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Ventilation in neonates

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https://www.readbyqxmd.com/read/29036732/predictors-of-poor-outcome-in-neonates-with-pyogenic-meningitis-in-a-level-three-neonatal-intensive-care-unit-of-developing-country
#1
Mala Kumar, Shalini Tripathi, Himanshu Kumar, S N Singh
Background: The mortality of neonatal pyogenic meningitis is reduced to 10-15%, but morbidity is unchanged. Methods: Primary objective is to determine the outcome, i.e. death or abnormal neurological examination (NE) at discharge and abnormal developmental quotient (DQ) at 3 months. Secondary objective is to find predictors of poor outcome. Results: In all, 89 neonates enrolled, 10 expired and 24 neonates had abnormal NE at discharge. A total of 59 neonates came for follow up, 13 had DQ < 70...
September 26, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29035425/inhaled-versus-systemic-corticosteroids-for-the-treatment-of-bronchopulmonary-dysplasia-in-ventilated-very-low-birth-weight-preterm-infants
#2
REVIEW
Sachin S Shah, Arne Ohlsson, Henry L Halliday, Vibhuti S Shah
BACKGROUND: This is an update of a review published in 2012. A related review "Inhaled versus systemic corticosteroids for preventing bronchopulmonary dysplasia in ventilated very low birth weight preterm neonates" has been updated as well. Bronchopulmonary dysplasia (BPD) is a serious and common problem among very low birth weight infants, despite the use of antenatal steroids and postnatal surfactant therapy to decrease the incidence and severity of respiratory distress syndrome. Due to their anti-inflammatory properties, corticosteroids have been widely used to treat or prevent BPD...
October 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29030937/changes-in-blood-volume-indicators-and-dynamic-indicators-measured-with-transpulmonary-ultrasound-velocity-during-blood-depletion-and-repletion-in-a-neonatal-swine-model
#3
Manuel Martin-Flores, Alvaro F Cisternas, Robin D Gleed
BACKGROUND: Dynamic indicators such as pulse pressure and stroke volume variations can be measured to track changes in preload during hemorrhage, and evaluate fluid therapy. However, these dynamic indicators require mechanical ventilation, and might be affected by cardiac dysrhythmias and changes in vascular tone. Blood volume indicators may offer alternatives for assessing changes in volume status. AIMS: The aims of this study were to measure changes in blood volume indicators and dynamic indicators during removal of blood in two stages and subsequent blood replacement in anesthetized, mechanically ventilated, neonatal pigs...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28988159/chest-compression-during-sustained-inflation-versus-3-1-chest-compression-ventilation-ratio-during-neonatal-cardiopulmonary-resuscitation-a-randomised-feasibility-trial
#4
Georg M Schmölzer, Megan O Reilly, Caroline Fray, Sylvia van Os, Po-Yin Cheung
BACKGROUND: Current neonatal resuscitation guidelines recommend 3:1 compression:ventilation (C:V) ratio. Recently, animal studies reported that continuous chest compressions (CC) during a sustained inflation (SI) significantly improved return of spontaneous circulation (ROSC). The approach of CC during SI (CC+SI) has not been examined in the delivery room during neonatal resuscitation. HYPOTHESIS: It is a feasibility study to compare CC+SI versus 3:1 C:V ratio during neonatal resuscitation in the delivery room...
October 7, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28987397/duration-of-postoperative-mechanical-ventilation-as-a-quality-metric-for-pediatric-cardiac-surgical-programs
#5
Michael Gaies, David K Werho, Wenying Zhang, Janet E Donohue, Sarah Tabbutt, Nancy S Ghanayem, Mark A Scheurer, John M Costello, J William Gaynor, Sara K Pasquali, Justin B Dimick, Mousumi Banerjee, Steven M Schwartz
BACKGROUND: Few metrics exist to assess quality of care at pediatric cardiac surgical programs, limiting opportunities for benchmarking and quality improvement. Postoperative duration of mechanical ventilation (POMV) may be an important quality metric because of its association with complications and resource utilization. In this study we modelled case-mix-adjusted POMV duration and explored hospital performance across POMV metrics. METHODS: This study used the Pediatric Cardiac Critical Care Consortium clinical registry to analyze 4,739 hospitalizations from 15 hospitals (October 2013 to August 2015)...
October 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28985401/clinical-characteristics-of-nosocomial-bloodstream-infections-in-neonates-in-two-hospitals-china
#6
Shanmei Wang, Sheng Chen, Wei Feng, Fengjun Sun, Qian Wang, Ke Zhu, Jie Song
Background: The improvement of medical condition requires prolonged hospital stays, which increase the risk of nosocomial bloodstream infections (BSIs). Methods: All nosocomial BSI newborns in two hospitals were included, and the demographic and clinical characteristics of bacteremia patients were obtained from the information systems. Isolates were identified by biochemical assays. Antimicrobial susceptibility was determined using disk diffusion method. Results: Except for three same risk factors, intubation with mechanical ventilation was a risk factor in Chongqing, while low birth weight was a risk factor in Henan...
July 21, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28981515/the-heuristics-of-nurse-responsiveness-to-critical-patient-monitor-and-ventilator-alarms-in-a-private-room-neonatal-intensive-care-unit
#7
Rohan Joshi, Heidi van de Mortel, Loe Feijs, Peter Andriessen, Carola van Pul
AIM: Alarm fatigue is a well-recognized patient safety concern in intensive care settings. Decreased nurse responsiveness and slow response times to alarms are the potentially dangerous consequences of alarm fatigue. The aim of this study was to determine the factors that modulate nurse responsiveness to critical patient monitor and ventilator alarms in the context of a private room neonatal intensive care setting. METHODS: The study design comprised of both a questionnaire and video monitoring of nurse-responsiveness to critical alarms...
2017: PloS One
https://www.readbyqxmd.com/read/28977137/dorsal-brainstem-syndrome-and-the-use-of-neurally-adjusted-ventilatory-assist-nava-in-an-infant
#8
José Colleti, Walter Koga, Werther Brunow de Carvalho
OBJECTIVE: To report a rare case of dorsal brainstem syndrome in an infant after hypoxic-ischemic episode due to severe sepsis and the use of neurally adjusted ventilatory assist (NAVA) to aid in diagnosis and in the removal of mechanical ventilation. CASE DESCRIPTION: A 2-month-old male infant, previously healthy, presented with severe sepsis that evolved to dorsal brainstem syndrome, which usually occurs after hypoxic-ischemic injury in neonates and infants, and is related to very specific magnetic resonance images...
September 21, 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28974162/antenatal-assessment-and-postnatal-outcome-of-fetal-echogenic-lung-lesions-a-decade-s-experience-at-a-tertiary-referral-hospital
#9
Stefan C Kane, Fabrício D A Silva Costa, Joseph A Crameri, Karen L Reidy, Helen Kaganov, Ricardo Palma-Dias
INTRODUCTION: Fetal echogenic lung lesions (ELL) are the commonest pulmonary pathology diagnosed on antenatal sonography, and include congenital pulmonary airway malformations (CPAMs) and bronchopulmonary sequestrations. This study aimed to evaluate the predictive utility of the CPAM volume ratio (CVR) at presentation in a series of fetuses with ELLs at a tertiary Australian referral hospital. MATERIAL AND METHODS: Retrospective cohort study of all pregnancies with a prenatal diagnosis of an isolated fetal echogenic lung lesion managed at the Royal Women's Hospital, Victoria, Australia, between 2005 and 2015...
October 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28974135/propofol-and-fentanyl-sedation-for-laser-treatment-of-retinopathy-of-prematurity-to-avoid-intubation
#10
Fiammetta Piersigilli, Alessandra Di Pede, Gino Catena, Simona Lozzi, Cinzia Auriti, Iliana Bersani, Irma Capolupo, Anna Lipreri, Vincenzo Di Ciommo, Andrea Dotta, Stefania Sgrò
BACKGROUND: Despite the optimization of neonatal assistance, severe retinopathy of prematurity (ROP, stage III-IV) remains a common condition among preterm infants. Laser photocoagulation usually requires general anesthesia and intubation, but extubation can be difficult and these infants often affected by chronic lung disease. We retrospectively evaluated the clinical charts of 13 neonates that were sedated with propofol in association with fentanyl for the laser treatment of ROP. This protocol was introduced in our unit to avoid intubation and minimize side effects of anesthesia and ventilation...
October 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28973344/effect-of-inhaled-nitric-oxide-on-survival-without-bronchopulmonary-dysplasia-in-preterm-infants-a-randomized-clinical-trial
#11
Shabih U Hasan, Jim Potenziano, Girija G Konduri, Jose A Perez, Krisa P Van Meurs, M Whit Walker, Bradley A Yoder
Importance: Bronchopulmonary dysplasia (BPD) occurs in approximately 40% of infants born at younger than 30 weeks' gestation and is associated with adverse pulmonary and neurodevelopmental outcomes. Objective: To test whether administration of inhaled nitric oxide to preterm infants requiring positive pressure respiratory support on postnatal days 5 to 14 improves the rate of survival without BPD. Design, Setting, and Participants: This intent-to-treat study was a randomized clinical trial performed at 33 US and Canadian neonatal intensive care units...
September 25, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28970693/acute-respiratory-distress-syndrome-in-a-neonate-due-to-possible-transfusion-related-acute-lung-injury
#12
Arti Maria, Sheetal Agarwal, Anu Sharma
Transfusion-related acute lung injury (TRALI) is a potentially life-threatening complication of blood component transfusion. It is relatively underdiagnosed entity in neonates with scant literature. We report a case of TRALI in a preterm neonate developing acute respiratory distress within 6 h of blood product transfusion in the absence of preexisting lung disease. Prompt ventilator and supportive management were instituted. The baby showed clinical and radiological improvement within 12 h; however, he succumbed to death due to acute massive pulmonary hemorrhage 36 h later...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28969229/surfactant-therapy-for-early-onset-pneumonia-in-late-preterm-and-term-neonates-needing-mechanical-ventilation
#13
Sujata Deshpande, Pradeep Suryawanshi, Kunal Ahya, Rajesh Maheshwari, Samir Gupta
INTRODUCTION: Pathophysiology of pneumonia involves leakage of plasma proteins into the airways and accumulation of cytokines within the lung. Several in vitro and in vivo studies have demonstrated that this proteinaceous material and lung inflammation inhibit surfactant function. AIM: To evaluate whether exogenous surfactant therapy improves oxygenation and gas exchange in late preterm and term neonates with early onset pneumonia and respiratory failure. MATERIALS AND METHODS: This prospective interventional cohort study was conducted at a tertiary care neonatal unit...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28966921/echocardiographic-evaluation-of-hemodynamics-in-neonates-and-children
#14
REVIEW
Yogen Singh
Hemodynamic instability and inadequate cardiac performance are common in critically ill children. The clinical assessment of hemodynamic status is reliant upon physical examination supported by the clinical signs such as heart rate, blood pressure, capillary refill time, and measurement of the urine output and serum lactate. Unfortunately, all of these parameters are surrogate markers of cardiovascular well-being and they provide limited direct information regarding the adequacy of blood flow and tissue perfusion...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28956137/deleterious-impact-of-maternal-hepatitis-c-viral-infection-on-maternal-and-fetal-outcome-a-5-year-prospective-study
#15
Mohamed Rezk, Zein Omar
OBJECTIVE: To assess prospectively the maternal and fetal outcome among pregnant women with chronic Hepatitis-C virus (HCV) infection compared to normal control group. METHODS: A prospective observational study conducted on 342 pregnant women with HCV who were divided into two groups according to polymerase chain reaction (PCR) result, group 1 (n = 184, HCV-PCR negative) and group 2 (n = 154, HCV-PCR positive) with a third group of normal pregnant women (n = 170)...
September 27, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28950821/modelling-bronchopulmonary-dysplasia-in-animals-arguments-for-the-preterm-rabbit-model
#16
Thomas Salaets, Andre Gie, Bieke Tack, Jan Deprest, Jaan Toelen
Bronchopulmonary dysplasia (BPD) remains a frequent and disabling consequence of preterm birth, despite the recent advances in neonatal intensive care. There is a need to further improve outcomes and many novel therapeutic or preventive strategies are therefore investigated in animal models. We discuss in this review the aspects of human BPD pathophysiology and phenotype, which ideally should be mimicked by an animal model for this disease. Prematurity remains the common denominator in the heterogeneous spectrum of human BPD, and preterm animal models thus have a clear translational advantage...
September 26, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28948345/is-gestational-diabetes-an-independent-risk-factor-of-neonatal-severe-respiratory-distress-syndrome-after-34%C3%A2-weeks-of-gestation-a-prospective-study
#17
Isabelle Mortier, Julie Blanc, Barthelemy Tosello, Catherine Gire, Florence Bretelle, Xavier Carcopino
PURPOSE: To evaluate if neonates delivered after 34(0/7) weeks from mothers diagnosed with gestational diabetes (GD) are exposed to an increased risk of neonatal severe respiratory distress syndrome (SRDS). METHODS: Women with singleton pregnancy in labour after 34(0/7) weeks of gestation or admitted for planned caesarean section and who had been systematically screened for GD were eligible to participate to this prospective cohort study. Diagnosis of SRDS was defined by the association of clinical signs of early neonatal respiratory distress, with consistent radiologic features and requiring mechanical ventilation with a fraction of inspired oxygen (FiO2) >0...
September 25, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28947918/efficacy-study-of-pulmonary-surfactant-combined-with-assisted-ventilation-for-acute-respiratory-distress-syndrome-management-of-term-neonates
#18
Jinfeng Liu, Gang Liu, Hongwei Wu, Zhenguang Li
The clinical efficacy of pulmonary surfactant (PS) combined with assisted ventilation was assessed for acute respiratory distress syndrome (RDS) management of term neonates. The total sample size was of 60 subjects. Group I: Experimental group, 30 cases were treated with standard of care with tracheal intubation, mechanical ventilation and PS (100-200 mg/kg). In case of hypoxaemia present even after 12 h standard of care was administered again, up to 4 times. Group II: Control group, 30 cases treated with conventional tracheal intubation and mechanical ventilation...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28947324/outcomes-of-gastroschisis-early-delivery-a-systematic-review-and-meta-analysis
#19
Rachel M Landisch, Ziyan Yin, Melissa Christensen, Aniko Szabo, Amy J Wagner
BACKGROUND/PURPOSE: Elective preterm delivery (EPD) of a fetus with gastroschisis may prevent demise and ameliorate intestinal injury. While the literature on optimal timing of delivery varies, we hypothesize that a potential benefit may be found with EPD. METHODS: A meta-analysis of publications describing timing of delivery in gastroschisis from 1/1990 to 8/2016 was performed, including studies where either elective preterm delivery (group 1, G1) or preterm gestational age (GA) (group 2, G2) were evaluated against respective comparators...
September 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28942433/therapeutic-hypothermia-in-mild-neonatal-encephalopathy-a-national-survey-of-practice-in-the-uk
#20
Vânia Oliveira, Dev Prya Singhvi, Paolo Montaldo, Peter J Lally, Josephine Mendoza, Swati Manerkar, Seetha Shankaran, Sudhin Thayyil
Although major cooling trials (and subsequent guidelines) excluded babies with mild encephalopathy, anecdotal evidence suggests that cooling is often offered to these infants. We report a national survey on current cooling practices for babies with mild encephalopathy in the UK. From 74 neonatal units contacted, 68 were cooling centres. We received 54 responses (79%) and included 48 (five excluded due to incomplete data and one found later not to offer cooling). Of these, 36 centres (75%) offered cooling to infants with mild encephalopathy...
September 23, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
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