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Invasive ventilation neonates

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https://www.readbyqxmd.com/read/28734732/perinatal-and-neonatal-use-of-sedation-and-analgesia
#1
REVIEW
Christopher McPherson, Terrie Inder
Optimal obstetric and neonatal care requires the provision of adequate analgesia for painful procedures. However, anesthetic and analgesic agents have the potential to adversely impact the developing fetal/neonatal brain. In this setting, clinicians must assess the risks and benefits of pharmacologic anesthesia and analgesia for specific indications in this population. General anesthesia is required for non-obstetric surgery and cesarean section in the absence of neuraxial anesthesia for the health of the mother and fetus...
July 19, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28718356/comparison-of-three-non-invasive-ventilation-strategies-nsippv-bipap-ncpap-for-rds-in-vlbw-infants
#2
Vincenzo Salvo, Gianluca Lista, Enrica Lupo, Alberto Ricotti, Luc J I Zimmermann, Antonio W D Gavilanes, Eloisa Gitto, Micaela Colivicchi, Valeria Ferraù, Diego Gazzolo
BACKGROUND: Noninvasive ventilation (NIV) significantly changed the management of respiratory distress syndrome (RDS) in preterm infants. Further perspectives for neonatologists regard the assessment of different NIV strategies in terms of availability, effectiveness and failure. OBJECTIVE: The aim of the present study is to evaluate the effectiveness of three different NIV strategies: nasal continuous pressure (N-CPAP), nasal synchronized intermittent positive pressure ventilation (N-SIPPV) and nasal bilevel CPAP (BiPAP), as first intention treatment for RDS in very low birth-weight infants (VLBW)...
July 18, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28665065/prophylactic-versus-early-rescue-surfactant-treatment-in-preterm-infants-born-at-less-than-30-weeks-gestation-or-with-birth-weight-less-than-or-equal-1-250-grams
#3
Jiyoung Chun, Se In Sung, Yo Han Ho, Jisook Kim, Ga Young Park, Shin Ae Yoon, So Yoon Ahn, Yun Sil Chang, Won Soon Park
Prophylactic surfactant is known to be effective to reduce chronic lung disease in preterm infants compared with rescue surfactant treatment. In Korea, early prophylactic surfactant therapy was introduced in 2011. However, recently, the increased utilization of antenatal steroids and early stabilization through continuous positive airway pressure (CPAP) in the delivery room may have changed the risks and benefits of prophylactic surfactant therapy of infants at high risk of respiratory distress syndrome (RDS)...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28645982/a-multicentre-randomised-controlled-non-inferiority-trial-comparing-nasal-high-flow-with-nasal-continuous-positive-airway-pressure-as-primary-support-for-newborn-infants-with-early-respiratory-distress-born-in-australian-non-tertiary-special-care-nurseries
#4
Brett J Manley, Calum T Roberts, Gaston R B Arnolda, Ian M R Wright, Louise S Owen, Kim M Dalziel, Jann P Foster, Peter G Davis, Adam G Buckmaster
INTRODUCTION: Nasal high-flow (nHF) therapy is a popular mode of respiratory support for newborn infants. Evidence for nHF use is predominantly from neonatal intensive care units (NICUs). There are no randomised trials of nHF use in non-tertiary special care nurseries (SCNs). We hypothesise that nHF is non-inferior to nasal continuous positive airway pressure (CPAP) as primary support for newborn infants with respiratory distress, in the population cared for in non-tertiary SCNs. METHODS AND ANALYSIS: The HUNTER trial is an unblinded Australian multicentre, randomised, non-inferiority trial...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28607284/a-comparison-of-clinical-outcomes-between-endoscopic-and-open-surgery-to-repair-neonatal-diaphragmatic-hernia
#5
Ma Lishuang, Wei Yandong, Liu Shuli, Feng Cuiru, Zhang Yue, Wang Ying, Zhang Yanxia, Sun Bin, Li Jingna, Li Long
OBJECTIVE: The objective of this study is to evaluate the clinical efficacies of open versus endoscopic surgery in the treatment of congenital diaphragmatic hernia (CDH) and investigate the feasibility and safety of endoscopic surgery as an alternative to open surgery in these cases. PATIENTS AND METHODS: A retrospective analysis was performed from June 2002 to February 2014. A total of 59 cases were attempted. The neonates were divided into either an endoscopic or open surgery group...
July 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28601870/restricted-ventilation-associated-with-reduced-neurodevelopmental-impairment-in-preterm-infants
#6
Roseanne J S Vliegenthart, Wes Onland, Aleid G van Wassenaer-Leemhuis, Anne P M De Jaegere, Cornelieke S H Aarnoudse-Moens, Anton H van Kaam
BACKGROUND AND OBJECTIVE: Restrictive use of invasive mechanical ventilation (IMV) in preterm infants reduces the risk of bronchopulmonary dysplasia (BPD). Our objective was to determine its effect on neurodevelopmental impairment (NDI) at 24 months' corrected age (CA). METHODS: This retrospective single-center cohort study included all patients with a gestational age <30 weeks born in 2004/2005 (epoch 1) and 2010/2011 (epoch 2). In epoch 2, we introduced a policy of restriction on IMV and liberalized the use of respiratory stimulants in the delivery room and neonatal intensive care...
June 10, 2017: Neonatology
https://www.readbyqxmd.com/read/28569744/delivery-room-interventions-to-prevent-bronchopulmonary-dysplasia-in-extremely-preterm-infants
#7
E E Foglia, E A Jensen, H Kirpalani
Bronchopulmonary dysplasia (BPD) is the most common chronic respiratory complication of preterm birth. Preterm infants are at risk for acute lung injury immediately after birth, which predisposes to BPD. In this article, we review the current evidence for interventions applied during neonatal transition (delivery room and first postnatal hours of life) to prevent BPD in extremely preterm infants: continuous positive airway pressure (CPAP), sustained lung inflation, supplemental oxygen use during neonatal resuscitation, and surfactant therapy including less-invasive surfactant administration...
June 1, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28546371/pediatric-aerosol-therapy
#8
Ariel Berlinski
Inhaled medications are the mainstay of therapy for many pediatric pulmonary diseases. Device and delivery technique selection is key to improving lung deposition of inhaled drugs. This paper will review the subject in relationship to several pediatric clinical situations: acute pediatric asthma, transnasal aerosol delivery, delivery through tracheostomies, and delivery during noninvasive and invasive mechanical ventilation. This review will focus on the pediatric age group and will not include neonates.
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28540346/less-invasive-surfactant-administration-reduces-the-need-for-mechanical-ventilation-in-preterm-infants-a-meta-analysis
#9
Christine S M Lau, Ronald S Chamberlain, Shyan Sun
Neonatal respiratory distress syndrome due to surfactant deficiency is associated with high morbidity and mortality in preterm infants, and the use of less invasive surfactant administration (LISA) has been increasingly studied. This meta-analysis found that LISA via thin catheter significantly reduced the need for mechanical ventilation within the first 72 hours (relative risk [RR] = 0.677; P = .021), duration of mechanical ventilation (difference in means [MD] = -39.302 hours; P < .001), duration of supplemental oxygen (MD = -68...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28521581/association-between-the-use-of-magnesium-sulfate-as-neuroprotector-in-prematurity-and-the-neonatal-hemodynamic-effects
#10
Rodrigo Dias Nunes, Flávia Duarte Schutz, Jefferson Luiz Traebert
PURPOSE: Cerebral palsy is often associated with prematurity and magnesium sulfate (MgSO4) has been used as a neuroprotector, with favorable results. However, its mechanism of action has not been fully elucidated. This study aimed to evaluate the association between MgSO4 at the imminent premature delivery and neonatal hemodynamic effects. MATERIALS AND METHODS: A cross-sectional study involving 94 newborns (NB) between 24 and 32 weeks at a Brazilian hospital was performed...
June 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28516821/pseudomonas-aeruginosa-outbreak-in-a-neonatal-intensive-care-unit-attributed-to-hospital-tap-water
#11
Cara Bicking Kinsey, Samir Koirala, Benjamin Solomon, Jon Rosenberg, Byron F Robinson, Antonio Neri, Alison Laufer Halpin, Matthew J Arduino, Heather Moulton-Meissner, Judith Noble-Wang, Nora Chea, Carolyn V Gould
OBJECTIVE To investigate an outbreak of Pseudomonas aeruginosa infections and colonization in a neonatal intensive care unit. DESIGN Infection control assessment, environmental evaluation, and case-control study. SETTING Newly built community-based hospital, 28-bed neonatal intensive care unit. PATIENTS Neonatal intensive care unit patients receiving care between June 1, 2013, and September 30, 2014. METHODS Case finding was performed through microbiology record review. Infection control observations, interviews, and environmental assessment were performed...
May 18, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28506358/-research-advances-in-noninvasive-high-frequency-oscillatory-ventilation-in-neonates
#12
Jia Huang, Lin Yuan, Chao Chen
Noninvasive ventilation is an important respiratory management technique for the treatment of mild or moderate respiratory failure in the neonatal intensive care unit. Its reasonable application can effectively avoid the use of invasive ventilation and related complications. Recent studies have found that noninvasive high-frequency oscillatory ventilation has the advantages of both nasal continuous positive airway pressure and high-frequency ventilation and can rapidly improve oxygenation, effectively remove carbon dioxide, and improve respiratory failure...
May 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28503300/how-to-decrease-bronchopulmonary-dysplasia-in-your-neonatal-intensive-care-unit-today-and-tomorrow
#13
REVIEW
Leif D Nelin, Vineet Bhandari
Bronchopulmonary dysplasia, or BPD, is the most common chronic lung disease in infants. Genetic predisposition and developmental vulnerability secondary to antenatal and postnatal infections, compounded with exposure to hyperoxia and invasive mechanical ventilation to an immature lung, result in persistent inflammation, culminating in the characteristic pulmonary phenotype of BPD of impaired alveolarization and dysregulated vascularization. In this article, we highlight specific areas in current management, and speculate on therapeutic strategies that are on the horizon, that we believe will make an impact in decreasing the incidence of BPD in your neonatal intensive care units...
2017: F1000Research
https://www.readbyqxmd.com/read/28495235/prenatal-detection-of-megacystis-not-always-an-adverse-prognostic-factor-experience-in-25-consecutive-cases-in-a-tertiary-referral-center-with-complete-neonatal-outcome-and-follow-up
#14
Marcella Pellegrino, Daniela Visconti, Vincenzo Davide Catania, Luisa D'Oria, Carlo Manzoni, Maria Giovanna Grella, Alessandro Caruso, Lucia Masini, Giuseppe Noia
INTRODUCTION: Megacystis is a condition of abnormal enlarged fetal bladder for gestational age, which is usually associated with urological malformations that may constitute a life-threatening condition for the baby. OBJECTIVE: The purpose of this study was to assess the prognostic and etiological criteria of fetal megacystis and to describe the neonatal outcome in a large series collected in a single tertiary center. STUDY DESIGN: A retrospective observational study was conducted between 2008 and 2012...
April 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28476473/decrease-in-delivery-room-intubation-rates-after-use-of-nasal-intermittent-positive-pressure-ventilation-in-the-delivery-room-for-resuscitation-of-very-low-birth-weight-infants
#15
Manoj Biniwale, Fiona Wertheimer
BACKGROUND: The literature supports minimizing duration of invasive ventilation to decrease lung injury in premature infants. Neonatal Resuscitation Program recommended use of non-invasive ventilation (NIV) in delivery room for infants requiring prolonged respiratory support. OBJECTIVE: To evaluate the impact of implementation of non-invasive ventilation (NIV) using nasal intermittent positive pressure ventilation (NIPPV) for resuscitation in very low birth infants...
July 2017: Resuscitation
https://www.readbyqxmd.com/read/28456514/respiratory-distress-in-term-neonates-in-low-resource-settings
#16
REVIEW
Sindhu Sivanandan, Ramesh Agarwal, Amanpreet Sethi
Most neonatal deaths worldwide occur in low- and middle-income countries (LMICs). Respiratory distress is an important cause of neonatal morbidity and mortality. The epidemiology of respiratory distress among term neonates who constitute the vast majority of births is under reported. The scarcely available data from LMICs suggest an incidence of 1.2% to 7.2% among term live births and greater morbidity compared to that in high-income countries. Pneumonia and meconium aspiration syndrome are the predominant causes among outborn neonates, but next only to transient tachypnea among inborn neonates...
April 26, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28444360/role-of-early-onset-neutropenia-in-development-of-candidemia-in-premature-infants
#17
Nermin Ramy, Mohamed Hashim, Heba Abou Hussein, Happy Sawires, Maha Gaafar, Ayat El Maghraby
Background: The aim of the study was to assess the effect of early-onset neutropenia (EON) on the development of candidemia in premature infants and evaluate other risk factors. Materials and Methods: This prospective study was carried out in a neonatal intensive care unit of Cairo University Hospital. Fifty neutropenic premature infants were matched to 50 non-neutropenics. Subjects were then regrouped into candidemics and non-candidemics to study other risk factors such as central venous catheters, mechanical ventilation, parenteral nutrition, drugs as corticosteroids and others...
April 24, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28443559/the-evolution-of-modern-respiratory-care-for-preterm-infants
#18
REVIEW
Louise S Owen, Brett J Manley, Peter G Davis, Lex W Doyle
Preterm birth rates are rising, and many preterm infants have breathing difficulty after birth. Treatments for infants with prolonged breathing difficulty include oxygen therapy, exogenous surfactant, various modes of respiratory support, and postnatal corticosteroids. In this Series paper, we review the history of neonatal respiratory care and its effect on long-term outcomes, and we outline the future direction of the research field. The delivery and monitoring of oxygen therapy remains controversial, despite being in use for more than 50 years...
April 22, 2017: Lancet
https://www.readbyqxmd.com/read/28399457/cumulative-pain-related-stress-and-developmental-outcomes-among-low-risk-preterm-infants-at-one-year-corrected-age
#19
Iris Morag, Ifat Rotem, Mor Frisch, Israel Hendler, Michal J Simchen, Leah Leibovitz, Ayala Maayan-Metzger, Tzipora Strauss
BACKGROUND: Extensive exposure of preterm infants to pain-related stress (PRS) at a time of physiological immaturity and rapid brain development may contribute to altered neurodevelopment. OBJECTIVE: To examine the relationship between early PRS and neurodevelopmental outcomes among low-risk very preterm infants at the age of one year corrected age (CA). METHODS: Participants included 107 infants born <32weeks gestational age (GA) and monitored prospectively at 12...
April 8, 2017: Early Human Development
https://www.readbyqxmd.com/read/28330506/clonidine-for-sedation-in-the-critically-ill-a-systematic-review-and-meta-analysis
#20
Jing Gennie Wang, Emilie Belley-Coté, Lisa Burry, Mark Duffett, Timothy Karachi, Dan Perri, Waleed Alhazzani, Frederick D'Aragon, Hannah Wunsch, Bram Rochwerg
BACKGROUND: This systematic review and meta-analysis investigates the efficacy and safety of clonidine as a sedative in critically ill patients requiring invasive mechanical ventilation. METHODS: We performed a comprehensive search of MEDLINE, EMBASE, CINAHL and the Cochrane trial registry. We identified RCTs that compared clonidine to any non-clonidine regimen in critically ill patients, excluding neonates, requiring mechanical ventilation. The GRADE method was used to assess certainty of evidence...
February 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
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