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Meconium aspiration syndrom

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https://www.readbyqxmd.com/read/29420583/controlled-hypothermia-may-improve-surfactant-function-in-asphyxiated-neonates-with-or-without-meconium-aspiration-syndrome
#1
Chiara Autilio, Mercedes Echaide, Daniele De Luca, Jesús Pérez-Gil
BACKGROUND: Whole-body hypothermia (WBH) is used to improve neurological outcomes in perinatal asphyxia. Recent studies suggested a beneficial effect of hypothermia for some types of acute respiratory failure. However, no data are available about the biophysical function of human surfactant during WBH. We investigated whether WBH improves surfactant biophysical properties in asphyxiated neonates with or without meconium aspiration syndrome (MAS). METHODS: Non-bronchoscopic bronchoalveolar lavage (BAL) has been collected from 10 asphyxiated neonates (2 with MAS, 8 with no lung disease (NLD)) at different time-points (pre-WBH, 24h, 48h, 72h of WBH and post-WBH)...
2018: PloS One
https://www.readbyqxmd.com/read/29341045/approach-to-infants-born-through-meconium-stained-amniotic-fluid-evolution-based-on-evidence
#2
Munmun Rawat, Sushma Nangia, Praveen Chandrasekharan, Satyan Lakshminrusimha
Meconium-stained amniotic fluid (MSAF) during delivery is a marker of fetal stress. Neonates born through MSAF often need resuscitation and are at risk of meconium aspiration syndrome (MAS), air leaks, hypoxic-ischemic encephalopathy, extracorporeal membrane oxygenation (ECMO), and death. The neonatal resuscitation approach to MSAF has evolved over the last three decades. Previously, nonvigorous neonates soon after delivery were suctioned under the vocal cords with direct visualization technique using a meconium aspirator...
January 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29324051/anti-il-8-antibody-potentiates-the-effect-of-exogenous-surfactant-in-respiratory-failure-caused-by-meconium-aspiration
#3
Pavol Mikolka, Jana Kopincova, Petra Kosutova, Maros Kolomaznik, Andrea Calkovska, Daniela Mokra
AIM: Meconium aspiration syndrome (MAS) is life-threatening respiratory failure of newborns which can be treated by exogenous surfactant. In response to meconium, increased levels of chemokine IL-8 (CXCL8) stimulate massive neutrophil infiltration of the lungs. Local accumulation and activation of neutrophils, on-going inflammation, lung edema, and oxidative damage contribute to inactivation of endogenous and therapeutically given surfactants. Therefore, we have hypothesized that addition of monoclonal anti-IL-8 antibody into exogenous surfactant can mitigate the neutrophil-induced local injury and the secondary surfactant inactivation and may finally result in improvement of respiratory functions...
January 11, 2018: Experimental Lung Research
https://www.readbyqxmd.com/read/29319634/hyperoxia-and-hypocapnia-during-pediatric-extracorporeal-membrane-oxygenation-associations-with-complications-mortality-and-functional-status-among-survivors
#4
Katherine Cashen, Ron Reeder, Heidi J Dalton, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, J Michael Dean, Robert Tamburro, Kathleen L Meert
OBJECTIVES: To determine the frequency of hyperoxia and hypocapnia during pediatric extracorporeal membrane oxygenation and their relationships to complications, mortality, and functional status among survivors. DESIGN: Secondary analysis of data collected prospectively by the Collaborative Pediatric Critical Care Research Network. SETTING: Eight Collaborative Pediatric Critical Care Research Network-affiliated hospitals. PATIENTS: Age less than 19 years and treated with extracorporeal membrane oxygenation...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29287296/risk-of-neonatal-neurologic-morbidity-in-advancing-term-gestations
#5
Adam K Lewkowitz, Molly J Stout, Methodius G Tuuli, Julia D López, George A Macones, Alison G Cahill
OBJECTIVE:  Placental insufficiency is associated with neonatal neurologic morbidity and late-term gestations (410/7-416/7 weeks). Whether late-term infants are at increased risk of neurologic morbidity compared with term infants (390/7-406/7 weeks) remains unclear. We aim to compare risk of neurologic morbidity among late-term and term infants. STUDY DESIGN:  This secondary analysis of a single-institution prospective cohort study included all liveborn, nonanomalous singleton term and late-term infants, with data on adverse neonatal outcomes up until 28 days of life...
December 29, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/29287292/procalcitonin-as-predictor-of-bacterial-infection-in-meconium-aspiration-syndrome
#6
Mahendiran K, Prerna Batra, M M A Faridi, N P Singh
BACKGROUND:  There is a lack of definite consensus on indications for initiating antibiotics in neonates with meconium aspiration syndrome (MAS), instigating researchers to search for a biomarker that can help differentiate MAS from MAS with bacterial infection. OBJECTIVE:  Our primary objective was to compare serum procalcitonin (PCT) levels in full-term vigorous neonates having MAS with or without bacterial infection. MATERIALS AND METHODS:  Seventy term vigorous neonates with diagnosis of MAS were enrolled...
December 29, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/29248183/is-extracorporeal-membrane-oxygenation-for-a-neonate-ever-ethically-obligatory
#7
Steven M Peterec, Matthew J Bizzarro, Mark R Mercurio
Certain interventions in the neonatal intensive care unit are considered ethically obligatory, and should be provided over parental objections. After reviewing a case, comparative outcome data, and relevant ethical principles, we propose that extracorporeal membrane oxygenation for meconium aspiration syndrome may, in some cases, be an ethically obligatory treatment.
December 13, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29219011/meconium-aspiration-syndrome-risk-factors-and-predictors-of-severity
#8
Cláudia Patrícia Lourenço Oliveira, Filipa Flôr-de-Lima, Gustavo Marcondes Duarte Rocha, Ana Paula Machado, Maria Hercília Ferreira Guimarães Pereira Areias
PURPOSE: To identify risk factors and predictors of severity associated with meconium aspiration syndrome (MAS) in the patients admitted to the neonatal intensive care unit (NICU). MATERIALS AND METHODS: Retrospective study including newborns admitted, between 2005 and 2015, with a diagnosis of MAS. RESULTS: Of the newborns admitted to the NICU, 0.66% were diagnosed with MAS. These had higher prevalence of caesarean delivery (p < .001), nonreassuring or abnormal cardiotocography (CTG) (p < ...
December 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29218325/protection-of-meconium-induced-lung-epithelial-injury-by-protease-inhibitors
#9
C Ota, I Gopallawa, V Ivanov, I H Gewolb, B D Uhal
Earlier work form this laboratory showed that exposure of alveolar epithelial cells (AECs) to meconium caused significant cell detachment and that meconium-induced detachment of cells was prevented by a protease inhibitor cocktail. Therefore, it was hypothesized that protease inhibitors might protect AEC monolayers against meconium-induced collapse of epithelial barrier function both in vitro and in vivo. To investigate this theory in vitro, albumin flux was measured across cultured, confluent monolayers of human type II derived cell line A549 on microporous filter inserts...
2017: Journal of Lung, Pulmonary & Respiratory Research
https://www.readbyqxmd.com/read/29204652/effect-of-nasal-continuous-positive-airway-pressure-on-infants-with-meconium-aspiration-syndrome-a-randomized-clinical-trial
#10
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
https://www.readbyqxmd.com/read/29136007/perinatal-mortality-associated-with-induction-of-labour-versus-expectant-management-in-nulliparous-women-aged-35-years-or-over-an-english-national-cohort-study
#11
COMPARATIVE STUDY
Hannah E Knight, David A Cromwell, Ipek Gurol-Urganci, Katie Harron, Jan H van der Meulen, Gordon C S Smith
BACKGROUND: A recent randomised controlled trial (RCT) demonstrated that induction of labour at 39 weeks of gestational age has no short-term adverse effect on the mother or infant among nulliparous women aged ≥35 years. However, the trial was underpowered to address the effect of routine induction of labour on the risk of perinatal death. We aimed to determine the association between induction of labour at ≥39 weeks and the risk of perinatal mortality among nulliparous women aged ≥35 years...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29103350/cesarean-section-in-the-absence-of-labor-and-risk-of-respiratory-complications-in-newborns-a-case-control-study
#12
Ugo Indraccolo, Margherita Pace, Giovanna Corona, Marco Bonito, Salvatore Renato Indraccolo, Romolo Di Iorio
AIM: To establish if labor and gestational age have an additive effect on the likelihood of newborn respiratory complications. METHODS: Case-control study on singleton pregnancies, delivered between 34 and 41 weeks. Cases were collected among newborns discharged with diagnoses of respiratory complications, as codified by ICD 9 1997. Subsequently, pneumonias, meconium aspiration syndromes, and pulmonary hemorrhage were excluded. Controls were all other newborns without respiratory complications...
November 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29095429/activation-of-toll-like-receptors-in-meconium-aspiration-syndrome
#13
V Anand, S Basu, S S Yadav, G Narayan, B D Bhatia, A Kumar
OBJECTIVE: Meconium aspiration syndrome (MAS) is a common cause of neonatal morbidity and mortality. Incomplete understanding of the pathogenesis of MAS has hindered the development of specific therapies. We hypothesized that activation of Toll-like receptors (TLRs) might play a role in the pathogenesis of MAS. The present study evaluated the expression of TLR 1, 4, 7, 8 and 9 in neonates with MAS. STUDY DESIGN: The study included 39 neonates with MAS and 17 healthy gestational age-matched neonates as controls...
February 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29043436/cervical-dilation-balloon-combined-with-intravenous-drip-of-oxytocin-for-induction-of-term-labor-a-multicenter-clinical-trial
#14
Xueqin Wu, Chunxiang Wang, Yufang Li, Chunmei Ouyang, Jiaying Liao, Weibin Cai, Yilei Zhong, Jianping Zhang, Hui Chen
OBJECTIVE: This study aimed to investigate the effectiveness and safety of a method combining double-balloon catheter for cervical ripening and intravenous drip of oxytocin on the induction of term labor, providing the reference for clinical safety. METHODS: A total of 120 pregnant women with a gestation between 37(+0) and  41(+6) weeks, indications of labor induction, singleton pregnancy with cephalic presentation were enrolled. The patients were divided into the research group receiving cervical dilation balloon combined with intravenous drip of oxytocin and the control group receiving an intravenous drip of oxytocin at a concentration of 0...
October 17, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29016584/morbidities-and-outcome-of-a-neonatal-intensive-care-in-western-nepal
#15
Sudhir Adhikari, Kalipatanam Seshagiri Rao, Ganesh B K, Namraj Bahadur
BACKGROUND: Neonatal mortality rate of developing countries is declining over decades. In the recent years increasing number of preterm and high risk neonates have facilities for tertiary care treatment. The aim of the study was to assess the morbidities and outcome of neonatal intensive care admissions. METHODS: It was a retrospective observational study carried out in neonatal intensive care unit of the Manipal Teaching Hospital, Pokhara, Nepal from January 2014 to December 2015...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28937237/selective-inhibition-of-nf-kappab-and-surfactant-therapy-in-experimental-meconium-induced-lung-injury
#16
J Kopincova, P Mikolka, M Kolomaznik, P Kosutova, A Calkovska, D Mokra
Meconium aspiration syndrome (MAS) in newborns is characterized mainly by respiratory failure due to surfactant dysfunction and inflammation. Previous meta-analyses did not prove any effect of exogenous surfactant treatment nor glucocorticoid administration on final outcome of children with MAS despite oxygenation improvement. As we supposed there is the need to intervene in both these fields simultaneously, we evaluated therapeutic effect of combination of exogenous surfactant and selective inhibitor of NF-kappaB (IKK-NBD peptide)...
September 22, 2017: Physiological Research
https://www.readbyqxmd.com/read/28937234/experimental-models-of-acute-lung-injury-in-the-newborns
#17
D Mokra, A Calkovska
Acute lung injury in the preterm newborns can originate from prematurity of the lung and insufficient synthesis of pulmonary surfactant. This situation is known as respiratory distress syndrome (RDS). In the term neonates, the respiratory insufficiency is related to a secondary inactivation of the pulmonary surfactant, for instance, by action of endotoxins in bacterial pneumonia or by effects of aspirated meconium. The use of experimental models of the mentioned situations provides new information on the pathophysiology of these disorders and offers unique possibility to test novel therapeutic approaches in the conditions which are very similar to the clinical syndromes...
September 22, 2017: Physiological Research
https://www.readbyqxmd.com/read/28923474/beyond-the-inhaled-nitric-oxide-in-persistent-pulmonary-hypertension-of-the-newborn
#18
REVIEW
Mei-Yin Lai, Shih-Ming Chu, Satyan Lakshminrusimha, Hung-Chih Lin
Persistent pulmonary hypertension (PPHN) is a consequence of failed pulmonary vascular transition at birth and leads to pulmonary hypertension with shunting of deoxygenated blood across the ductus arteriosus (DA) and foramen ovale (FO) resulting in severe hypoxemia, and it may eventually lead to life-threatening circulatory failure. PPHN is a serious event affecting both term and preterm infants in the neonatal intensive care unit. It is often associated with diseases such as congenital diaphragmatic hernia, meconium aspiration, sepsis, congenital pneumonia, birth asphyxia and respiratory distress syndrome...
August 10, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28922267/the-1-year-follow-up-clinic-for-neonates-and-children-after-respiratory-extracorporeal-membrane-oxygenation-support-a-10-year-single-institution-experience
#19
Suzan Kakat, Maura O'Callaghan, Liz Smith, Raymond Hreiche, Deborah A Ridout, Jo Wray, Timothy Thiruchelvam, Katherine L Brown, Aparna U Hoskote
OBJECTIVES: To establish the effectiveness of a "1-year extracorporeal membrane oxygenation follow-up clinic" and to characterize any neurodevelopmental concerns identified. DESIGN: Single-center retrospective cohort of respiratory extracorporeal membrane oxygenation survivors over 10 years. SETTING: Nationally commissioned center for neonatal and pediatric (> 28 d of life) respiratory extracorporeal membrane oxygenation. PATIENTS: Children attending the follow-up clinic 1 year after receiving respiratory extracorporeal membrane oxygenation between 2003 and 2013...
November 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28832917/propensity-score-method-for-analyzing-the-effect-of-labor-induction-in-prolonged-pregnancy
#20
Aura Pyykönen, Anna-Maija Tapper, Mika Gissler, Jari Haukka, Jari Petäjä, Lasse Lehtonen
There is an ongoing debate on the optimal time of labor induction to reduce the risks associated with prolonged pregnancy MATERIAL AND METHODS: Registry-based study of 212,716 term, singleton cephalic deliveries between 2006 and 2012 in Finland comparing the outcomes of labor induction to those of expectant management in five three-day gestational age periods between 40 and 42 weeks (Group 1:40+0-40+2; 2:40+3-40+5;3: 40+6-41+1;4: 41+2-41+4;5: 41+5-42+0). Using Poisson regression, induced deliveries in each of the gestational age periods were compared to all ongoing pregnancies...
August 21, 2017: Acta Obstetricia et Gynecologica Scandinavica
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