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https://www.readbyqxmd.com/read/28723921/postnatal-dexamethasone-respiratory-and-neurodevelopmental-outcomes-at-two-years-in-babies-born-extremely-preterm
#1
Gordon Qin, Jessica W Lo, Neil Marlow, Sandy A Calvert, Anne Greenough, Janet L Peacock
IMPORTANCE: Postnatal dexamethasone is associated with reduction in bronchopulmonary dysplasia. There remains, however, concern that its short-term benefits are accompanied by long-term adverse effects e.g. poorer neurodevelopmental outcomes. OBJECTIVE: Our aim was to determine the effects of administration of postnatal dexamethasone on respiratory and neurodevelopmental outcome at two years of age after adjusting for neonatal and infant risk factors. MATERIALS AND METHODS: The study included 412 infants born at 23-28 weeks of gestation, 29% had received postnatal dexamethasone...
2017: PloS One
https://www.readbyqxmd.com/read/28719483/difficult-intubation-and-ventilation-in-an-infant-with-retropharyngeal-abscess-with-mediastinal-extension
#2
Michael A Bruno, Tomas Drabek, Mioara D Manole
A previously healthy 7-month-old male infant presented for evaluation of fever, deceased oral intake, and intermittent noisy breathing. Physical examination revealed neck tenderness. Soft tissue neck radiographs and computed tomography (CT) scan supported a diagnosis of retropharyngeal swelling with extension to the superior mediastinum. Surgical exploration was planned, and endotracheal intubation was performed in the operating room. Significant cardiorespiratory derangements developed immediately after the tracheal tube was inserted, including hypotension, hypoxia, and bradycardia with signs of cardiac ischemia...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28719384/anesthetic-management-of-an-infant-with-postnatally-diagnosed-tracheal-agenesis-undergoing-tracheal-reconstruction-a-case-report
#3
Brittany L Willer, Kayla G Bryan, Daiva E Parakininkas, Michael R Uhing, Susan R Staudt, Kathleen M Dominguez, Michael E McCormick, Michael E Mitchell, John C Densmore, Keith T Oldham, Richard J Berens
A term infant born cyanotic failed multiple intubation attempts and tracheostomy placement. After esophageal intubation resulted in the ability to ventilate, he was presumed to have tracheal agenesis and distal bronchoesophageal fistula. He was transferred to our institution where he was diagnosed with Floyd Type II tracheal agenesis. He underwent staged tracheal reconstruction. He was discharged to home at 4 months of age with a tracheostomy collar, cervical spit fistula, and gastrostomy tube. He represents the sole survivor-to-discharge of tracheal agenesis in the United States...
July 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28718356/comparison-of-three-non-invasive-ventilation-strategies-nsippv-bipap-ncpap-for-rds-in-vlbw-infants
#4
Vincenzo Salvo, Gianluca Lista, Enrica Lupo, Alberto Ricotti, Luc J I Zimmermann, Antonio W D Gavilanes, Eloisa Gitto, Micaela Colivicchi, Valeria Ferraù, Diego Gazzolo
BACKGROUND: Noninvasive ventilation (NIV) significantly changed the management of respiratory distress syndrome (RDS) in preterm infants. Further perspectives for neonatologists regard the assessment of different NIV strategies in terms of availability, effectiveness and failure. OBJECTIVE: The aim of the present study is to evaluate the effectiveness of three different NIV strategies: nasal continuous pressure (N-CPAP), nasal synchronized intermittent positive pressure ventilation (N-SIPPV) and nasal bilevel CPAP (BiPAP), as first intention treatment for RDS in very low birth-weight infants (VLBW)...
July 18, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28716018/prediction-of-extubation-readiness-in-extremely-preterm-infants-by-the-automated-analysis-of-cardiorespiratory-behavior-study-protocol
#5
Wissam Shalish, Lara J Kanbar, Smita Rao, Carlos A Robles-Rubio, Lajos Kovacs, Sanjay Chawla, Martin Keszler, Doina Precup, Karen Brown, Robert E Kearney, Guilherme M Sant'Anna
BACKGROUND: Extremely preterm infants (≤ 28 weeks gestation) commonly require endotracheal intubation and mechanical ventilation (MV) to maintain adequate oxygenation and gas exchange. Given that MV is independently associated with important adverse outcomes, efforts should be made to limit its duration. However, current methods for determining extubation readiness are inaccurate and a significant number of infants fail extubation and require reintubation, an intervention that may be associated with increased morbidities...
July 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28709948/mechanical-ventilation-strategies
#6
REVIEW
Martin Keszler
Although only a small proportion of full term and late preterm infants require invasive respiratory support, they are not immune from ventilator-associated lung injury. The process of lung damage from mechanical ventilation is multifactorial and cannot be linked to any single variable. Atelectrauma and volutrauma have been identified as the most important and potentially preventable elements of lung injury. Respiratory support strategies for full term and late preterm infants have not been as thoroughly studied as those for preterm infants; consequently, a strong evidence base on which to make recommendations is lacking...
July 11, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28707773/sudden-onset-of-pheochromocytoma-multisystem-crisis-at-38%C3%A2-weeks-of-gestation-resulted-in-intrauterine-fetal-death-a-case-report
#7
Jun Iwase, Michiko Yamanaka
A 24-year-old woman at 38 weeks of gestation with no past medical history was transferred to our hospital because of acute onset of severe dyspnea. Her conscious level was E4V2M5 on the Glasgow Coma Scale and she displayed stress cardiomyopathy (Takotsubo cardiomyopathy) with multiple organ failure. Intrauterine fetal death was confirmed. After immediate application of intubated ventilation, percutaneous cardiopulmonary support and hemodialysis, she was diagnosed with pheochromocytoma multisystem crisis. After multidisciplinary team discussion, surgical resection of the left pheochromocytoma was performed on the same day...
July 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28707404/sustained-versus-standard-inflations-during-neonatal-resuscitation-to-prevent-mortality-and-improve-respiratory-outcomes
#8
REVIEW
Matteo Bruschettini, Colm Pf O'Donnell, Peter G Davis, Colin J Morley, Lorenzo Moja, Simona Zappettini, Maria Grazia Calevo
BACKGROUND: At birth, infants' lungs are fluid-filled. For newborns to have a successful transition, this fluid must be replaced by air to enable effective breathing. Some infants are judged to have inadequate breathing at birth and are resuscitated with positive pressure ventilation (PPV). Giving prolonged (sustained) inflations at the start of PPV may help clear lung fluid and establish gas volume within the lungs. OBJECTIVES: To assess the efficacy of an initial sustained (> 1 second duration) lung inflation versus standard inflations (≤ 1 second) in newly born infants receiving resuscitation with intermittent PPV...
July 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28705653/solving-the-extubation-equation-successfully-weaning-infants-born-extremely-preterm-from-mechanical-ventilation
#9
EDITORIAL
Brett J Manley, Peter G Davis
No abstract text is available yet for this article.
July 10, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28704819/electrical-cardiometry-to-monitor-cardiac-output-in-preterm-infants-with-patent-ductus-arteriosus-a-comparison-with-echocardiography
#10
Kai-Hsiang Hsu, Tai-Wei Wu, I-Hsyuan Wu, Mei-Yin Lai, Shih-Yun Hsu, Hsiao-Wen Huang, Tze-Yee Mok, Reyin Lien
BACKGROUND: Electrical cardiometry (EC) is an impedance-based monitoring that provides noninvasive cardiac output (CO) assessment. Through comparison to transthoracic echocardiography (Echo), the accuracy of EC has been verified. However, left-to-right patent ductus arteriosus (PDA) shunting is a concern because PDA shunts aortic flow to the pulmonary artery and may interfere with EC in measuring CO. OBJECTIVE: To determine the agreement between EC and Echo in preterm infants with a hemodynamically significant PDA (hsPDA)...
July 14, 2017: Neonatology
https://www.readbyqxmd.com/read/28704815/relaxation-rate-of-the-respiratory-muscles-and-prediction-of-extubation-outcome-in-prematurely-born-infants
#11
Theodore Dassios, Ourania Kaltsogianni, Anne Greenough
BACKGROUND: Accurate prediction of extubation outcome could result in a significant reduction of respiratory morbidity in premature neonates. OBJECTIVES: To assess whether the respiratory muscle time constant of relaxation (τ) predicted extubation outcome in mechanically ventilated, premature infants. METHODS: Forty-six mechanically ventilated infants with a median gestational age of 26 (interquartile range [IQR] 25-29) weeks were prospectively studied...
July 14, 2017: Neonatology
https://www.readbyqxmd.com/read/28702694/mortality-and-morbidity-in-oesophageal-atresia
#12
Robert T Peters, Hany Ragab, Malachy O Columb, James Bruce, Ralph J MacKinnon, Ross J Craigie
BACKGROUND: Several classification systems exist to predict mortality in oesophageal atresia, the most widely quoted of these being over 20 years old. No classification system exists to predict morbidity. We sought to test whether these classification systems remain relevant and to determine whether they can be useful to predict morbidity. In addition, we aimed to identify independent risk factors for predicting mortality and morbidity. METHODS: Neonates presenting with oesophageal atresia over a 20-year period (1990-2010) were retrospectively reviewed...
July 12, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28701321/pituitary-adenylate-cyclase-activating-polypeptide-pacap-drives-cardiorespiratory-responses-to-heat-stress-in-neonatal-mice
#13
Karlene T Barrett, John Andrew Daubenspeck, Richard J A Wilson
The neuropeptide, pituitary adenylate cyclase-activating polypeptide (PACAP), has emerged as a principal and rate-limiting regulator of physiological stress responses in adult rodents and has been implicated in SIDS (Sudden Infant Death Syndrome). Recent studies show that PACAP plays a role in neonatal cardiorespiratory responses to hypoxia, hypercapnia and hypothermia, but not hyperthermia, which is often associated with SIDS. Here we tested the hypothesis that, consistent with a role in SIDS, PACAP is involved in regulating the neonatal cardiorespiratory responses to severe heat...
July 12, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28698268/effects-of-volume-guaranteed-ventilation-combined-with-two-different-modes-in-preterm-infants
#14
Sezin Unal, Ebru Ergenekon, Selma Aktas, Nilgun Altuntas, Serdar Beken, Ebru Kazanci, Ferit Kulali, Ozlem Gulbahar, Ibrahim M Hirfanoglu, Esra Onal, Canan Turkyilmaz, Esin Koc, Yildiz Atalay
BACKGROUND: Volume-controlled ventilation modes have been shown to reduce duration of mechanical ventilation, incidence of chronic lung disease, failure of primary mode of ventilation, hypocarbia, severe intraventricular hemorrhage, pneumothorax, and periventricular leukomalacia in preterm infants when compared with pressure limited ventilation modes. Volume-guarantee (VG) ventilation is the most commonly used mode for volume-controlled ventilation. Assist control, pressure-support ventilation (PSV), and synchronized intermittent mandatory ventilation (SIMV) can be combined with VG; however, there is a lack of knowledge on the superiority of each regarding clinical outcomes...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28690548/optimization-of-variable-ventilation-for-physiology-immune-response-and-surfactant-enhancement-in-preterm-lambs
#15
Erzsébet Bartolák-Suki, Peter B Noble, Samer Bou Jawde, Jane J Pillow, Béla Suki
Preterm infants often require mechanical ventilation due to lung immaturity including reduced or abnormal surfactant. Since cyclic stretch with cycle-by-cycle variability is known to augment surfactant release by epithelial cells, we hypothesized that such in vivo mechanotransduction improves surfactant maturation and hence lung physiology in preterm subjects. We thus tested whether breath-by-breath variability in tidal volume (VT) in variable ventilation (VV) can be tuned for optimal performance in a preterm lamb model...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28684015/bioimpedance-spectroscopy-measurements-of-phase-angle-and-height-for-age-are-predictive-of-outcome-in-children-following-surgery-for-congenital-heart-disease
#16
L V Marino, R Meyer, M Johnson, C Newell, C Johnstone, A Magee, K Sykes, S A Wootton, J V Pappachan
OBJECTIVE: Children with congenital heart disease (CHD) are often growth restricted (low weight- and/or height-for-age) which may increase risk of poor post operative resilience. Bioelectrical impedance spectroscopy (BIS) has been used to determine body composition in different clinical settings and has been shown to mark differences in nutritional state and clinical outcome. In disease conditions were fluid is not normally distributed it is proposed that raw impedance values and BIS derived phase-angle may serve as prognostic indicators of clinical outcome...
June 28, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28682316/neonatal-outcomes-based-on-mode-and-intensity-of-delivery-room-resuscitation
#17
A Bashir, B Bird, L Wu, S Welles, H Taylor, E Anday, V Bhandari
OBJECTIVE: To examine outcomes of neonates based on the mode and intensity of resuscitation received in the delivery room (DR). STUDY DESIGN: A retrospective study of 439 infants with birth weight ⩽1500 g receiving DR resuscitation at two hospital centers in Philadelphia, Pennsylvania. RESULTS: Of 439 infants, 22 (5%) received routine care, 188 (43%) received noninvasive positive pressure ventilation (PPV) and 229 (52%) received endotracheal tube (ETT) intubation in the DR...
July 6, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28682001/weight-correction-of-carbon-dioxide-diffusion-coefficient-dco2-reduces-its-inter-individual-variability-and-improves-its-correlation-with-blood-carbon-dioxide-levels-in-neonates-receiving-high-frequency-oscillatory-ventilation
#18
Gusztav Belteki, Benjamin Lin, Colin J Morley
BACKGROUND: Carbon-dioxide elimination during high-frequency oscillatory ventilation (HFOV) is thought to be proportional to the carbon dioxide diffusion coefficient (DCO2 ) which is calculated as frequency x (tidal volume)(2) . DCO2 can be used to as an indicator of CO2 elimination but values obtained in different patients cannot be directly compared. OBJECTIVES: To analyze the relationship between DCO2 , the weight-corrected DCO2 (DCO2 corr) and blood gas PCO2 values obtained from infants receiving HFOV...
July 6, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28678385/release-of-atp-by-preb%C3%A3-tzinger-complex-astrocytes-contributes-to-the-hypoxic-ventilatory-response-via-a-ca-2-dependent-p2y1-receptor-mechanism
#19
V Rajani, Y Zhang, V Jalubula, V Rancic, S SheikhBahaei, J D Zwicker, S Pagliardini, C T Dickson, K Ballanyi, S Kasparov, A V Gourine, G D Funk
The hypoxic ventilatory response (HVR) is biphasic, consisting of a phase I increase in ventilation followed by a secondary depression (to a steady-state phase II) that can be life-threatening in premature infants who suffer from frequent apneas and respiratory depression. ATP released in the ventrolateral medulla oblongata during hypoxia attenuates the secondary depression. We explored a working hypothesis that vesicular release of ATP by astrocytes in the preBötzinger Complex (preBötC) inspiratory rhythm generating network acts via P2Y1 receptors to mediate this effect...
July 5, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28672098/inhaled-corticosteroids-in-transient-tachypnea-of-the-newborn-a-randomized-placebo-controlled-study
#20
Yulia Vaisbourd, Bahaa Abu-Raya, Shmuel Zangen, Shmuel Arnon, Arieh Riskin, Irit Shoris, Nael Elias, David Bader, Amir Kugelman
OBJECTIVE: Prenatal corticosteroids were shown to reduce the respiratory complication in late preterm infants. Our objective was to determine if early inhaled corticosteroids could alleviate the respiratory distress and morbidity in late preterm and term neonates with transient tachypnea of the newborn (TTN). STUDY DESIGN: Double-blind, randomized placebo-controlled, multicenter pilot study. Infants born at >34 weeks gestational age with TTN at 4 h of age were randomized to two doses, 12 h apart, of inhaled Budesonide 1000 μg/dose or placebo within 6 h from delivery...
August 2017: Pediatric Pulmonology
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