Browsing by Author "Toso Milos, Alberto Antonio"

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    Antenatal Exposure to Magnesium Sulphate and Neonatal Outcomes in Very Low Birth Weight Infants: a multicenter study.
    (2023) Ferreira, María Vaz; Caro, José; Villarroel, Luis; Muñoz, Sergio; Álvarez, Patricia; Flores, Gerardo; Herrera, Tamara; Toso Milos, Alberto Antonio; Toso Milos Paulina Alejandra; Tapia, José
    Objective: To explore the association between antenatal magnesium sulphate ( MgSO4 ), mortality and incidence of intraventricular hemorrhage (IVH) in very low birth weight (VLBW) infants. Study design: Retrospective, cohort study of infants < 32 weeks’ GA born at centers of NEOCOSUR Network between January 2015 and December 2020. Subjects were categorized as exposed vs non-exposed to antenatal MgSO4. Primary outcomes were death, incidence of severe IVH (Grade III-IV) and severe IVH/death. Secondary outcomes included relevant morbidities. Results: 7418 VLBW infants were eligible. Antenatal MgSO4 was associated with a signicantly decreased death rate after admission (aOR 0.59 [95% CI, 0.46–0.74]) and severe IVH/ death (aOR 0.63 [95% CI, 0.490.83]). No signicant reduction in severe IVH was observed (aOR 0.89 [95% CI, 0.63–1.25]). No differences between groups were observed in rates of morbidities. Conclusion: Antenatal MgSO4 was associated with a decreased death rate after admission and in severe IVH/ death.
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    Doble arco aórtico y fistula aortotraqueal como causa de hemorragia masiva fatal: una asociación rara y peligrosa
    (2024) Ramos, Phoebe H.; Cabello, Pablo; Contreras, Alondra; Albrich, Diego; Toso Milos, Alberto Antonio
    Vascular rings are unusual congenital malformations. Among them, double aortic arch (DAA) is often difficult to diagnose due to its low incidence of symptoms. DAA can be associated with tracheal or esophageal compression and, in severe cases, could require tracheal intubation or chronic use of a nasogastric tube. This scenario favors the development of aortotracheal fistulas (ATF) or aortoesophageal fistulas (AEF).
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    Population pharmacokinetics of amikacin in suspected cases of neonatal sepsis
    (Wiley, 2023) Severino Cuevas, Nicolás Felipe; Urzúa Baquedano, Maria Soledad; Ibacache Figueroa, Mauricio Enrique; Paulos Arenas, Claudio; Cortinez Fernandez, Luis Ignacio; Toso Milos, Alberto Antonio; Leguizamon Marino, Liliana Marcela; Inojosa Mackenzie, Fernanda; Maccioni Romero, Andrea Ana; Meza Cañas, Sebastián Jaime; Garcia, Andres; Ramirez, Marcelo; Von Mentlen Gutierrez, Catalina Paz; Ceballos Jorquera Javiera Nicol; Paredes Galvez, Noemi Saray
    Aims:This study aimed to characterize the population pharmacokinetic parameters of intravenously administered amikacin in newborns and assess the effect of sepsis in amikacin exposure. Methods: Newborns aged >= 3 days who received at least 1 dose of amikacin during their hospitalization period were eligible for the study. Amikacin was administered intravenously during a 60-min infusion period. Three venous blood samples were taken from each patient during the first 48 h. Population pharmacokinetic parameter estimates were obtained using a population approach with the programme NONMEM. ResultsData from 329 drug assay samples were obtained from 116 newborn patients (postmenstrual age [PMA] 38.3, range 32-42.4 weeks; weight 2.8, range 1.6-3.8 kg). Measured amikacin concentrations ranged from 0.8 to 56.4 mg/L. A 2-compartment model with linear elimination produced a good fit of the data. Estimated parameters for a typical subject (2.8 kg, 38.3 weeks) were clearance (Cl = 0.16 L/h), intercompartmental clearance (Q = 0.15 L/h), volume of distribution of the central compartment (Vc = 0.98 L) and peripheral volume of distribution (Vp = 1.23 L). Total bodyweight, PMA and the presence of sepsis positively influenced Cl. Plasma creatinine concentration and circulatory instability (shock) negatively influenced Cl. ConclusionOur main results confirm previous findings showing that weight, PMA and renal function are relevant factors influencing newborn amikacin pharmacokinetics. In addition, current results showed that pathophysiological states of critically ill neonates, such as sepsis and shock, were associated with opposite effects in amikacin clearance and should be considered in dose adjustments.