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neonatal mechanical ventilation

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https://www.readbyqxmd.com/read/28213294/a-low-cost-simplified-and-scaleable-pneumotachograph-and-face-mask-for-neonatal-mouse-respiratory-measurements
#1
Jenny J Sun, Roshan Nanu, Russell S Ray
INTRODUCTION: Neonatal respiratory disorders are a leading cause of perinatal mortality due to complications resulting from premature births and prenatal exposure to drugs of abuse, but optimal treatments for these symptoms are still unclear due to a variety of confounds and risk factors. Mouse models present an opportunity to study the underlying mechanisms and efficacy of potential treatments of these conditions with controlled variables. However, measuring respiration in newborn mice is difficult and commercial components are expensive and often require modification, creating a barrier and limiting our understanding of the short and long-term effects of birth complications on respiratory function...
February 14, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/28212478/-risk-factors-related-with-ventilator-associated-pneumonia-in-a-neonatal-intensive-care-therapy
#2
Juan Pablo Romo-Gamboa, Bertha Alicia Sandoval-Pérez, Ana Bertha Rodríguez-López, Marco Antonio Torres-González, Juan Carlos Barrera-de León
BACKGROUND: Ventilator-associated pneumonia (VAP) represents the second cause of nosocomial infections and it is associated with greater morbility, duration of mechanical ventilation (MV), and hospital stay. The objective was to determine factors related with VAP in neonates. METHODS: Analytical transversal study including newborns admitted already intubated with at least 48 hours of MV or who were intubated in Neonatal Therapy. VAP was defined according to the criteria of the Centers for Disease Control and Prevention: "those patients submitted to MV during at least 48 hours"...
2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28206733/end-of-life-decisions-in-34-slovene-intensive-care-units-a-nationwide-prospective-clinical-study
#3
Miha Orazem, Urh Groselj, Manca Stojan, Neza Majdic, Gaj Vidmar, Stefan Grosek
BACKGROUND: To determine how end-of-life decisions (EOLD) on limitations of life- sustaining treatment (LST) are made in three different types of intensive care units (ICUs) in Slovenia. METHODS: A national multicenter prospective study among 31 adult and three pediatric/neonatal ICUs (PICUs). The questionnaire form on EOLD was designed to assess the clinical practice. Data were collected between January 1, 2013, and March 31, 2013. For statistical analysis we used IBM® SPSS® Statistics 20 software package...
February 15, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28203337/comparison-of-the-efficacy-of-three-natural-surfactants-curosurf-survanta-and-alveofact-in-the-treatment-of-respiratory-distress-syndrome-among-neonates-a-randomized-controlled-trial
#4
Mirhadi Mussavi, Keyvan Mirnia, Khairollah Asadollahi
BACKGROUND: Although several different types of natural surfactants are available, including Alveofact, Curosurf, and Survanta, the preferred type and the magnitude of their effects are unknown. OBJECTIVES: This study was designed to compare the effects of these three surfactants on the gas exchange and clinical outcomes of neonates with respiratory distress syndrome (RDS). METHODS: This triple-blind randomized clinical trial studied all preterm neonates ≤ 37 weeks with RDS who were admitted to the neonatal intensive care unit (NICU) of Taleghani hospital (Tabriz, Iran) between 2012 and 2013...
October 2016: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/28203330/risk-factors-for-health-care-associated-bloodstream-infections-in-a-neonatal-intensive-care-unit
#5
Sabahattin Ertugrul, Fesih Aktar, Ilyas Yolbas, Ahmet Yilmaz, Bilal Elbey, Ahmet Yildirim, Kamil Yilmaz, Recep Tekin
BACKGROUND: Healthcare-associated bloodstream infections (HCA-BSI) are a major cause of morbidity and mortality in neonatal intensive care units (NICUs). OBJECTIVES: We aimed to determine the causative organisms and risk factors of HCA-BSIs in NICUs. METHODS: This study was performed between January 2011 and December 2014 in the neonatal intensive care unit of Dicle university, Turkey. The study consisted of 126 patients (infected group) with positive blood culture and 126 randomly selected patients (uninfected control group) with negative blood culture after four days of hospitalization...
October 2016: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/28202108/-clinical-efficacy-of-pulmonary-surfactant-combined-with-budesonide-for-preventing-bronchopulmonary-dysplasia-in-very-low-birth-weight-infants
#6
Jing Pan, Ming-Wu Chen, Wen-Quan Ni, Tao Fang, Hui Zhang, Ye Chen, Jia-Hua Pan
OBJECTIVE: To explore the clinical efficacy of intratracheal instillation of pulmonary surfactant (PS) combined with budesonide for preventing bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) infants. METHODS: Thirty VLBW infants with gestational age <32 weeks who developed neonatal respiratory distress syndrome (NRDS) (grade III-IV) suffering from intrauterine infection were randomly assigned into a PS + budesonide group and a PS alone group...
February 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28199933/idiopathic-neonatal-pneumoperitoneum-a-case-report
#7
Sarah Magdy Abdelmohsen, Mohamed Abdelkader Osman
INTRODUCTION: There have been non-surgical conditions secondary to neonatal pneumoperitoneum (e.g., mechanical ventilation, pulmonary diseases and pneumatosis cystoides intestinalis) that neonates were able to overcome without the need for abdominal exploration. Idiopathic pneumoperitoneum, although similar to perforation of the alimentary tract and the previously mentioned non-surgical conditions, is a rare and benign condition that does not yet have a definite cause. The criteria by which a surgeon decides on which abdomen to open and which one to observe, is ill-defined...
January 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28197644/routine-application-of-bloodless-priming-in-neonatal-cardiopulmonary-bypass-a-3-year-experience
#8
Wolfgang Boettcher, Nicodème Sinzobahamvya, Oliver Miera, Matthias Redlin, Frank Dehmel, Mi-Young Cho, Peter Murin, Felix Berger, Joachim Photiadis
A restrictive transfusion strategy led us to routinely try to conduct donor-blood free open-heart surgery even in neonates. The cardio-pulmonary bypass (CPB) circuit was minimized by priming volumina at 73 ml for the smallest patients with body weight up to 2.5 kg and 85-95 ml for those with body weight of more than 2.5 kg, and by positioning the console as close as possible to operation table. Measures were applied to save blood during the procedure. Transfusion threshold of 8 g/dl hemoglobin was retained...
February 14, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28176485/preterm-birth-prevention-in-twin-pregnancies-with-progesterone-pessary-or-cerclage-a-systematic-review-and-meta-analysis
#9
REVIEW
A Jarde, O Lutsiv, C K Park, J Barrett, J Beyene, S Saito, J M Dodd, P S Shah, J L Cook, A B Biringer, L Giglia, Z Han, K Staub, W Mundle, C Vera, L Sabatino, S K Liyanage, S D McDonald
BACKGROUND: About half of twin pregnancies deliver preterm, and it is unclear whether any intervention reduces this risk. OBJECTIVES: To assess the evidence for the effectiveness of progesterone, cerclage, and pessary in twin pregnancies. SEARCH STRATEGY: We searched Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ISI Web of Science, without language restrictions, up to 25 January 2016. SELECTION CRITERIA: Randomised controlled trials of progesterone, cerclage, or pessary for preventing preterm birth in women with twin pregnancies, without symptoms of threatened preterm labour...
February 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28176308/fluid-restriction-for-treatment-of-preterm-infants-with-chronic-lung-disease
#10
REVIEW
Keith J Barrington, Etienne Fortin-Pellerin, Thomas Pennaforte
BACKGROUND: Fluid restriction is often recommended as part of the management of infants with early or established bronchopulmonary dysplasia (BPD). OBJECTIVES: To determine whether fluid restriction as part of the therapeutic intervention for early or established BPD improves clinical outcomes. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1) in the Cochrane Library (searched 16 February 2016), MEDLINE via PubMed (1966 to 16 February 2016), Embase (1980 to 16 February 2016), and CINAHL (1982 to 16 February 2016)...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28168185/optimal-chest-compression-rate-and-compression-to-ventilation-ratio-in-delivery-room-resuscitation-evidence-from-newborn-piglets-and-neonatal-manikins
#11
REVIEW
Anne Lee Solevåg, Georg M Schmölzer
Cardiopulmonary resuscitation (CPR) duration until return of spontaneous circulation (ROSC) influences survival and neurologic outcomes after delivery room (DR) CPR. High quality chest compressions (CC) improve cerebral and myocardial perfusion. Improved myocardial perfusion increases the likelihood of a faster ROSC. Thus, optimizing CC quality may improve outcomes both by preserving cerebral blood flow during CPR and by reducing the recovery time. CC quality is determined by rate, CC to ventilation (C:V) ratio, and applied force, which are influenced by the CC provider...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28151493/surfactant-reduced-the-mortality-of-neonates-with-birth-weight-%C3%A2-1500%C3%A2-g-and-hypoxemic-respiratory-failure-a-survey-from-an-emerging-nicu-network
#12
H Wang, X Gao, C Liu, C Yan, X Lin, Y Dong, B Sun
OBJECTIVE: We evaluated the efficacy of surfactant therapy and assisted ventilation on morbidity and mortality of neonates with birth weight (BW) ⩾1500 g and hypoxemic respiratory failure (HRF). STUDY DESIGN: We retrospectively analyzed 5650 patients with BW ⩾1500 g for incidence, management and outcome of HRF, defined as acute hypoxemia requiring mechanical ventilation and/or nasal continuous positive airway pressure ⩾24 h. The patients were allocated into groups of moderate preterm (1735, 30...
February 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28146296/nasal-intermittent-positive-pressure-ventilation-nippv-versus-nasal-continuous-positive-airway-pressure-ncpap-for-preterm-neonates-after-extubation
#13
REVIEW
Brigitte Lemyre, Peter G Davis, Antonio G De Paoli, Haresh Kirpalani
BACKGROUND: Previous randomised trials and meta-analyses have shown that nasal continuous positive airway pressure (NCPAP) is a useful method for providing respiratory support after extubation. However, this treatment sometimes 'fails' in infants, and they may require endotracheal re-intubation with its attendant risks and expense. Nasal intermittent positive pressure ventilation (NIPPV) can augment NCPAP by delivering ventilator breaths via nasal prongs. Older children and adults with chronic respiratory failure benefit from NIPPV, and the technique has been applied to neonates...
February 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28145652/amniotic-fluid-infection-cytokine-levels-and-mortality-and-adverse-pulmonary-intestinal-and-neurologic-outcomes-in-infants-at-32-weeks-gestation-or-less
#14
Eun Young Jung, Kyo Hoon Park, Bo Ryoung Han, Soo Hyun Cho, Ha Na Yoo, Juyoung Lee
To what extent the risks of neonatal morbidities are directly related to premature birth or to biological mechanisms of preterm birth remains uncertain. We aimed to examine the effect of exposure to amniotic fluid (AF) infection and elevated cytokine levels on the mortality and pulmonary, intestinal, and neurologic outcomes of preterm infants, and whether these associations persist after adjustment for gestational age at birth. This retrospective cohort study included 152 premature singleton infants who were born at ≤ 32 weeks...
March 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28142154/a-quality-improvement-initiative-to-reduce-the-need-for-mechanical-ventilation-in-extremely-low-gestational-age-neonates
#15
Ludivine Templin, Camille Grosse, Virginie Andres, Clotilde Des Robert, Laurence Fayol, Umberto Simeoni, Farid Boubred
Objective Limiting early intubation and mechanical ventilation in extremely low gestational age neonates (ELGAN) may decrease neonatal morbidity and mortality. The aim of our study was to demonstrate the feasibility, efficacy, and tolerability of a delivery room respiratory management protocol, including delayed umbilical cord clamping (DUCC) in combination with optimized nCPAP with high PEEP levels and less invasive surfactant administration (LISA). Study Design This cohort quality improvement study analyzed the respiratory and neonatal outcomes of all consecutive infants born between 24(+0) and 26(+6) weeks' gestation before (period 1, n = 40) and after (period 2, n = 52) implementing the new protocol...
January 31, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28141913/systemic-corticosteroid-regimens-for-prevention-of-bronchopulmonary-dysplasia-in-preterm-infants
#16
REVIEW
Wes Onland, Anne Pmc De Jaegere, Martin Offringa, Anton van Kaam
BACKGROUND: Cochrane systematic reviews show that systemic postnatal corticosteroids reduce the risk of bronchopulmonary dysplasia (BPD) in preterm infants. However, corticosteroids have also been associated with an increased risk of neurodevelopmental impairment. It is unknown whether these beneficial and adverse effects are modulated by differences in corticosteroid treatment regimens. OBJECTIVES: To assess the effects of different corticosteroid treatment regimens on mortality, pulmonary morbidity, and neurodevelopmental outcome in very low birth weight (VLBW) infants...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28141719/-more-than-meets-the-eye-when-the-neonatal-course-may-impact-several-years-out
#17
Fadiyla Dopwell, John Maypole, Bharati Sinha, Heidi Currier, William DeBassio, Marilyn Augustyn
Nadia is a 7-year-old girl who you have followed since her discharge from the Neonatal Intensive Care Unit (NICU). Her parents are here today for an urgent visit with behavioral concerns, such as inattention, hyperactivity, and aggression.Nadia is a former 40-weeker born through vacuum-assisted vaginal delivery at 9 pounds 7 ounces. Her delivery was complicated with shoulder dystocia, which resulted in resuscitation. Her Apgar scores were 1, 3, and 4 at 1, 5, and 10 minutes, respectively. After intubation and stabilization on mechanical ventilation, Nadia was transferred to the NICU...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28130967/a-randomized-controlled-trial-of-the-laryngeal-mask-airway-for-surfactant-administration-in-neonates
#18
Rosilu F Barbosa, Ana C Simões E Silva, Yerkes P Silva
OBJECTIVE: To compare the short-term efficacy of surfactant administration by laryngeal mask airway (LMA) versus endotracheal tube (ETT). METHODS: Preterm infants (28-35 weeks of gestational age), weighing 1kg or more, with respiratory distress syndrome, requiring nasal continuous positive airway pressure (nCPAP), with increased respiratory effort and/or fraction of inspired oxygen (FiO2)≥0.40 to maintain oxygen saturation 91-95%, were randomized to receive surfactant by LMA following nCPAP or by ETT following mechanical ventilation (MV)...
January 25, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28121833/volume-targeted-ventilation-in-the-neonate-benchmarking-ventilators-on-an-active-lung-model
#19
Tobias J Krieger, Martin Wald
OBJECTIVE: Mechanically ventilated neonates have been observed to receive substantially different ventilation after switching ventilator models, despite identical ventilator settings. This study aims at establishing the range of output variability among 10 neonatal ventilators under various breathing conditions. DESIGN: Relative benchmarking test of 10 neonatal ventilators on an active neonatal lung model. SETTING: Neonatal ICU. SUBJECTS: Ten current neonatal ventilators...
January 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28121046/maternal-hypertensive-disorders-are-associated-with-increased-use-of-respiratory-support-but-not-chronic-lung-disease-or-poorer-neurodevelopmental-outcomes-in-preterm-neonates-at-29%C3%A2-weeks-of-gestation
#20
Mara Matić, Violet Inati, Mohamed E Abdel-Latif, Alison L Kent
AIM: To assess whether maternal hypertensive disorders in pregnancies result in higher respiratory requirements, risk of chronic lung disease (CLD) and poorer neurodevelopmental outcome in <29-week premature neonates. METHODS: This is a multicentre, retrospective cohort study, within a geographically defined area in Australia, served by a network of 10 neonatal intensive care units (NICUs), consisting of infants <29 weeks of gestational age who were admitted to NICUs between 1998 and 2004...
January 25, 2017: Journal of Paediatrics and Child Health
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