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mechanical ventilator in preterms

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https://www.readbyqxmd.com/read/27918754/interventions-to-improve-rates-of-successful-extubation-in-preterm-infants-a-systematic-review-and-meta-analysis
#1
Kristin N Ferguson, Calum T Roberts, Brett J Manley, Peter G Davis
Importance: Clinicians aim to extubate preterm infants as early as possible, to minimize the risks of mechanical ventilation. Extubation is often unsuccessful owing to lung disease or inadequate respiratory drive. Objective: To conduct a systematic review and meta-analysis of interventions to improve rates of successful extubation in preterm infants. Data Sources: Searches were undertaken in PubMed and The Cochrane Library. Study Selection: The review was conducted using the methods of the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
December 5, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27918385/neurally-adjusted-ventilatory-assist-in-preterm-infants-with-established-or-evolving-bronchopulmonary-dysplasia-on-high-intensity-mechanical-ventilatory-support-a-single-center-experience
#2
Young Hwa Jung, Han-Suk Kim, Juyoung Lee, Seung Han Shin, Ee-Kyung Kim, Jung-Hwan Choi
OBJECTIVES: The aim of the present study was to report possible improvements in ventilator variables associated with a transition from synchronized intermittent mandatory ventilation to neurally adjusted ventilatory assist in preterm infants with bronchopulmonary dysplasia who required a high level of mechanical ventilatory support in a single center. DESIGN: Retrospective study. SETTING: Neonatal ICU. PATIENTS: Twenty-nine preterm infants with a median gestational age of 25...
December 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27918382/conventional-versus-prolonged-infusion-of-meropenem-in-neonates-with-gram-negative-late-onset-sepsis-a-randomized-controlled-trial
#3
Abd Elazeez Shabaan, Islam Nour, Heba Elsayed Eldegla, Nehad Nasef, Basma Shouman, Hesham Abdel-Hady
BACKGROUND: Gram-negative bacteria are associated with significant morbidity and mortality in preterm and term newborns. Meropenem has widespread efficacy and often allows for monotherapy in this group. Prolonged infusion instead of infusion over 30 minutes has been suggested to result in higher microbiologic efficacy. OBJECTIVE: To compare the clinical and microbiologic efficacy and safety of prolonged infusions versus conventional dosing of meropenem in neonates with Gram negative late onset sepsis (GN-LOS)...
November 30, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27917436/looking-ahead-where-to-next-for-animal-models-of-bronchopulmonary-dysplasia
#4
REVIEW
Claudio Nardiello, Ivana Mižíková, Rory E Morty
Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth, with appreciable morbidity and mortality in a neonatal intensive care setting. Much interest has been shown in the identification of pathogenic pathways that are amenable to pharmacological manipulation (1) to facilitate the development of novel therapeutic and medical management strategies and (2) to identify the basic mechanisms of late lung development, which remains poorly understood. A number of animal models have therefore been developed and continue to be refined with the aim of recapitulating pathological pulmonary hallmarks noted in lungs from neonates with BPD...
December 5, 2016: Cell and Tissue Research
https://www.readbyqxmd.com/read/27894031/artificial-placenta-analysis-of-recent-progress
#5
REVIEW
Stephen D Bird
The artificial placenta (AP) has for many decades captured the imagination of scientists and authors with popular fiction including The Matrix and Aldous Huxley's "Brave New World", depicting a human surviving ex-utero in an artificial uterine environment (AUE). For scientists this has fascinated as a way forward for extremely preterm infants (EPIs) born less than 28 weeks of gestation. Early successes with mechanical ventilation (MV) for infants born above 28 weeks of gestation meant that AP research lost momentum...
November 11, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27881405/effectiveness-of-individualised-lung-recruitment-strategies-at-birth-an-experimental-study-in-preterm-lambs
#6
David G Tingay, Anushi E Rajapaksa, Emanuela Zannin, Prue M Pereira-Fantini, Raffaele Dellacà, Elizabeth Perkins, Cornelis Elroy E Zonneveld, Andy Adler, Don Black, Inez Frerichs, Anna Lavizzari, Magdy Sourial, Bartłomiej Grychtol, Fabio Mosca, Peter G Davis
Respiratory transition at birth involves rapidly clearing fetal lung liquid and preventing efflux back into the lung whilst aeration is established. We have developed a sustained inflation (SIOPT) individualized to volume-response and a dynamic tidal positive end-expiratory pressure (open lung volume, OLV) strategy that both enhance this process. We aimed to compare the effect of each with a group managed with PEEP of 8 cmH2O and no recruitment manoeuvre (No-RM), on gas exchange, lung mechanics, spatiotemporal aeration and lung injury in 127±1d preterm lambs...
November 23, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27879381/pediatric-prolonged-mechanical-ventilation-considerations-for-definitional-criteria
#7
REVIEW
Michaël Sauthier, Louise Rose, Philippe Jouvet
A 2005 consensus conference led by the National Association for Medical Direction of Respiratory Care (NAMDRC) defined prolonged mechanical ventilation (PMV) for adults as invasive and/or noninvasive mechanical ventilation (NIV) for ≥21 consecutive days for ≥6 h/d. In children, no such consensus definition exists. This results in substantial variability in definitional criteria, making study of the impact and outcomes of PMV across and within settings problematic. The objective of this work was to identify how PMV for children and neonates is described in the literature and to outline pediatric/neonatal considerations related to PMV, with the goal of proposing a pediatric/neonatal adaptation to the NAMDRC definition...
November 22, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27852668/less-invasive-surfactant-administration-versus-intubation-for-surfactant-delivery-in-preterm-infants-with-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#8
Jose C Aldana-Aguirre, Merlin Pinto, Robin M Featherstone, Manoj Kumar
CONTEXT: In spontaneously breathing preterm infants with respiratory distress syndrome (RDS) receiving nasal continuous positive airway pressure, a method of less invasive surfactant administration (LISA) using a thin catheter has been described as an alternative to endotracheal intubation for surfactant delivery to reduce lung injury. OBJECTIVE: A systematic review of randomised controlled trials (RCTs) comparing LISA with the standard method of surfactant delivery for clinical outcomes...
November 15, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27834785/physiological-effects-of-a%C3%A2-single-chest-physiotherapy-session-in-mechanically-ventilated-and-extubated-preterm-neonates
#9
Y Mehta, J Shetye, R Nanavati, A Mehta
OBJECTIVE: To assess the changes on various physiological cardio-respiratory parameters with a single chest physiotherapy session in mechanically ventilated and extubated preterm neonates with respiratory distress syndrome. STUDY DESIGN: This is a prospective observational study in neonatal intensive care unit setting. Sixty preterm neonates with respiratory distress syndrome, thirty mechanically ventilated and thirty extubated preterm neonates requiring chest physiotherapy were enrolled in the study...
November 9, 2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/27834669/a-translational-cellular-model-to-study-the-impact-of-high-frequency-oscillatory-ventilation-hfov-on-human-epithelial-cell-function
#10
Anja Karolin Mowes, Beatriz E de Jongh, Timothy Cox, Yan Zhu, Thomas H Shaffer
High frequency oscillatory ventilation (HFOV) has been proposed as gentle ventilation strategy to prevent lung injury in the preterm infant. High frequency ventilation leads to dimensional and mechanical airway deformation in animal airway models, which is consistent with translational studies demonstrating the impact of oxygen and biophysical stresses on normal airway cellular function. There is an overall paucity of clinical and cellular data on the impact of HFOV on the conducting airway. We developed an innovative method to test the impact of the clinical HFO Ventilator (Sensormedic 3100A) on human epithelial cell function...
November 10, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27790346/factors-associated-with-retinopathy-of-prematurity-in-hospitalized-preterm-infants-in-sanandaj-iran
#11
Majid Mansouri, Sirous Hemmatpour, Fouzieh Sedighiani, Mojgan Ghamari, Delnia Chavoshi
INTRODUCTION: In the near future, retinopathy of prematurity (ROP) will be the most significant cause of blindness in upper and middle-income countries. Due to the increasing survival chances for premature and low birth weight infants and the importance of the diagnosis and treatment of ROP, this study was aimed at determining the prevalence of ROP and its related factors in Sanandaj, Iran, in 2014. METHODS: This cross-sectional study was performed on 47 preterm infants, weighing less than 2000 g or with a gestational age of less than of 34 weeks...
September 2016: Electronic Physician
https://www.readbyqxmd.com/read/27755464/burden-of-severe-respiratory-syncytial-virus-disease-among-33-35-week-gestational-age-infants-born-during-multiple-respiratory-syncytial-virus-seasons
#12
Evan J Anderson, Xavier Carbonell-Estrany, Maarten Blanken, Marcello Lanari, Margaret Sheridan-Pereira, Barry Rodgers-Gray, John Fullarton, Elisabeth Rouffiac, Pamela Vo, Gerard Notario, Fiona Campbell, Bosco Paes
BACKGROUND: Moderate-late preterm infants, 33-35 weeks' gestational age (wGA), are at increased risk for respiratory syncytial virus hospitalization (RSVH). OBJECTIVE: To quantify the burden of RSVH in moderate-late preterm infants. METHODS: A pooled analysis was conducted on RSVH from 7 prospective, observational studies in the Northern Hemisphere from 2000-2014. Infants' 33 -35 wGA without comorbidity born during the RSV season who did not receive RSV immunoprophylaxis were enrolled...
October 17, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27753874/yia-01-01-adverse-neonatal-health-correlates-with-long-term-cardiac-functional-and-structural-remodeling-in-young-adults-born-preterm
#13
Muhammad Oneeb Rehman Mian, Julie Demeulemeester, Jean-Luc Bigras, Mariane Bertagnolli, Li Feng Xie, Katryn Paquette, Rong Wu, Anik Cloutier, Thuy Mai Luu, Anne-Monique Nuyt
OBJECTIVE: Studies support a direct causal association between preterm birth and increased risk of cardiovascular diseases. Increased left and right ventricular mass, and impaired systolic and diastolic function were observed in young adults born preterm. Deleterious neonatal conditions, as in preterm birth, could significantly impact on myocardial tissue. We investigated how left ventricle (LV) echocardiographic parameters in young adults born preterm correlated with neonatal health parameters and interventions data...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27752095/paradoxical-diurnal-cortisol-changes-in-neonates-suggesting-preservation-of-foetal-adrenal-rhythms
#14
Masahiro Kinoshita, Sachiko Iwata, Hisayoshi Okamura, Mamoru Saikusa, Naoko Hara, Chihoko Urata, Yuko Araki, Osuke Iwata
Studies suggested the presence of foetal adrenal rhythms of cortisol, which are entrained in antiphase to maternal rhythms. In contrast, neonates are thought to have no adrenal rhythm until 2-3 months after birth. To test the hypothesis that a foetal-type adrenal rhythm is preserved after birth, saliva samples were collected from 65 preterm/term infants during hospital stay (30-40 weeks corrected age) at 10:00 and 19:00 h. Cortisol levels were assessed for their diurnal difference and dependence on antenatal/postnatal clinical variables...
October 18, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27751209/-relationship-between-serum-erythropoietin-levels-and-brain-injury-in-preterm-infants
#15
Guang-Fu Chen, Hui-Tao Li, Jin-Jie Huang, Zhang-Xing Wang, Yun Li, Chuan-Zhong Yang, Ben-Qing Wu, Wen-Lan Liu, Li-Hui Liu, Qi Kong, Rong-Tian Liu
OBJECTIVE: To study the relationship between the levels of erythropoietin (EPO) in serum and brain injury in preterm infants. METHODS: Three hundred and four preterm infants (gestational age: 28-34 weeks) born between October 2014 and September 2015 were enrolled in this study. Brain injury was diagnosed using cerebral ultrasound and MRI. The levels of EPO, S100 protein, neuron-specific enolase (NSE) and myelin basic protein (MBP) in serum were detected using ELISA...
October 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/27744438/vaginal-probiotic-administration-in-the-management-of-preterm-premature-rupture-of-membranes
#16
George J Daskalakis, Alexis K Karambelas
OBJECTIVE: To examine the influence of vaginal probiotic administration as an adjunct to standard antibiotic treatment on perinatal outcome in women with preterm premature rupture of membranes (PPROM). MATERIALS AND METHODS: This was a prospective randomized trial of cases with PPROM (24-34 weeks) that were admitted to our department between 2011 and 2015. Forty-nine cases received vaginal probiotics for 10 days in combination with antibiotic prophylaxis and were compared to 57 others that received only antibiotics for the same time period...
October 15, 2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/27741177/antenatal-corticosteroids-and-outcomes-of-small-for-gestational-age-neonates
#17
Nir Melamed, Alex Pittini, Jon Barrett, Jyotsna Shah, Eugene W Yoon, Brigitte Lemyre, Shoo K Lee, Kellie E Murphy, Prakesh S Shah
OBJECTIVE: To assess the association of antenatal corticosteroids and neonatal outcomes of preterm small-for-gestational-age (SGA) neonates and estimate whether the association is similar to that observed in appropriate-for-gestational-age (AGA) neonates. METHODS: We conducted a retrospective cohort study using data collected on singleton neonates born between 24 0/7 and 33 6/7 weeks of gestation and admitted to tertiary neonatal units in Canada between 2010 and 2014...
November 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27737427/effects-of-manual-hyperinflation-in-preterm-newborns-under-mechanical-ventilation
#18
Camila Chaves Viana, Carla Marques Nicolau, Regina Celia Turola Passos Juliani, Werther Brunow de Carvalho, Vera Lucia Jornada Krebs
OBJECTIVE: To assess the effects of manual hyperinflation, performed with a manual resuscitator with and without the positive end-expiratory pressure valve, on the respiratory function of preterm newborns under mechanical ventilation. METHODS: Cross-sectional study of hemodynamically stable preterm newborns with gestational age of less than 32 weeks, under mechanical ventilation and dependent on it at 28 days of life. Manual hyperinflation was applied randomly, alternating the use or not of the positive end-expiratory pressure valve, followed by tracheal aspiration for ending the maneuver...
September 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/27733360/antenatal-corticosteroids-for-maturity-of-term-or-near-term-fetuses-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#19
Gabriele Saccone, Vincenzo Berghella
OBJECTIVE:  To evaluate the effectiveness of antenatal corticosteroids given at ≥34 weeks' gestation. DESIGN:  Systematic review with meta-analysis. DATA SOURCES:  Electronic databases were searched from their inception to February 2016. ELIGIBILITY CRITERIA FOR STUDY SELECTION:  Randomized clinical trials comparing antenatal corticosteroids with placebo or no treatment in women with a singleton pregnancy at ≥34 weeks' gestation...
October 12, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27729961/urinary-uric-acid-creatinine-ratio-as-a-marker-of-mortality-and-unfavorable-outcome-in-nicu-admitted-neonates
#20
Shahin Nariman, Ziba Mosayebi, Setareh Sagheb, Hadith Rastad, Seyyed Saeed Hosseininodeh
BACKGROUND: The survival of neonates who have been admitted to the NICU, especially premature infants with few mortality and morbidity, is the most important attitude. OBJECTIVES: We presumed whether urinary uric acid/creatinine (UUA/Cr) ratio can be a marker of mortality and adverse outcome in neonates which were admitted to the NICU. PATIENTS AND METHODS: All preterm infants admitted to our NICU after birth from March 2014 to April 2015 were enrolled in this prospective cohort study...
August 2016: Iranian Journal of Pediatrics
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