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JOURNAL ARTICLE
Sherry E Courtney, Anton H van Kaam, J Jane Pillow
High frequency ventilation (HFV) in neonates has been in use for over forty years. Some early HFV ventilators are no longer available, but high frequency oscillatory ventilation (HFOV) and jet ventilators (HFJV) continue to be commonly employed. Advanced HFOV models available outside of the United States are much quieter and easier to use, and are available as options on many conventional ventilators, providing important improvements such as tidal volume measurement and targeting. HFJV excels in treating air leak and non-homogenous lung disease and is often used for other diseases as well...
March 23, 2024: Seminars in Perinatology
#2
JOURNAL ARTICLE
Mandy Brasher, Alexandr Virodov, Thomas M Raffay, Henrietta S Bada, M Douglas Cunningham, Cody Bumgardner, Elie G Abu Jawdeh
OBJECTIVE: To predict extubation readiness in preterm infants using machine learning analysis of bedside pulse oximeter and ventilator data. STUDY DESIGN: This is an observational study with prospective recordings of oxygen saturation (SpO2 ) and ventilator data from infants < 30 weeks' gestation age (GA). Research pulse oximeters collected SpO2 (1 Hz sampling rate) to quantify intermittent hypoxemia (IH). Continuous ventilator metrics were collected (4-5 min sampling) from bedside ventilators...
March 30, 2024: Journal of Pediatrics
#3
JOURNAL ARTICLE
Suchitra Ranjit, Rajeswari Natraj
The three pathophysiologic contributors to septic shock include varying combinations of hypovolemia (relative > absolute), decreased vascular tone or vasoplegia, and myocardial dysfunction. The three pillars of hemodynamic support include fluid boluses, vasopressors with or without inotrope infusions. The three end-points of hemodynamic resuscitation include an adequate cardiac output (CO), adequate mean arterial pressure (MAP) and diastolic blood pressure (DBP) for organ perfusion, and avoiding congestion (worse filling) parameters...
March 15, 2024: Indian Pediatrics
#4
REVIEW
Mamdouh Alanazi, Mohammed A Altawili, Ahmed I Khayyal, Abdulrahman S Alahmari, Asmaa Abdullah Alhakami, Abdulrahman Mohammed A Alshehri
Preterm birth remains a significant global health concern as it can lead to various health complications and long-term developmental challenges. Early nutrition intervention plays a crucial role in optimizing the growth, development, and overall health outcomes of premature infants. This review aims to summarize and analyze the existing literature regarding the effect of early nutrition interventions on premature babies. A comprehensive search was conducted through various electronic databases, including PubMed, Scopus, and Google Scholar, focusing on nutrition interventions specifically targeting premature infants...
February 2024: Curēus
#5
RANDOMIZED CONTROLLED TRIAL
Martin L Blakely, Andrea Krzyzaniak, Melvin S Dassinger, Claudia Pedroza, Jorn-Hendrik Weitkamp, Ankush Gosain, Michael Cotten, Susan R Hintz, Henry Rice, Sherry E Courtney, Kevin P Lally, Namasivayam Ambalavanan, Catherine M Bendel, Kim Chi T Bui, Casey Calkins, Nicole M Chandler, Roshni Dasgupta, Jonathan M Davis, Katherine Deans, Daniel A DeUgarte, Jeffrey Gander, Carl-Christian A Jackson, Martin Keszler, Karen Kling, Stephen J Fenton, Kimberley A Fisher, Tyler Hartman, Eunice Y Huang, Saleem Islam, Frances Koch, Shabnam Lainwala, Aaron Lesher, Monica Lopez, Meghna Misra, Jamie Overbey, Brenda Poindexter, Robert Russell, Steven Stylianos, Douglas Y Tamura, Bradley A Yoder, Donald Lucas, Donald Shaul, P Ben Ham, Colleen Fitzpatrick, Kara Calkins, Aaron Garrison, Diomel de la Cruz, Shahab Abdessalam, Charlotte Kvasnovsky, Bradley J Segura, Joel Shilyansky, Lynne M Smith, Jon E Tyson
IMPORTANCE: Inguinal hernia repair in preterm infants is common and is associated with considerable morbidity. Whether the inguinal hernia should be repaired prior to or after discharge from the neonatal intensive care unit is controversial. OBJECTIVE: To evaluate the safety of early vs late surgical repair for preterm infants with an inguinal hernia. DESIGN, SETTING, AND PARTICIPANTS: A multicenter randomized clinical trial including preterm infants with inguinal hernia diagnosed during initial hospitalization was conducted between September 2013 and April 2021 at 39 US hospitals...
March 26, 2024: JAMA
#6
REVIEW
Annette Gawron Roberts, Noelle Younge, Rachel Gottron Greenberg
Necrotizing enterocolitis (NEC) is a life-threatening disease predominantly affecting premature and very low birth weight infants resulting in inflammation and necrosis of the small bowel and colon and potentially leading to sepsis, peritonitis, perforation, and death. Numerous research efforts have been made to better understand, treat, and prevent NEC. This review explores a variety of factors involved in the pathogenesis of NEC (prematurity, low birth weight, lack of human breast milk exposure, alterations to the microbiota, maternal and environmental factors, and intestinal ischemia) and reports treatment modalities surrounding NEC, including pain medications and common antibiotic combinations, the rationale for these combinations, and recent antibiotic stewardship approaches surrounding NEC treatment...
April 2, 2024: Paediatric Drugs
#7
REVIEW
Charles Christoph Roehr, Tomasz Szczapa, Tom Stiris, Adamos Hadjipanayis, Berthold Koletzko, Rob Ross-Russell, Petra Hüppi, Sven Wellmann, Maximo Vento
INTRODUCTION: The European Union stipulates transnational recognition of professional qualifications for several sectoral professions, including medical doctors. The Union of European Medical Specialists (UEMS), in its "Charter on Training of Medical Specialists," defines the principles for high-level medical training. These principles are manifested in the framework for European Training Requirements (ETR), ensuring medical training reflects modern medical practice and current scientific findings...
March 22, 2024: Neonatology
#8
REVIEW
Domenico Umberto De Rose, Maria Paola Ronchetti, Alessandra Santisi, Paola Bernaschi, Ludovica Martini, Ottavia Porzio, Andrea Dotta, Cinzia Auriti
The fear of missing sepsis episodes in neonates frequently leads to indiscriminate use of antibiotics, and prescription program optimization is suggested for reducing this inappropriate usage. While different authors have studied how to reduce antibiotic overprescription in the case of early onset sepsis episodes, with different approaches being available, less is known about late-onset sepsis episodes. Biomarkers (such as C-reactive protein, procalcitonin, interleukin-6 and 8, and presepsin) can play a crucial role in the prompt diagnosis of late-onset sepsis, but their role in antimicrobial stewardship should be further studied, given that different factors can influence their levels and newborns can be subjected to prolonged therapy if their levels are expected to return to zero...
March 19, 2024: Tropical Medicine and Infectious Disease
#9
JOURNAL ARTICLE
Marina Colella, Anna Zanin, Artemis Toumazi, Aurélie Bourmaud, Priscilla Boizeau, Sophie Guilmin-Crepon, Noémie Leick, Sophea Khat, Marianne Alison, Olivier Baud, Valerie Biran
INTRODUCTION: Neonatal portal vein thrombosis (PVT) is frequently related to umbilical venous catheterization (UVC), but risk factors remain unclear. This study aims to analyze the variables associated to PVT in near- to full-term newborns with UVC, with a focus on newborns exposed to controlled therapeutic hypothermia (CTH) for hypoxic ischemic encephalopathy (HIE). METHODS: This is retrospective cohort study of infants delivered at or after 36 weeks and with a birthweight over 1,500 g...
March 22, 2024: Neonatology
#10
REVIEW
Rebecca F D'Cruz, Nicholas Hart
This state-of-the-art review provides an overview of the history of home mechanical ventilation (HMV), including early descriptions of mechanical ventilation from ancient and Renaissance perspectives and the mass development of ventilators designed for long-term use during the poliomyelitis epidemic. Seminal data from key clinical trials supports the application of HMV in certain patients with chronic obstructive pulmonary disease, neuromuscular disease and obesity-related respiratory failure. Innovative engineering coupled with refined physiological understanding now permits widespread delivery of home mechanical ventilation to a global population, using portable devices with advanced ventilatory modes and telemonitoring capabilities...
2024: Chronic Respiratory Disease
#11
JOURNAL ARTICLE
Abhishek Nath, Sushil Srivastava, Ravi Sachan, Dheeraj Shah
BACKGROUND: Non-invasive ventilation (NIV) modalities minimize the requirement for invasive mechanical ventilation (IMV) in preterm neonates, therefore improving neonatal outcomes, as IMV is linked to increased complications. However, NIV has demonstrated an elevated likelihood of failure, for which various studies have been done, but very little research is available addressing the factors that are responsible for NIV failure in resource-limited areas of developing nations. Understanding the underlying factors and their association with NIV failure in very and moderately preterm neonates at a tertiary care hospital would be important in devising targeted strategies to increase NIV success and newborn outcomes...
February 2024: Curēus
#12
JOURNAL ARTICLE
Basak Kaya, Dilek Dilli, Yasin Sarikaya, Hasan Akduman, Rumeysa Citli, Utku A Orun, Mehmet Tasar, Aysegul Zenciroglu
BACKGROUND: Newborns with critical congenital heart disease (CCHD) with increased pulmonary blood flow (PBF) are at high risk for congestive heart failure. In this study, we aimed to evaluate the presence and degree of pulmonary edema in newborns with CCHD using lung ultrasound (LUS) during the perioperative period. METHODS: Prospective clinical trial, 44 newborn patients with CCHD were evaluated in this prospective clinical trial. LUS was repeatedly performed to determine the course of pulmonary edema during the perioperative period...
March 16, 2024: Pediatrics and Neonatology
#13
JOURNAL ARTICLE
Wei Meng, Qing Wang, Qingyu Xu, Hongli Gao, Yunjun Zhou, Wei Shao
BACKGROUND: The occurrence of necrotizing enterocolitis (NEC) is a common and severe disease of the digestive system in neonates. This study aims to assess the value of the intestinal tissue oxygen saturation (rint SO2 ) combined with the levels of procalcitonin (PCT) and mean platelet volume (MPV) in predicting the severity of NEC in preterm infants. METHODS: This experiment was a retrospective cohort study conducted in the Department of Pediatrics, Hongqi Hospital Affiliated to Mudanjiang Medical University between January 2017 and July 2022...
2024: International Journal of General Medicine
#14
JOURNAL ARTICLE
Sonja Baldursdottir, Kolbrun Gunnarsdottir, Snorri Donaldsson, Baldvin Jonsson, Thomas Drevhammar
BACKGROUND: The rPAP respiratory support system, used for delivery room stabilisation with nasal prongs, has been shown to reduce the need for intubation in extremely preterm infants. A simplified version of the system has been developed. The purpose of this study was to determine the feasibility of providing uninterrupted respiratory support with the simplified rPAP from birth up to 4 hours of life and to assess ease of use for skin-to skin stabilisation. METHODS: This was a non-randomised feasibility study conducted at Karolinska University Hospital, Sweden...
March 21, 2024: Archives of Disease in Childhood. Fetal and Neonatal Edition
#15
JOURNAL ARTICLE
Johan Gyllensvärd, Marie Studahl, Lars Gustavsson, Elisabet Hentz, Karin Åkesson, Huiqi Li, Mikael Norman, Anders Elfvin
IMPORTANCE: Antibiotic treatment saves lives in newborns with early-onset sepsis (EOS), but unwarranted antibiotic use is associated with resistant bacteria and adverse outcomes later in life. Surveillance is needed to optimize treatment strategies. OBJECTIVE: To describe antibiotic use in association with the incidence and mortality from EOS among late-preterm and full-term newborns. DESIGN, SETTING, AND PARTICIPANTS: The Sweden Neonatal Antibiotic Use study was a nationwide observational study that included all late-preterm and full-term neonates born from January 1, 2012, to December 31, 2020, in neonatal units of all levels...
March 4, 2024: JAMA Network Open
#16
REVIEW
Kethely L Marques, Victor Rodrigues, Cassiana T N Balduci, Guilherme C Montes, Penha C Barradas, Marta C Cunha-Rodrigues
Perinatal hypoxia-ischemia represents a significant risk to CNS development, leading to high mortality rates, diverse damages, and persistent neurological deficits. Despite advances in neonatal medicine in recent decades, the incidence of HIE remains substantial. Motor deficits can manifest early, while cognitive impairments may be diagnosed later, emphasizing the need for extended follow-up. This review aims to explore potential candidates for therapeutic interventions for hypoxic-ischemic encephalopathy (HIE), with a focus on cognitive deficits...
2024: Frontiers in Pharmacology
#17
JOURNAL ARTICLE
Xuejing Xu, Hongfang Ma, Shuqi Cheng, Jiang Xue
OBJECTIVE: The objective was to study the effect of early preventive calcium and phosphorus supplementation on metabolic bone disease in preterm infants. METHODS: A retrospective analysis of 234 preterm infants with a gestational age < 32 weeks or birth weight < 1500 g who were hospitalized in the Neonatology Department of the Second Hospital of Shandong University from 01.2018 to 12.2020 was conducted. One hundred thirty-two premature infants hospitalized from 01...
March 8, 2024: BMC Pediatrics
#18
REVIEW
Riddhi K Desai, Hilal Yildiz Atar, Satyan Lakshminrusimha, Rita M Ryan
Surfactant replacement therapy is currently approved by the United States Food and Drug Administration (FDA) for premature infants with respiratory distress syndrome (RDS) caused by surfactant deficiency due to immaturity. There is strong evidence that surfactant decreases mortality and air leak syndromes in premature infants with RDS. However, surfactant is also used "off-label" for respiratory failure beyond classic RDS. This review discusses current evidence for the use of off-label surfactant therapy for (1) term infants with lung disease such as meconium aspiration syndrome (MAS), pneumonia/sepsis, and congenital diaphragmatic hernia (2) premature infants after 72 h for acute respiratory failure, and (3) the use of surfactant lavage...
March 8, 2024: Journal of Perinatology: Official Journal of the California Perinatal Association
#19
Chien-Ming Chen, Mei-Yung Chung, Hong-Ya Kang, Mei-Chen Ou-Yang, Teh-Ming Wang, Chung-Ting Hsu
Pulmonary interstitial emphysema (PIE) is a complication observed in extremely low birth weight (ELBW) infants on mechanical ventilation. Despite various proposed therapeutic interventions, the success rates have shown inconsistency. Neurally adjusted ventilatory assist (NAVA) stands out as a novel respiratory support mode, offering lower pressure and tidal volume in comparison to conventional ventilation methods. In this case report, we present five ELBW infants with refractory PIE who were transitioned to NAVA ventilation...
2024: Frontiers in Pediatrics
#20
Ilari Kuitunen, Kati Räsänen
INTRODUCTION: In spontaneously breathing neonates, surfactant can be administered via thin catheter while enabling the own breathing (less invasive surfactant administration [LISA]). Alternatively, the neonate is intubated for surfactant delivery (intubation, surfactant, rapid extubation [INSURE]). Thus, the aim was to provide an overview of the efficacy of the LISA compared to INSURE. METHODS: We performed an umbrella review of previous meta-analyses including randomized controlled trials...
March 19, 2024: Neonatology
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