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mechanical ventilator in preterms

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https://www.readbyqxmd.com/read/29214783/effective-tidal-volume-for-normocapnia-in-very-low-birth-weight-infants-using-high-frequency-oscillatory-ventilation
#1
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
#2
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/29209598/inflammatory-mediators-in-tracheal-aspirates-of-preterm-infants-participating-in-a-randomized-trial-of-permissive-hypercapnia
#3
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/29206362/prevalence-of-neonate-adhesive-skin-injuries-in-a-jordanian-intensive-care-unit
#4
Laila Habiballah
AIM: To determine the prevalence of adhesive skin injuries in neonates in a Jordanian neonatal intensive care unit (NICU) and to examine the characteristics of neonates with these injuries. METHOD: A cross-sectional period-prevalence study was conducted in a NICU in Irbid National University Hospital in Jordan. A total of 169 neonates were examined for skin injuries caused by adhesive equipment. RESULTS: The prevalence of skin injuries in this population was 26...
December 5, 2017: Nursing Children and Young People
https://www.readbyqxmd.com/read/29189671/neural-breathing-pattern-and-patient-ventilator-interaction-during-neurally-adjusted-ventilatory-assist-and-conventional-ventilation-in-newborns
#5
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/29184049/does-diaphragmatic-electrical-activity-in-preterm-infants-predict-extubation-success
#6
Neetu Singh, Matthew J McNally, Robert A Darnall
BACKGROUND: Despite many advances in respiratory care and mechanical ventilation, neonatologists lack an objective tool to aid in decision making for timely extubation. Electrical activity of the diaphragm (EAdi), a measure of neural respiratory drive and inspiratory load, may be a useful predictor of extubation success in preterm neonates. The objective of this work was to investigate whether peak EAdi could distinguish successful versus failed extubation in mechanically ventilated preterm infants...
November 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29181317/a-predictive-score-for-retinopathy-of-prematurity-by-using-clinical-risk-factors-and-serum-insulin-like-growth-factor-1-levels
#7
Yeşim Coşkun, Ceyhun Dalkan, Özge Yabaş, Özlem Ünay Demirel, Elif Samiye Bayar, Sibel Sakarya, Tuba Müftüoğlu, Dilaver Erşanlı, Nerin Bahçeciler, İpek Akman
AIM: To detect the impact of insulin-like growth factor-1 (IGF-1) and other risk factors for the early prediction of retinopathy of prematurity (ROP) and to establish a scoring system for ROP prediction by using clinical criteria and serum IGF-1 levels. METHODS: The study was conducted with 127 preterm infants. IGF-1 levels in the 1st day of life, 1st, 2nd, 3rd and 4th week of life was analyzed. The score was established after logistic regression analysis, considering the impact of each variable on the occurrences of any stage ROP...
2017: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/29174079/laryngeal-mask-airway-for-surfactant-administration-in-neonates-a-randomized-controlled-trial
#8
Kari D Roberts, Roland Brown, Andrea L Lampland, Tina A Leone, Kyle D Rudser, Neil N Finer, Wade D Rich, T Allen Merritt, Adam J Czynski, Julie M Kessel, Sajani M Tipnis, Erin C Stepka, Mark C Mammel
OBJECTIVE: To determine if preterm infants with moderate respiratory distress syndrome on continuous positive airway pressure (CPAP) who received surfactant via a laryngeal mask airway (LMA) would have a decreased rate of intubation and mechanical ventilation compared with those on CPAP who did not receive surfactant. STUDY DESIGN: In this prospective, multicenter, randomized controlled trial, 103 premature infants 280/7-356/7 weeks gestation, ≥1250 g and ≤36 hours old on CPAP requiring fraction of inspired oxygen 0...
November 21, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29172232/review-demonstrates-that-less-invasive-surfactant-administration-in-preterm-neonates-leads-to-fewer-complications
#9
REVIEW
Ludwig Gortner, Simone S Schüller, Egbert Herting
Surfactant treatment of neonatal respiratory distress syndrome (RDS) was introduced into Europe during the 1990s. Meta-analyses have indicated that using less invasive surfactant administration (LISA) techniques on preterm neonates receiving continuous positive airway pressure (CPAP) results in improved survival rates without bronchopulmonary dysplasia. Surfactant should be administered early and ventilator settings adapted to changing oxygen requirements and lung mechanics. Side effects including initial bradycardia, oxygen desaturation, tube obstruction and isolated cases of pulmonary haemorrhage have been reported CONCLUSION: Less invasive surfactant therapy improves pulmonary outcomes in preterm neonates with RDS and should ideally be administered in combination with CPAP...
November 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29169929/compound-heterozygous-ryr1-mutations-in-a-preterm-with-arthrogryposis-multiplex-congenita-and-prenatal-cns-bleeding
#10
Florian Brackmann, Matthias Türk, Nils Gratzki, Oliver Rompel, Heinz Jungbluth, Rolf Schröder, Regina Trollmann
RYR1 mutations, the most common cause of non-dystrophic neuromuscular disorders, are associated with the malignant hyperthermia susceptibility (MHS) trait as well as congenital myopathies with widely variable clinical and histopathological manifestations. Recently, bleeding anomalies have been reported in association with certain RYR1 mutations. Here we report a preterm infant born at 32 weeks gestation with arthrogryposis multiplex congenita due to compound heterozygous, previously MHS-associated RYR1 mutations, with additional signs of prenatal hemorrhage...
September 28, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/29169167/structural-pulmonary-abnormalities-still-evident-in-schoolchildren-with-new-bronchopulmonary-dysplasia
#11
Eveliina Ronkainen, Marja Perhomaa, Lauri Mattila, Mikko Hallman, Teija Dunder
BACKGROUND: A new pattern of bronchopulmonary dysplasia (BPD) has emerged with the improved survival of preterm children. OBJECTIVES: Our aim was to characterize structural abnormalities associated with new BPD and to evaluate whether the severity of high-resolution computed tomography (HRCT) changes is associated with lung function. METHODS: HRCT scans were performed on 21 schoolchildren with a history of new BPD (mild, n = 9; moderate, n = 4; and severe, n = 8) with a mean age of 12...
November 24, 2017: Neonatology
https://www.readbyqxmd.com/read/29157044/prenatal-complications-are-associated-with-the-postnatal-airway-host-response-and-microbiota-in-intubated-preterm-infants
#12
Brandie D Wagner, Marci K Sontag, J Kirk Harris, Joshua I Miller, Lindsey Morrow, Charles E Robertson, Mark J Stephens, Brenda B Poindexter, Steven H Abman, Peter M Mourani
PURPOSE: To prospectively examine the relationship between prenatal events, postnatal airway host response and microbiota, and clinical outcomes. MATERIALS AND METHODS: Tracheal aspirates collected at 7 days of age from 71 mechanically ventilated infants (median gestational age (GA), 25 weeks [range 23-28]) were simultaneously processed for a 12-plex protein assay and bacterial identification by 16S rRNA sequencing. Phenotypes were determined by unsupervised clustering of the protein analytes...
November 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29152912/physiological-and-anatomical-dead-space-in-mechanically-ventilated-newborn-infants
#13
Theodore Dassios, Paul Dixon, Ann Hickey, Sotirios Fouzas, Anne Greenough
OBJECTIVES: To compare the anatomical (VD-Ana ) and alveolar dead space (VD-Alv ) in term and prematurely born infants and identify the clinical determinants of those indices. WORKING HYPOTHESIS: VD-Ana and VD-Alv will be higher in prematurely born compared to term born infants. STUDY DESIGN: Retrospective analysis of data collected at King's College Hospital NHS Foundation Trust, London, UK. PATIENT SELECTION: Fifty-six infants (11 term, 45 preterm) were studied at a median age of 8 (IQR 2-33) days...
November 20, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29138031/mortality-and-pulmonary-outcomes-of-extremely-preterm-infants-exposed-to-antenatal-corticosteroids
#14
Colm P Travers, Waldemar A Carlo, Scott A Mcdonald, Abhik Das, Edward F Bell, Namasivayam Ambalavanan, Alan H Jobe, Ronald N Goldberg, Carl T D'Angio, Barbara J Stoll, Seetha Shankaran, Abbot R Laptook, Barbara Schmidt, Michele C Walsh, Pablo J Sanchez, M Bethany Ball, Ellen C Hale, Nancy S Newman, Rosemary D Higgins
BACKGROUND: Antenatal corticosteroids are given primarily to induce fetal lung maturation but results from meta-analyses of randomized controlled trials have not shown mortality or pulmonary benefits for extremely preterm infants although these are the infants most at risk of mortality and pulmonary disease. OBJECTIVE: To determine if exposure to antenatal corticosteroids is associated with a lower rate of death and pulmonary morbidities by 36 weeks' postmenstrual age...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29129516/is-there-a-potential-link-between-vitamin-d-and-pulmonary-morbidities-in-preterm-infants
#15
Yang Yang, Yun Feng, Xu Chen, Xiao-Nan Mao, Jing-Han Zhang, Li Zhao, You-Yan Zhao, Rui Cheng
BACKGROUND: There hasn't been conclusive proof about the association between vitamin D and pulmonary morbidities of prematurity. METHODS: 106 preterm infants were retrospectively included into this study. Clinical data and blood samples of all the patients were collected within 24 h of admission. RESULTS: (1) Respiratory distress syndrome (RDS) patients were mainly concentrated in "≤30 weeks" stage when compared with other two gestational age groups...
November 9, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29116547/the-bpd-trio-interaction-of-dysregulated-pdgf-vegf-and-tgf-signaling-in-neonatal-chronic-lung-disease
#16
REVIEW
Prajakta Oak, Anne Hilgendorff
The development of neonatal chronic lung disease (nCLD), i.e., bronchopulmonary dysplasia (BPD) in preterm infants, significantly determines long-term outcome in this patient population. Risk factors include mechanical ventilation and oxygen toxicity impacting on the immature lung resulting in impaired alveolarization and vascularization. Disease development is characterized by inflammation, extracellular matrix remodeling, and apoptosis, closely intertwined with the dysregulation of growth factor signaling...
November 7, 2017: Molecular and Cellular Pediatrics
https://www.readbyqxmd.com/read/29097178/delayed-versus-early-umbilical-cord-clamping-for-preterm-infants-a-systematic-review-and-meta-analysis
#17
Michael Fogarty, David A Osborn, Lisa Askie, Anna Lene Seidler, Kylie Hunter, Kei Lui, John Simes, William Tarnow-Mordi
OBJECTIVE: To compare the effects of delayed versus early cord clamping on hospital mortality (primary outcome) and morbidity in preterm infants using Cochrane Collaboration Neonatal Review Group methodology. DATA SOURCES: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Chinese articles, cross-referencing citations, expert informants and trial registries to 31 July 2017. STUDY ELIGIBILITY: RCTs of delayed (≥ 30 seconds) vs early (<30 seconds) clamping in infants born <37 weeks gestation...
October 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29092682/evaluation-of-dynamic-thiol-disulfide-homeostasis-in-very-low-birth-weighted-preterms
#18
Sezin Unal, Dilek Ulubas Isik, Ahmet Yagmur Bas, Sara Erol, İlter Arifoglu, Murat Alisik, Ozcan Erel, Nihal Demirel
BACKGROUND: Thiols are organic compounds containing sulfhydryl groups which exert antioxidant effects via dynamic thiol-disulfide homeostasis. The shift towards disulfides indicates the presence of oxidative environment. Thiol-disulfide homeostasis has not been evaluated in neonates. We aimed to evaluate dynamic thiol-disulfide homeostasis in preterm infants. METHODS: Preterm infants with birth weight less than 1500 grams (25-32 weeks of gestation) were included...
November 1, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29091782/ante-peri-and-postnatal-factors-associated-with-intraventricular-hemorrhage-in-very-premature-infants
#19
Martin Poryo, Judith Caroline Boeckh, Ludwig Gortner, Michael Zemlin, Perrine Duppré, Daniel Ebrahimi-Fakhari, Stefan Wagenpfeil, Matthias Heckmann, Eva Mildenberger, Anne Hilgendorff, Andreas W Flemmer, Georg Frey, Sascha Meyer
BACKGROUND: Intraventricular hemorrhage (IVH) is one of the most serious complications in preterm infants and is associated with neurological sequelae and mortality. Over the past few decades, the rate of IVH has decreased due to improved neonatal intensive care. However, up to 15-25% of very and extremely premature infants (<32 and <28weeks of pregnancy (WOP) respectively) still suffer from IVH. STUDY PURPOSE: The aim of this study was to perform an updated, multicenter analysis to identify ante-, peri, and postnatal factors other than gestational age/birth weight associated with IVH of any grade in a large cohort of very and extremely premature infants...
October 26, 2017: Early Human Development
https://www.readbyqxmd.com/read/29089616/exacerbation-of-ventilation-induced-lung-injury-and-inflammation-in-preterm-lambs-by-high-dose-nanoparticles
#20
Ishmael M Inocencio, Robert J Bischof, Sue D Xiang, Valerie A Zahra, Vy Nguyen, Tammy Lim, Domenic LaRosa, Jade Barbuto, Mary Tolcos, Magdalena Plebanski, Graeme R Polglase, Timothy J Moss
Mechanical ventilation of preterm neonates causes lung inflammation and injury, with potential life-long consequences. Inert 50-nm polystyrene nanoparticles (PS50G) reduce allergic inflammation in the lungs of adult mice. We aimed to confirm the anti-inflammatory effects of PS50G in a sheep asthma model, and investigate the effects of prophylactic administration of PS50G on ventilation-induced lung injury (VILI) in preterm lambs. We assessed lung inflammatory cell infiltration, with and without PS50G, after airway allergen challenge in ewes sensitised to house dust mite...
October 31, 2017: Scientific Reports
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