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https://www.readbyqxmd.com/read/29436355/care-of-the-neonate-on-nasal-continuous-positive-airway-pressure-a-bedside-guide
#1
Jennifer M Guay, Dru Carvi, Deborah A Raines, Wendy A Luce
Respiratory distress continues to be a major cause of neonatal morbidity. Current neonatal practice recommends the use of nasal continuous positive airway pressure (nCPAP) in the immediate resuscitation and continued support of neonates of all gestations with clinical manifestations of respiratory distress. Despite the many short- and long-term benefits of nCPAP, many neonatal care units have met resistance in its routine use. Although there have been numerous recent publications investigating the use and outcomes of various modes of nCPAP delivery, surfactant administration, mechanical ventilation, and other forms of noninvasive respiratory support (high-flow nasal cannula, nasal intermittent positive pressure ventilation), there has been a relative lack of publications addressing the practical bedside care of infants managed on nCPAP...
January 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29434789/effects-of-pumpless-extracorporeal-lung-assist-on-hemodynamics-gas-exchange-and-inflammatory-cascade-response-during-experimental-lung-injury
#2
Zhihai Ju, Jinhui Ma, Chen Wang, Jie Yu, Yeru Qiao, Feilong Hei
Pumpless extracorporeal lung assist (pECLA) has been reported to efficiently remove the systemic CO 2 production and provide mild to moderate oxygenation, thereby allowing for ventilator settings and modes prioritizing oxygenation and lung protection. However, an adequate bypass flow, the capacity to provide respiratory support and the effect on the inflammatory cascade response and tissue perfusion require further study to be determined. After induction of acute lung injury (ALI) by oleic acid injection, pECLA was implemented in 12 anaesthetized and mechanically ventilated dogs for 48 h...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29429200/-outcome-of-pediatric-extracorporeal-membrane-oxygenation-in-a-single-center
#3
Q Bao, X Y Hong, Y Y Liu, X J Zhang, H T Gao, Z C Feng
Objective: To investigate the application and outcome of pediatric extracorporeal membrane oxygenation (ECMO) in a single center. Methods: The clinical data of 52 pediatric patients with cardiopulmonary failure received ECMO support in Bayi Children's Hospital Affiliated to General Hospital of Beijing Military Command of PLA were collected from January 2012 to October 2016. All patients were divided into two stages by time. January 2012 to December 2014 was stage one. January 2015 to October 2016 was stage two...
February 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29428594/predictive-value-of-oxygenation-index-for-outcomes-in-left-sided-congenital-diaphragmatic-hernia
#4
Ashley S Bruns, Patricio E Lau, Gurpreet S Dhillon, Joseph Hagan, Joshua A Kailin, George B Mallory, Pablo Lohmann, Oluyinka O Olutoye, Rodrigo Ruano, Caraciolo J Fernandes
BACKGROUND & OBJECTIVES: Congenital Diaphragmatic Hernia (CDH) is associated with significant morbidity and mortality. This study compares the efficacy of the highest oxygenation index in the first 48 h (HiOI) versus current prenatal indices to predict survival and morbidity. METHODS: Medical records of 50 prenatally diagnosed, isolated, left-sided CDH patients treated from January 2011 to April 2016 were reviewed. Data abstracted included HiOI, lung to head ratio (LHR), observed to expected total fetal lung volume (O/E TFLV), percent liver herniation (%LH), 6 month survival, respiratory support at discharge, ventilator days and length of stay...
January 13, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29426853/performance-of-the-silverman-andersen-respiratory-severity-score-in-predicting-pco2-and-respiratory-support-in-newborns-a-prospective-cohort-study
#5
Anna Bruett Hedstrom, Nancy E Gove, Dennis E Mayock, Maneesh Batra
OBJECTIVE: To determine if the Silverman Andersen respiratory severity score, which is assessed by physical exam, within 1 h of birth is associated with elevated carbon dioxide level and/or the need for increased respiratory support. STUDY DESIGN: Prospective cohort study including 140 neonates scored within 1 h of birth. We report respiratory scores and their association with carbon dioxide and respiratory support within 24 h. RESULTS: Carbon dioxide level correlated with respiratory score (n = 33, r = 0...
February 9, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29420246/ards-complicating-pustular-psoriasis-treatment-with-low-dose-corticosteroids-vitamin-c-and-thiamine
#6
Paul Ellis Marik, Ashleigh Long
We report the case of a 45-year-old Caucasian woman with a history of psoriasis, admitted to our Medical intensive care unit following the acute onset of diffuse rash and progressive dyspnoea and hypoxaemia requiring escalating respiratory support (continuous positive airway pressure of 10 cm H2O). Her chest X-ray was consistent with findings of non-cardiogenic pulmonary oedema. Echocardiogram was normal. Dermatology considered her skin lesions to be consistent with psoriasis vulgaris with pustular flare. In the absence of an identifiable cause for her respiratory failure, she was diagnosed with acute respiratory distress syndrome due to her psoriatic flare...
February 2, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29406439/oxygen-and-preterm-infant-resuscitation-what-else-do-we-need-to-know
#7
Ju-Lee Oei, Ola D Saugstad, Maximo Vento
PURPOSE OF REVIEW: To evaluate current evidence for the use of lower or higher oxygen strategies for preterm infant resuscitation RECENT FINDINGS: The equipoise for using higher fraction of inspired oxygen (FiO2) (>0.4) to initiate preterm infant respiratory stabilization has been lost. Recent meta-analyses of randomized controlled trials assessing outcomes after using higher (FiO2 ≥ 0.6) vs. lower (FiO2 ≤ 0.3) oxygen strategies to initiate preterm resuscitation shows no difference in the rates of death or major morbidities...
February 5, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29401084/safety-and-efficacy-of-bedside-percutaneous-endoscopic-gastrostomy-placement-in-the-neonatal-intensive-care-unit
#8
Kelly Driver, Rebecca Schilling, Annie Goodwin, Denise Martinez, Ernest Amankwah, Michael Wilsey, Fauzia Shakeel
OBJECTIVE: The aim of the study is to describe the safety and efficacy of bedside percutaneous endoscopic gastrostomy (PEG) placement in a level 3 neonatal intensive care unit (NICU). METHODS: A retrospective chart review was performed on 106 infants with a birthweight ≤6 kg receiving bedside PEG placement at Johns Hopkins All Children's Hospital between 2007 and 2013. Preprocedure, postprocedure, and demographic data were collected. The main safety outcome was postprocedure complication rate and the main efficacy outcome was time to initiate feeds and time on respiratory support...
February 3, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29393237/high-flow-nasal-cannula-versus-nasal-continuous-positive-airway-pressure-for-primary-respiratory-support-in-preterm-infants-with-respiratory-distress-a-randomized-controlled-trial
#9
Srinivas Murki, Jayesh Singh, Chiragkumar Khant, Swarup Kumar Dash, Tejo Pratap Oleti, Percy Joy, Nandkishor S Kabra
BACKGROUND: Nasal continuous positive airway pressure (nCPAP) is the standard noninvasive respiratory support for newborns with respiratory distress. Evidence for high-flow nasal cannula (HFNC) as an alternative mode of respiratory support is inconclusive. OBJECTIVE: The aim of this work was to evaluate whether HFNC is not inferior to nCPAP in reducing the need for higher respiratory support in the first 72 h of life when applied as a noninvasive respiratory support mode for preterm neonates with respiratory distress...
January 23, 2018: Neonatology
https://www.readbyqxmd.com/read/29385861/admission-volume-is-associated-with-mortality-of-neonatal-respiratory-failure-in-emerging-neonatal-intensive-care-units
#10
Huanhuan Wang, Ying Dong, Bo Sun
OBJECTIVE: The aim of this survey was to explore the relationship between admission volume and mortality of neonates with hypoxemic respiratory failure (NRF) in emerging neonatal intensive care units (NICUs). METHODS: NRF from 55 NICUs were retrospectively included with death risk as the major outcome. Perinatal comorbidities, underlying disease severity, respiratory support, facility utilization, and economic burden in the early postnatal period were compared among five NICU admission volume categories defined by NRF incidence, with score for neonatal acute physiology perinatal extension II (SNAPPE-II) also assessed as initial severity...
January 31, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29384906/a-rare-case-report-of-multiple-myeloma-presenting-with-paralytic-ileus-and-type-ii-respiratory-failure-due-to-hypercalcemic-crisis
#11
Yuchen Guo, Liang He, Yiming Liu, Xueyuan Cao
RATIONALE: Paralytic ileus is characterized by the signs and symptoms of intestinal obstruction but without any mechanical lesions in the intestinal lumen. Several medical and surgical conditions can lead to this ailment, such as electrolyte disturbances that impair intestinal motility. However, hypercalcemia secondary to multiple myeloma as a major cause of paralytic ileus has rarely been reported. PATIENT CONCERNS: The patient got severe constipation with difficulty in the passage of both gas and feces for 7 days...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29382794/helmet-versus-nasal-prong-cpap-in-infants-with-acute-bronchiolitis
#12
Juan Mayordomo-Colunga, Corsino Rey, Alberto Medina, Pablo Martínez-Camblor, Ana Vivanco-Allende, Andrés Concha
BACKGROUND: Nasal prongs are frequently used to deliver noninvasive CPAP in bronchiolitis, especially in the youngest children. A helmet interface is an alternative that might be comparable to nasal prongs. We sought to compare these interfaces. METHODS: We performed a prospective, randomized, crossover, single-center study in an 8-bed multidisciplinary pediatric ICU in a university hospital. Infants age <3 months who were consecutively admitted to the pediatric ICU during a bronchiolitis epidemic season and fulfilled inclusion criteria were recruited...
January 30, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29373331/the-physiology-of-neonatal-resuscitation
#13
Stuart B Hooper, Marcus J Kitchen, Graeme R Polglase, Charles C Roehr, Arjan B Te Pas
PURPOSE OF REVIEW: As the infant's physiology changes dramatically after birth, modern neonatal resuscitation approaches should detect and be modified in response to these changes. This review describes the changes in respiratory physiology at birth and highlights approaches that can assist these changes. RECENT FINDINGS: To better target assistance given to infants at birth, the changes in lung physiology have been classified into three phases. The first phase involves lung aeration...
January 25, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29373236/hyperechogenicity-of-lenticulostriate-vessels-a-poor-prognosis-or-a-normal-variant-a-seven-year-retrospective-study
#14
Candice Fabre, Barthélémy Tosello, Estelle Pipon, Catherine Gire, Kathia Chaumoitre
BACKGROUND: Lenticulostriate vasculopathy (LSV) is a hyperechogenicity of the lenticulostriate branches of the basal ganglia and/or thalamus' middle cerebral arteries and is frequently seen in neonatology. Our study primarily describes the perinatal data and long-term follow-up of newborns with lenticulostriate vessel hyperechoic degeneration. Secondly, it describes the cerebral imaging data as a function of perinatal factors and neurodevelopmental follow-up of these newborns. METHODS: This retrospective study assesses the outcome of newborns with LSV hyperechogenicity on cerebral ultrasound (two grades)...
January 6, 2018: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29369703/recent-advances-in-extracorporeal-life-support-as-a-bridge-to-lung-transplantation
#15
Jens Gottlieb, Mark Greer
Invasive mechanical respiratory support in candidate bridging to transplant (BTT) has become common practice in recent years. This usually consists of mechanical ventilation, extracorporeal life support (ECLS) or a combination of both techniques. Areas covered: This review covers epidemiology, technical considerations, indications and outcome of ELCS as BTT. Published literature was identified by searching the MEDLINE bibliographic database (1946-present) and appropriate papers were reviewed. In a retrospective analysis of the period 2010-2016 (n=92 cases of ECLS bridging, 62% ECLS only) at our institution, bridging success was 73%, with 1-year survival among patients surviving to transplant 78%, surpassing our previously published results between 2005-2009 (bridging success 58%, 1-year survival 58%, p=0...
January 25, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29363502/prevention-of-bronchopulmonary-dysplasia-in-extremely-low-gestational-age-neonates-current-evidence
#16
REVIEW
Christian F Poets, Laila Lorenz
Bronchopulmonary dysplasia (BPD) is one of the most frequent complications in extremely low gestational age neonates, but has remained largely unchanged in rate. We reviewed data on BPD prevention focusing on recent meta-analyses. Interventions with proven effectiveness in reducing BPD include the primary use of non-invasive respiratory support, the application of surfactant without endotracheal ventilation and the use of volume-targeted ventilation in infants requiring endotracheal intubation. Following extubation, synchronised nasal ventilation is more effective than continuous positive airway pressure in reducing BPD...
January 23, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29357947/overnight-auto-adjusting-continuous-airway-pressure%C3%A2-%C3%A2-standard-care-compared-with-standard-care-alone-in-the-prevention-of-morbidity-in-sickle-cell-disease-phase-ii-poms2b-study-protocol-for-a-randomised-controlled-trial
#17
Jo Howard, April E Slee, Simon Skene, Baba Inusa, Jamie Kawadler, Michelle Downes, Johanna Gavlak, Melanie Koelbel, Hanne Stotesbury, Maria Chorozoglou, Susan Tebbs, Subarna Chakravorty, Moji Awogbade, David C Rees, Atul Gupta, Patrick B Murphy, Nicholas Hart, Sati Sahota, Carol Nwosu, Maureen Gwam, Dawn Saunders, Vivek Muthurangu, Nathaniel Barber, Emmanuel Ako, Swee Lay Thein, Melanie Marshall, Isabel C Reading, Man Ying Edith Cheng, Fenella J Kirkham, Christina Liossi
BACKGROUND: In addition to pain, sickle cell anaemia (HbSS) complications include neurocognitive difficulties in attention and processing speed associated with low daytime and night-time oxygen saturation compounded by obstructive sleep apnoea (OSA). In the general population OSA is treated with continuous positive airways pressure (CPAP). The aim of this single-blind, randomised, controlled phase II trial is to compare auto-adjusting CPAP (APAP) with standard care to standard care alone in individuals with HbSS to determine whether the intervention improves attention and processing speed, brain structure, pain and quality of life...
January 22, 2018: Trials
https://www.readbyqxmd.com/read/29357126/integration-of-central-and-peripheral-regulation-of-the-circulation-during-exercise-acute-and-chronic-adaptations
#18
Patrick J Mueller, Philip S Clifford, Craig G Crandall, Scott A Smith, Paul J Fadel
Physical movement lasting any more than a few seconds (e.g., exercise), requires coordination of motor control with concomitant changes in the cardiovascular and respiratory support necessary to respond to the rapid increases in metabolic demand. Without such coordination, delivery of oxygen and removal of waste products become rate limiting and will restrict the duration, speed, and quality of movement. Fortunately, under healthy conditions, the central and peripheral nervous systems contribute importantly to this remarkable level of coordination via complex mechanisms that remain to be fully elucidated...
December 12, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/29353257/ethical-dilemmas-of-recording-and-reviewing-neonatal-resuscitation
#19
REVIEW
Maria C den Boer, Mirjam Houtlosser, Henriëtte Anje van Zanten, Elizabeth E Foglia, Dirk P Engberts, Arjan B Te Pas
Neonatal resuscitation is provided to approximately 3% of neonates. Adequate ventilation is often the key to successful resuscitation, but this can be difficult to provide. There is increasing evidence that inappropriate respiratory support can have severe consequences. Several neonatal intensive care units have recorded and reviewed neonatal resuscitation procedures for quality assessment, education and research; however, ethical dilemmas sometimes make it difficult to implement this review process. We reviewed the literature on the development of recording and reviewing neonatal resuscitation and have summarised the ethical concerns involved...
January 20, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29349730/ccn5-in-alveolar-epithelial-proliferation-and-differentiation-during-neonatal-lung-oxygen-injury
#20
Najla Fiaturi, Joshua W Russo, Heber C Nielsen, John J Castellot
Lung immaturity is the major cause of morbidity and mortality in premature infants, especially those born <28 weeks of gestation. These infants are at high risk of developing respiratory distress syndrome (RDS), a lung disease caused by insufficient surfactant production and immaturity of saccular/alveolar type II epithelial cells in the lung. RDS treatment includes oxygen and respiratory support that improve survival but also increase the risk for bronchopulmonary dysplasia (BPD), a chronic lung disease characterized by arrested alveolarization, airway hyperreactivity, and pulmonary hypertension...
January 18, 2018: Journal of Cell Communication and Signaling
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