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https://www.readbyqxmd.com/read/29042870/update-of-minimally-invasive-surfactant-therapy
#1
REVIEW
Gyu-Hong Shim
To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death...
September 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29035757/pulmonary-hypertension-associated-with-bronchopulmonary-dysplasia-in-preterm-infants
#2
REVIEW
Christine B Bui, Merrin A Pang, Arvind Sehgal, Christiane Theda, Jason C Lao, Philip J Berger, Marcel F Nold, Claudia A Nold-Petry
Bronchopulmonary dysplasia (BPD) and BPD-associated pulmonary hypertension (BPD-PH) are chronic inflammatory cardiopulmonary diseases with devastating short- and long-term consequences for infants born prematurely. The immature lungs of preterm infants are ill-prepared to achieve sufficient gas exchange, thus usually necessitating immediate commencement of respiratory support and oxygen supplementation. These therapies are life-saving, but they exacerbate the tissue damage that is inevitably inflicted on a preterm lung forced to perform gas exchange...
October 2, 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/29033358/predictive-factors-of-early-postoperative-respiratory-complications-after-tonsillectomy-in-children-with-unidentified-risks-for-this-complication
#3
Florence Julien-Marsollier, Pierre Salis, Rachida Abdat, Thierno Diallo, Thierry van Den Abbelle, Souhayl Dahmani
INTRODUCTION: Tonsillectomy is considered as a therapeutic option in obstructive sleep apnoea syndrome (OSAS). Postoperative respiratory failure is a complication that can require respiratory support. The main objective of our study is to determine risk factors of postoperative respiratory complications in children undergoing tonsillectomy. MATERIAL AND METHODS: This is a retrospective single centre observational study including patients with unanticipated postoperative respiratory failure...
October 12, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28989917/comparison-of-perinatal-outcomes-in-late-preterm-birth-between-singleton-and-twin-pregnancies
#4
Eun-Hye Yoo, Dasom Chun, Mi Ju Kim, Hyun-Hwa Cha, Won Joon Seong
OBJECTIVE: To determine whether late preterm twin neonates have a more favorable perinatal outcome than singleton late preterm neonates. METHODS: We studied 401 late preterm births between 34+0 and 36+6 weeks of gestation, from January 2011 to December 2014 in our institution. We compared the maternal and neonatal characteristics and perinatal outcomes between singleton and twin pregnancies. Perinatal outcomes included Apgar score, admission to the neonatal intensive care unit (NICU) or special care nursery, duration of NICU stay, and the rate of composite morbidity (antibiotic use, hypoglycemia, hypocalcemia, hyperbilirubinemia requiring phototherapy, respiratory support, and respiratory distress syndrome)...
September 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28981170/the-distance-between-the-delivery-room-and-neonatal-intensive-care-unit-had-no-impact-on-the-respiratory-management-of-preterm-infants-at-birth
#5
Daniele Trevisanuto, Francesca Rech Morassutti, Nicoletta Doglioni, Cristina Contessotto Avilés, Alfonso Galderisi, Francesco Cavallin
The respiratory management of extremely low birth weight (ELBW) infants is crucial during the postnatal stabilisation phase, as it has potential short and long-term consequences (1). Ideally, the neonatal intensive care unit (NICU) should be located near the delivery area (1). We hypothesised that a longer distance between the delivery room and NICU could encourage clinicians to favour invasive respiratory support for ELBW infants to maximise their safe transport to the NICU. This article is protected by copyright...
October 5, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28978595/hiv-related-pneumocystis-jirovecii-pneumonia-managed-with-caspofungin-and-veno-venous-extracorporeal-membrane-oxygenation-rescue-therapy
#6
Nathaniel Lee, David Lawrence, Brijesh Patel, Stephane Ledot
Patients with pneumocystis pneumonia have a risk of progressing to acute respiratory failure necessitating admission to intensive care. The case described is of a patient with a newly diagnosed HIV infection presenting with pneumocystis pneumonia. Despite initiating the appropriate pharmacological treatment the patient's clinical condition deteriorated, and required both rescue pharmacological therapy with echinocandins as well as respiratory support with extracorporeal membrane oxygenation therapy. The patient recovered well on ventilator and circulatory support despite a long weaning process complicated by sequelae common to pneumocystis pneumonia...
October 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28977653/to-compare-the-efficacy-of-heated-humidified-high-flow-nasal-cannula-and-continuous-positive-airway-pressure-in-post-extubation-period-in-vlbw-infants
#7
Bhawan Deep Garg, Naveen Bajaj, Deepak Sharma
Objective: The objective of this study was to compare efficacy of continuous positive airway pressure (CPAP) and heated humidified high-flow nasal cannula (HHHFNC) as noninvasive respiratory support in post-extubation period in very low birth weight (VLBW) infants. Method: This retrospective study enrolled 136 neonates, ≤32 weeks gestation and ≤1500 grams birth weight, requiring noninvasive respiratory support during post-extubation period. Results: There was no significant difference in post-extubation failure in HHHFNC group when compared with CPAP group ( p  > 0...
August 8, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28977098/what-every-intensivist-should-know-about-acute-respiratory-distress-syndrome-and-diffuse-alveolar-damage
#8
Fernando Rios, Teresa Iscar, Pablo Cardinal-Fernández
Acute respiratory distress syndrome is a challenging entity for the intensivist. The pathological hallmark of the acute phase is diffuse alveolar damage, which is present in approximately half of living patients with acute respiratory distress syndrome. It is clear that respiratory support for acute respiratory distress syndrome has gradually been improving over recent decades. However, it is also evident that these procedures are beneficial, as they reduce lung injury and keep the patient alive. This could be interpreted as a time-gaining strategy until the trigger or causal or risk factor improves, the inflammatory storm decreases and the lung heals...
September 28, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28974507/isolated-ascites-in-a-newborn-with-apple-peel-jejunal-atresia
#9
Otilia Osmulikevici, Elizabeth Renji, Bruce Jaffray, Nicholas Embleton
Isolated fetal ascites was diagnosed at 20 weeks in a primiparous woman with no significant medical history. Progressive fetal ascites worsened after 28 weeks and resulted in fetal hydroceles. Delivery was by caesarian section at 33 weeks, preceded by reduction of fetal ascites under ultrasound guidance. Following delivery, the baby required further reduction of abdominal fluid and endotracheal intubation to provide respiratory support. An extensive set of investigations, including metabolic and genetic screening, was performed; all results were negative...
October 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28974135/propofol-and-fentanyl-sedation-for-laser-treatment-of-retinopathy-of-prematurity-to-avoid-intubation
#10
Fiammetta Piersigilli, Alessandra Di Pede, Gino Catena, Simona Lozzi, Cinzia Auriti, Iliana Bersani, Irma Capolupo, Anna Lipreri, Vincenzo Di Ciommo, Andrea Dotta, Stefania Sgrò
BACKGROUND: Despite the optimization of neonatal assistance, severe retinopathy of prematurity (ROP, stage III-IV) remains a common condition among preterm infants. Laser photocoagulation usually requires general anesthesia and intubation, but extubation can be difficult and these infants often affected by chronic lung disease. We retrospectively evaluated the clinical charts of 13 neonates that were sedated with propofol in association with fentanyl for the laser treatment of ROP. This protocol was introduced in our unit to avoid intubation and minimize side effects of anesthesia and ventilation...
October 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28973344/effect-of-inhaled-nitric-oxide-on-survival-without-bronchopulmonary-dysplasia-in-preterm-infants-a-randomized-clinical-trial
#11
Shabih U Hasan, Jim Potenziano, Girija G Konduri, Jose A Perez, Krisa P Van Meurs, M Whit Walker, Bradley A Yoder
Importance: Bronchopulmonary dysplasia (BPD) occurs in approximately 40% of infants born at younger than 30 weeks' gestation and is associated with adverse pulmonary and neurodevelopmental outcomes. Objective: To test whether administration of inhaled nitric oxide to preterm infants requiring positive pressure respiratory support on postnatal days 5 to 14 improves the rate of survival without BPD. Design, Setting, and Participants: This intent-to-treat study was a randomized clinical trial performed at 33 US and Canadian neonatal intensive care units...
September 25, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28970314/nasal-injury-in-preterm-infants-receiving-non-invasive-respiratory-support-a-systematic-review
#12
Dilini I Imbulana, Brett J Manley, Jennifer A Dawson, Peter G Davis, Louise S Owen
No abstract text is available yet for this article.
September 28, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28967603/-the-care-of-extremely-preterm-infants-a-french-view-of-the-swedish-experience
#13
C Casper, P Kuhn
Extreme prematurity, defined as birth occurring before 27 weeks of gestation in Sweden, is managed according to the latest data of the most recent literature, with monitoring of the results through a continuous perinatal registry. National guidelines were issued in 2013. They highlight the importance of infant developmentally supportive and family-centered care focused on the child and the family, nutritional support, pain management, management of ductus arteriosus, and brain damage. However, there remain areas without national consensus including respiratory support management...
September 26, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28953487/spontaneous-respiration-using-intravenous-anesthesia-and-high-flow-nasal-oxygen-strive-hi-management-of-acute-adult-epiglottitis-a-case-report
#14
Phillip Kwan-Giet Lee, Anton Willis Gerard Booth, Kim Vidhani
High-flow nasal oxygen (HFNO) is a potentially life-saving adjunct in the emergency management of the obstructed airway. HFNO has multiple beneficial applications in critical care and respiratory support, but its use in emergency-obstructed airway management has not been defined. This case report describes spontaneous respiration using intravenous anesthesia and high-flow nasal oxygen to successfully manage acute adult epiglottitis with rapidly progressing airway obstruction. Oxygenation, carbon dioxide levels, and airway patency were maintained, which facilitated endotracheal intubation while the patient was spontaneously breathing during general anesthesia...
September 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28948340/do-we-need-randomized-clinical-trials-in-extracorporeal-respiratory-support-no
#15
EDITORIAL
Luciano Gattinoni, Michael Quintel
No abstract text is available yet for this article.
September 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28948309/do-we-need-randomized-clinical-trials-in-extracorporeal-respiratory-support-we-are-not-sure
#16
EDITORIAL
Jean-Louis Vincent, Laurent J Brochard
No abstract text is available yet for this article.
September 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28947032/the-use-of-high-flow-nasal-cannula-hfnc-as-respiratory-support-in-neonatal-and-pediatric-intensive-care-units-in-germany-a-nationwide-survey
#17
Florian Schmid, Dirk Manfred Olbertz, Manfred Ballmann
BACKGROUND: High-flow nasal cannula (HFNC)(1) is a technique of oxygen supply, initially being used as a potentially less-invasive alternative to nasal continuous positive airway pressure (nCPAP)(2) for premature infants/neonates, which nowadays crosses the border of neonatal care. HFNC builds up a positive end-expiratory pressure (PEEP)(3) but lacks the opportunity for continuous monitoring. Therefore, pressure-depending complications are a risk. Our goal was to evaluate the current use of HFNC in Germany regarding indications, techniques of application and complications experienced...
October 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28943321/a-randomized-pilot-study-comparing-the-role-of-peep-o2-flow-and-high-flow-air-for-weaning-of-ventilatory-support-in-very-low-birth-weight-infants
#18
Chang-Yo Yang, Mei-Chin Yang, Shih-Ming Chu, Ming-Chou Chiang, Reyin Lien
BACKGROUND: There is a lack of evidence to guide step-wise weaning of positive pressure respiratory support for premature infants. This study sought to compare the efficacy of three weaning protocols we designed to facilitate weaning of very low birth weight (VLBW, less than 1500 g) preterm infants from nasal continuous positive airway pressure (NCPAP) support. METHODS: This was a prospective, randomized, controlled trial of VLBW preterm infants who received positive pressure ventilatory support in our neonatal intensive care unit (NICU) from April 2008 through March 2009...
September 6, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28941535/mechanical-ventilation-and-decision-support-in-pediatric-intensive-care
#19
REVIEW
Christopher John L Newth, Robinder G Khemani, Philippe A Jouvet, Katherine A Sward
Respiratory support is required in most children in the pediatric intensive care unit. Decision-support tools (paper or electronic) have been shown to improve the quality of medical care, reduce errors, and improve outcomes. Computers can assist clinicians by standardizing descriptors and procedures, consistently performing calculations, incorporating complex rules with patient data, and capturing relevant data. This article discusses computer decision-support tools to assist clinicians in making flexible but consistent, evidence-based decisions for equivalent patient states...
October 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28935428/predictive-factors-for-the-outcome-of-high-flow-nasal-cannula-therapy-in-a-pediatric-intensive-care-unit-is-the-spo2-fio2-ratio-useful
#20
Fulya Kamit Can, Ayşe Berna Anil, Murat Anil, Neslihan Zengin, Fatih Durak, Caner Alparslan, Zeynep Goc
OBJECTIVES: To determine the predictive factors for the outcome of high-flow nasal cannula (HFNC) therapy in a pediatric intensive care unit (PICU). MATERIALS AND METHODS: We prospectively included all patients with acute respiratory distress/failure aged 1month to 18years who were admitted to the PICU between January 2015 and May 2016 and treated with HFNC as a primary support and for postextubation according to our pre-established protocol. HFNC failure was defined as the need for escalation to non-invasive ventilation (NIV) or invasive mechanical ventilation (MV)...
September 6, 2017: Journal of Critical Care
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