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surfactant in prematurity babies

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https://www.readbyqxmd.com/read/28465315/a-first-in-human-clinical-study-of-a-new-sp-b-and-sp-c-enriched-synthetic-surfactant-chf5633-in-preterm-babies-with-respiratory-distress-syndrome
#1
David G Sweet, Mark A Turner, Zbyněk Straňák, Richard Plavka, Paul Clarke, Ben J Stenson, Dominique Singer, Rangmar Goelz, Laura Fabbri, Guido Varoli, Annalisa Piccinno, Debora Santoro, Christian P Speer
OBJECTIVE: CHF5633 (Chiesi Farmaceutici S.p.A., Parma, Italy) is the first fully synthetic surfactant enriched by peptide analogues of two human surfactant proteins. We planned to assess safety and tolerability of CHF5633 and explore preliminary efficacy. DESIGN: Multicentre cohort study. PATIENTS: Forty infants from 27(+0) to 33(+6) weeks gestation with respiratory distress syndrome requiring fraction of inspired oxygen (FiO2) ≥0.35 were treated with a single dose of CHF5633 within 48 hours after birth...
May 2, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28258032/morbidity-and-mortality-trends-in-very-very-low-birth-weight-premature-infants-in-light-of-recent-changes-in-obstetric-care
#2
Péter Varga, Botond Berecz, Ákos Gasparics, Zsófia Dombi, Zsuzsa Varga, Judit Jeager, Zsófia Magyar, János Rigó, József Gábor Joó, László Kornya
OBJECTIVE: In this study, we describe trends in morbidity and mortality of preterm infants with less than 500mg birth weight in the changing landscape of obstetric and neonatal care. STUDY DESIGN: During a ten year study period between 2006 and 2016 we assessed outcome data for all neonates with less than 500mg birth weight born at our Neonatal Intensive Care Unit. We divided study subjects into two groups based on whether their birth date fell in the first half (2006-2010; n=39) versus the second half (2011-2015; n=27) of the study period comparing clinical outcomes in the two groups...
April 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28099980/challenges-faced-in-translating-the-benefits-of-surfactant-replacement-therapy-to-a-resource-limited-setting
#3
N Hamilton, Helen Trotman
Aim To determine the challenges, if any, in translating the benefits of surfactant replacement therapy (SRT) to a resource-limited setting. Method This was a retrospective descriptive study comparing the outcome of 75 cases who received surfactant and 69 controls who did not at the University Hospital of the West Indies during the period 2001 to 2011. Descriptive analyses were performed. Statistical significance was taken at the level p < 0.05. Results Only 13% of neonates with respiratory distress syndrome received surfactant therapy...
July 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/27992064/survey-shows-large-differences-between-the-nordic-countries-in-the-use-of-less-invasive-surfactant-administration
#4
Christian Heiring, Baldvin Jonsson, Sture Andersson, Lars J Björklund
AIM: Less invasive surfactant administration (LISA), namely surfactant instillation through a thin catheter in the trachea during spontaneous breathing, is increasingly used for premature infants. We surveyed the use of this technique in the Nordic countries in autumn 2015. METHODS: A link to a web-based survey of surfactant administration methods was emailed to the directors of all neonatal units in the Nordic Region, apart from Finland, where only the five university-based departments were invited...
December 19, 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27545716/preventing-newborn-deaths-due-to-prematurity
#5
REVIEW
Kishwar Azad, Jiji Mathews
Preterm births (PTBs), defined as births before 37 weeks of gestation account for the majority of deaths in the newborn period. Prediction and prevention of PTB is challenging. A history of preterm labour or second trimester losses and accurate measurement of cervical length help to identify women who would benefit from progesterone and cerclage. Fibronectin estimation in the cervicovaginal secretions of a symptomatic woman with an undilated cervix can predict PTB within 10 days of testing. Antibiotics should be given to women with preterm prelabour rupture of membranes but tocolysis has a limited role in the management of preterm labour...
October 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27424553/tracheal-agenesis-a-report-of-two-cases
#6
A V Desai, Sudha Rao, P R Shanbhag, M Rupani
Tracheal agenesis is an extremely rare congenital anomaly involving the respiratory system. It is generally associated with anomalies of other systems. Antenatal diagnosis of this condition is difficult; therefore, it presents as a medical emergency in the labor room. Intubation in these babies is difficult. As many of these babies are born prematurely, respiratory distress syndrome (RDS) adds to the management difficulties. Here, we describe two babies with this lethal anomaly and RDS where esophageal intubation and surfactant therapy proved beneficial...
July 2016: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/26958689/strategies-of-using-surfactant-results-of-the-first-polish-national-survey-of-daily-practice
#7
Maria Katarzyna Borszewska-Kornacka, Marzena Kostuch, Piotr Korbal, Paweł Krajewski
BACKGROUND: The efficiency of routine practices in the management of neonatal respiratory distress syndrome (RDS) have never been systematically investigated in Poland. OBJECTIVE: To evaluate RDS treatment policies and short-term outcomes in neonatal intensive care units (NICUs). MATERIAL AND METHODS: We retrospectively analyzed medical records of premature neonates ≤ 32 weeks' gestation, diagnosed with RDS in level-2 and level-3 referral centers...
July 2015: Developmental Period Medicine
https://www.readbyqxmd.com/read/26733541/stabilisation-of-premature-infants-in-the-delivery-room-with-nasal-high-flow
#8
Peter Reynolds, Stamatina Leontiadi, Tracy Lawson, Tosin Otunla, Olayinka Ejiwumi, Nicola Holland
OBJECTIVE: This was a pilot study to determine the feasibility of using nasal high flow (nHF) (also known as heated humidified high-flow nasal cannula) for stabilisation of babies born at <30 weeks gestation in the delivery room (DR) and transfer to the neonatal intensive care unit (NICU). DESIGN: Observational study. SETTING: Single-centre NICU. PATIENTS: Infants born at <30 weeks gestation. INTERVENTIONS: Stabilisation and transfer to NICU using nHF...
July 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/25885964/a-pilot-study-of-less-invasive-surfactant-administration-in-very-preterm-infants-in-a-chinese-tertiary-center
#9
RANDOMIZED CONTROLLED TRIAL
Yingying Bao, Guolian Zhang, Mingyuan Wu, Lixin Ma, Jiajun Zhu
BACKGROUND: Less invasive surfactant administration (LISA) to spontaneously breathing preterm infants has been reported to reduce the duration of mechanical ventilation and the incidence of bronchopulmonary dysplasia (BPD) in previous study. The objective of this study was to explore the feasibility and potential benefits of LISA in early preterm infants on nasal continuous positive airway pressure (nCPAP) compared to conventional endotracheal instillation. METHODS: All infants with respiratory distress born at 28-32 weeks' gestational age from January 2012 to December 2012 (n=90), who were eligible for exogenous pulmonary surfactant (PS) therapy were randomized to receive PS by intubation with an endotracheal tube (Intubation group, n=43), or by intubation using a catheter while on nCPAP (LISA group, n=47)...
2015: BMC Pediatrics
https://www.readbyqxmd.com/read/25777608/a-pilot-study-of-less-invasive-surfactant-administration-in-very-preterm-infants-in-a-chinese-tertiary-center
#10
Yingying Bao, Guolian Zhang, Mingyuan Wu, Lixin Ma, Jiajun Zhu
BACKGROUND: Less invasive surfactant administration (LISA) to spontaneously breathing preterm infants has been reported to reduce the duration of mechanical ventilation and the incidence of bronchopulmonary dysplasia (BPD) in previous study. The objective of this study was to explore the feasibility and potential benefits of LISA in early preterm infants on nasal continuous positive airway pressure (nCPAP) compared to conventional endotracheal instillation. METHODS: All infants with respiratory distress born at 28-32 weeks' gestational age from January 2012 to December 2012 (n=90), who were eligible for exogenous pulmonary surfactant (PS) therapy were randomized to receive PS by intubation with an endotracheal tube (Intubation group, n=43), or by intubation using a catheter while on nCPAP (LISA group, n=47)...
December 2015: BMC Pediatrics
https://www.readbyqxmd.com/read/25683992/efficacy-of-surfactant-ta-calfactant-and-poractant-alfa-for-preterm-infants-with-respiratory-distress-syndrome-a-retrospective-study
#11
COMPARATIVE STUDY
Ga Won Jeon, Minkyung Oh, Jong Beom Sin
PURPOSE: To compare the efficacy of the new drug calfactant with the commonly used drugs surfactant-TA and poractant alfa. MATERIALS AND METHODS: A total of 332 preterm infants at 24-31 weeks' gestation with respiratory distress syndrome (RDS) were enrolled and allocated to three groups according to the surfactant instilled; Group 1 (n=146, surfactant-TA), Group 2 (n=96, calfactant), and Group 3 (n=90, poractant alfa). The diagnosis of RDS and the decision to replace the pulmonary surfactant were left to the attending physician and based on patient severity determined by chest radiography and blood gas analysis...
March 2015: Yonsei Medical Journal
https://www.readbyqxmd.com/read/25530316/support-and-the-ethics-of-study-implementation-lessons-for-comparative-effectiveness-research-from-the-trial-of-oxygen-therapy-for-premature-babies
#12
John D Lantos, Chris Feudtner
The design of SUPPORT has been widely misunderstood. This confusion has driven much of the debate about the trial - and threatens the whole enterpise of comparative effectiveness research.
January 2015: Hastings Center Report
https://www.readbyqxmd.com/read/25456299/universal-cranial-ultrasound-screening-in-preterm-infants-with-gestational-age-33-36-weeks-a-retrospective-analysis-of-724-newborns
#13
Elisa Ballardini, Anna Tarocco, Alessandro Baldan, Elisa Antoniazzi, Giampaolo Garani, Caterina Borgna-Pignatti
BACKGROUND: Cranial ultrasonography is a useful tool to detect intracranial lesions in premature neonates at risk. Our primary aim was to determine the number of patients with abnormal cranial ultrasonography. Secondary aims were to evaluate the usefulness of universal cranial ultrasonography screening in moderately preterm infants. METHODS: All infants born from 2007 to 2012 at the University Hospital of Ferrara (Italy), with gestational age of 33-36 weeks, were included in the study...
December 2014: Pediatric Neurology
https://www.readbyqxmd.com/read/24931328/ethical-pitfalls-in-neonatal-comparative-effectiveness-trials
#14
Neena Modi
Evidence-based medicine has been embraced wholeheartedly, and rightly so, as the best approach for reducing clinical uncertainty and ensuring that patients receive treatment and care that are efficacious (i.e. they work) and effective (i.e. they work in real life). High-quality evidence comes from high-quality clinical research. It would hence be reasonable to assume that these two would form a closely integrated partnership. Alas, this is not yet the case. So many uncertainties in medical care relate to treatments and practices already widely in use...
2014: Neonatology
https://www.readbyqxmd.com/read/24796503/improvement-of-pulmonary-surfactant-activity-by-introducing-d-amino-acids-into-highly-hydrophobic-amphiphilic-%C3%AE-peptide-hel-13-5
#15
Yoshihiro Nakamura, Ko Yukitake, Hiromichi Nakahara, Sooyoung Lee, Osamu Shibata, Sannamu Lee
The high costs of artificial pulmonary surfactants, ranging in hundreds per kilogram of body weight, used for treating the respiratory distress syndrome (RDS) premature babies have limited their applications. We have extensively studied soy lecithins and higher alcohols as lipid alternatives to expensive phospholipids such as DPPC and PG. As a substitute for the proteins, we have synthesized the peptide Hel 13-5D3 by introducing D-amino acids into a highly lipid-soluble, basic amphiphilic peptide, Hel 13-5, composed of 18 amino acid residues...
August 2014: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/24335141/type-i-and-ii-pneumocyte-differentiation-in-the-developing-fetal-chicken-lung-conservation-of-pivotal-proteins-from-birds-to-human-in-the-struggle-for-life-at-birth
#16
Sigrid Bjørnstad, Ragnhild E Paulsen, Aage Erichsen, Joel C Glover, Borghild Roald
BACKGROUND: Antenatal corticosteroids and surfactant replacement therapy have dramatically reduced mortality caused by lung disease in premature babies. Knowledge about mechanisms regulating epithelial differentiation of the respiratory membrane is limited, as are effects of pharmacological interventions. The chicken fetus is a valuable model for exploring pharmacological actions on developing organs. However, more precise information about the timing of developmental events in the chicken lung is needed for human correlation...
2014: Neonatology
https://www.readbyqxmd.com/read/24297389/antibiotics-for-preterm-rupture-of-membranes
#17
REVIEW
Sara Kenyon, Michel Boulvain, James P Neilson
BACKGROUND: Premature birth carries substantial neonatal morbidity and mortality. Subclinical infection is associated with preterm rupture of membranes (PROM). Prophylactic maternal antibiotic therapy might lessen infectious morbidity and delay labour, but could suppress labour without treating underlying infection. OBJECTIVES: To evaluate the immediate and long-term effects of administering antibiotics to women with PROM before 37 weeks, on maternal infectious morbidity, neonatal morbidity and mortality, and longer-term childhood development...
December 2, 2013: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/24140977/calcium-signaling-related-proteins-are-associated-with-broncho-pulmonary-dysplasia-progression
#18
Cinzia Magagnotti, Piero Giuseppe Matassa, Angela Bachi, Valentina Vendettuoli, Isabella Fermo, Maria Rosa Colnaghi, Rose Mary Carletti, Domenica Mercadante, Elena Fattore, Fabio Mosca, Annapaola Andolfo
UNLABELLED: Broncho-pulmonary dysplasia (BPD) is a chronic pulmonary disorder that follows premature birth. It is preceded by respiratory distress syndrome (RDS), characterized by acute respiratory failure due to deficiency of surfactant at birth. Clinical characteristics of infants affected by BPD have widely changed in the last decades: they are extraordinarly immature, with impaired alveolar and vascular lung development. To build up new therapeutic strategies for BPD babies, it is necessary to understand the pathogenic mechanisms, which are complicated by environmental risk factors and genetic predisposition...
December 6, 2013: Journal of Proteomics
https://www.readbyqxmd.com/read/24113118/-ante-natal-corticosteroids-and-prevention-of-respiratory-distress-in-the-premature-newborn-usefulness-of-rescue-treatment
#19
O López-Suárez, C García-Magán, R Saborido-Fiaño, A Pérez-Muñuzuri, A Baña-Souto, M L Couce-Pico
The effectiveness of antenatal corticosteroid therapy for foetal lung maturation in pre-term infants is well known, but there is uncertainty about the time that the treatment remains effective. A descriptive, longitudinal study was conducted to determine whether the need for surfactant administration was determined by the time-lapse between corticosteroids administration and delivery, and when repeating the doses of maternal corticosteroids should be considered. A total of 91 premature infants ≤32 weeks and/or ≤1,500 g (limit 34+6 weeks) whose mothers had received a complete course of corticosteroids were included...
August 2014: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/24075206/less-invasive-surfactant-administration-lisa-ways-to-deliver-surfactant-in-spontaneously-breathing-infants
#20
Egbert Herting
The idea to deliver surfactant to spontaneously breathing premature infants is not new. The spectrum of methods reported reaches from aerosol administration over pharyngeal deposition, the use of laryngeal masks, short term intubation, surfactant administration and rapid extubation (INSURE) to an approach of keeping premature neonates on spontaneous breathing with continuous positive airway pressure support and administering surfactant by laryngoscopy via a small diameter tube. This way of Less Invasive Surfactant Administration (LISA) is in increasing use in the last decade in Germany...
November 2013: Early Human Development
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