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Invasive ventilation neonates

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
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...
February 23, 2018: Anesthesia and Analgesia
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...
February 19, 2018: European Journal of Pediatric Surgery
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
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
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
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
Theodore Dassios, Ourania Kaltsogianni, Miltiadis Krokidis, Ann Hickey, Anne Greenough
We hypothesised that extremely premature infants would have decreased muscle mass at term-corrected age compared to term-born infants and that the degree of reduced muscle mass acquisition would correlate with the duration of invasive mechanical ventilation. The MRI brain scans of infants admitted in the neonatal unit at King's College Hospital between 1 January 2010 and 1 June 2016 were retrospectively reviewed. The coronal cross-sectional area of the left deltoid muscle (DCSA) was measured in 17 infants born < 28 weeks of gestation and in 20 infants born at term...
January 19, 2018: European Journal of Pediatrics
(no author information available yet)
OBJECTIVE: Mechanical ventilation (MV) in preterm infants (PTI) causes discomfort. Whether it causes pain is controversial. Meta analysis reviews of published work on PTI during MV have shown no clinically significant impact of opioids on pain scales, and hence not recommended for routine use in neonatal intensive care units (NICUs). Similarly regular use of sedative midazolam is also not recommended. Therefore we hypothesized a downward trend in narcotics and sedatives used in MV of PTI in NICUs...
January 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Vera Lucia Barros Abelenda, Tania Cristina Oliveira Valente, Cirlene Lima Marinho, Agnaldo José Lopes
The development of less invasive ventilatory strategies in very-low-birth-weight (VLBW) preterm newborns has been a growing concern in recent decades. This study aimed to measure differences in the clinical progression of preterm newborns using two distinct periods in a university hospital: before and after using underwater bubble continuous positive airway pressure (ubCPAP). This is a retrospective study of VLBW preterm newborns with gestational ages less than or equal to 32 weeks admitted to the neonatal intensive care unit...
January 1, 2018: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
Carmen Rey-Santano, Victoria E Mielgo, Miguel Angel Gomez-Solaetxe, Francesca Ricci, Federico Bianco, Fabrizio Salomone, Begoña Loureiro, Jon López de Heredia Y Goya
BACKGROUND: Nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV), forms of non-invasive ventilation (NIV) for respiratory support, are increasingly being chosen as the initial treatment for neonates with surfactant (SF) deficiency. Our objective was to compare NCPAP with NIPPV with or without SF administration as a primary mode of ventilation. METHODS: Twenty-four newborn piglets with SF-deficient lung injury produced by repetitive bronchoalveolar lavages were randomly assigned to NCPAP or NIPPV, with or without SF administration (InSurE method)...
January 10, 2018: Pediatric Research
Antonio Di Mauro, Manuela Capozza, Sergio Cotugno, Silvio Tafuri, Francesco Paolo Bianchi, Federico Schettini, Raffaella Panza, Nicola Laforgia
BACKGROUND: Pulmonary disorders and respiratory failure represent one of the most common morbidities of preterm newborns admitted to neonatal intensive care units (NICUs). The use of nasal high-flow therapy (nHFT) has been more recently introduced into the NICUs as a non-invasive respiratory (NIV) support. METHODS: We performed a retrospective study to evaluate safety and effectiveness of nHFT as primary support for infants born < 29 weeks of gestation and/or VLBW presenting with mild Respiratory Distress Syndrome (RDS)...
December 28, 2017: Italian Journal of Pediatrics
Maria Katarzyna Borszewska-Kornacka, Roman Hożejowski, Magdalena Rutkowska, Ryszard Lauterbach
BACKGROUND: There is growing evidence that supports the benefits of early use of caffeine in preterm neonates with RDS; however, no formal recommendations specifying the exact timing of therapy initiation have been provided. OBJECTIVES: We compared neonatal outcomes in infants receiving early (initial dose on the 1st day of life) and late (initial dose on day 2+ of life) caffeine therapy. METHODS: Using data from a prospective, cohort study, we identified 986 infants ≤32 weeks' gestation with RDS and assessed the timing of caffeine therapy initiation, need for ventilatory support, mortality and incidence of typical complications of prematurity...
2017: PloS One
Savita Bhunwal, Kanya Mukhopadhyay, Shalmoli Bhattacharya, Pranab Dey, Lakhbir Kaur Dhaliwal
OBJECTIVE: To find out the incidence and associations of bronchopulmonary dysplasia (BPD) in preterm neonates. DESIGN: Prospective, observational. METHODS: All consecutively born neonates <33 weeks gestation requiring oxygen or respiratory support first 3 days of life were enrolled from a level III neonatal unit in Chandigarh, India. Those with malformations were excluded. Placenta was examined for histological chorioamnionitis in preterm rupture of membranes and/or preterm spontaneous onset of labour...
December 14, 2017: Indian Pediatrics
Alice Miranda, Susana Roque, José M Pêgo, Jorge Correia-Pinto
BACKGROUND: Laparoscopy is becoming more common in neonates. However, concerns remain about the impact of the carbon-dioxide (CO2 )-insufflation over the neonatal brain. We aim to evaluate the peripheral (serum) and central (cerebrospinal fluid [CSF]) cytokine response after neonatal CO2 -pneumoperitoneum and its impact over neurodevelopmental milestones acquisition and long-term behavioral outcomes. MATERIALS AND METHODS: Rats were subjected to a systematic assessment of neurodevelopmental milestones between postnatal day 1 (PND 1) and PND 21...
January 2018: Journal of Surgical Research
Jad Jabbour, Thomas Robey
INTRODUCTION: Vocal fold immobility (VFI) is an important sequela of preterm birth due to patent ductus arteriosus (PDA) ligation and invasive ventilation. A minority of these patients experience VFI resolution. The purpose of this study is to determine factors associated with VFI resolution in preterm infants. METHODS: This is a case control study of preterm (<37 weeks gestation) infants admitted to a metropolitan Level IV neonatal intensive care unit from 2006 to 2012...
December 2017: International Journal of Pediatric Otorhinolaryngology
Aakash Pandita, Srinivas Murki, Tejo Pratap Oleti, Baswaraj Tandur, Sai Kiran, Sachin Narkhede, Amrut Prajapati
Importance: Nasal continuous positive airway pressure (NCPAP) as a primary respiratory therapy in meconium aspiration syndrome (MAS) has not been studied extensively. Nasal continuous positive airway pressure, when applied in newborns with MAS, may resolve atelectasis by sufficiently expanding partially obstructed small airways and stabilizing the collapsing terminal airways to enhance oxygen exchange. Objective: To compare NCPAP vs standard care in neonates with moderate to severe respiratory failure due to MAS in reducing the need for invasive ventilation...
February 1, 2018: JAMA Pediatrics
Young-Bin Choi, Juyoung Lee, Jisun Park, Yong Hoon Jun
OBJECTIVE: To evaluate the in-hospital consequences of prolonged respiratory support with invasive mechanical ventilation in very low birth weight infants. STUDY DESIGN: A cohort study was performed using prospectively collected data from 69 neonatal intensive care units participating in the Korean national registry. In total, 3508 very low birth weight infants born between January 1, 2013 and December 31, 2014 were reviewed. RESULTS: The adjusted hazard ratio for death increased significantly for infants who received mechanical ventilation for more than 2 weeks compared with those were mechanically ventilated for 7 days or less...
March 2018: Journal of Pediatrics
Gilles Jourdain, Marie De Tersant, Valentina Dell'Orto, Giorgio Conti, Daniele De Luca
OBJECTIVE: We sought to investigate the pressure delivery during less invasive surfactant administration, as we hypothesize that it might be reduced. STUDY DESIGN: Physiologic in vitro study in a ventilation lab, using different pressure generators, levels, and leaks in a model of neonatal airways/lung mimicking mechanical characteristics of respiratory distress syndrome. Pressure was measured at the lung and verified in vivo measuring pharyngeal pressure in 19 neonates under same conditions...
December 1, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
Pradeep V Mally, Jennifer Beck, Christer Sinderby, Martha Caprio, Sean M Bailey
OBJECTIVE: To compare neurally adjusted ventilatory assist and conventional ventilation on patient-ventilator interaction and neural breathing patterns, with a focus on central apnea in preterm infants. DESIGN: Prospective, observational cross-over study of intubated and ventilated newborns. Data were collected while infants were successively ventilated with three different ventilator conditions (30 min each period): 1) synchronized intermittent mandatory ventilation (SIMV) combined with pressure support at the clinically prescribed, SIMV with baseline settings (SIMVBL), 2) neurally adjusted ventilatory assist, 3) same as SIMVBL, but with an adjustment of the inspiratory time of the mandatory breaths (SIMV with adjusted settings [SIMVADJ]) using feedback from the electrical activity of the diaphragm)...
January 2018: Pediatric Critical Care Medicine
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