Praveen Chandrasekharan
Biographic Data
| ID | 8015860 |
|---|---|
| NAME | Praveen Chandrasekharan |
| GIVEN NAMES | Praveen |
| FAMILY NAME | Chandrasekharan |
| SIGNATURE | CHANDRASEKHARAN P |
| AFFILIATIONS | University at Buffalo, State University of New York |
| ORCID | 0000-0001-8727-3017 |
| VERIFIED | Yes |
| TOTAL WORKS | 12 |
| TOTAL CITATIONS | 0 |
| WORKS AS AUTHOR | 12 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 2019 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 0 |
The Utility of Umbilical Cord Pulse Oximetry—A Translational Study with Four Minutes of Deferred Cord Clamping Using an Asphyxiated Preterm Ovine Model
In a translational preterm model, UCP accurately predicted preductal SaO 2 and carotid HR (a surrogate for umbilical flow). Using UCP in the delivery room will help guide supplemental oxygen and determine the optimal duration of clamping the umbilical cord. These proof-of-concept studies/pilot findings require validation with larger animal cohorts and newborn infants
Impact of Change in Neonatal Resuscitation Program Guidelines for Infants Born Through Meconium-Stained Amniotic Fluid
Background : In 2016, the neonatal resuscitation program (NRP) changed its recommendation to perform endotracheal suctioning in non-vigorous neonates born through meconium-stained amniotic fluid (MSAF). The objective of this study is to compare outcomes in non-vigorous neonates born through MSAF before and after the change in the NRP's recommendations. Methods : This is a retrospective cohort study in a single center assessing all neonates ≥34 we…
Optimal Duration of Umbilical Cord Clamping with Ventilation in a Preterm Asphyxiated Ovine Model
Background : There is inadequate evidence to support recommendations for the delayed clamping of umbilical cords in preterm neonates who are born non-vigorous. Objective : In a preterm bradycardic ovine model, our objective was to compare the effects of early cord clamping with ventilation (ECCV) and various time periods of delayed cord clamping with ventilation (DCCV) at 1 min (DCCV1), 2 min (DCCV2), 3 min (DCCV3), 4 min (DCCV4), and 5 min (DCCV…
Dextrose with Insulin During Neonatal Resuscitation for Prolonged Asphyxia in a Near-Term Ovine Model
Background : Neonatal myocytes rely predominantly on glycolytic metabolism for survival during hypoxic conditions. During asphyxia, metabolic pathway dysregulation impairs cardiac myocyte contractility. Co-administration of dextrose and insulin may help restore metabolic homeostasis and improve cardiac function. Methods : Following blinded randomization and instrumentation, near-term lambs (138-140 days gestational age) were asphyxiated by umbili…
Femoral Occlusion during Neonatal Cardiopulmonary Resuscitation Improves Outcomes in an Ovine Model of Perinatal Cardiac Arrest
Femoral occlusion resulted in faster and higher incidence of ROSC, most likely due to attaining increased diastolic pressures, coronary and carotid flow. This is a low-tech intervention that can be easily adapted in resource limited settings, with the potential to improve survival and neurodevelopmental outcomes
Masked Randomized Trial of Epinephrine versus Vasopressin in an Ovine Model of Perinatal Cardiac Arrest
Current neonatal resuscitation guidelines recommend the use of epinephrine for bradycardia/arrest not responding to ventilation and chest compressions. Vasopressin is a systemic vasoconstrictor and is more effective than epinephrine in postnatal piglets with cardiac arrest. There are no studies comparing vasopressin with epinephrine in newly born animal models with cardiac arrest induced by umbilical cord occlusion. Objective: To compare the effe…
Staphylococcus lugdunensis Bacteremia with an Infected Aortic Thrombus in a Preterm Infant
Staphylococcus lugdunensis is a rare cause of late-onset sepsis in preterm infants. To our best knowledge, we report the fourth case of a male preterm infant who developed fulminant late-onset sepsis due to Staphylococcus lugdunensis with persistent bacteremia secondary to an infected aortic thrombus confirmed with two positive blood cultures. Our patient was an extremely low birth weight growth-restricted infant born at 27 weeks gestation and in…
Initial Use of 100% but Not 60% or 30% Oxygen Achieved a Target Heart Rate of 100 bpm and Preductal Saturations of 80% Faster in a Bradycardic Preterm Model
Background: Currently, 21−30% supplemental oxygen is recommended during resuscitation of preterm neonates. Recent studies have shown that 58% of infants < 32 week gestation age are born with a heart rate (HR) < 100 bpm. Prolonged bradycardia with the inability to achieve a preductal saturation (SpO2) of 80% by 5 min is associated with mortality and morbidity in preterm infants. The optimal oxygen concentration that enables the achievement of a HR…
Sustained Inflation Reduces Pulmonary Blood Flow during Resuscitation with an Intact Cord
The optimal timing of cord clamping in asphyxia is not known. Our aims were to determine the effect of ventilation (sustained inflation-SI vs. positive pressure ventilation-V) with early (ECC) or delayed cord clamping (DCC) in asphyxiated near-term lambs. We hypothesized that SI with DCC improves gas exchange and hemodynamics in near-term lambs with asphyxial bradycardia. A total of 28 lambs were asphyxiated to a mean blood pressure of 22 mmHg. L…
Effect of a Larger Flush Volume on Bioavailability and Efficacy of Umbilical Venous Epinephrine during Neonatal Resuscitation in Ovine Asphyxial Arrest
The 7th edition of the Textbook of Neonatal Resuscitation recommends administration of epinephrine via an umbilical venous catheter (UVC) inserted 2-4 cm below the skin, followed by a 0.5-mL to 1-mL flush for severe bradycardia despite effective ventilation and chest compressions (CC). This volume of flush may not be adequate to push epinephrine to the right atrium in the absence of intrinsic cardiac activity during CC. The objective of our study…
Resuscitation with an Intact Cord Enhances Pulmonary Vasodilation and Ventilation with Reduction in Systemic Oxygen Exposure and Oxygen Load in an Asphyxiated Preterm Ovine Model
(1) Background: Optimal initial oxygen (O 2 ) concentration in preterm neonates is controversial. Our objectives were to compare the effect of delayed cord clamping with ventilation (DCCV) to early cord clamping followed by ventilation (ECCV) on O 2 exposure, gas exchange, and hemodynamics in an asphyxiated preterm ovine model. (2) Methods: Asphyxiated preterm lambs (127-128 d) with heart rate 2 and titrated based on preductal saturations (SpO 2 …
Oxygenation and Hemodynamics during Chest Compressions in a Lamb Model of Perinatal Asphyxia Induced Cardiac Arrest
The current guidelines recommend the use of 100% O2 during resuscitation of a neonate requiring chest compressions (CC). Studies comparing 21% and 100% O2 during CC were conducted in postnatal models and have not shown a difference in incidence or timing of return of spontaneous circulation (ROSC). The objective of this study is to evaluate systemic oxygenation and oxygen delivery to the brain during CC in an ovine model of perinatal asphyxial ar…
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Oxygenation and Hemodynamics during Chest Compressions in a Lamb Model of Perinatal Asphyxia Induced Cardiac Arrest
The current guidelines recommend the use of 100% O2 during resuscitation of a neonate requiring chest compressions (CC). Studies comparing 21% and 100% O2 during CC were conducted in postnatal models and have not shown a difference in incidence or timing of return of spontaneous circulation (ROSC). The objective of this study is to evaluate systemic oxygenation and oxygen delivery to the brain during CC in an ovine model of perinatal asphyxial ar…
Sustained Inflation Reduces Pulmonary Blood Flow during Resuscitation with an Intact Cord
The optimal timing of cord clamping in asphyxia is not known. Our aims were to determine the effect of ventilation (sustained inflation-SI vs. positive pressure ventilation-V) with early (ECC) or delayed cord clamping (DCC) in asphyxiated near-term lambs. We hypothesized that SI with DCC improves gas exchange and hemodynamics in near-term lambs with asphyxial bradycardia. A total of 28 lambs were asphyxiated to a mean blood pressure of 22 mmHg. L…
Effect of a Larger Flush Volume on Bioavailability and Efficacy of Umbilical Venous Epinephrine during Neonatal Resuscitation in Ovine Asphyxial Arrest
The 7th edition of the Textbook of Neonatal Resuscitation recommends administration of epinephrine via an umbilical venous catheter (UVC) inserted 2-4 cm below the skin, followed by a 0.5-mL to 1-mL flush for severe bradycardia despite effective ventilation and chest compressions (CC). This volume of flush may not be adequate to push epinephrine to the right atrium in the absence of intrinsic cardiac activity during CC. The objective of our study…
Resuscitation with an Intact Cord Enhances Pulmonary Vasodilation and Ventilation with Reduction in Systemic Oxygen Exposure and Oxygen Load in an Asphyxiated Preterm Ovine Model
(1) Background: Optimal initial oxygen (O 2 ) concentration in preterm neonates is controversial. Our objectives were to compare the effect of delayed cord clamping with ventilation (DCCV) to early cord clamping followed by ventilation (ECCV) on O 2 exposure, gas exchange, and hemodynamics in an asphyxiated preterm ovine model. (2) Methods: Asphyxiated preterm lambs (127-128 d) with heart rate 2 and titrated based on preductal saturations (SpO 2 …
Staphylococcus lugdunensis Bacteremia with an Infected Aortic Thrombus in a Preterm Infant
Staphylococcus lugdunensis is a rare cause of late-onset sepsis in preterm infants. To our best knowledge, we report the fourth case of a male preterm infant who developed fulminant late-onset sepsis due to Staphylococcus lugdunensis with persistent bacteremia secondary to an infected aortic thrombus confirmed with two positive blood cultures. Our patient was an extremely low birth weight growth-restricted infant born at 27 weeks gestation and in…
Initial Use of 100% but Not 60% or 30% Oxygen Achieved a Target Heart Rate of 100 bpm and Preductal Saturations of 80% Faster in a Bradycardic Preterm Model
Background: Currently, 21−30% supplemental oxygen is recommended during resuscitation of preterm neonates. Recent studies have shown that 58% of infants < 32 week gestation age are born with a heart rate (HR) < 100 bpm. Prolonged bradycardia with the inability to achieve a preductal saturation (SpO2) of 80% by 5 min is associated with mortality and morbidity in preterm infants. The optimal oxygen concentration that enables the achievement of a HR…
Femoral Occlusion during Neonatal Cardiopulmonary Resuscitation Improves Outcomes in an Ovine Model of Perinatal Cardiac Arrest
Femoral occlusion resulted in faster and higher incidence of ROSC, most likely due to attaining increased diastolic pressures, coronary and carotid flow. This is a low-tech intervention that can be easily adapted in resource limited settings, with the potential to improve survival and neurodevelopmental outcomes
Masked Randomized Trial of Epinephrine versus Vasopressin in an Ovine Model of Perinatal Cardiac Arrest
Current neonatal resuscitation guidelines recommend the use of epinephrine for bradycardia/arrest not responding to ventilation and chest compressions. Vasopressin is a systemic vasoconstrictor and is more effective than epinephrine in postnatal piglets with cardiac arrest. There are no studies comparing vasopressin with epinephrine in newly born animal models with cardiac arrest induced by umbilical cord occlusion. Objective: To compare the effe…
The Utility of Umbilical Cord Pulse Oximetry—A Translational Study with Four Minutes of Deferred Cord Clamping Using an Asphyxiated Preterm Ovine Model
In a translational preterm model, UCP accurately predicted preductal SaO 2 and carotid HR (a surrogate for umbilical flow). Using UCP in the delivery room will help guide supplemental oxygen and determine the optimal duration of clamping the umbilical cord. These proof-of-concept studies/pilot findings require validation with larger animal cohorts and newborn infants
Impact of Change in Neonatal Resuscitation Program Guidelines for Infants Born Through Meconium-Stained Amniotic Fluid
Background : In 2016, the neonatal resuscitation program (NRP) changed its recommendation to perform endotracheal suctioning in non-vigorous neonates born through meconium-stained amniotic fluid (MSAF). The objective of this study is to compare outcomes in non-vigorous neonates born through MSAF before and after the change in the NRP's recommendations. Methods : This is a retrospective cohort study in a single center assessing all neonates ≥34 we…
Optimal Duration of Umbilical Cord Clamping with Ventilation in a Preterm Asphyxiated Ovine Model
Background : There is inadequate evidence to support recommendations for the delayed clamping of umbilical cords in preterm neonates who are born non-vigorous. Objective : In a preterm bradycardic ovine model, our objective was to compare the effects of early cord clamping with ventilation (ECCV) and various time periods of delayed cord clamping with ventilation (DCCV) at 1 min (DCCV1), 2 min (DCCV2), 3 min (DCCV3), 4 min (DCCV4), and 5 min (DCCV…
Dextrose with Insulin During Neonatal Resuscitation for Prolonged Asphyxia in a Near-Term Ovine Model
Background : Neonatal myocytes rely predominantly on glycolytic metabolism for survival during hypoxic conditions. During asphyxia, metabolic pathway dysregulation impairs cardiac myocyte contractility. Co-administration of dextrose and insulin may help restore metabolic homeostasis and improve cardiac function. Methods : Following blinded randomization and instrumentation, near-term lambs (138-140 days gestational age) were asphyxiated by umbili…
Medicine (9 works) · Neonatal Respiratory Health Research (9 works) · Anesthesia (8 works) · Cardiac Arrest and Resuscitation (8 works) · Resuscitation (8 works) · Asphyxia (6 works) · Internal Medicine (6 works) · Cardiology (5 works) · Neuroscience of respiration and sleep (5 works) · Neonatal and fetal brain pathology (4 works)