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Invasive ventilation neonates

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https://www.readbyqxmd.com/read/28146296/nasal-intermittent-positive-pressure-ventilation-nippv-versus-nasal-continuous-positive-airway-pressure-ncpap-for-preterm-neonates-after-extubation
#1
REVIEW
Brigitte Lemyre, Peter G Davis, Antonio G De Paoli, Haresh Kirpalani
BACKGROUND: Previous randomised trials and meta-analyses have shown that nasal continuous positive airway pressure (NCPAP) is a useful method for providing respiratory support after extubation. However, this treatment sometimes 'fails' in infants, and they may require endotracheal re-intubation with its attendant risks and expense. Nasal intermittent positive pressure ventilation (NIPPV) can augment NCPAP by delivering ventilator breaths via nasal prongs. Older children and adults with chronic respiratory failure benefit from NIPPV, and the technique has been applied to neonates...
February 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28142154/a-quality-improvement-initiative-to-reduce-the-need-for-mechanical-ventilation-in-extremely-low-gestational-age-neonates
#2
Ludivine Templin, Camille Grosse, Virginie Andres, Clotilde Des Robert, Laurence Fayol, Umberto Simeoni, Farid Boubred
Objective Limiting early intubation and mechanical ventilation in extremely low gestational age neonates (ELGAN) may decrease neonatal morbidity and mortality. The aim of our study was to demonstrate the feasibility, efficacy, and tolerability of a delivery room respiratory management protocol, including delayed umbilical cord clamping (DUCC) in combination with optimized nCPAP with high PEEP levels and less invasive surfactant administration (LISA). Study Design This cohort quality improvement study analyzed the respiratory and neonatal outcomes of all consecutive infants born between 24(+0) and 26(+6) weeks' gestation before (period 1, n = 40) and after (period 2, n = 52) implementing the new protocol...
January 31, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28130789/retrospective-study-shows-that-doxapram-therapy-avoided-the-need-for-endotracheal-intubation-in-most-premature-neonates
#3
Robert Flint, Nienke Halbmeijer, Naomi Meesters, Joost van Rosmalen, Irwin Reiss, Monique van Dijk, Sinno Simons
AIM: Using doxapram to treat neonates with apnoea of prematurity might avoid the need for endotracheal intubation and invasive ventilation. We studied whether doxapram prevented the need for intubation and identified the predictors of the success. METHODS: This was a retrospective study of preterm infants born from January 2006 to August 2014 who received oral or intravenous doxapram. Success was defined as no need for endotracheal intubation, due to apnoea, during doxapram therapy...
January 27, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28109060/morphine-pharmacodynamics-in-mechanically-ventilated-preterm-neonates-undergoing-endotracheal-suctioning
#4
P A Välitalo, Ehj Krekels, M van Dijk, Shp Simons, D Tibboel, Caj Knibbe
To date, morphine pharmacokinetics (PKs) are well quantified in neonates, but results about its efficacy are ambiguous. This work presents an analysis of a previously published study on pain measurements in mechanically ventilated preterm neonates who received either morphine or placebo to improve comfort during invasive ventilation. The research question was whether morphine reduces the pain associated with endotracheal or nasal suctioning before, during, and after suctioning. Because these neonates cannot verbalize their pain levels, pain was assessed on the basis of several validated pain measurement instruments (i...
January 21, 2017: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/28108103/respiratory-support-for-very-low-birth-weight-infants-receiving-dexamethasone
#5
Yamini V Virkud, Christoph P Hornik, Daniel K Benjamin, Matthew M Laughon, Reese H Clark, Rachel G Greenberg, P Brian Smith
OBJECTIVE: To assess how neonatal intensive care units followed the American Academy of Pediatrics guidelines for use of dexamethasone in preterm infants by evaluating respiratory support at the time of dexamethasone administration. STUDY DESIGN: This is an observational study of infants discharged from one of 290 neonatal intensive care units from 2003 to 2010. The cohort included very low birth weight (<1500 g birth weight) infants born at ≤32 weeks gestational age...
January 18, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28106628/neonatal-micrognathia-national-trends-in-early-mandibular-surgery
#6
Hillary E Jenny, Benjamin B Massenburg, E Hope Weissler, Peter J Taub
BACKGROUND: Micrognathia is a congenital anomaly that may pose breathing and feeding limitations in newborns, sometimes necessitating invasive management. The present study aims to identify the complications associated with receiving mandibular surgery during the birth stay in order to better predict which patients may benefit from early surgical intervention. METHODS: A retrospective cohort study was performed using the 2000 to 2012 kids' inpatient databases. We included all live newborn infants born in the hospital through vaginal delivery or caesarean section...
March 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28102857/vocal-fold-paralysis-in-preterm-infants-prevalence-and-analysis-of-risk-factors
#7
J Jabbour, M Uhing, T Robey
OBJECTIVE: To calculate the prevalence of vocal fold paralysis (VFP) in preterm (<37 weeks of gestation) infants at a single neonatal intensive care unit (NICU) and identify risk factors for the development of VFP. STUDY DESIGN: This is a case control study of all surviving preterm infants admitted to the NICU at Children's Hospital of Wisconsin from 2006 to 2012, comparing those with and without VFP. Multivariate analysis was performed to identify significant risk factors for VFP...
January 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28067830/bronchopulmonary-dysplasia-chronic-lung-disease-of-infancy-and-long-term-pulmonary-outcomes
#8
REVIEW
Lauren M Davidson, Sara K Berkelhamer
Bronchopulmonary dysplasia (BPD) is a chronic lung disease most commonly seen in premature infants who required mechanical ventilation and oxygen therapy for acute respiratory distress. While advances in neonatal care have resulted in improved survival rates of premature infants, limited progress has been made in reducing rates of BPD. Lack of progress may in part be attributed to the limited therapeutic options available for prevention and treatment of BPD. Several lung-protective strategies have been shown to reduce risks, including use of non-invasive support, as well as early extubation and volume ventilation when intubation is required...
January 6, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28050683/effect-of-surfactant-therapy-using-orogastric-tube-for-tracheal-catheterization-in-preterm-newborns-with-respiratory-distress
#9
Rampal Singh Tomar, Ranjit Ghuliani, Dinesh Yadav
OBJECTIVE: To assess the outcome of a modified method of Minimally Invasive Surfactant Therapy (MIST) therapy where an orogastric tube was used for tracheal catherization to deliver surfactant in preterm newborns less than 34 wk of gestation with respiratory distress syndrome (RDS). METHODS: A single centre, prospective observational study was conducted to enroll eligible inborn preterm neonates with gestation age more than 24 wk but less than 34 wk and suffering from RDS to receive surfactant using MIST...
January 3, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28040456/exhaled-breath-condensate-analysis-from-intubated-newborns-by-nano-hplc-coupled-to-high-resolution-ms
#10
A S Kononikhin, N L Starodubtseva, V V Chagovets, A Y Ryndin, A A Burov, I A Popov, A E Bugrova, R A Dautov, A O Tokareva, Y L Podurovskaya, O V Ionov, V E Frankevich, E N Nikolaev, G T Sukhikh
Invasiveness of examination and therapy methods is a serious problem for intensive care and nursing of premature infants. Exhaled breath condensate (EBC) is the most attractive biofluid for non-invasive methods development in neonatology for monitoring the status of intubated infants. The aim of the study was to propose an approach for EBC sampling and analysis from mechanically ventilated neonates. EBC collection system with good reproducibility of sampling was demonstrated. Discovery-based proteomic and metabolomic studies were performed using nano-HPLC coupled to high resolution MS...
December 23, 2016: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/27892756/use-of-high-non-invasive-respiratory-support-pressures-in-preterm-neonates-a-single-centre-experience
#11
Abdulaziz Binmanee, Salhab El Helou, Sandesh Shivananda, Christoph Fusch, Amit Mukerji
PURPOSE: To describe the incidence, indications and clinical outcomes following high pressures on non-invasive respiratory support (NRS) in preterm neonates. STUDY DESIGN: Retrospective cohort study of all neonates with BW < 1,500 g admitted from July 2012 to June 2014 and placed on high NRS, defined as mean airway pressure ≥ 10 cm H2O for at least 12 continuous hours using NCPAP and/or nasal high frequency ventilation (NIHFV). Clinical and physiological outcomes following high NRS were ascertained...
November 28, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27879381/pediatric-prolonged-mechanical-ventilation-considerations-for-definitional-criteria
#12
Michaël Sauthier, Louise Rose, Philippe Jouvet
BACKGROUND: A 2005 consensus conference led by the National Association for Medical Direction of Respiratory Care (NAMDRC) defined prolonged mechanical ventilation (PMV) for adults as invasive and/or noninvasive mechanical ventilation (NIV) for ≥ 21 consecutive days for ≥ 6 h/d. In children, no such consensus definition exists. This results in substantial variability in definitional criteria, making study of the impact and outcomes of PMV across and within settings problematic. The objective of this work was to identify how PMV for children and neonates is described in the literature and to outline pediatric/neonatal considerations related to PMV, with the goal of proposing a pediatric/neonatal adaptation to the NAMDRC definition...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/27879380/performance-of-leak-compensation-in-all-age-icu-ventilators-during-volume-targeted-neonatal-ventilation-a-lung-model-study
#13
Taiga Itagaki, Desmond J Bennett, Christopher T Chenelle, Daniel F Fisher, Robert M Kacmarek
BACKGROUND: Volume-targeted ventilation is increasingly used in low birthweight infants because of the potential for reducing volutrauma and avoiding hypocapnea. However, it is not known what level of air leak is acceptable during neonatal volume-targeted ventilation when leak compensation is activated concurrently. METHODS: Four ICU ventilators (Servo-i, PB980, V500, and Avea) were compared in available invasive volume-targeted ventilation modes (pressure control continuous spontaneous ventilation [PC-CSV] and pressure control continuous mandatory ventilation [PC-CMV])...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/27878783/prediction-of-significant-hyperbilirubinemia-in-term-neonates-by-early-non-invasive-bilirubin-measurement
#14
Manish Jain, Akash Bang, Anju Tiwari, Shuchi Jain
BACKGROUND: Neonatal jaundice is a common problem. We evaluated the utility and best cut-off values of 24-and 48-hour transcutaneous bilirubin indices (TcBI) in predicting subsequent significant hyperbilirubinemia and evaluated various associated maternal and fetal risk factors. METHODS: TcBI at 24 and 48 hours and serum bilirubin levels at 72 hours of age were obtained for healthy, term, appropriate for gestational age neonates. Neonates with prematurity, birth weight <2500 g, ABO or Rh incompatibility, onset of clinical jaundice <24 hours, clinical suspicion of septicemia, positive pressure ventilation at birth, admission in neonatal intensive care unit and contraindications for BiliChek were excluded...
November 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27852668/less-invasive-surfactant-administration-versus-intubation-for-surfactant-delivery-in-preterm-infants-with-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#15
REVIEW
Jose C Aldana-Aguirre, Merlin Pinto, Robin M Featherstone, Manoj Kumar
CONTEXT: In spontaneously breathing preterm infants with respiratory distress syndrome (RDS) receiving nasal continuous positive airway pressure, a method of less invasive surfactant administration (LISA) using a thin catheter has been described as an alternative to endotracheal intubation for surfactant delivery to reduce lung injury. OBJECTIVE: A systematic review of randomised controlled trials (RCTs) comparing LISA with the standard method of surfactant delivery for clinical outcomes...
January 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27808413/a-new-solution-for-neonatal-bilateral-vocal-cord-paralysis-endoscopic-arytenoid-abduction-lateropexy
#16
Shahram Madani, Ádám Bach, Vera Matievics, Eszter Erdélyi, Balázs Sztanó, Ilona Szegesdi, Paul F Castellanos, László Rovó
OBJECTIVES/HYPOTHESIS: Bilateral vocal cord paralysis in early childhood is a life-threatening condition, which often requires immediate intervention. One of the treatment options is a quick, reversible simple suture vocal cord lateralizing technique, whereby the arytenoid cartilage is directly lateralized to the normal abducted position. Considering pediatric laryngeal anatomy, a small endolaryngeal thread guide instrument was designed for precise suture insertion. STUDY DESIGN: New instrument validation...
November 3, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27783410/survey-of-noninvasive-respiratory-support-practices-in-canadian-neonatal-intensive-care-units
#17
Amit Mukerji, Prakesh S Shah, Sandesh Shivananda, Wendy Yee, Brooke Read, John Minski, Ruben Alvaro, Christoph Fusch
AIM: To evaluate practice variation with respect to noninvasive respiratory support (NRS) use across Canadian neonatal intensive care units (NICUs). METHODS: A web-based survey was sent to all site investigators of the 30 level 3 NICUs participating in the Canadian Neonatal Network. The survey inquired about the use of five commonly described NRS modes. In addition, the presence and adherence to local guidelines were ascertained. Descriptive analyses were performed to identify variations in practice...
October 26, 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27752095/paradoxical-diurnal-cortisol-changes-in-neonates-suggesting-preservation-of-foetal-adrenal-rhythms
#18
Masahiro Kinoshita, Sachiko Iwata, Hisayoshi Okamura, Mamoru Saikusa, Naoko Hara, Chihoko Urata, Yuko Araki, Osuke Iwata
Studies suggested the presence of foetal adrenal rhythms of cortisol, which are entrained in antiphase to maternal rhythms. In contrast, neonates are thought to have no adrenal rhythm until 2-3 months after birth. To test the hypothesis that a foetal-type adrenal rhythm is preserved after birth, saliva samples were collected from 65 preterm/term infants during hospital stay (30-40 weeks corrected age) at 10:00 and 19:00 h. Cortisol levels were assessed for their diurnal difference and dependence on antenatal/postnatal clinical variables...
October 18, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27750254/temporal-profile-of-circulating-micrornas-after-global-hypoxia-ischemia-in-newborn-piglets
#19
Håvard Tetlie Garberg, Marianne U Huun, Lars O Baumbusch, Monica Åsegg-Atneosen, Rønnaug Solberg, Ola Didrik Saugstad
BACKGROUND: There is a lack of reliable biomarkers that can identify and grade acute hypoxic-ischemic encephalopathy in newborns. MicroRNAs (miRNA) are short, non-coding strands of RNA that are released into the circulation in response to tissue stress and injury. Some miRNAs are highly tissue specific and thus may potentially be non-invasive biomarkers of neonatal hypoxic-ischemic brain injury. OBJECTIVE: The aim of this study was to characterize the temporal expression of selected circulating miRNAs in a clinically relevant piglet model of neonatal hypoxia-ischemia (HI)...
2017: Neonatology
https://www.readbyqxmd.com/read/27711045/non-invasive-inhaled-nitric-oxide-in-the-treatment-of-hypoxemic-respiratory-failure-in-term-and-preterm-infants
#20
R Sahni, X Ameer, K Ohira-Kist, J-T Wung
OBJECTIVES: Inhaled nitric oxide (iNO) is effective in conjunction with tracheal intubation (TI) and mechanical ventilation (MV) for treating arterial pulmonary hypertension and hypoxemic respiratory failure (HRF) in near-term and term newborns. Non-invasive respiratory support with nasal continuous positive airway pressure (CPAP) is increasingly used to avoid morbidity associated with TI and MV, yet the effectiveness of iNO delivery via nasal CPAP remains unknown. To evaluate the effectiveness of iNO delivered via the bubble nasal CPAP system in term and preterm newborns with HRF...
January 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
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