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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
#1
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/29230549/a-nationwide-survey-of-incidence-rates-and-risk-factors-of-inguinal-hernia-in-preterm-children
#2
Yu-Wei Fu, Mei-Lien Pan, Yao-Jen Hsu, Tai-Wai Chin
PURPOSE: Clinical observations showed a higher incidence rate of inguinal hernia (IH) in preterm infants. In this study, we calculated the incidence rate of preterm IH from the National Health Insurance Research Database (NHIRD) of Taiwan. METHODS: From NHIRD, 92,308 subjects born in the year of 1997-2005 were randomly selected as the study cohort. The medical claims of these subjects from birth to 6th year of age were analyzed. Preterm births were defined using ICD code 765...
December 11, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29227860/respiratory-syncytial-virus-in-brazilian-infants-ten-years-two-cohorts
#3
Elinara Wollmeister, Alfonso Eduardo Alvarez, Juliana Cristina Santiago Bastos, Fernando Augusto Lima Marson, José Dirceu Ribeiro, Emílio Carlos Elias Baracat, Clarice Weis Arns, Adriana Gut Lopes Riccetto
BACKGROUND: Each year, a considerable amount of children will experience at least one episode of acute viral bronchiolitis (AVB) during their first year of life. About 10% of them will be hospitalized, with significant physical and economic burdens. OBJECTIVES: To compare two cohorts of infants with AVB, from same region, in a ten-year interval, regarding epidemiologic factors and viral etiology. STUDY DESIGN: Cohorts: 142 (2004) and 172 (2014) infants at ages zero to 12 months; clinical diagnosis of AVB; medical care in hospital and genetic screening of nasopharyngeal secretion for respiratory viruses...
December 6, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29224772/resolution-of-vocal-fold-immobility-in-preterm-infants
#4
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/29214783/effective-tidal-volume-for-normocapnia-in-very-low-birth-weight-infants-using-high-frequency-oscillatory-ventilation
#5
Seul Mi Lee, Ran Namgung, Ho Sun Eun, Soon Min Lee, Min Soo Park, Kook In Park
PURPOSE: Removal of CO₂ is much efficient during high-frequency oscillatory ventilation (HFOV) for preterm infants. However, an optimal carbon dioxide diffusion coefficient (DCO₂) and tidal volume (VT) have not yet been established due to much individual variance. This study aimed to analyze DCO₂ values, VT, and minute volume in very-low-birth-weight (VLBW) infants using HFOV and correlates with plasma CO₂ (pCO₂). MATERIALS AND METHODS: Daily respiratory mechanics and ventilator settings from twenty VLBW infants and their two hundred seventeen results of blood gas analysis were collected...
January 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29211751/diffusion-tensor-imaging-detects-ventilation-induced-brain-injury-in-preterm-lambs
#6
Dhafer M Alahmari, Kyra Y Y Chan, Vanesa Stojanovska, Domenic LaRosa, Samantha K Barton, Ilias Nitsos, Valerie Zahra, Jade Barbuto, Michael Farrell, Shigeo Yamaoka, James T Pearson, Graeme R Polglase
PURPOSE: Injurious mechanical ventilation causes white matter (WM) injury in preterm infants through inflammatory and haemodynamic pathways. The relative contribution of each of these pathways is not known. We hypothesised that in vivo magnetic resonance imaging (MRI) can detect WM brain injury resulting from mechanical ventilation 24 h after preterm delivery. Further we hypothesised that the combination of inflammatory and haemodynamic pathways, induced by umbilical cord occlusion (UCO) increases brain injury at 24 h...
2017: PloS One
https://www.readbyqxmd.com/read/29210721/technique-utilizing-a-modified-oral-ring-adair-elwyn-tube-to-provide-continuous-oxygen-and-sevoflurane-delivery-during-nasotracheal-intubation-in-an-infant-with-a-difficult-airway-a-case-report
#7
Janice Y Man, John E Fiadjoe, Grace Hsu
Managing the airway of an infant with Pierre Robin sequence (PRS) is particularly challenging for anesthesiologists. Patients with PRS have the triad of micrognathia, glossoptosis, and airway obstruction that potentially and frequently leads to difficulty with both ventilation and intubation. Thus continuous oxygenation and spontaneous ventilation during intubation are essential. We describe a new method to deliver continuous oxygen and volatile anesthetic during nasotracheal intubation in an infant with PRS...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29209598/inflammatory-mediators-in-tracheal-aspirates-of-preterm-infants-participating-in-a-randomized-trial-of-permissive-hypercapnia
#8
Sarah Gentner, Mandy Laube, Ulrike Uhlig, Yang Yang, Hans W Fuchs, Jens Dreyhaupt, Helmut D Hummler, Stefan Uhlig, Ulrich H Thome
Background: Ventilator-induced lung injury is considered to be a main factor in the pathogenesis of bronchopulmonary dysplasia (BPD). Optimizing ventilator strategies may reduce respiratory morbidities in preterm infants. Permissive hypercapnia has been suggested to attenuate lung injury. We aimed to determine if a higher PCO2 target range results in less lung injury compared to the control target range and possibly reduces pro-inflammatory cytokines and acid sphingomyelinase (ASM) in tracheal aspirates (TA), which has not been addressed before...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29209032/comparison-of-state-risk-appropriate-neonatal-care-policies-with-the-2012-aap-policy-statement
#9
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
#10
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/29204652/effect-of-nasal-continuous-positive-airway-pressure-on-infants-with-meconium-aspiration-syndrome-a-randomized-clinical-trial
#11
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/29202248/bag-valve-mask-ventilation-as-a-perceptual-cognitive-skill
#12
Joel M Mumma, Francis T Durso, Michelle Dyes, Rogelio Dela Cruz, Valerie P Fox, Mary Hoey
Objective This study used a high-fidelity infant mannequin to examine the relationship between the quality of bag valve mask ventilation (BVMV) and how providers of varying levels of experience use visual feedback (e.g., electronic vital signs) to guide their performance. Background BVMV is a common and critical procedure for managing pediatric respiratory emergencies. However, providers do not consistently deliver effective BVMV. Efforts to improve BVMV have ignored the question of how providers effectively use feedback often available during BVMV...
December 1, 2017: Human Factors
https://www.readbyqxmd.com/read/29198532/impact-of-prolonged-mechanical-ventilation-in-very-low-birth-weight-infants-results-from-a-national-cohort-study
#13
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/29197374/prevalence-and-associated-factors-of-strabismus-in-former-preterm-and-full-term-infants-between-4-and-10%C3%A2-years-of-age
#14
Achim Fieß, Ruth Kölb-Keerl, Alexander K Schuster, Markus Knuf, Bernd Kirchhof, Philipp S Muether, Jacqueline Bauer
BACKGROUND: Limited data exist collating most of the associated factors for strabismus in one analysis. The aim of this study was to assess the prevalence of strabismus and to analyse associated factors in former preterm and full-term infants. METHODS: In this cross-sectional study, 239 former preterm infants with gestational age (GA) ≤ 32 weeks and 264 former full-term born infants with GA ≥ 37 weeks underwent detailed ophthalmologic examination in the age of 4-10 years and perinatal data assessment for risk factor analysis...
December 2, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/29195837/evaluation-of-the-efficacy-of-tongue-lip-adhesion-in-pierre-robin-sequence
#15
H Broucqsault, M-D Lamblin, G Hosana, P Fayoux
OBJECTIVE: Tongue-lip adhesion may be used to relieve obstructive sleep apnoea in infants with Pierre Robin sequence (PRS), but only a few studies have objectively evaluated its efficacy. The purpose of this study was to evaluate the results of tongue-lip adhesion by polysomnography. MATERIEL AND METHODS: A single-centre retrospective study was conducted in infants with PRS treated by tongue-lip adhesion from 2004 to 2015, in whom at least laryngotracheal endoscopy and polysomnography were performed...
November 28, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
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/29191812/physiologically-based-cord-clamping-stabilises-cardiac-output-and-reduces-cerebrovascular-injury-in-asphyxiated-near-term-lambs
#17
Graeme R Polglase, Douglas A Blank, Samantha K Barton, Suzanne L Miller, Vanesa Stojanovska, Martin Kluckow, Andrew W Gill, Domenic LaRosa, Arjan B Te Pas, Stuart B Hooper
BACKGROUND: Physiologically based cord clamping (PBCC) has advantages over immediate cord clamping (ICC) during preterm delivery, but its efficacy in asphyxiated infants is not known. We investigated the physiology of PBCC following perinatal asphyxia in near-term lambs. METHODS: Near-term sheep fetuses (139±2 (SD) days' gestation) were instrumented to measure umbilical, carotid, pulmonary and femoral arterial flows and pressures. Systemic and cerebral oxygenation was recorded using pulse oximetry and near-infrared spectroscopy, respectively...
November 30, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
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
#18
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
#19
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/29189669/measurement-of-dead-space-fraction-upon-icu-admission-predicts-length-of-stay-and-clinical-outcomes-following-bidirectional-cavopulmonary-anastomosis
#20
Claire L Cigarroa, Sarah J van den Bosch, Xiaoqi Tang, Kimberlee Gauvreau, Christopher W Baird, James A DiNardo, John Nagi Kheir
OBJECTIVES: Increased alveolar dead space fraction has been associated with prolonged mechanical ventilation and increased mortality in pediatric patients with respiratory failure. The association of alveolar dead space fraction with clinical outcomes in patients undergoing bidirectional cavopulmonary anastomosis for single ventricle congenital heart disease has not been reported. We describe an association of alveolar dead space fraction with postoperative outcomes in patients undergoing bidirectional cavopulmonary anastomosis...
November 20, 2017: Pediatric Critical Care Medicine
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