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Ventilation in neonates

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https://www.readbyqxmd.com/read/29465446/current-practices-and-attitudes-regarding-use-of-inhaled-nitric-oxide-in-the-nicu-results-from-a-survey-of-members-of-the-national-association-of-neonatal-nurse-practitioners
#1
Allyson Kayton, Paula Timoney, Lyn Vargo, Jose A Perez
BACKGROUND: Excessive supplemental oxygen exposure in the neonatal intensive care unit (NICU) can be associated with oxygen-related toxicities, which can lead to negative clinical consequences. Use of inhaled nitric oxide (iNO) can be a successful strategy for avoiding hyperoxia in the NICU. iNO selectively produces pulmonary vasodilation and has been shown to improve oxygenation parameters across the spectrum of disease severity, from mild to very severe, in neonates with hypoxic respiratory failure associated with persistent pulmonary hypertension of the newborn...
February 20, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29463286/bronchopulmonary-dysplasia-clinical-aspects-and-preventive-and-therapeutic-strategies
#2
REVIEW
Nicola Principi, Giada Maria Di Pietro, Susanna Esposito
BACKGROUND: Bronchopulmonary dysplasia (BPD) is the result of a complex process in which several prenatal and/or postnatal factors interfere with lower respiratory tract development, leading to a severe, lifelong disease. In this review, what is presently known regarding BPD pathogenesis, its impact on long-term pulmonary morbidity and mortality and the available preventive and therapeutic strategies are discussed. MAIN BODY: Bronchopulmonary dysplasia is associated with persistent lung impairment later in life, significantly impacting health services because subjects with BPD have, in most cases, frequent respiratory diseases and reductions in quality of life and life expectancy...
February 20, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29459604/immediate-outcome-of-preterm-neonates-with-respiratory-distress-syndrome-required-mechanical-ventilation
#3
M A Mannan, M A Hossain, J Nasim, Y Sabina, F Navila, D Subir
Since its inception, the neonatal mechanical ventilator has been considered an essential tool for managing preterm neonates with Respiratory Distress Syndrome (RDS) and is still regarded as an integral component in the neonatal respiratory care continuum. Mechanical ventilation of newborn has been practiced for several years with several advances made in the way. This clinical intervention study was done to analyze immediate outcome of preterm neonates with RDS required mechanical ventilation and conducted on preterm neonates with RDS required mechanical ventilation from July 2014 to June 2015...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29458230/perioperative-complications-of-congenital-diaphragmatic-hernia-repair
#4
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
https://www.readbyqxmd.com/read/29444748/aortopulmonary-collaterals-in-neonates-with-d-transposition-of-the-great-arteries-clinical-significance-early-after-arterial-switch-operation
#5
Alexandra Wipf, Martin Christmann, Susanne Navarini-Meury, Hitendu Dave, Daniel Quandt, Walter Knirsch, Oliver Kretschmar
OBJECTIVES: Purpose of this study is to evaluate the clinical significance of major aortopulmonary collateral arteries (MAPCAs) during the early postoperative course after arterial switch operation (ASO) in d-transposition of the great arteries (dTGA). METHODS: Clinical data of 98 patients with simple dTGA between January 2007 and December 2016 at the University Children's Hospital Zurich, Switzerland were analyzed retrospectively. RESULTS: 37 from 98 patients (38%) required cardiac catheterization (CC) due to an early complicated postoperative course or difficult coronary transfer due to special coronary anatomy...
February 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29443114/causes-and-circumstances-of-death-in-a-neonatal-unit-over-20-years
#6
Marissa C Michel, Tarah T Colaizy, Jonathan M Klein, Jeffrey L Segar, Edward F Bell
BackgroundWe examined changes in the causes and circumstances of death in our neonatal intensive care unit (NICU) over 20 years.MethodsFor 551 infants who died between 1993 and 2013, the principal cause of death was recorded. Circumstances of death were assigned to one of the following four categories: death following cardiopulmonary resuscitation (CPR), death while being mechanically ventilated without CPR, death after withholding life-support interventions, and death after withdrawal of life support. Data were compared across four 5-year epochs...
February 14, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29440285/nutrient-intake-in-the-first-two-weeks-of-life-and-brain-growth-in-preterm-neonates
#7
Juliane Schneider, Céline J Fischer Fumeaux, Emma G Duerden, Ting Guo, Justin Foong, Myriam Bickle Graz, Patric Hagmann, M Mallar Chakravarty, Petra S Hüppi, Lydie Beauport, Anita C Truttmann, Steven P Miller
BACKGROUND: Optimizing early nutritional intake in preterm neonates may promote brain health and neurodevelopment through enhanced brain maturation. Our objectives were (1) to determine the association of energy and macronutrient intake in the first 2 weeks of life with regional and total brain growth and white matter (WM) maturation, assessed by 3 serial MRI scans in preterm neonates; (2) to examine how critical illness modifies this association; and (3) to investigate the relationship with neurodevelopmental outcomes...
February 13, 2018: Pediatrics
https://www.readbyqxmd.com/read/29439205/inhaled-nitric-oxide-in-extremely-premature-neonates-with-respiratory-distress-syndrome
#8
William A Carey, Amy L Weaver, Kristin C Mara, Reese H Clark
BACKGROUND: Inhaled nitric oxide (iNO) is increasingly prescribed to extremely premature neonates with respiratory distress syndrome (RDS). Most of this off-label use occurs during the first week of life. We studied this practice, hypothesizing that it would not be associated with improved survival. METHODS: We queried the Pediatrix Medical Group Clinical Data Warehouse to identify all neonates born at 22 to 29 weeks' gestation from 2004 to 2014. In our study sample, we included singletons who required mechanical ventilation for treatment of RDS and excluded those with anomalies...
February 9, 2018: Pediatrics
https://www.readbyqxmd.com/read/29438810/nasal-high-frequency-oscillatory-ventilation-inhibits-gastroesophageal-reflux-in-the-neonatal-period
#9
Danny Cantin, Djamal Djeddi, Nathalie Samson, Charlène Nadeau, Jean-Paul Praud
Nasal high-frequency oscillatory ventilation (nHFOV) in neonates is increasingly considered due to enhanced alveolar ventilation, absence of patient-ventilator asynchrony and lessened ventilator-induced lung injury. Although any type of non-invasive respiratory support can lead to gastric distension via esophageal air passage and thus promote gastroesophageal refluxes (GERs), we have shown that nasal continuous positive airway pressure (CPAP; 6 cmH 2 O) and intermittent positive pressure ventilation (15/4 cmH 2 O) conversely inhibit GERs in lambs...
February 10, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29438655/short-term-neurodevelopmental-outcome-in-children-born-with-high-risk-congenital-lung-lesions
#10
Enrico Danzer, Casey Hoffman, Jo Ann D'Agostino, Matthew M Boelig, Marsha Gerdes, Judy C Bernbaum, Hannah Rosenthal, Lindsay N Waqar, Natalie E Rintoul, Lisa M Herkert, Michael J Kallan, William H Peranteau, Alan W Flake, N Scott Adzick, Holly L Hedrick
BACKGROUND: To evaluate neurodevelopmental outcome in high-risk congenital lung lesions (CLLs) survivors who underwent prenatal intervention or postnatal surgery within the first month of life. METHODS: Forty-five high-risk CLLs survivors underwent assessment using the Bayley Scales of Infant Development, 3rd Edition between 07/2004 and 12/2016. Scores were grouped as average, at-risk, and delayed based on standard deviation intervals. Correlations between outcome and risk factors were analyzed by Fisher's exact test or two-sided t-test as appropriate, with significant p-values <0...
February 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29436355/care-of-the-neonate-on-nasal-continuous-positive-airway-pressure-a-bedside-guide
#11
Jennifer M Guay, Dru Carvi, Deborah A Raines, Wendy A Luce
Respiratory distress continues to be a major cause of neonatal morbidity. Current neonatal practice recommends the use of nasal continuous positive airway pressure (nCPAP) in the immediate resuscitation and continued support of neonates of all gestations with clinical manifestations of respiratory distress. Despite the many short- and long-term benefits of nCPAP, many neonatal care units have met resistance in its routine use. Although there have been numerous recent publications investigating the use and outcomes of various modes of nCPAP delivery, surfactant administration, mechanical ventilation, and other forms of noninvasive respiratory support (high-flow nasal cannula, nasal intermittent positive pressure ventilation), there has been a relative lack of publications addressing the practical bedside care of infants managed on nCPAP...
January 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29432890/risk-factors-for-gastrostomy-tube-placement-in-single-ventricle-patients-following-the-norwood-procedure
#12
Kurt D Piggott, Jaqueline Babb, Sylvia Yong, Harun Fakioglu, Carlos Blanco, William DeCampli, Kamal Pourmoghadam
OBJECTIVES: Neonates with single ventricle heart disease frequently suffer from poor oral feeding and inconsistent weight gain, often requiring gastrostomy tube (gtube) placement. We sought to identify risk factors for g-tube placement in neonates following the Norwood procedure at our institution. METHODS: We retrospectively reviewed multiple preoperative, operative and postoperative variables in neonates <30 days with single ventricle heart disease following the Norwood procedure...
February 9, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29432293/is-spinal-anaesthesia-in-young-infants-really-safer-and-better-than-general-anaesthesia
#13
Nicola Disma, Natasha Clunies-Ross, George A Chalkiadis
PURPOSE OF REVIEW: Concerns regarding the potential neurotoxic effects of general anaesthesia have seen resurgence in awake spinal anaesthesia in neonates and infants. This review includes recently published data from a large prospective randomized controlled trial with view to determining if spinal anaesthesia is safer and better than general anaesthesia in this population. RECENT FINDINGS: Compared with general anaesthesia, spinal anaesthesia results in less haemodynamic instability and fewer early (<30 min) apnoeic episodes in neonates and infants undergoing inguinal herniorraphy; the overall incidence of apnoeas in the first 12 h postoperatively was similar...
February 9, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29426854/association-between-plasma-cortisol-and-death-or-vasopressor-refractory-hypotension-in-preterm-neonates-a-prospective-cohort-study
#14
Monisha Rameshbabu, Venkataseshan Sundaram, Naresh Sachdeva, Rama Walia, Shiv Sajan Saini, Sourabh Dutta
OBJECTIVES: Temporal relation between adrenal insufficiency and hypotension is poorly understood. We examined the association between basal and post-stimulation cortisol and death or vasopressor refractory hypotension in preterm neonates. STUDY DESIGN: Prospective cohort study in ≤30 weeks' and/or <1,250 g weight. Primary outcome-composite of death or vasopressor refractory hypotension by day 14 of life. Plasma cortisol levels were measured at 24-36 h (T1), 72-84 h (T2) and 10 days (T3), and post-stimulation cortisol at T1 and later at T2 and T3 if the adrenal response was inadequate earlier...
February 9, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29426584/non-invasive-ventilation-in-children-and-adults-in-low-and-low-middle-income-countries-a-systematic-review-and-meta-analysis
#15
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
https://www.readbyqxmd.com/read/29425911/antenatal-and-neonatal-antecedents-of-learning-limitations-in-10-year-old-children-born-extremely-preterm
#16
Alan Leviton, Robert M Joseph, Elizabeth N Allred, T Michael O'Shea, Karl K C Kuban
BACKGROUND: Children born extremely preterm are at increased risk of learning limitations. AIM: To identify the antecedents of learning limitations of children born extremely preterm. STUDY DESIGN: Prospective observational study from birth to age 10 years. Variables entered into the multinomial logistic regression analyses were ordered temporally, with the earliest occurring predictors/covariates of each learning limitation risk entered first and not displaced by later occurring covariates...
February 6, 2018: Early Human Development
https://www.readbyqxmd.com/read/29409551/impact-of-prenatal-diagnosis-on-the-management-and-early-outcome-of-critical-duct-dependent-cardiac-lesions
#17
Varsha Thakur, Nathalie Dutil, Steven M Schwartz, Edgar Jaeggi
OBJECTIVE: The objective of this study was to compare the preoperative management and outcome of neonates with duct-dependent critical CHD with fetal versus postnatal diagnosis. METHODS: Patients referred with CHD to our centre from January 1, 2009 to December 31, 2010 were enrolled prospectively. Live births with a critical form of CHD, a gestational age ⩾36 weeks and a weight ⩾2 kg at birth, and the intention-to-treat were included in this sub-study. Excluded were neonates with lethal non-cardiac and/or genetic anomalies...
February 7, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29403154/perinatal-factors-affecting-growth-and-development-at-age-3-years-in-extremely-low-birth-weight-infants-born-small-for-gestational-age
#18
Nozomi Matsuda, Atsuko Taki, Atsumi Tsuji, Keisuke Nakajima, Kei Takasawa, Chikako Morioka, Yoshihiro Minosaki, Kikuko Oku, Kenichi Kashimada, Tomohiro Morio
Factors affecting growth and development in extremely low birth weight infants (ELBWIs) born small for gestational age (SGA) have not been precisely elucidated. We performed a retrospective analysis of ELBWIs born SGA who were treated in the neonatal intensive care unit of Kawaguchi Municipal Medical Centre, Japan. A total 244 ELBWIs were born from 2003 to 2010, and 31 were born with weight and height below the 10th percentile for their gestational age. Among the 31 ELBWIs born SGA, we excluded 9 who died before they reached 3 yr of age or who had severe developmental retardation...
2018: Clinical Pediatric Endocrinology: Case Reports and Clinical Investigations: Official Journal of the Japanese Society for Pediatric Endocrinology
https://www.readbyqxmd.com/read/29401084/safety-and-efficacy-of-bedside-percutaneous-endoscopic-gastrostomy-placement-in-the-neonatal-intensive-care-unit
#19
Kelly Driver, Rebecca Schilling, Annie Goodwin, Denise Martinez, Ernest Amankwah, Michael Wilsey, Fauzia Shakeel
OBJECTIVE: The aim of the study is to describe the safety and efficacy of bedside percutaneous endoscopic gastrostomy (PEG) placement in a level 3 neonatal intensive care unit (NICU). METHODS: A retrospective chart review was performed on 106 infants with a birthweight ≤6 kg receiving bedside PEG placement at Johns Hopkins All Children's Hospital between 2007 and 2013. Preprocedure, postprocedure, and demographic data were collected. The main safety outcome was postprocedure complication rate and the main efficacy outcome was time to initiate feeds and time on respiratory support...
February 3, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29397933/associations-between-unplanned-cardiac-reinterventions-and-outcomes-after-pediatric-cardiac-operations
#20
John M Costello, Michael C Mongé, Kevin D Hill, Sunghee Kim, Sara K Pasquali, Babatunde A Yerokun, Jeffrey P Jacobs, Carl L Backer, Mjaye L Mazwi, Marshall L Jacobs
BACKGROUND: After pediatric heart operations, we sought to determine the incidence of unplanned cardiac reinterventions during the same hospitalization, assess risk factors for these reinterventions, and explore associations between reinterventions and outcomes. We hypothesized that younger patients undergoing more complex operations would be at greater risk for unplanned cardiac reinterventions and that operative mortality and postoperative length of stay (PLOS) would be greater in patients who undergo reintervention than in those who do not...
February 1, 2018: Annals of Thoracic Surgery
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