Browsing by Author "Gupta, Bhvya"
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Publication Cerebral Hemodyanamics in Stable Preterm Infants Before and After Packed Cell Transfusion Authors(Nepal Paediatric Society (JNPS), 2021) Chetan, Chinmay; Zaw, Nyein Nyein; Suryawanshi, Pradeep; Banait, Nishant; Pareek, Prince; Deshpande, Sujata; Gupta, Bhvya; Garegrat, ReemaAbstract: Introduction: In a year, around 3.5 million preterm deliveries occur in India alone. Some of these babies will require packed cell volume (PCV) transfusion. There is a paucity of robust data on effect of blood transfusions on the cerebral hemodynamic from India. This study was done to see the effect of PCV transfusion on blood flow velocities and resistive index (RI) of anterior cerebral artery (ACA) in stable preterm infants. Methods: A prospective observational study was conducted in a tertiary care hospital in Pune, India. All stable preterm infants (< 37 weeks) receiving PCV transfusion were enrolled. USG Doppler study of ACA was done before and after PCV transfusion. Peak systolic velocity (PSV), end-diastolic velocity (EDV) and RI were measured pre and post PCV transfusion. Results: Thirty infants were included in the study, with median gestation age of 28.8 {interquartile range (IQR), 27-30.55} weeks and median birth weight of 970 {interquartile range (IQR), 869.5 - 1190} grams. There was a significant decrease in PSV pre and post PCV transfusion - 58.46 (± 18.44) cm / sec and 46.34 (± 13.93) cm / sec respectively (p value < 0.001). Changes in RI and EDV were non-significant. Conclusions: PCV transfusion significantly decreased PSV, reflecting improved cerebral oxygenation, and decreased cardiac output after correction of anaemia. Laboratory threshold for PCV transfusion in stable preterm infants are not known. USG Doppler study has the potential to provide one of the objective criteria for PCV transfusion in these infants though large scale randomized controlled trials are needed to prove its efficacy.Publication Cerebral Hemodynamics in Late Onset Neonatal Sepsis in Preterm Neonates: A Prospective Observation Study(Nepal Paediatric Society (JNPS), 2023) Chetan, Chinmay; Gupta, Bhvya; Pareek, Prince; Suryawanshi, Sonali; Maheshwari, Rajesh; Suryawanshi, PradeepAbstract: Introduction: Late onset neonatal sepsis (LONS) is one of the most prevalent conditions in neonates in developing countries. The aim of this study was to assess the changes in cerebral hemodynamics in neonates with LONS. Methods: Preterm neonates (N = 60) with suspected LONS were enrolled over a period of 21 months and divided into three cohorts: Group A with clinical sepsis but with negative septic markers and culture report, group B, where septic markers were positive, but cultures were sterile and group C, where either blood or CSF culture was positive. Ultrasound doppler of the anterior cerebral artery was done at 0 hrs, 48 hrs and 5th day after suspecting sepsis. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) were measured and compared in three groups and sequentially at specific time points. Results: A total of 60 neonates with a median gestational age of 30.5 [IQR (28 - 32.6)] weeks were enrolled: 21 in group A, 20 in group B and 19 in group C. RI was lowest in Group C at zero hours with a mean of 0.72 (SD ± 0.09) [p < 0.05], which gradually improved after starting antibiotics. Klebsiella sp. was the most common organism isolated. Conclusion: Neonates with culture-positive LONS had the least resistive index. This parameter may have diagnostic implications and significance on the hemodynamic management in LONS.