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Invasive ventilation neonates

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https://www.readbyqxmd.com/read/29792168/trends-in-the-incidence-and-associated-factors-of-late-onset-sepsis-associated-with-improved-survival-in-extremely-preterm-infants-born-at-23-26-weeks-gestation-a-retrospective-study
#1
Jin Kyu Kim, Yun Sil Chang, Sein Sung, So Yoon Ahn, Won Soon Park
BACKGROUND: To investigate the trends in the incidence and associated factors of late-onset sepsis (LOS) associated with improved survival in extremely preterm infants. METHODS: Medical records of 364 infants who were born at 23-26 weeks' gestation from 2000 to 2005 (period I, n = 124) and from 2006 to 2011 (period II, n = 240) were retrospectively reviewed. The infants were stratified into subgroups of 23-24 and 25-26 weeks' gestation within each period, and survival, LOS rate, and clinical characteristics were analyzed...
May 23, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29790677/predicting-healthcare-outcomes-in-prematurely-born-infants-using-cluster-analysis
#2
Victoria MacBean, Alan Lunt, Simon B Drysdale, Muska N Yarzi, Gerrard F Rafferty, Anne Greenough
AIMS: Prematurely born infants are at high risk of respiratory morbidity following neonatal unit discharge, though prediction of outcomes is challenging. We have tested the hypothesis that cluster analysis would identify discrete groups of prematurely born infants with differing respiratory outcomes during infancy. METHODS: A total of 168 infants (median (IQR) gestational age 33 (31-34) weeks) were recruited in the neonatal period from consecutive births in a tertiary neonatal unit...
May 23, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29789465/efficacy-safety-and-usability-of-remifentanil-as-premedication-for-insure-in-preterm-neonates
#3
Hadiyah Y Audil, Sara Tse, Chad Pezzano, Amy Mitchell-van Steele, Joaquim M B Pinheiro
Background : We previously reported a 67% extubation failure with INSURE (Intubation, Surfactant, Extubation) using morphine as analgosedative premedication. Remifentanil, a rapid- and short-acting narcotic, might be ideal for INSURE, but efficacy and safety data for this indication are limited. Objectives : To assess whether remifentanil premedication increases extubation success rates compared with morphine, and to evaluate remifentanil's safety and usability in a teaching hospital context. Methods : Retrospective review of remifentanil orders for premedication, at a large teaching hospital neonatal intensive care unit (NICU)...
May 22, 2018: Children
https://www.readbyqxmd.com/read/29745619/incidence-and-risk-factors-of-ventilator-associated-pneumonia-in-neonatal-intensive-care-unit-a-first-french-study
#4
Guillaume Geslain, Isabelle Guellec, Romain Guedj, Julia Guilbert, Sandrine Jean, Cécile Valentin, Maryne Demoulin, Yohann Soreze, Ricardo Carbajal, Pierre-Louis Leger, Jerome Rambaud
BACKGROUND: Ventilator-associated pneumonia (VAP) is a severe intensive complication and remains under estimated in neonatal intensive care unit (NICU). Center for Disease Control defined criteria for adults and pediatrics without neonatal criteria. The objective of this article was to evaluate the rate, the risks factors and the outcome of neonates suffering from ventilator-associated pneumonia in a French NICU. METHODS: We conducted a prospective observational study within a one-year period in our NICU...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29723923/a-humidifier-in-the-invasive-mode-during-non-invasive-respiratory-support-could-increase-condensation-and-thereby-impair-airway-patency
#5
Rutger C Flink, Anton H van Kaam, Frans H de Jongh
AIM: Humidifying non-invasively ventilated preterm infants is critical to prevent dehydration of respiratory mucosa, but over humidification can result in impaired airway patency and lung mechanics. This neonatal bench study investigated the humidity delivered using invasive and non-invasive humidification modes during nasal continuous positive airway pressure. METHODS: The study was conducted at the neonatal intensive care unit of Emma Children's Hospital, the Netherlands, in March 2014...
May 3, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29704686/a-novel-nkx3-2-mutation-associated-with-perinatal-lethal-phenotype-of-spondylo-megaepiphyseal-metaphyseal-dysplasia-in-a-neonate
#6
Pelin Ozlem Simsek-Kiper, Can Kosukcu, Ozlem Akgun-Dogan, Rahsan Gocmen, Gulen Eda Utine, Tutku Soyer, Ayse Korkmaz-Toygar, Gen Nishimura, Mehmet Alikasifoglu, Koray Boduroglu
Spondylo-megaepiphyseal-metaphyseal dysplasia (SMMD) is an autosomal recessive skeletal dysplasia, characterized by disproportionate short stature with a short and stiff neck and trunk. SMMD is caused by inactivating mutations in NKX3-2, which encodes a homeobox-containing protein. Because of the rarity of the disorder, the diagnostic feature has not been fully established yet. We describe an affected newborn with dysmorphic facial features and severe short trunk. The patient required immediate intubation at the delivery room and duodenal atresia was detected during his course in neonatal intensive care unit...
April 25, 2018: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/29696135/successful-deployment-of-high-flow-nasal-cannula-in-a-peruvian-pediatric-intensive-care-unit-using-implementation-science-lessons-learned
#7
Katie R Nielsen, Rosario Becerra, Gabriela Mallma, José Tantaleán da Fieno
Acute lower respiratory infections are the leading cause of death outside the neonatal period for children less than 5 years of age. Widespread availability of invasive and non-invasive mechanical ventilation in resource-rich settings has reduced mortality rates; however, these technologies are not always available in many low- and middle-income countries due to the high cost and trained personnel required to implement and sustain their use. High flow nasal cannula (HFNC) is a form of non-invasive respiratory support with growing evidence for use in pediatric respiratory failure...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29694993/new-ventilator-strategies-high-frequency-oscillatory-ventilation-combined-with-volume-guarantee
#8
M Sánchez-Luna, N González-Pacheco, J Belik, M Santos, F Tendillo
High-frequency oscillatory ventilation (HFOV) has been proposed as an alternative method of invasive ventilation in immature infants to prevent ventilator lung injury. To better control the size of the high-frequency tidal volume and to prevent large tidal volumes, a new strategy of controlling the tidal volume during HFOV (VThf) has been developed, HFOV-volume guarantee (VG). Data from preclinical, neonatal animal studies in normal and surfactant-depleted lungs have demonstrated the feasibility of this technique to directly control the VThf in the normal compliance and low compliance situations...
May 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29694989/is-less-invasive-surfactant-administration-necessary-or-only-helpful-or-just-a-fashion
#9
Gianluca Lista, Ilia Bresesti, Laura Fabbri
In the 1990s, the most relevant pillars in the treatment of neonatal respiratory distress syndrome (RDS) have been improvements in ventilation strategies, the introduction of exogenous surfactant replacement therapy, and the use of antenatal steroids. Lately, in addition to the standard INSURE (INtubation-SURfactant administration-Extubation) method to administer surfactant, a new technique has been gaining increasing popularity. It is the so-called less invasive surfactant administration (LISA) method, which has shown promising results in preventing bronchopulmonary dysplasia development and in reducing mortality in preterm neonates...
May 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29666685/identifying-risk-factors-for-healthcare-associated-infections-caused-by-carbapenem-resistant-acinetobacter-baumannii-in-a-neonatal-intensive-care-unit
#10
Amira M Sultan, Wael A Seliem
Objectives: Acinetobacter baumannii is a causative pathogen of various healthcare-associated infections (HAIs) and is particularly prevalent in high-risk hospital settings. This study aimed to determine risk factors associated with HAIs caused by carbapenem-resistant A. baumannii (CRAB) in a neonatal intensive care unit (NICU). Methods: This prospective study was performed between January 2013 and June 2014 among NICU patients at the Mansoura University Children's Hospital, Mansoura, Egypt...
February 2018: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29656287/respiratory-management-of-extremely-preterm-infants-an-international-survey
#11
Marc Beltempo, Tetsuya Isayama, Máximo Vento, Kei Lui, Satoshi Kusuda, Liisa Lehtonen, Gunnar Sjörs, Stellan Håkansson, Mark Adams, Akihiko Noguchi, Brian Reichman, Brian A Darlow, Naho Morisaki, Dirk Bassler, Simone Pratesi, Shoo K Lee, Abhay Lodha, Neena Modi, Kjell Helenius, Prakesh S Shah
BACKGROUND: There are significant international variations in chronic lung disease rates among very preterm infants yet there is little data on international variations in respiratory strategies. OBJECTIVE: To evaluate practice variations in the respiratory management of extremely preterm infants born at < 29 weeks' gestational age (GA) among 10 neonatal networks participating in the International Network for Evaluating Outcomes (iNeo) of Neonates collaboration...
April 13, 2018: Neonatology
https://www.readbyqxmd.com/read/29627403/ventilatory-practices-in-extremely-low-birth-weight-infants-in-a-level-iii-neonatal-intensive-care-unit
#12
S Abreu-Pereira, R Pinto-Lopes, F Flôr-de-Lima, G Rocha, H Guimarães
INTRODUCTION: Although non-invasive forms of ventilation have recently spread in neonatology, invasive ventilation still plays a key role in the support of extremely low birth weight (ELBW) infants. The purpose of this study was to assess changes in neonatal ventilation practices for ELBW infants and compare outcomes between two epochs (2005-2009 vs. 2010-2015) to analyze progression stemming from the implementation of newer clinical guidelines. MATERIALS AND METHODS: We conducted a retrospective study with data collection from all ELBW infants born between 2005 and 2015 in our center through their individual clinical records...
April 4, 2018: Pulmonology
https://www.readbyqxmd.com/read/29594085/stress-signals-during-sucking-activity-are-associated-with-longer-transition-time-to-full-oral-feeding-in-premature-infants
#13
You Gyoung Yi, Byung-Mo Oh, Seung Han Shin, Jin Yong Shin, Ee-Kyung Kim, Hyung-Ik Shin
Several treatments have been proposed to shorten the time to the attainment of full oral feeding (FOF) for premature infants, but there are only a few evaluation methods useful in estimating predictors of this period. We investigated whether specific items within the disorganized sucking patterns described by the Neonatal Oral-Motor Assessment Scale (NOMAS) could estimate the time to FOF in preterm infants with feeding difficulty. Preterm infants diagnosed with a disorganized sucking pattern in the NOMAS evaluation before 50 weeks of postmenstrual age were included...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29541430/the-effect-of-inhaled-budesonide-on-the-prevention-of-chronic-lung-disease-in-premature-neonates-with-respiratory-distress-syndrome
#14
Alireza Sadeghnia, Behzad Koorang Beheshti, Majid Mohammadizadeh
Background: Considering all the latest achievements in neonatal respiratory care, bronchopulmonary dysplasia (BPD) is still among the most prevalent morbidity causes in premature infants. Involvement in this process results in longer period of hospitalization for the newborn and in the long run makes the living conditions more difficult. Taking the multifactorial pathogenesis into account, approaches to tackle chronic lung disease (CLD) are mainly focused on interventions and prevention procedures...
2018: International Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29481437/treatment-patterns-and-clinical-outcomes-in-neonates-diagnosed-with-respiratory-distress-syndrome-in-a-low-income-country-a-report-from-bangladesh
#15
Richard M Hubbard, Kamal M Choudhury, Grace Lim
Respiratory distress syndrome remains a leading cause of neonatal mortality worldwide. This retrospective study describes practice patterns for respiratory distress syndrome in a resource-limited setting and seeks to identify both risk factors for mortality and beneficial treatment modalities. Health, demographic, and treatment data were collected. Potential associations were analyzed using univariable and multivariable logistic regression. Of 104 children included for analysis, 38 died. Although most children were initially treated with noninvasive respiratory support, 59 progressed to invasive ventilation...
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29458230/perioperative-complications-of-congenital-diaphragmatic-hernia-repair
#16
REVIEW
Catarina Barroso, Jorge Correia-Pinto
Although improvements have been made, the management of congenital diaphragmatic hernia (CDH) remains a major challenge for perinatologists and neonatal surgeons. Many aspects of the disease remain unknown and, being a rare entity, evidence-based data are hard to find. Surgical morbidity is considerable and affects long-term quality of life. Perioperative complications have been reviewed focusing on thoracoscopic repair. Intraoperative acidosis was more severe during thoracoscopy when compared with open surgery (OS), though it is possible that later neurodevelopment was not affected...
April 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29426584/non-invasive-ventilation-in-children-and-adults-in-low-and-low-middle-income-countries-a-systematic-review-and-meta-analysis
#17
Keren Mandelzweig, Aleksandra Leligdowicz, Srinivas Murthy, Rejani Lalitha, Robert A Fowler, Neill K J Adhikari
PURPOSE: We systematically reviewed the effects of NIV for acute respiratory failure (ARF) in low- and low-middle income countries. MATERIALS AND METHODS: We searched MEDLINE, CENTRAL, and EMBASE (to January 2016) for observational studies and trials of NIV for ARF or in the peri-extubation period in adults and post-neonatal children. We abstracted outcomes data and assessed quality. Meta-analyses used random-effect models. RESULTS: Fifty-four studies (ten pediatric/n=1099; 44 adult/n=2904), mostly South Asian, were included...
January 12, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29396929/is-less-noise-light-and-parental-caregiver-stress-in-the-neonatal-intensive-care-unit-better-for-neonates
#18
Rohini Venkataraman, Majeeda Kamaluddeen, Harish Amin, Abhay Lodha
In utero sensory stimuli and interaction with the environment strongly influence early phases of fetal and infant development. Extremely premature infants are subjected to noxious procedures and routine monitoring, in addition to exposure to excessive light and noise, which disturb the natural sleep cycle and induce stress. Non-invasive ventilation, measures to prevent sepsis, and human milk feeding improve short-term and long-term neurodevelopmental outcomes in premature infants. To preserve brain function, and to improve quality of life and long-term neurodevelopmental outcomes, the focus now is on the neonatal intensive care unit (NICU) environment and its impact on the infant during hospital stay...
January 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29373986/etiological-heterogeneity-and-clinical-variability-in-newborns-with-esophageal-atresia
#19
Ettore Piro, Ingrid Anne Mandy Schierz, Mario Giuffrè, Giovanni Cuffaro, Simona La Placa, Vincenzo Antona, Federico Matina, Giuseppe Puccio, Marcello Cimador, Giovanni Corsello
BACKGROUND: The aim of this study was to define different characteristics of infants with esophageal atresia and correlations with neonatal level of care, morbidity and mortality occurring during hospital stay. METHODS: Charts of all newborns with esophageal atresia (EA) admitted to our University NICU between January 2003 and November 2016 were reviewed and subdivided in four groups related to different clinical presentations; EA as an isolated form (A), with a concomitant single malformation (B), as VACTERL association (C), and in the context of a syndrome or an entity of multiple congenital anomalies (D)...
January 26, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29363502/prevention-of-bronchopulmonary-dysplasia-in-extremely-low-gestational-age-neonates-current-evidence
#20
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...
May 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
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