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Lung function neonatology

Carlo Caffarelli, Francesca Santamaria, Dora Di Mauro, Carla Mastrorilli, Virginia Mirra, Sergio Bernasconi
This review focuses key advances in different pediatric fields that were published in Italian Journal of Pediatrics and in international journals in 2015. Weaning studies continue to show promise for preventing food allergy. New diagnostic tools are available for identifying the allergic origin of allergic-like symptoms. Advances have been reported in obesity, short stature and autoimmune endocrine disorders. New molecules are offered to reduce weight gain and insulin-resistance in obese children. Regional investigations may provide suggestions for preventing short stature...
August 27, 2016: Italian Journal of Pediatrics
Isabella Panfoli, Michela Cassanello, Matteo Bruschettini, Marina Colella, Roberto Cerone, Silvia Ravera, Daniela Calzia, Giovanni Candiano, Luca Ramenghi
Our preliminary data show high levels of adenosine in the blood of very low birth weight (VLBW) infants, positively correlating to their prematurity (i.e. body weight class). This prompted us to look for a mechanism promoting such impressive adenosine increase. We hypothesized a correlation with oxygen challenge. In fact, it is recognized that either oxygen lack or its excess contribute to the pathogenesis of the injuries of prematurity, such as retinopathy (ROP) and periventricular white matter lesions (PWMI)...
May 2016: Medical Hypotheses
Chiara Grasso, Pietro Sciacca, Valentina Giacchi, Caterina Carpinato, Carmine Mattia, Grazia Maria Palano, Pasqua Betta
BACKGROUND: Sustained Lung Inflation (SLI) is a maneuver of lung recruitment in preterm newborns at birth that can facilitate the achieving of larger inflation volumes, leading to the clearance of lung fluid and formation of functional residual capacity (FRC). AIM: To investigate if Sustained Lung Inflation (SLI) reduces the need of invasive procedures and iatrogenic risks. STUDY DESIGN: 78 newborns (gestational age≤34 weeks, weighing≤2000 g) who didn't breathe adequately at birth and needed to receive SLI in addition to other resuscitation maneuvers (2010 guidelines)...
January 2015: Early Human Development
L Vakrilova, P Radulova, St Hitrova, B Slancheva
Pulmonary hypertension of the newborn is a clinical syndrome with diverse etiology in which the transition from fetal circulation with high pulmonary vascular resistance to postnatal circulation with low pulmonary vascular resistance failed. The persistence of high pulmonary vascular pressure leads to right-left shunts and marked cyanosis. Despite of the advances in neonatology, the treatment of some forms of PPHN is often difficult and mortality rate remains high. In infants with PPHN appropriate interventions are critical to reverse hypoxemia, improve pulmonary and systemic perfusion and preserve end-organ function...
2014: Akusherstvo i Ginekologii︠a︡
D Fanni, R Ambu, C Gerosa, S Nemolato, M Castagnola, P Van Eyken, G Faa, V Fanos
The cytochrome P450 superfamily (CYP450) in humans is formed by 57 functional monooxygenases critical for the metabolism of numerous endogenous and exogenous compounds. The superfamily is organized into 18 families and 44 subfamilies. CYP nomenclature is based on the identity of amino acids. The most important functions of the CYP450 are related to metabolism of endogenous compounds, detoxification of exogenous xenobiotics and decomposition of the vast majority of currently used drugs. The expression of CYP450 enzymes in the human body is characterized by a marked substrate and tissue specificity, the most important being localized in the liver, but also present in kidney, lung, brain, breast, prostate and in the small intestine...
January 2014: International Journal of Immunopathology and Pharmacology
J F Beek, T Menovsky, H L van Straaten, H J Sterenborg, J G Koppe, M J van Gemert
Pneumothorax monitoring by remittance measurement in neonatology is investigated using model experiments. The results are compared to previous animal experiments. A multifibre probe is used to measure the change in remittance at 632.8 nm and 790 nm as a function of the thickness of a layer of air between a model chest wall (optically matched to piglet chest walls) and a model lung. An increase in thickness of this layer of air results in a decrease in remittance. Only when a relatively thin model chest wall is used (thickness 4 or 6 mm) and detection fibres are at some distance from the source, is this decrease in remittance preceded by an initial increase in remittance...
March 1999: Lasers in Medical Science
Ilaria Baldoli, Selene Tognarelli, Francesca Cecchi, Rosa Teresa Scaramuzzo, Massimiliano Ciantelli, Marzia Gentile, Armando Cuttano, Cecilia Laschi, Arianna Menciassi, Antonio Boldrini, Paolo Dario
Mechanical ventilation is a current support therapy for newborns affected by respiratory diseases. However, several side effects have been observed after treatment, making it mandatory for physicians to determine more suitable approaches. High fidelity simulation is an efficient educational technique that recreates clinical experience. The aim of the present study is the design of an innovative and versatile neonatal respiratory simulator which could be useful in training courses for physicians and nurses as for mechanical ventilation...
June 2014: Journal of Clinical Monitoring and Computing
Francesca Castoldi, Gianluca Lista, Fabio Scopesi, Marco Somaschini, Armando Cuttano, Lidia Grappone, Gianfranco Maffei
Preterm birth is a significant problem in the world regarding perinatal mortality and morbidity in the long term, especially bronchopulmonary dysplasia (BPD). Premature delivery is often associated to failure in transition to create an early functional residual capacity (FRC), since many preterm babies need frequently respiratory support. The first and most effective preventive measure to reduce the incidence of BPD is represented by the attempt to avoid preterm birth. Whenever this fails, the prevention of every known risk factors for BPD should start in the delivery room and should be maintained in the NICU through the use of tailored management of high-risk infants...
October 2013: Early Human Development
Jovana Visnjevac, Aleksandra Novakov-Mikić, Aleksandra Nikolić
Even though artificial surfactant is now available, respiratory distress syndrome still remains a serious problem in neonatology. Prenatal analysis of the amniotic fluid can provide data giving insight into the fetal lung maturity, which enables planning of the further outcome of high-risk pregnancies. Surfactant prevents atelectasis by forming a layer rich in phospholipids between the air and liquid phase in alveoli thus leading to increased surface tension in them, which is a precondition for a good lung function after birth...
July 2010: Medicinski Pregled
P Papoff, E Caresta, M Manganaro, R Cicchetti, M Mancuso, V Ferro, C Moretti
Mechanical ventilation is considered a supportive, nontherapeutic technology used to perform the work of breathing for patients who are unable to do so on their own. In neonatology, mechanical ventilation is often used for premature neonates who are unable to sustain ventilation because of reduced functional residual capacity due to surfactant deficiency. Mechanical ventilation is thus an attempt to mimic the respiratory system's physiological function of gas exchange until the respiratory system reaches maturation...
June 2010: Minerva Pediatrica
F Sessions Cole, Claudia Alleyne, John D E Barks, Robert J Boyle, John L Carroll, Deborah Dokken, William H Edwards, Michael Georgieff, Katherine Gregory, Michael V Johnston, Michael Kramer, Christine Mitchell, Josef Neu, DeWayne M Pursley, Walter Robinson, David H Rowitch
OBJECTIVE: To provide healthcare providers, patients, and the general public with a responsible assessment of currently available data on the use of inhaled nitric oxide in early routine, early rescue, or later rescue regimens in the care of premature infants <34 weeks gestation who require respiratory support. PARTICIPANTS: A non-Department of Health and Human Services, nonadvocate 16-member panel representing the fields of biostatistics, child psychology, clinical trials, ethics, family-centered care, neonatology, neurodevelopmental follow-up, nursing, pediatric epidemiology, neurobehavior, neurological surgery, neurology, and pulmonology, perinatology, and research methodology...
October 29, 2010: NIH Consensus and State-of-the-science Statements
Jacob V Aranda, Kay Beharry, Gloria B Valencia, Girija Natarajan, Jonathan Davis
Caffeine is a silver bullet in neonatology. This ubiquitous trimethylxanthine, pervasively used in the human diet and beverages, significantly impacts on major acute neonatal morbidities including apnea of prematurity, bronchopulmonary dysplasia, patent ductus arteriousus with or without surgical ligation and post-operative apnea. Potential uses in respiratory distress syndrome as suggested by improved lung function in primate models is supported by the decreased time on mechanical ventilation and need for oxygen therapy...
October 2010: Journal of Maternal-fetal & Neonatal Medicine
J Dembinski, M Kroll, M Lewin, P Winkler
Unilateral pulmonary anomalies are rare events of unknown etiology and large clinical variability. Neonatal history does not allow for a reliable prognosis. Interdisciplinary mangament includes prenatal diagnostics and obstetrics, genetics, neonatology, pediatric cardiology and surgery as well as pediatric orthopedics. Neonatal history and long-term follow-up in three patients are presented here including a discussion of prenatal diagnostics and the embryo-genetic basics of lung development. In three term neonates the diagnoses of unilateral pulmonary agenesis, aplasia and dysplasia, respectively, were based on angiography, MRI and bronchoscopy...
April 2009: Zeitschrift Für Geburtshilfe und Neonatologie
Andreas Woerner, Katharina Schwendener, Rainer Wolf, Mathias Nelle
BACKGROUND: Bronchopulmonary sequestration is a lung malformation characterized by nonfunctioning lung tissue without primary communication with the tracheobronchial tree. Intrauterine complications such as mediastinal shift, pleural effusion or fetal hydrothorax can be present. We present the case of a newborn with bilateral intralobar pulmonary sequestration. METHODS: Prenatal ultrasonography in a primigravida at 20 weeks of gestation revealed echogenic masses in the right fetal hemithorax with mediastinal shift towards the left side...
November 2008: World Journal of Pediatrics: WJP
N Djemal, H Ben Ammar, K Masmoudi, R Rguaieg, L Trigui, A Ben Hmad, M Kannou, N Hmida, A Gargouri, N Zouari, A Rekik
BACKGROUND: Meconium aspiration syndrome is a disease of the newborn mature or post mature. The acute pulmonary consequences can be extremely severe. In the few studies of the long-term pulmonary sequelae, it seems that certain children surviving meconium aspiration syndrome keep an obstructive syndrome. The aim of our study was to assess long term respiratory residual damage from meconium aspiration syndrome. METHODS: During a seven-year period going from 1994 to 2000, we reviewed the files of children hospitalized in neonatology department of Sfax for meconium aspiration syndrome...
February 2008: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
H S Fischer, C C Roehr, H Proquitté, R R Wauer, G Schmalisch
Although several commercial devices are available which allow tidal volume and air leak monitoring during continuous positive airway pressure (CPAP) in neonates, little is known about their measurement accuracy and about the influence of air leaks on volume measurement. The aim of this in vitro study was the validation of volume and leak measurement under CPAP using a commercial ventilatory device, taking into consideration the clinical conditions in neonatology. The measurement accuracy of the Leoni ventilator (Heinen & Löwenstein, Germany) was investigated both in a leak-free system and with leaks simulated using calibration syringes (2-10 ml, 20-100 ml) and a mechanical lung model...
January 2008: Physiological Measurement
Jefferson G Resende, Cristiane G Menezes, Ana M C Paula, Antonio C P Ferreira, Carlos A M Zaconeta, César A M Silva, Marcelo P Rodrigues, Paulo Tavares
OBJECTIVE: To evaluate the peak inspiratory pressure and ventilation rate achieved by physicians when using a neonatal self-inflating bag on a lung model. METHODS: Fifteen physicians ventilated full term and preterm infant lung simulators while the outcomes were captured by a ventilation monitor. RESULTS: Median peak pressures in cmH(2)O for full term and preterm lungs were 23 (interquartile range: 15-47) and 26 (interquartile range: 14-51), being less than 20 in 41...
September 2006: Jornal de Pediatria
Thomas Halvorsen, Britt Torunn Skadberg, Geir Egil Eide, Ola Drange Røksund, Trond Markestad
AIMS: To assess whether lung function in late childhood had improved in subjects born extremely prematurely in the early 1990s compared to the early 1980s, and whether neonatal factors in the respective periods had different impact on long-term pulmonary outcome. DESIGN: Population-based, controlled cohort study. Lung function was determined in 81 of 86 (94%) eligible subjects born with gestational age < or =28 weeks or birthweight < or =1000 g in Western Norway in 1982-85 (n=46) and 1991-92 (n=35), and in 81 matched control subjects born at term...
May 2006: Acta Paediatrica
Michael E Msall
During the past 2 decades, major advances in maternal-fetal medicine and neonatology have resulted in unprecedented survival of very preterm (<32 weeks) and extremely preterm (<28 weeks) babies. Despites these advances in prenatal care, neurodevelopmental motor impairment remains a substantial sequela. This article describes the major progress and challenges in understanding pathways of preterm children who go on to have one of the cerebral palsy syndromes. The contributions of chronic lung disease, intraventricular hemorrhage, retinopathy of prematurity, and postnatal steroids are analyzed...
June 2006: Clinics in Perinatology
Michael Obladen
Remarkable insight into disturbed lung mechanics of preterm infants was gained in the 18th and 19th century by the founders of obstetrics and neonatology who not only observed respiratory failure but also designed devices to treat it. Surfactant research followed a splendid and largely logical growth curve. Pathological changes in the immature lung were characterized in Germany by Virchow in 1854 and by Hochheim in 1903. The Swiss physiologist von Neergard fully understood surfactant function in 1929, but his paper was ignored for 25 years...
2005: Biology of the Neonate
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