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High flow oxygen and neonates

L Talemal, M T Donofrio
D-transposition of the great arteries (D-TGA) is the most commonly diagnosed cyanotic congenital heart disease presenting in the neonatal period. The survival after an arterial switch operation, with freedom from adverse cardiovascular events, has been reported to be as high as 93% at 25 years. However, despite excellent surgical outcomes, there continues to be significant preoperative morbidity and potential mortality due to compromise in the delivery room from foramen ovale closure requiring urgent balloon atrial septostomy for stabilization in the first minutes of life...
September 16, 2016: Journal of Neonatal-perinatal Medicine
Anna Lavizzari, Mariarosa Colnaghi, Francesca Ciuffini, Chiara Veneroni, Stefano Musumeci, Ivan Cortinovis, Fabio Mosca
Importance: Heated, humidified high-flow nasal cannula (HHHFNC) has gained increasing popularity as respiratory support for newborn infants thanks to ease of use and improved patient comfort. However, its role as primary therapy for respiratory distress syndrome (RDS) of prematurity needs to be further elucidated by large, randomized clinical trials. Objective: To determine whether HHHFNC provides respiratory support noninferior to nasal continuous positive airway pressure (nCPAP) or bilevel nCPAP (BiPAP) as a primary approach to RDS in infants older than 28 weeks' gestational age (GA)...
August 8, 2016: JAMA Pediatrics
Oxana Semyachkina-Glushkovskaya, Ekaterina Borisova, Anton Namikin, Ivan Fedosov, Arkady Abdurashitov, Ekaterina Zhinchenko, Artem Gekalyuk, Maria Ulanova, Victoria Rezunbaeva, Latchezar Avramov, Dan Zhu, Qingming Luo, Valery Tuchin
We studied the level of blood oxygen saturation (SpO2) in the brain in newborn rats in the pre- and post-stroke periods, as well as the changes in cerebral blood flow and beta-arrestin-1 as a marker of hypoxic stress. Our results show that mild hypoxia precedes the stroke development and is associated with venous relaxation and decrease blood outflow from the brain resulting in the elevation of synthesis of beta-arrestin-1 in the brain. The incidence of stroke is characterized by severe hypoxia, which is accompanied by the progression of pathological changes in cerebral veins and the high level of beta-arrestin-1...
2016: Advances in Experimental Medicine and Biology
Ingvild Bruun Mikalsen, Peter Davis, Knut Øymar
High flow nasal cannula (HFNC) is a relatively new non-invasive ventilation therapy that seems to be well tolerated in children. Recently a marked increase in the use of HFNC has been seen both in paediatric and adult care settings. The aim of this study was to review the current knowledge of HFNC regarding mechanisms of action, safety, clinical effects and tolerance in children beyond the newborn period.We performed a systematic search of the databases PubMed, Medline, EMBASE and Cochrane up to 12th of May 2016...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Xudan Shi, Liang Xu, Desislava Met Doycheva, Jiping Tang, Min Yan, John H Zhang
Hypoxic-ischemic encephalopathy is a condition caused by reduced oxygen and cerebral blood flow to the brain resulting in neurological impairments. Effective therapeutic treatments to ameliorate these disabilities are still lacking. We sought to investigate the role of sestrin2, a highly conserved stress-inducible protein, in a neonatal rat hypoxic-ischemic encephalopathy model. Ten-day-old rat pups underwent right common carotid artery ligation followed by 2.5 h hypoxia. At 1 h post hypoxic-ischemic encephalopathy, rats were intranasally administered with recombinant human sestrin2 and sacrificed for brain infarct area measurement, Fluoro-Jade C, immunofluorescence staining, Western blot, and neurological function testing...
July 5, 2016: Journal of Cerebral Blood Flow and Metabolism
Daniele De Luca, Valentina Dell'Orto
Non-invasive high-frequency oscillatory ventilation (NHFOV) consists of the application of a bias flow generating a continuous distending positive pressure with superimposed oscillations, which have constant frequency and active expiratory phase. NHFOV matches together the advantages of high-frequency ventilation (no need for synchronisation, high efficacy in removing CO2) and nasal continuous positive airway pressure (CPAP) (non-invasive interface, increase in functional residual capacity allowing oxygenation to improve)...
June 28, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Jessie Mei Lim, Theodore Kingdom, Brahmdeep Saini, Vann Chau, Martin Post, Susan Blaser, Christopher Macgowan, Steven P Miller, Mike Seed
OBJECTIVE: To investigate preoperative cerebral hemodynamics in newborns with congenital heart disease. We hypothesized that cerebral blood flow and oxygen delivery would be decreased in newborns with congenital heart disease compared with controls. METHODS: Using a "feed-and-sleep" approach to performing neonatal magnetic resonance imaging, we measured cerebral blood flow by using a slice prescription perpendicular to the right and left internal carotid arteries and basilar artery at the level of the clivus...
October 2016: Journal of Thoracic and Cardiovascular Surgery
Siv Fredly, Cathrine S Nygaard, Janne H Skranes, Tom Stiris, Drude Fugelseth
BACKGROUND: Therapeutic hypothermia is presumed to suppress inflammatory processes after perinatal asphyxia. In a previous study of neonatal hypoxic-ischemic encephalopathy (HIE) we found altered skin microcirculation in about a third of the infants after rewarming. We speculated whether this could be linked to increased inflammatory responses, such as high C-reactive protein (CRP). The present study further explored this question. OBJECTIVE: The aim of this study was to explore the differences in skin microcirculation and its oxygen delivery ability during cooling and after rewarming in HIE infants with or without high CRP...
June 21, 2016: Neonatology
Manuel Maliqueo, Bárbara Echiburú, Nicolás Crisosto
Adequate blood supply to the uterine-placental region is crucial to ensure the transport of oxygen and nutrients to the growing fetus. Multiple factors intervene to achieve appropriate uterine blood flow and the structuring of the placental vasculature during the early stages of pregnancy. Among these factors, oxygen concentrations, growth factors, cytokines, and steroid hormones are the most important. Sex steroids are present in extremely high concentrations in the maternal circulation and are important paracrine and autocrine regulators of a wide range of maternal and placental functions...
2016: Frontiers in Physiology
Pei-Yi Lin, Katherine Hagan, Angela Fenoglio, P Ellen Grant, Maria Angela Franceschini
Low-grade germinal matrix-intraventricular hemorrhage (GM-IVH) is the most common complication in extremely premature neonates. The occurrence of GM-IVH is highly associated with hemodynamic instability in the premature brain, yet the long-term impact of low-grade GM-IVH on cerebral blood flow and neuronal health have not been fully investigated. We used an innovative combination of frequency-domain near infrared spectroscopy and diffuse correlation spectroscopy (FDNIRS-DCS) to measure cerebral oxygen saturation (SO2) and an index of cerebral blood flow (CBFi) at the infant's bedside and compute an index of cerebral oxygen metabolism (CMRO2i)...
2016: Scientific Reports
Marlene Speth, Frank Münch, Ariawan Purbojo, Martin Glöckler, Okan Toka, Robert A Cesnjevar, André Rüffer
This study reports a single-centre experience of the Medos Deltastream diagonal-pump (DP3) for extracorporeal cardiac, pulmonary, or combined support in a single-center pediatric cohort. Twenty-seven consecutive patients with 28 runs of the DP3 between January 2013 and June 2014 were included for analysis. Median patient age, weight, and duration of support were 278 days (range: 0 days-14.2 years), 7.2 kg (range: 2.5-39 kg), and 8 days (range: 2-69 days). Midline sternotomy (n = 20, 71.4%) or cervical approaches (n = 8, 28...
July 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Sarah L Morley
Non-invasive ventilation (NIV) is a well recognised and increasingly prevalent intervention in the paediatric critical care setting. In the acute setting NIV is used to provide respiratory support in a flexible manner that avoids a requirement for endotracheal intubation or tracheostomy, with the aim of avoiding the complications of invasive ventilation. This article will explore the physiological benefits, complications and epidemiology of the different modes of NIV including continuous positive airway pressure (CPAP), non-invasive positive pressure ventilation (NIPPV) and high-flow nasal cannula oxygen (HFNC)...
March 14, 2016: Paediatric Respiratory Reviews
Lorena Bermúdez Barrezueta, Nuria García Carbonell, Jorge López Montes, Rafael Gómez Zafra, Purificación Marín Reina, Jana Herrmannova, Javier Casero Soriano
OBJECTIVE: To determine whether the availability of heated humidified high-flow nasal cannula (HFNC) therapy was associated with a decrease in need for mechanical ventilation in neonates hospitalised with acute bronchiolitis. METHODS: A combined retrospective and prospective (ambispective) cohort study was performed in a type II-B Neonatal Unit, including hospitalised neonates with acute bronchiolitis after the introduction of HFNC (HFNC-period; October 2011-April 2015)...
April 8, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Phani Kiran Yajamanyam, Robert J S Negrine, Shree Vishna Rasiah, Javier Zamora, Andrew K Ewer
OBJECTIVES: To assess myocardial function and presence of pulmonary hypertension (PH) using both tissue Doppler imaging (TDI) and conventional echocardiography in preterm infants of <32 weeks gestation with chronic lung disease (CLD). DESIGN: Prospective observational study. SETTING: Tertiary neonatal intensive care unit. PATIENTS: Three groups of preterm infants were recruited. Group 1-CLD receiving positive pressure airway support including high-flow humidified nasal cannula oxygen (n=25), group 2-CLD receiving low-flow nasal oxygen (n=25) and group 3-no CLD (n=22)...
April 5, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Masaji Nishimura
High-flow nasal cannula (HFNC) oxygen therapy is carried out using an air/oxygen blender, active humidifier, single heated tube, and nasal cannula. Able to deliver adequately heated and humidified medical gas at flows up to 60 L/min, it is considered to have a number of physiological advantages compared with other standard oxygen therapies, including reduced anatomical dead space, PEEP, constant F(IO2), and good humidification. Although few large randomized clinical trials have been performed, HFNC has been gaining attention as an alternative respiratory support for critically ill patients...
April 2016: Respiratory Care
Dominic Wilkinson, Chad Andersen, Colm P F O'Donnell, Antonio G De Paoli, Brett J Manley
BACKGROUND: High flow nasal cannulae (HFNC) are small, thin, tapered binasal tubes that deliver oxygen or blended oxygen/air at gas flows of more than 1 L/min. HFNC are increasingly being used as a form of non-invasive respiratory support for preterm infants. OBJECTIVES: To compare the safety and efficacy of HFNC with other forms of non-invasive respiratory support in preterm infants. SEARCH METHODS: We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 1), MEDLINE via PubMed (1966 to 1 January 2016), EMBASE (1980 to 1 January 2016), and CINAHL (1982 to 1 January 2016)...
2016: Cochrane Database of Systematic Reviews
Sandeep Shetty, Katie Hunt, Amy Douthwaite, Maria Athanasiou, Ann Hickey, Anne Greenough
OBJECTIVE: To determine whether the time to achieve full oral feeding differed between infants with bronchopulmonary dysplasia (BPD) supported by nasal continuous positive airway pressure (nCPAP) compared with those supported by nCPAP and subsequently transferred to heated, humidified, high-flow nasal cannula oxygen (HHFNC). DESIGN: Two-cohort comparison. SETTING: Tertiary neonatal unit. PATIENTS: -72 infants, median gestational age 27 (range 24-32) weeks in the nCPAP group, and 44 infants, median gestational age 27 (range 24-31) weeks in the nCPAP/HHFNC group...
September 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Cynthia Gyamfi-Bannerman, Elizabeth A Thom, Sean C Blackwell, Alan T N Tita, Uma M Reddy, George R Saade, Dwight J Rouse, David S McKenna, Erin A S Clark, John M Thorp, Edward K Chien, Alan M Peaceman, Ronald S Gibbs, Geeta K Swamy, Mary E Norton, Brian M Casey, Steve N Caritis, Jorge E Tolosa, Yoram Sorokin, J Peter VanDorsten, Lucky Jain
BACKGROUND: Infants who are born at 34 to 36 weeks of gestation (late preterm) are at greater risk for adverse respiratory and other outcomes than those born at 37 weeks of gestation or later. It is not known whether betamethasone administered to women at risk for late preterm delivery decreases the risks of neonatal morbidities. METHODS: We conducted a multicenter, randomized trial involving women with a singleton pregnancy at 34 weeks 0 days to 36 weeks 5 days of gestation who were at high risk for delivery during the late preterm period (up to 36 weeks 6 days)...
April 7, 2016: New England Journal of Medicine
Hua Wang, Jinlin Wu
Hyperoxia is a high risk factor for neurodevelopmental disorders and can cause nerve cell death. 17β‑Estradiol (E2) has been demonstrated as a neuroprotective agent. In the present study, the effect of hyperoxia on rat oligodendrocyte precursor cells (OPCs) in vivo and the neuroprotective effects of E2 on these cells were investigated. OPCs were treated with various concentrations of E2 and were harvested for reverse transcription‑quantitiative polymerase chain reaction (RT‑qPCR) analysis at various time‑points...
March 2016: Molecular Medicine Reports
Alexander Caicedo, Thomas Alderliesten, Gunnar Naulaers, Petra Lemmers, Frank van Bel, Sabine Van Huffel
We present a new framework for the assessment of cerebral hemodynamics regulation (CHR) in neonates using near-infrared spectroscopy (NIRS). In premature infants, NIRS measurements have been used as surrogate variables for cerebral blood flow (CBF) in the assessment of cerebral autoregulation (CA). However, NIRS measurements only reflect changes in CBF under constant changes in arterial oxygen saturation (SaO2). This condition is unlikely to be met at the bedside in the NICU. Additionally, CA is just one of the different highly coupled mechanisms that regulate brain hemodynamics...
2016: Advances in Experimental Medicine and Biology
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