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Ventilation AND preterm

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https://www.readbyqxmd.com/read/28625498/the-impact-of-routine-evaluation-of-gastric-residual-volumes-on-the-time-to-achieve-full-enteral-feeding-in-preterm-infants
#1
Arieh Riskin, Keren Cohen, Amir Kugelman, Arina Toropine, Waseem Said, David Bader
OBJECTIVE: To evaluate the time to full enteral feedings in preterm infants after a practice change from routine evaluation of gastric residual volume before each feeding to selective evaluation of gastric residual volume , and to evaluate the impact of this change on the incidence of necrotizing enterocolitis (NEC). STUDY DESIGN: Data were collected on all gavage-fed infants born at ≤34 weeks gestational age (GA) for 2 years before (n = 239) and 2 years after the change (n = 233)...
June 15, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28614994/are-preterm-born-survivors-at-risk-of-long-term-respiratory-disease
#2
Katarzyna Kaczmarczyk, Ida Wiszomirska, Magdalena Szturmowicz, Andrzej Magiera, Michalina Błażkiewicz
BACKGROUND: To evaluate the long-term impact of preterm birth on respiratory function in female patients born preterm, we undertook spirometric examinations twice, as they reached the age of puberty, then follow-up examinations of part of the same cohort in adulthood. We sought evidence that preterm birth is correlated with poorer spirometric results into adulthood. METHODS: A total of 70 girls (aged 12.2 ± 1.5 years in 1997) who had been born preterm (at 34.7 ± 1...
July 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28609542/effect-of-single-use-laser-cut-slow-flow-nipples-on-respiration-and-milk-ingestion-in-preterm-infants
#3
Katlyn E McGrattan, David H McFarland, Jesse C Dean, Elizabeth Hill, David R White, Bonnie Martin-Harris
Purpose: Single-use, laser-cut, slow-flow nipples were evaluated for their effect on respiration and milk ingestion in 13 healthy preterm infants (32.7-37.1 weeks postmenstrual age) under nonlaboratory, clinical conditions. Method: The primary outcomes of minute ventilation and overall milk transfer were measured by using integrated nasal airflow and volume-calibrated bottles during suck bursts and suck burst breaks during slow-flow and standard-flow nipple bottle feedings...
June 13, 2017: American Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28603716/optimizing-nutrition-in-preterm-low-birth-weight-infants-consensus-summary
#4
REVIEW
R Kishore Kumar, Atul Singhal, Umesh Vaidya, Saswata Banerjee, Fahmina Anwar, Shashidhar Rao
Preterm birth survivors are at a higher risk of growth and developmental disabilities compared to their term counterparts. Development of strategies to lower the complications of preterm birth forms the rising need of the hour. Appropriate nutrition is essential for the growth and development of preterm infants. Early administration of optimal nutrition to preterm birth survivors lowers the risk of adverse health outcomes and improves cognition in adulthood. A group of neonatologists, pediatricians, and nutrition experts convened to discuss and frame evidence-based recommendations for optimizing nutrition in preterm low birth weight (LBW) infants...
2017: Frontiers in Nutrition
https://www.readbyqxmd.com/read/28601870/restricted-ventilation-associated-with-reduced-neurodevelopmental-impairment-in-preterm-infants
#5
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/28596379/using-exhaled-co2-to-guide-initial-respiratory-support-at-birth-a-randomised-controlled-trial
#6
Ashley Y Ngan, Po-Yin Cheung, Ann Hudson-Mason, Megan O'Reilly, Sylvia van Os, Manoj Kumar, Khalid Aziz, Georg M Schmölzer
IMPORTANCE: A sustained inflation (SI) provided at birth might reduce bronchopulmonary dysplasia (BPD). OBJECTIVE: This study aims to examine whether an SI-guided exhaled carbon dioxide (ECO2) compared with positive pressure ventilation (PPV) alone at birth decreases BPD. DESIGN: Randomised controlled trial. Infants were randomly allocated to either SI (SI group) or PPV (PPV group). PARTICIPANTS: Participants of this study include infants between 23(+0) and 32(+6) weeks gestation with a need for PPV at birth...
June 8, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28589122/the-future-of-bronchopulmonary-dysplasia-emerging-pathophysiological-concepts-and-potential-new-avenues-of-treatment
#7
REVIEW
Jennifer J P Collins, Dick Tibboel, Ismé M de Kleer, Irwin K M Reiss, Robbert J Rottier
Yearly more than 15 million babies are born premature (<37 weeks gestational age), accounting for more than 1 in 10 births worldwide. Lung injury caused by maternal chorioamnionitis or preeclampsia, postnatal ventilation, hyperoxia, or inflammation can lead to the development of bronchopulmonary dysplasia (BPD), one of the most common adverse outcomes in these preterm neonates. BPD patients have an arrest in alveolar and microvascular development and more frequently develop asthma and early-onset emphysema as they age...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28578361/current-umbilical-cord-clamping-practices-and-attitudes-of-obstetricians-and-midwives-toward-delayed-cord-clamping-in-saudi-arabia
#8
Nadia O Ibrahim, Hatouf H Sukkarieh, Rami T Bustami, Elaf A Alshammari, Lama Y Alasmari, Hanan M Al-Kadri
BACKGROUND: In Saudi Arabia, as in many countries, there is usually no clear definition of the timing of umbilical cord clamping (UCC) in the policies and procedures used by hospitals. The World Health Organization (WHO) recommends delayed cord clamping (DCC) ( > 1 minute after birth) as it can significantly improve hemodynamics and long-term neurodevelopment. OBJECTIVE: To investigate current practices of healthcare professionals on the timing of UCC in Saudi Arabia...
May 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28578157/carbon-dioxide-fluctuations-are-associated-with-changes-in-cerebral-oxygenation-and-electrical-activity-in-infants-born-preterm
#9
Laura Marie Louise Dix, Lauren Carleen Weeke, Linda Simone de Vries, Floris Groenendaal, Willem Baerts, Frank van Bel, Petra Maria Anna Lemmers
OBJECTIVES: To evaluate the effects of acute arterial carbon dioxide partial pressure changes on cerebral oxygenation and electrical activity in infants born preterm. STUDY DESIGN: This retrospective observational study included ventilated infants born preterm with acute fluctuations of continuous end-tidal CO2 (etCO2) as a surrogate marker for arterial carbon dioxide partial pressure, during the first 72 hours of life. Regional cerebral oxygen saturation and fractional tissue oxygen extraction were monitored with near-infrared spectroscopy...
May 31, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28569744/delivery-room-interventions-to-prevent-bronchopulmonary-dysplasia-in-extremely-preterm-infants
#10
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/28567320/pneumoperitoneum-without-intestinal-perforation-in-a-neonate-case-report-and-literature-review
#11
Prabhavathi Gummalla, Gratias Mundakel, Maksim Agaronov, Haesoon Lee
Pneumoperitoneum in a preterm neonate usually indicates perforation of the intestine and is considered a surgical emergency. However, there are cases of pneumoperitoneum with no evidence of rupture of the intestine reported in the literature. We report a case of pneumoperitoneum with no intestinal perforation in a preterm neonate with respiratory distress syndrome who was on high frequency oscillatory ventilation (HFOV). He developed bilateral pulmonary interstitial emphysema with localized cystic lesion, likely localized pulmonary interstitial emphysema, and recurrent pneumothoraces...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28559463/development-and-testing-of-a-bubble-bi-level-positive-airway-pressure-system
#12
Stephen C John, Joseph D Barnett, Nickolas D Habben, Hoa T Le, Eric Cheng, Sunil P John, Peter A Gustafson
BACKGROUND: Neonatal respiratory distress results in > 1 million annual deaths worldwide. Bubble CPAP is a simple, effective, and widely used therapy for infants in respiratory distress. In low-resource settings, more advanced respiratory support is limited by cost, technical expertise, and sporadic electricity. We sought to develop a safe, inexpensive, and simple solution to provide further respiratory support for these infants. METHODS: A standard bubble CPAP system was modified to provide 2 levels of positive airway pressure (bi-level positive airway pressure) by attaching a novel device...
May 30, 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
#13
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/28538237/update-on-postnatal-steroids
#14
Henry L Halliday
Antenatal steroid treatment to enhance fetal lung maturity and surfactant treatment to prevent or treat respiratory distress syndrome have been major advances in perinatal medicine in the past 40 years contributing to improved outcomes for preterm infants. Use of postnatal steroids to prevent or treat chronic lung disease in preterm infants has been less successful and associated with adverse neurodevelopmental outcomes. Although early (in the first week of life) postnatal steroid treatment facilitates earlier extubation and reduces the risk of chronic lung disease, it is associated with adverse effects, such as hyperglycemia, hypertension, gastrointestinal bleeding and perforation, hypertrophic cardiomyopathy, growth failure, and cerebral palsy, and cannot be recommended...
2017: Neonatology
https://www.readbyqxmd.com/read/28538236/surfactant-for-respiratory-distress-syndrome-new-ideas-on-a-familiar-drug-with-innovative-applications
#15
H J Niemarkt, M C Hütten, Boris W Kramer
In the last 4 decades, advances in neonatology have led to a significant increase in the survival of preterm infants. One of the biggest advances was the introduction of surfactant replacement therapy for the treatment of respiratory distress syndrome. This is the main cause of respiratory insufficiency in preterm infants and is one of the major causes of perinatal morbidity and mortality. Surfactant replacement therapy is already a well-investigated and established therapy in neonatology. However, surfactant replacement therapy has progressed and been refined over recent decades, especially with the increasing care for preterm infants born before 26 weeks' gestational age and the recent clinical focus on avoiding mechanical ventilation...
2017: Neonatology
https://www.readbyqxmd.com/read/28538235/what-should-we-do-about-low-blood-pressure-in-preterm-infants
#16
Eugene M Dempsey
The management of preterm infants with low blood pressure soon after birth remains unresolved. The definition of what constitutes low blood pressure is uncertain. At birth, mean blood pressure appears to be gestation specific and increases in the first few days of life. Antenatal steroids, delayed cord clamping, and the avoidance of mechanical ventilation are all associated with higher mean blood pressure and less hypotension after birth. Rates of hypotension of 15-50% have been reported in various studies of extremely preterm infants...
2017: Neonatology
https://www.readbyqxmd.com/read/28492159/iloprost-instillation-in-two-neonates-with-pulmonary-hypertension
#17
Sezin Unal, Selma Aktas, Meltem Aksu, Ibrahim M Hirfanoglu, Yildiz Atalay, Canan Turkyilmaz
Pulmonary hypertension may coexist with certain diseases in neonates. Iloprost inhalation is one of the treatments which cause selective pulmonary vasodilatation. Inhalation is not an easy way of drug administration in mechanically ventilated infants; as some exhibit desaturations during inhalation. Moreover, inhalation of drug requires cessation of mechanical ventilation, if patient is on high frequency oscillatory ventilation. We presented two patients with pulmonary hypertension; term baby with congenital diaphragmatic hernia and preterm baby with respiratory distress syndrome; who had iloprost instillation during mechanical ventilation treatment...
April 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28488361/clonidine-for-sedation-and-analgesia-for-neonates-receiving-mechanical-ventilation
#18
REVIEW
Olga Romantsik, Maria Grazia Calevo, Elisabeth Norman, Matteo Bruschettini
BACKGROUND: Although routine administration of pharmacologic sedation or analgesia during mechanical ventilation in preterm neonates is not recommended, its use in clinical practice remains common. Alpha-2 agonists, mainly clonidine and dexmedetomidine, are used as adjunctive (or alternative) sedative agents alongside opioids and benzodiazepines. Clonidine has not been systematically assessed for use in neonatal sedation during ventilation. OBJECTIVES: To assess whether clonidine administered to term and preterm newborn infants receiving mechanical ventilation reduces morbidity and mortality rates...
May 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28487624/clara-cell-protein-expression-in-mechanically-ventilated-term-and-preterm-infants-with-respiratory-distress-syndrome-and-at-risk-of-bronchopulmonary-dysplasia-a-pilot-study
#19
José Guzmán-Bárcenas, Antonio Calderón-Moore, Héctor Baptista-González, Claudine Irles
The aim of this pilot study was to determine Clara cell protein (CC16) concentration in bronchoalveolar lavages (BAL) fluid from full-term and preterm (<37 weeks' gestational age) neonates requiring respiratory support, having symptoms of neonatal respiratory distress syndrome, and at risk of bronchopulmonary dysplasia (BPD). We hypothesized that CC16 may be predictive of BPD diagnosis regardless of gestational age. BAL fluid CC16 was measured by ELISA at birth and at day 7 of life. Both groups that developed BPD showed significantly decreased BAL fluid CC16 levels compared to those infants that did not develop the disease...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28486543/preterm-brain-injury-on-term-equivalent-age-mri-in-relation-to-perinatal-factors-and-neurodevelopmental-outcome-at-two-years
#20
Margaretha J Brouwer, Karina J Kersbergen, Britt J M van Kooij, Manon J N L Benders, Ingrid C van Haastert, Corine Koopman-Esseboom, Jeffrey J Neil, Linda S de Vries, Hiroyuki Kidokoro, Terrie E Inder, Floris Groenendaal
OBJECTIVES: First, to apply a recently extended scoring system for preterm brain injury at term-equivalent age (TEA-)MRI in a regional extremely preterm cohort; second, to identify independent perinatal factors associated with this score; and third, to assess the prognostic value of this TEA-MRI score with respect to early neurodevelopmental outcome. STUDY DESIGN: 239 extremely preterm infants (median gestational age [range] in weeks: 26.6 [24.3-27.9]), admitted to the Wilhelmina Children's Hospital between 2006 and 2012 were included...
2017: PloS One
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