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Mariam Hakobyan, Koen P Dijkman, Sabrina Laroche, Gunnar Naulaers, Monique Rijken, Katerina Steiner, Henrica L M van Straaten, Renate M C Swarte, Hendrik J Ter Horst, Alexandra Zecic, Inge A Zonnenberg, Floris Groenendaal
BACKGROUND: Animal models suggest that neuroprotective effects of therapeutic hypothermia (TH) after perinatal asphyxia are reduced in infants with early-onset sepsis. OBJECTIVES: To assess the outcome of infants with perinatal asphyxia, neonatal encephalopathy, and TH in the presence of early-onset sepsis. METHODS: In a retrospective cohort of 1,084 infants with perinatal asphyxia and TH, the outcome of 42 infants (gestational age 36.1-42...
November 12, 2018: Neonatology
Rajesh Shah, Jane Harding, Julie Brown, Christopher McKinlay
BACKGROUND: Hypoglycaemia is the most common metabolic problem in neonates but there is no universally accepted threshold for safe blood glucose concentrations due to uncertainty regarding effects on neurodevelopment. OBJECTIVE: To systematically assess the association between neonatal hypoglycaemia on neurodevelopment outcomes in childhood and adolescence. METHODS: We searched MEDLINE, EMBASE, CINAHL, and PsycINFO from inception until February 2018...
November 8, 2018: Neonatology
Joo Young Lee, Hyun-Kyung Park, Hyun Ju Lee
BACKGROUND: The prediction of neurodevelopmental outcomes in preterm infants is one of the clinical challenges of pediatrics. Despite the recent interest in brain development and white matter connectivity using a network-based analysis, very little is known about the brain network of at term-equivalent age in preterm infants. OBJECTIVE: We aimed to investigate the structural brain network using diffusion MRI following preterm delivery at term-equivalent age compared with term infants and explored the influence of gestational age (GA) and clinical factors...
November 1, 2018: Neonatology
Victoria C Ziesenitz, Erin Fox, Mark Zocchi, Samira Samiee-Zafarghandy, Johannes N van den Anker, Maryann Mazer-Amirshahi
BACKGROUND: Prescription drug shortages have increased significantly during the past two decades and also impact drugs used in critical care and pediatrics. OBJECTIVES: To analyze drug shortages affecting medications used in neonatal intensive care units (NICUs). METHODS: Drug shortage data for the top 100 NICU drugs were retrieved from the University of Utah Drug Information Service from 2001 to 2016. Data were analyzed focusing on drug class, formulation, reason for shortage, and shortage duration...
November 1, 2018: Neonatology
Cornelia G de Waal, Gerard J Hutten, Juliette V Kraaijenga, Frans H de Jongh, Anton H van Kaam
BACKGROUND: Doxapram is a treatment option for severe apnea of prematurity (AOP). However, the effect of doxapram on the diaphragm, the main respiratory muscle, is not known. OBJECTIVES: To investigate the effect of doxapram on diaphragmatic activity measured with transcutaneous electromyography of the diaphragm (dEMG). METHODS: A pilot study was conducted in a tertiary neonatal intensive care unit. Diaphragmatic activity was measured from 30 min before up to 3 h after the start of doxapram treatment...
October 23, 2018: Neonatology
Joline L H de Sévaux, Peter G J Nikkels, Maarten H Lequin, Floris Groenendaal
BACKGROUND: Autopsy rates in neonatal intensive care unit (NICU) patients who died are declining worldwide. Postmortem magnetic resonance imaging (MRI) is suggested as adjunct to or substitute for autopsy. OBJECTIVE: The aim of this paper was to determine the additional diagnostic value of autopsy in NICU patients and whether autopsy findings were potentially detectable using postmortem MRI. METHODS: From 2008 to 2015, 298 infants died during admission to our NICU...
October 23, 2018: Neonatology
Laura Sillers, Sara C Handley, Jennifer R James, Elizabeth E Foglia
BACKGROUND: The most recent guidelines by the Neonatal Resuscitation Program recommend use of electrocardiography monitoring during advanced resuscitation. OBJECTIVE: We describe a case in whom detection of pulseless electrical activity (PEA) on electronic heart rate monitoring complicated delivery room management of an extremely low birth weight infant and offer suggestions for the identification of PEA for neonatal providers. CONCLUSION: Further prospective studies are needed to determine the true incidence of PEA in the delivery room setting as well as its prognosis in newborns...
October 23, 2018: Neonatology
Iuri Corsini, Niccolò Parri, Elena Gozzini, Caterina Coviello, Valentina Leonardi, Chiara Poggi, Martina Giacalone, Tommaso Bianconi, Lorenzo Tofani, Francesco Raimondi, Carlo Dani
BACKGROUND: Respiratory distress (RD) is the most common neonatal illness. Lung ultrasound (LUS) is a technique previously tested in neonatal studies on RD, but literature regarding its routine clinical applicability is still lacking. OBJECTIVE: To assess the concordance between LUS performed by neonatologists with different training levels and chest X-ray (CXR) for the diagnosis of RD in newborns during the first 24 h of life. METHODS: We enrolled newborns with RD during the first 24 h of life...
October 10, 2018: Neonatology
Paolo Montaldo, Myrsini Kaforou, Gabriele Pollara, David Hervás-Marín, Ines Calabria, Joaquin Panadero, Laia Pedrola, Peter J Lally, Vânia Oliveira, Anup Kage, Gaurav Atreja, Josephine Mendoza, Aung Soe, Santosh Pattnayak, Seetha Shankaran, Máximo Vento, Jethro Herberg, Sudhin Thayyil
BACKGROUND: Variable responses to hypothermic neuroprotection are related to the clinical heterogeneity of encephalopathic babies; hence better disease stratification may facilitate the development of individualized neuroprotective therapies. OBJECTIVES: We examined if whole blood gene expression analysis can identify specific transcriptome profiles in neonatal encephalopathy. MATERIAL AND METHODS: We performed next-generation sequencing on whole blood RNA from 12 babies with neonatal encephalopathy and 6 time-matched healthy term babies...
October 10, 2018: Neonatology
Rocky Greer, Azif Safarulla, Robin Koeppel, Muhammad Aslam, Fayez M Bany-Mohammed
BACKGROUND: Minimizing initial neonatal blood draws and their associated pain is important. The placenta has ample fetal blood that is otherwise discarded; obtaining admission laboratory evaluations from fetal umbilical venous blood (FUVB) may provide a suitable alternative. OBJECTIVE: We hypothesized that obtaining an aerobic bacterial blood culture (BCX) and a complete blood count with manual differential (CBC/diff) from FUVB is feasible and yields results comparable to those obtained directly from the neonate...
October 9, 2018: Neonatology
Vânia Oliveira, Rui Martins, Natasha Liow, Justinas Teiserskas, Wilhelm von Rosenberg, Tricia Adjei, Vijayakumar Shivamurthappa, Peter J Lally, Danilo Mandic, Sudhin Thayyil
BACKGROUND: Heart rate variability analysis offers real-time quantification of autonomic disturbance after perinatal asphyxia, and may therefore aid in disease stratification and prognostication after neonatal encephalopathy (NE). OBJECTIVE: To systematically review the existing literature on the accuracy of early heart rate variability (HRV) to predict brain injury and adverse neurodevelopmental outcomes after NE. DESIGN/METHODS: We systematically searched the literature published between May 1947 and May 2018...
October 9, 2018: Neonatology
Nisha Rana, Ashish Kc, Mats Målqvist, Kalpana Subedi, Ola Andersson
BACKGROUND: Delayed cord clamping (DCC) is associated with an improved iron status at 8 months, a reduction of anemia at 12 months, and an improved development at 4 years. Assessment of the development after DCC has not been performed earlier in a setting with a high prevalence of iron deficiency. OBJECTIVE: The aim of this paper was to investigate the effects of DCC compared to early cord clamping (ECC) on the development evaluated with the Ages and Stages Questionnaire (ASQ) at 12 months of age...
October 2, 2018: Neonatology
Colleen C Claassen, Noah H Hillman, Kimberly Brown, Howard L Williams, Marya L Strand
INTRODUCTION: Bubble continuous positive airway pressure (bCPAP) generates a variable pressure due to bubble size and frequency, and these pressure oscillations may contribute to lung recruitment and gas exchange. Single-outlet bCPAP devices generate larger pressure fluctuation than bCPAP devices with diffusers, but clinical efficacy is unclear. Our hypothesis was that a single-outlet bCPAP device (B&B Bubbler©) would decrease extubation failure and improve oxygenation compared with a bCPAP device with a diffuser (BabiPlus©)...
October 2, 2018: Neonatology
Ellen H M de Kort, Peter Andriessen, Irwin K H Reiss, Monique van Dijk, Sinno H P Simons
BACKGROUND: Premedication for neonatal intubation facilitates the procedure and reduces stress and physiological disturbances. However, no validated scoring system to assess the effect of premedication prior to intubation is available. OBJECTIVE: To evaluate the usefulness of an Intubation Readiness Score (IRS) to assess the effect of premedication prior to intubation in newborn infants. METHODS: Two-center prospective study in neonates who needed endotracheal intubation...
October 2, 2018: Neonatology
Sota Iwatani, Jordan Burgess, Flora Kalish, Ronald J Wong, David K Stevenson
BACKGROUND: Increased bilirubin production due to hemolysis can lead to severe neonatal hyperbilirubinemia and, if left untreated, to bilirubin neurotoxicity. Post-cardiac surgery newborns have been shown to be at an increased risk for developing hyperbilirubinemia and also hemolysis. Isoflurane (ISO), a volatile anesthetic agent routinely used in newborn surgery, has been reported to upregulate heme oxygenase 1 (HO-1) expression. HO is the rate-limiting enzyme in the bilirubin production pathway...
September 11, 2018: Neonatology
Himanshu Popat, Claire Galea, Nicholas Evans, Barbara Lingwood, Paul B Colditz, Robert Halliday, David Osborn
BACKGROUND AND OBJECTIVE: The mechanism of reported benefits of delayed cord clamping (DCC) are unclear. We aimed to determine whether DCC compared to immediate cord clamping (ICC) in very preterm infants improves cerebral oxygenation in the first 24 h. STUDY DESIGN: This is a prospective study of a subset of infants at < 30 weeks of gestation who were randomised to DCC (≥60 s) or ICC (< 10 s) and required an indwelling arterial catheter. Regional cerebral oxygenation (rScO2), blood pressure, PI, and peripheral saturation were measured and cerebral fractional tissue oxygen extraction (cFTOE) calculated for the following 3 time intervals: 3-6, 6-12, and 12-28 h of age...
September 10, 2018: Neonatology
Allison J Judkins, Brianna C MacQueen, Robert D Christensen, Erick Henry, Gregory L Snow, Sterling T Bennett
BACKGROUND: Schistocytes are circulating erythrocyte fragments. They can be identified microscopically from a blood smear; but automated systems evaluate more cells and avoid inconsistencies in microscopy. Studies using adult subjects indicate that automated quantification of schistocytes can be clinically useful. However, reference intervals for automated schistocyte counts of neonates have not been published, and the relevance of a high automated schistocyte count from neonates has not been reported...
September 5, 2018: Neonatology
Ashok Buchiboyina, Chi Seong Andrew Yip, Sirisha Madhala, Sanjay Patole
BACKGROUND: In recent years, many neonatal intensive care units have adopted the practice of routinely performing brain magnetic resonance imaging (MRI) of extremely preterm (EP) infants at term-equivalent age (TEA). This practice may result in increased identification of incidental findings (IF). OBJECTIVES: To determine the prevalence and clinical significance of incidental findings on routine MRI of EP infants. METHODS: We retrospectively reviewed findings on routine brain MRI on 165 EP infants at TEA (gestation < 28 weeks) admitted between June 2015 and December 2017...
August 28, 2018: Neonatology
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No abstract text is available yet for this article.
2018: Neonatology
Silvia Carloni, Fabrizio Facchinetti, Nicola Pelizzi, Giuseppe Buonocore, Walter Balduini
BACKGROUND: Hypoxic-ischemic encephalopathy is a major cause of neonatal morbidity. Therapeutic hypothermia, while beneficial, still leaves many treated infants with lifelong disabilities. Thus, adjunctive therapies, such as melatonin, are needed to provide additional neuroprotection. OBJECTIVES: The aim of this study was to determine a range of melatonin concentrations that could result in neuroprotective synergy with hypothermia. METHODS: Hypoxia-ischemia was simulated by transient oxygen-glucose deprivation (OGD) in organotypic hippocampal slice cultures derived from neonatal rats...
2018: Neonatology
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