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neonatal resuscitation

Chance R Anderson, Breena R Taira
BACKGROUND: The Train the Trainer (TTT) model is increasingly used in limited resource settings as a mechanism to disseminate resuscitation knowledge and skills among providers. Anecdotally, however, many resuscitation programs that use this model fail to achieve sustainability. OBJECTIVE: We aim to systematically review the literature to describe the evidence for the TTT method of knowledge dissemination for resuscitation courses in limited resource settings. METHODS: We conducted a systematic review of the literature in accordance with PRISMA guidelines of the PubMed, Cochrane Library, MEDLARS online (MEDLINE), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases...
March 12, 2018: Resuscitation
Mosarrat J Qureshi, Manoj Kumar
BACKGROUND: Providing effective positive pressure ventilation is considered to be the single most important component of successful neonatal resuscitation. Ventilation is frequently initiated manually with bag and face mask (BMV) followed by endotracheal intubation if respiratory depression continues. These techniques may be difficult to perform successfully resulting in prolonged resuscitation or neonatal asphyxia. The laryngeal mask airway (LMA) may achieve initial ventilation and successful resuscitation faster than a bag-mask device or endotracheal intubation...
March 15, 2018: Cochrane Database of Systematic Reviews
Zbynĕk Straňák, Simona Feyereislová, Peter Korček, Eugene Dempsey
Postnatal adaptation in preterm newborn comprises complex physiological processes that involve significant changes in the circulatory and respiratory system. Increasing hemoglobin level and blood volume following placental transfusion may be of importance in enhancing arterial oxygen content, increasing cardiac output, and improving oxygen delivery. The European consensus on resuscitation of preterm infants recommends delayed cord clamping (DCC) for at least 60 s to promote placenta-fetal transfusion in uncompromised neonates...
2018: Frontiers in Pediatrics
Paola Algeri, Clelia Callegari, Davide Paolo Bernasconi, Maddalena Incerti, Sabrina Cozzolino, Giuseppe Paterlini, Salvatore Andrea Mastrolia, Francesca Pellizzoni, Patrizia Vergani
OBJECTIVE: Optimal management of twin deliveries is controversial. We aimed to assess potential risk factors correlated to the development of hypoxia in the second twin after vaginal delivery of the first twin. STUDY DESIGN: This is a retrospective observational study including diamniotic twin pregnancies delivering at our Institution at 35 weeks of gestational age or more, weighing ≥ 1800 g. Hypoxia was defined as at least one of the following: Apgar score < 5 at 10', neonatal resuscitation for > 10 minutes, neonatal acidosis (pH ≤ 7 and/or BE ≥ 12 mmol/L)...
March 11, 2018: Journal of Maternal-fetal & Neonatal Medicine
Jinglan Zhang, Jiakai Lu, Xiaorui Zhou, Xuefeng Xu, Qing Ye, Qitan Ou, Yanna Li, Jiapeng Huang
OBJECTIVES: The mortality of pregnant women with idiopathic pulmonary arterial hypertension (PAH) is very high. There are limited data on the management of idiopathic PAH during pregnancy. The authors aimed to examine systematically the characteristics of parturient women with idiopathic PAH, to explore the adverse effects of idiopathic PAH on pregnancy outcomes, and to report the multidisciplinary perioperative management strategy from the largest comprehensive cardiac hospital in China...
March 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Justine Dol, Marsha Campbell-Yeo, Gail Tomblin Murphy, Megan Aston, Douglas McMillan, Brianna Richardson
OBJECTIVE: The objective of this review was to evaluate the impact of the Helping Babies Survive program on neonatal outcomes and healthcare provider knowledge and skills. INTRODUCTION: The Helping Babies Survive program consists of three modules: Helping Babies Breathe, Essential Care for Every Baby, and Essential Care for Small Babies. It was developed to reduce preventable newborn deaths through skill-based learning using simulation, learning exercises, and peer-to-peer training of healthcare providers in low-resource areas...
March 2018: JBI Database of Systematic Reviews and Implementation Reports
Matthew J Drago, Ursula Guillén, Maria Schiaratura, Jennifer Batza, Annette Zygmunt, Anja Mowes, David Munson, John M Lorenz, Christiana Farkouh-Karoleski, Haresh Kirpalani
Objective How Latino parents perceive and understand antenatal counseling for extreme prematurity, < 26 weeks of gestational age (GA), is not clear. We aim to characterize Latino parental perceptions of antenatal counseling in order to construct and validate a Spanish decision-aid (SDA) to improve parental knowledge of prematurity after antenatal consults. Methods This is a three-phased, prospective, multicenter study. First, interviews of 22 Latino parents with a history of birth < 26 weeks GA were conducted...
March 8, 2018: Maternal and Child Health Journal
Arpitha Chiruvolu, Elise Elliott, Diana Rich, Genna Leal Stone, Huanying Qin, Robert W Inzer
BACKGROUND: In the range of timing suggested by American College of Obstetricians and Gynecologists 30 to 60 s, preterm infants may potentially derive more short and long-term benefits with delayed cord clamping (DCC) for at least 60 s. However, there are concerns with longer resuscitation delay in this vulnerable population. OBJECTIVE: To compare the clinical consequences of 45 versus 60 s delay in umbilical cord clamping in singleton infants born between 230/7 to 316/7 weeks gestation...
March 5, 2018: Early Human Development
Pilar Anton-Martin, Michael Papacostas, Elisabeth Lee, Paul A Nakonezny, Michael L Green
BACKGROUND: Malnutrition is associated with an increased risk of mortality in patients admitted to the intensive care unit. Children requiring extracorporeal membrane oxygenation (ECMO) support represent an extremely ill subset of this population. There is a lack of data on the impact of nutrition state on survival in this cohort. We examined the association between being underweight and in-hospital mortality among children supported with ECMO. MATERIALS AND METHODS: This article reports on an observational retrospective cohort study performed among neonatal and pediatric patients supported with ECMO in a tertiary children's hospital from May 1996 through June 2013...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Marta Thio, Jennifer A Dawson, Kelly J Crossley, Timothy J Moss, Charles C Roehr, Graeme R Polglase, Peter G Davis, Stuart B Hooper
BACKGROUND: In neonatal resuscitation, a ventilation device providing positive end-expiratory pressure (PEEP) is recommended. There is limited information about PEEP delivery in vivo, using different models of self-inflating bag (SIB) at different inflation rates and PEEP settings. METHODS: We compared PEEP delivery to intubated preterm lambs using four commonly available models of paired SIBs and PEEP valves, with a T-piece, with gas flow of 8 L/min. Peak inspiratory pressure inflations of 30 cmH2 O, combined with set PEEP of 5, 7 and 10 cmH2 O, were delivered at rates of 20, 40 and 60/min...
March 2, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
Emma R Allanson, Robert C Pattison, Nathan A Elizabeth, Jan E Dickinson
OBJECTIVES: To assess umbilical artery lactate levels and perinatal outcomes among women with and without HIV infection. METHODS: The present prospective cohort study recruited women planning to undergo vaginal delivery at Kalafong Hospital, South Africa, between March 3 and November 12, 2014. Umbilical artery lactate levels were measured and perinatal outcome data were recorded. Outcome analyses were stratified by maternal HIV status, and a subgroup analysis was performed where women with a CD4 count below 350×106 cells/L were compared with women without HIV...
March 1, 2018: International Journal of Gynaecology and Obstetrics
Nariae Baik, Megan O'Reilly, Caroline Fray, Sylvia van Os, Po-Yin Cheung, Georg M Schmölzer
Approximately, 10-20% of newborns require breathing assistance at birth, which remains the cornerstone of neonatal resuscitation. Fortunately, the need for chest compression (CC) or medications in the delivery room (DR) is rare. About 0.1% of term infants and up to 15% of preterm infants receive these interventions, this will result in approximately one million newborn deaths annually worldwide. In addition, CC or medications (epinephrine) are more frequent in the preterm population (~15%) due to birth asphyxia...
2018: Frontiers in Pediatrics
Emer Finan, Douglas M Campbell, Khalid Aziz, Patrick J McNamara
The International Liaison Committee on Resuscitation (ILCOR) Neonatal Task Force reviews available resuscitation science every 5 years and develops guidelines which are integrated into educational programs such as the Neonatal Resuscitation Program (NRP). The most recent ILCOR Neonatal Task Force consensus guidelines were published in October 2015. The Canadian Paediatric Society's NRP Steering Committee has reviewed ILCOR guidelines alongside the 7th edition (2016) NRP materials. Using a case-based approach, this practice point highlights the main changes relating to the delivery of NRP, within the Canadian context...
September 2017: Paediatrics & Child Health
Brigitte Lemyre, Linh Ly, Vann Chau, Anil Chacko, Nicholas Barrowman, Hilary Whyte, Steven P Miller
Objective: To identify factors associated with early initiation and achievement of therapeutic hypothermia (TH) in newborns with hypoxic-ischemic encephalopathy (HIE). Methods: Retrospective cohort study of newborns who received TH according to National Institute of Child Health and Human Development (NICHD) criteria in two academic level 3 Neonatal Intensive Care Units (NICU) between 2009 and 2013. All infants were transported by a neonatal transport team (NNTT)...
August 2017: Paediatrics & Child Health
Heideh H Matterson, Demian Szyld, Brad R Green, Heather B Howell, Martin V Pusic, Pradeep V Mally, Sean M Bailey
BACKGROUND: Following neonatal resuscitation program (NRP) training, decay in clinical skills can occur. Simulation-based deliberate practice (SBDP) has been shown to maintain NRP skills to a variable extent. Our study objectives were (a) to determine whether a single 30 min simulation-based intervention that incorporates SBDP and mastery learning (ML) can effectively restore skills and prevent skill decay and (b) to compare different timing options. METHODS: Following NRP certification, pediatric residents were randomly assigned to receive a video-recorded baseline assessment plus SBDP-ML refresher education at between 6 and 9 months (early) or between 9 and 12 months (late)...
February 16, 2018: Journal of Perinatal Medicine
Gustavo Rocha, Hercília Guimarães
Pneumomediastinum after birth, without birth injury or resuscitation maneuvers, is an unusual situation that can present with grunting, deafening of cardiac sounds, and bulging of the hemithorax. If clinical condition allows, conservative approach is advised even if the pneumomediastinum does not spontaneously resolve in 1 or 2 days.
February 2018: Clinical Case Reports
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
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
Eva M Schwindt, Florian Hoffmann, Philipp Deindl, Thomas J Waldhoer, Jens C Schwindt
OBJECTIVES: To compare the duration to establish an umbilical venous catheter and an intraosseous access in real hospital delivery rooms and as a secondary aim to assess delaying factors during establishment and to provide recommendations to accelerate vascular access in neonatal resuscitation. DESIGN: Retrospective analysis of audio-video recorded neonatal simulation training. SETTINGS: Simulation training events in exact replications of actual delivery/resuscitation rooms of 16 hospitals with different levels of care (Austria and Germany)...
February 9, 2018: Pediatric Critical Care Medicine
Q Bao, X Y Hong, Y Y Liu, X J Zhang, H T Gao, Z C Feng
Objective: To investigate the application and outcome of pediatric extracorporeal membrane oxygenation (ECMO) in a single center. Methods: The clinical data of 52 pediatric patients with cardiopulmonary failure received ECMO support in Bayi Children's Hospital Affiliated to General Hospital of Beijing Military Command of PLA were collected from January 2012 to October 2016. All patients were divided into two stages by time. January 2012 to December 2014 was stage one. January 2015 to October 2016 was stage two...
February 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
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