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Ventilation in neonates

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https://www.readbyqxmd.com/read/29234596/exploring-the-multiple-hit-hypothesis-of-preterm-white-matter-damage-using-diffusion-mri
#1
Madeleine L Barnett, Nora Tusor, Gareth Ball, Andrew Chew, Shona Falconer, Paul Aljabar, Jessica A Kimpton, Nigel Kennea, Mary Rutherford, A David Edwards, Serena J Counsell
Background: Preterm infants are at high risk of diffuse white matter injury and adverse neurodevelopmental outcome. The multiple hit hypothesis suggests that the risk of white matter injury increases with cumulative exposure to multiple perinatal risk factors. Our aim was to test this hypothesis in a large cohort of preterm infants using diffusion weighted magnetic resonance imaging (dMRI). Methods: We studied 491 infants (52% male) without focal destructive brain lesions born at < 34 weeks, who underwent structural and dMRI at a specialist Neonatal Imaging Centre...
2018: NeuroImage: Clinical
https://www.readbyqxmd.com/read/29234148/quality-improvement-to-reduce-chronic-lung-disease-rates-in-very-low-birth-weight-infants-high-compliance-with-a-respiratory-care-bundle-in-a-small-nicu
#2
Zuzanna Kubicka, Eyad Zahr, Tamara Rousseau, Henry A Feldman, John Fiascone
OBJECTIVE: Reduce chronic lung disease by 10% among very-low birth weight infants by implementing a consistent respiratory care bundle. STUDY DESIGN: Prospective quality improvement study of infants below 32 weeks gestation in a small neonatal intensive care unit. A respiratory care bundle to eliminate inter-provider variability and minimize use of mechanical ventilation was implemented. This included: defining delivery room management with use of continuous positive airway pressure/nasal intermittent positive pressure ventilation, uniform intubation/extubation criteria, and standardizing ventilation/post-extubation support...
December 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29234146/practices-surrounding-pulmonary-hypertension-and-bronchopulmonary-dysplasia-amongst-neonatologists-caring-for-premature-infants
#3
Gabriel Altit, Henry C Lee, Susan Hintz, Theresa A Tacy, Jeffrey A Feinstein, Shazia Bhombal
OBJECTIVE: Pulmonary hypertension (PH) is associated with bronchopulmonary dysplasia (BPD). Screening strategies, a thorough investigation of co-morbidities, and multidisciplinary involvement prior to anti-PH medications have been advocated by recent guidelines. We sought to evaluate current practices of neonatologists caring for premature infants with PH. DESIGN: Electronic survey of American Academy of Pediatrics neonatology members. RESULTS: Among 306 neonatologist respondents, 38% had an institutional screening protocol for patients with BPD; 83% screened at 36 weeks for premature neonates on oxygen/mechanical ventilation...
December 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29232665/the-laryngeal-mask-airway-and-its-use-in-neonatal-resuscitation-a-critical-review-of-where-we-are-in-2017-2018
#4
Satvik Chaitanya Bansal, Stefano Caoci, Eugene Dempsey, Daniele Trevisanuto, Charles Christoph Roehr
Studies using videotape recordings and respiratory function monitoring have shown that both face mask (FM) application and endotracheal tube (ETT) placement represent a challenge for resuscitators. Hence, there is a strong need for devices that can largely be used independently of individual operator training levels, in order to ensure more reliable support in time-critical situations, such as neonatal resuscitation. The laryngeal mask airway device (LMA) has evolved as a potentially very valuable tool. We conducted a systematic review of studies evaluating the use of the LMA in neonatal resuscitation...
December 13, 2017: Neonatology
https://www.readbyqxmd.com/read/29229141/neurodevelopment-impact-of-co2-pneumoperitoneum-in-neonates-experimental-study-in-a-rat-model
#5
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
https://www.readbyqxmd.com/read/29224772/resolution-of-vocal-fold-immobility-in-preterm-infants
#6
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
https://www.readbyqxmd.com/read/29219011/meconium-aspiration-syndrome-risk-factors-and-predictors-of-severity
#7
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/29217332/revisiting-high-frequency-oscillatory-ventilation-in-vitro-and-in-silico-in-neonatal-conductive-airways
#8
REVIEW
Katrin Bauer, Eliram Nof, Josué Sznitman
BACKGROUND: High frequency oscillatory ventilation is often used for lung support in premature neonates suffering from respiratory distress syndrome. Despite its broad use in neonatal intensive care units, there are to date no accepted protocols for the choice of appropriate ventilation parameter settings. In this context, the underlying mass transport mechanisms are still not fully understood. METHODS: We revisit the question of flow phenomena under conventional mechanical ventilation and high frequency oscillatory ventilation in an anatomically-inspired model of neonatal conductive airways spanning the first few airway generations...
November 28, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/29214159/quality-of-care-during-neonatal-resuscitation-in-kakamega-county-general-hospital-kenya-a-direct-observation-study
#9
Duncan N Shikuku, Benson Milimo, Elizabeth Ayebare, Peter Gisore, Gorrette Nalwadda
Background: Birth asphyxia is the leading cause of neonatal mortality in Kenya. Quality care during neonatal resuscitation (NR) can contribute to a reduction in neonatal mortality related to birth asphyxia by 30 percent. This study assessed the quality of care (QoC) during NR for newborns with birth asphyxia. Methods: Direct observations of 138 newborn resuscitations were done in labor ward and maternity theatre. Twenty-eight healthcare providers were observed 3-5 times using a structured checklist...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29209032/comparison-of-state-risk-appropriate-neonatal-care-policies-with-the-2012-aap-policy-statement
#10
Charlan D Kroelinger, Ekwutosi M Okoroh, David A Goodman, Sarah M Lasswell, Wanda D Barfield
OBJECTIVE: Compare state policies with standards outlined in the 2012 AAP Policy Statement on Levels of Neonatal Care. STUDY DESIGN: Systematic, web-based review of publicly available policies on levels of care in all states in 2014. Infant risk information, equipment capabilities, and specialty staffing were abstracted from published rules, statutes, and regulations. RESULT: Twenty-two states had a policy on regionalized perinatal care. State policies vary in consistency with the AAP Policy, with 60% of states including standards consistent with Level I criteria, 48% Level II, 14% Level III, and one state with Level IV...
December 5, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29208663/haemodynamic-effects-of-umbilical-cord-milking-in-premature-sheep-during-the-neonatal-transition
#11
Douglas A Blank, Graeme R Polglase, Martin Kluckow, Andrew William Gill, Kelly J Crossley, Alison Moxham, Karyn Rodgers, Valerie Zahra, Ishmael Inocencio, Fiona Stenning, Domeic A LaRosa, Peter G Davis, Stuart B Hooper
OBJECTIVE: Umbilical cord milking (UCM) at birth may benefit preterm infants, but the physiological effects of UCM are unknown. We compared the physiological effects of two UCM strategies with immediate umbilical cord clamping (UCC) and physiological-based cord clamping (PBCC) in preterm lambs. METHODS: At 126 days' gestational age, fetal lambs were exteriorised, intubated and instrumented to measure umbilical, pulmonary and cerebral blood flows and arterial pressures...
December 5, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29206362/prevalence-of-neonate-adhesive-skin-injuries-in-a-jordanian-intensive-care-unit
#12
Laila Habiballah
AIM: To determine the prevalence of adhesive skin injuries in neonates in a Jordanian neonatal intensive care unit (NICU) and to examine the characteristics of neonates with these injuries. METHOD: A cross-sectional period-prevalence study was conducted in a NICU in Irbid National University Hospital in Jordan. A total of 169 neonates were examined for skin injuries caused by adhesive equipment. RESULTS: The prevalence of skin injuries in this population was 26...
December 5, 2017: Nursing Children and Young People
https://www.readbyqxmd.com/read/29204652/effect-of-nasal-continuous-positive-airway-pressure-on-infants-with-meconium-aspiration-syndrome-a-randomized-clinical-trial
#13
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...
December 4, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29198532/impact-of-prolonged-mechanical-ventilation-in-very-low-birth-weight-infants-results-from-a-national-cohort-study
#14
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...
November 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29196736/continuous-positive-airway-pressure-delivery-during-less-invasive-surfactant-administration-a-physiologic-study
#15
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
https://www.readbyqxmd.com/read/29193814/hospital-admissions-for-lower-respiratory-tract-infections-in-children-born-moderately-late-preterm
#16
Paula Haataja, Päivi Korhonen, Riitta Ojala, Mikko Hirvonen, Matti Korppi, Mika Gissler, Tiina Luukkaala, Outi Tammela
OBJECTIVE: To evaluate the frequency and predictors of hospital admissions for lower respiratory tract infections (LRTIs) in moderately preterm (MP, 32+0 to 33+6 weeks) and late preterm (LP, 34+0 to 36+6 weeks) infants compared to term (T ≥37 weeks) and very preterm (VP, <32+0 weeks) infants. STUDY DESIGN: This national register-based study covered all infants born in Finland in 1991-2008. Data on 1 018 256 infants were analyzed in four gestational age-based groups: VP (n = 6329), MP (n = 6796), LP (n = 39 928), and T (n = 965 203) groups...
November 29, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29191811/neonatal-mannequin-comparison-of-the-upright-self-inflating-bag-and-snap-fit-mask-versus-standard-resuscitators-and-masks-leak-applied-load-and-tidal-volumes
#17
Anthony Richard Rafferty, Lucy Johnson, Peter G Davis, Jennifer Anne Dawson, Marta Thio, Louise S Owen
OBJECTIVE: Neonatal mask ventilation is a difficult skill to acquire and maintain. Mask leak is common and can lead to ineffective ventilation. The aim of this study was to determine whether newly available neonatal self-inflating bags and masks could reduce mask leak without additional load being applied to the face. DESIGN: Forty operators delivered 1 min episodes of mask ventilation to a mannequin using the Laerdal Upright Resuscitator, a standard Laerdal infant resuscitator (Laerdal Medical) and a T-Piece Resuscitator (Neopuff), using both the Laerdal snap-fit face mask and the standard Laerdal size 0/1 face mask (equivalent sizes)...
November 30, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29189671/neural-breathing-pattern-and-patient-ventilator-interaction-during-neurally-adjusted-ventilatory-assist-and-conventional-ventilation-in-newborns
#18
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)...
November 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29185948/pneumopericardium-in-the-neonate
#19
Tiffany L Walker, Dorothy A Shannon
Pneumopericardium occurs when air accumulates in the pericardial sac surrounding the heart and is one of the rarest forms of air leaks in neonates. Because of various advances in neonatal care, including gentler modes of ventilation, surfactant replacement, and antenatal steroids, the incidence of pneumopericardium has decreased. Despite the decrease in incidence of pneumopericardium, most cases arise in premature infants with a history of respiratory distress and mechanical ventilation. Evidence has shown that the incidence is inversely related to birth weight and that pneumopericardium has high mortality and morbidity rates...
November 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/29184049/does-diaphragmatic-electrical-activity-in-preterm-infants-predict-extubation-success
#20
Neetu Singh, Matthew J McNally, Robert A Darnall
BACKGROUND: Despite many advances in respiratory care and mechanical ventilation, neonatologists lack an objective tool to aid in decision making for timely extubation. Electrical activity of the diaphragm (EAdi), a measure of neural respiratory drive and inspiratory load, may be a useful predictor of extubation success in preterm neonates. The objective of this work was to investigate whether peak EAdi could distinguish successful versus failed extubation in mechanically ventilated preterm infants...
November 28, 2017: Respiratory Care
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