FernandoAbstract Objective. The aim of our study is to describe the effects of vasopressin on term infants with persistent pulmonary hypertension under a standardized protocol. Study Design: In 2019, we designed a standardized protocol for the management of refractory hypotension in the context of pulmonary hypertension, which included the use of vasopressin. This is a retrospective cohort study to evaluate the clinical, laboratory, and echocardiographic outcomes of patients who required vasopressin in the context of this new protocol in a referral level IV neonatal intensive care unit. Results: We included 48 neonates with a median gestational age of 37 weeks in a period of 30 months (December 2019 to May 2022). Congenital diaphragmatic hernia was the main cause of persistent pulmonary hypertension in this cohort (82%). All patients were on mechanical ventilation and receiving inhaled nitric oxide. In our cohort at 4 hours after initiation of vasopressin, blood pressure, serum pH, and urinary output increased significantly. The vasoactive inotropic score, lactate and oxygenation index decreased. Echocardiographic follow-up also showed a decrease in the relative pressure of the right ventricle and an improvement in the cardiac output of both ventricles. There were no episodes of severe hyponatremia (<120 mmol/L). Discussion: This study showed that the use of vasopressin in neonates with persistent pulmonary hypertension and refractory systemic hypotension was associated with a rapid and significant improvement in oxygenation and hemodynamic markers of perfusion, including blood pressure. This association was early during the first hours of treatment and vasopressin was safely withdrawn after a median of 3 days of treatment.