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neonatal mechanical ventilation

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https://www.readbyqxmd.com/read/29041034/inhaled-versus-systemic-corticosteroids-for-preventing-bronchopulmonary-dysplasia-in-ventilated-very-low-birth-weight-preterm-neonates
#1
REVIEW
Sachin S Shah, Arne Ohlsson, Henry L Halliday, Vibhuti S Shah
BACKGROUND: Bronchopulmonary dysplasia (BPD) remains an important cause of mortality and morbidity in preterm infants and inflammation plays a significant role in its pathogenesis. The use of inhaled corticosteroids may modulate the inflammatory process without concomitant high systemic steroid concentrations and less risk of adverse effects. This is an update of a review published in 2012 (Shah 2012). We recently updated the related review on "Inhaled versus systemic corticosteroids for treating bronchopulmonary dysplasia in ventilated very low birth weight preterm neonates"...
October 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29036732/predictors-of-poor-outcome-in-neonates-with-pyogenic-meningitis-in-a-level-three-neonatal-intensive-care-unit-of-developing-country
#2
Mala Kumar, Shalini Tripathi, Himanshu Kumar, S N Singh
Background: The mortality of neonatal pyogenic meningitis is reduced to 10-15%, but morbidity is unchanged. Methods: Primary objective is to determine the outcome, i.e. death or abnormal neurological examination (NE) at discharge and abnormal developmental quotient (DQ) at 3 months. Secondary objective is to find predictors of poor outcome. Results: In all, 89 neonates enrolled, 10 expired and 24 neonates had abnormal NE at discharge. A total of 59 neonates came for follow up, 13 had DQ < 70...
September 26, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29035425/inhaled-versus-systemic-corticosteroids-for-the-treatment-of-bronchopulmonary-dysplasia-in-ventilated-very-low-birth-weight-preterm-infants
#3
REVIEW
Sachin S Shah, Arne Ohlsson, Henry L Halliday, Vibhuti S Shah
BACKGROUND: This is an update of a review published in 2012. A related review "Inhaled versus systemic corticosteroids for preventing bronchopulmonary dysplasia in ventilated very low birth weight preterm neonates" has been updated as well. Bronchopulmonary dysplasia (BPD) is a serious and common problem among very low birth weight infants, despite the use of antenatal steroids and postnatal surfactant therapy to decrease the incidence and severity of respiratory distress syndrome. Due to their anti-inflammatory properties, corticosteroids have been widely used to treat or prevent BPD...
October 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29030937/changes-in-blood-volume-indicators-and-dynamic-indicators-measured-with-transpulmonary-ultrasound-velocity-during-blood-depletion-and-repletion-in-a-neonatal-swine-model
#4
Manuel Martin-Flores, Alvaro F Cisternas, Robin D Gleed
BACKGROUND: Dynamic indicators such as pulse pressure and stroke volume variations can be measured to track changes in preload during hemorrhage, and evaluate fluid therapy. However, these dynamic indicators require mechanical ventilation, and might be affected by cardiac dysrhythmias and changes in vascular tone. Blood volume indicators may offer alternatives for assessing changes in volume status. AIMS: The aims of this study were to measure changes in blood volume indicators and dynamic indicators during removal of blood in two stages and subsequent blood replacement in anesthetized, mechanically ventilated, neonatal pigs...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28987397/duration-of-postoperative-mechanical-ventilation-as-a-quality-metric-for-pediatric-cardiac-surgical-programs
#5
Michael Gaies, David K Werho, Wenying Zhang, Janet E Donohue, Sarah Tabbutt, Nancy S Ghanayem, Mark A Scheurer, John M Costello, J William Gaynor, Sara K Pasquali, Justin B Dimick, Mousumi Banerjee, Steven M Schwartz
BACKGROUND: Few metrics exist to assess quality of care at pediatric cardiac surgical programs, limiting opportunities for benchmarking and quality improvement. Postoperative duration of mechanical ventilation (POMV) may be an important quality metric because of its association with complications and resource utilization. In this study we modelled case-mix-adjusted POMV duration and explored hospital performance across POMV metrics. METHODS: This study used the Pediatric Cardiac Critical Care Consortium clinical registry to analyze 4,739 hospitalizations from 15 hospitals (October 2013 to August 2015)...
October 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28985401/clinical-characteristics-of-nosocomial-bloodstream-infections-in-neonates-in-two-hospitals-china
#6
Shanmei Wang, Sheng Chen, Wei Feng, Fengjun Sun, Qian Wang, Ke Zhu, Jie Song
Background: The improvement of medical condition requires prolonged hospital stays, which increase the risk of nosocomial bloodstream infections (BSIs). Methods: All nosocomial BSI newborns in two hospitals were included, and the demographic and clinical characteristics of bacteremia patients were obtained from the information systems. Isolates were identified by biochemical assays. Antimicrobial susceptibility was determined using disk diffusion method. Results: Except for three same risk factors, intubation with mechanical ventilation was a risk factor in Chongqing, while low birth weight was a risk factor in Henan...
July 21, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28977137/dorsal-brainstem-syndrome-and-the-use-of-neurally-adjusted-ventilatory-assist-nava-in-an-infant
#7
José Colleti, Walter Koga, Werther Brunow de Carvalho
OBJECTIVE: To report a rare case of dorsal brainstem syndrome in an infant after hypoxic-ischemic episode due to severe sepsis and the use of neurally adjusted ventilatory assist (NAVA) to aid in diagnosis and in the removal of mechanical ventilation. CASE DESCRIPTION: A 2-month-old male infant, previously healthy, presented with severe sepsis that evolved to dorsal brainstem syndrome, which usually occurs after hypoxic-ischemic injury in neonates and infants, and is related to very specific magnetic resonance images...
September 21, 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28974135/propofol-and-fentanyl-sedation-for-laser-treatment-of-retinopathy-of-prematurity-to-avoid-intubation
#8
Fiammetta Piersigilli, Alessandra Di Pede, Gino Catena, Simona Lozzi, Cinzia Auriti, Iliana Bersani, Irma Capolupo, Anna Lipreri, Vincenzo Di Ciommo, Andrea Dotta, Stefania Sgrò
BACKGROUND: Despite the optimization of neonatal assistance, severe retinopathy of prematurity (ROP, stage III-IV) remains a common condition among preterm infants. Laser photocoagulation usually requires general anesthesia and intubation, but extubation can be difficult and these infants often affected by chronic lung disease. We retrospectively evaluated the clinical charts of 13 neonates that were sedated with propofol in association with fentanyl for the laser treatment of ROP. This protocol was introduced in our unit to avoid intubation and minimize side effects of anesthesia and ventilation...
October 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28973344/effect-of-inhaled-nitric-oxide-on-survival-without-bronchopulmonary-dysplasia-in-preterm-infants-a-randomized-clinical-trial
#9
Shabih U Hasan, Jim Potenziano, Girija G Konduri, Jose A Perez, Krisa P Van Meurs, M Whit Walker, Bradley A Yoder
Importance: Bronchopulmonary dysplasia (BPD) occurs in approximately 40% of infants born at younger than 30 weeks' gestation and is associated with adverse pulmonary and neurodevelopmental outcomes. Objective: To test whether administration of inhaled nitric oxide to preterm infants requiring positive pressure respiratory support on postnatal days 5 to 14 improves the rate of survival without BPD. Design, Setting, and Participants: This intent-to-treat study was a randomized clinical trial performed at 33 US and Canadian neonatal intensive care units...
September 25, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28969229/surfactant-therapy-for-early-onset-pneumonia-in-late-preterm-and-term-neonates-needing-mechanical-ventilation
#10
Sujata Deshpande, Pradeep Suryawanshi, Kunal Ahya, Rajesh Maheshwari, Samir Gupta
INTRODUCTION: Pathophysiology of pneumonia involves leakage of plasma proteins into the airways and accumulation of cytokines within the lung. Several in vitro and in vivo studies have demonstrated that this proteinaceous material and lung inflammation inhibit surfactant function. AIM: To evaluate whether exogenous surfactant therapy improves oxygenation and gas exchange in late preterm and term neonates with early onset pneumonia and respiratory failure. MATERIALS AND METHODS: This prospective interventional cohort study was conducted at a tertiary care neonatal unit...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28950821/modelling-bronchopulmonary-dysplasia-in-animals-arguments-for-the-preterm-rabbit-model
#11
Thomas Salaets, Andre Gie, Bieke Tack, Jan Deprest, Jaan Toelen
Bronchopulmonary dysplasia (BPD) remains a frequent and disabling consequence of preterm birth, despite the recent advances in neonatal intensive care. There is a need to further improve outcomes and many novel therapeutic or preventive strategies are therefore investigated in animal models. We discuss in this review the aspects of human BPD pathophysiology and phenotype, which ideally should be mimicked by an animal model for this disease. Prematurity remains the common denominator in the heterogeneous spectrum of human BPD, and preterm animal models thus have a clear translational advantage...
September 26, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28948345/is-gestational-diabetes-an-independent-risk-factor-of-neonatal-severe-respiratory-distress-syndrome-after-34%C3%A2-weeks-of-gestation-a-prospective-study
#12
Isabelle Mortier, Julie Blanc, Barthelemy Tosello, Catherine Gire, Florence Bretelle, Xavier Carcopino
PURPOSE: To evaluate if neonates delivered after 34(0/7) weeks from mothers diagnosed with gestational diabetes (GD) are exposed to an increased risk of neonatal severe respiratory distress syndrome (SRDS). METHODS: Women with singleton pregnancy in labour after 34(0/7) weeks of gestation or admitted for planned caesarean section and who had been systematically screened for GD were eligible to participate to this prospective cohort study. Diagnosis of SRDS was defined by the association of clinical signs of early neonatal respiratory distress, with consistent radiologic features and requiring mechanical ventilation with a fraction of inspired oxygen (FiO2) >0...
September 25, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28947918/efficacy-study-of-pulmonary-surfactant-combined-with-assisted-ventilation-for-acute-respiratory-distress-syndrome-management-of-term-neonates
#13
Jinfeng Liu, Gang Liu, Hongwei Wu, Zhenguang Li
The clinical efficacy of pulmonary surfactant (PS) combined with assisted ventilation was assessed for acute respiratory distress syndrome (RDS) management of term neonates. The total sample size was of 60 subjects. Group I: Experimental group, 30 cases were treated with standard of care with tracheal intubation, mechanical ventilation and PS (100-200 mg/kg). In case of hypoxaemia present even after 12 h standard of care was administered again, up to 4 times. Group II: Control group, 30 cases treated with conventional tracheal intubation and mechanical ventilation...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28936698/recommendations-for-mechanical-ventilation-of-critically-ill-children-from-the-paediatric-mechanical-ventilation-consensus-conference-pemvecc
#14
Martin C J Kneyber, Daniele de Luca, Edoardo Calderini, Pierre-Henri Jarreau, Etienne Javouhey, Jesus Lopez-Herce, Jürg Hammer, Duncan Macrae, Dick G Markhorst, Alberto Medina, Marti Pons-Odena, Fabrizio Racca, Gerhard Wolf, Paolo Biban, Joe Brierley, Peter C Rimensberger
PURPOSE: Much of the common practice in paediatric mechanical ventilation is based on personal experiences and what paediatric critical care practitioners have adopted from adult and neonatal experience. This presents a barrier to planning and interpretation of clinical trials on the use of specific and targeted interventions. We aim to establish a European consensus guideline on mechanical ventilation of critically children. METHODS: The European Society for Paediatric and Neonatal Intensive Care initiated a consensus conference of international European experts in paediatric mechanical ventilation to provide recommendations using the Research and Development/University of California, Los Angeles, appropriateness method...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28926832/persistent-pulmonary-hypertension-of-the-newborn-in-twin-twin-transfusion-syndrome-a-case-control-study
#15
Manon Gijtenbeek, M C Haak, Derk Jan Ten Harkel, Arjan B Te Pas, Johanna M Middeldorp, Frans J C M Klumper, Nan van Geloven, Dick Oepkes, Enrico Lopriore
BACKGROUND: Persistent pulmonary hypertension of the newborn (PPHN) is associated with severe morbidity and mortality. Twin-twin transfusion syndrome (TTTS) is suggested to increase the risk of PPHN. OBJECTIVES: To describe the incidence of PPHN in TTTS twins and to identify risk factors in TTTS twins for the development of severe PPHN. METHODS: Cases with severe PPHN were extracted from our monochorionic twin database (2002-2016). Severe PPHN was defined as severe hypoxaemia requiring mechanical ventilation and inhaled nitric oxide (iNO) treatment, confirmed by strict echocardiographic criteria...
September 20, 2017: Neonatology
https://www.readbyqxmd.com/read/28923828/attenuated-pdgf-signaling-drives-alveolar-and-microvascular-defects-in-neonatal-chronic-lung%C3%A2-disease
#16
Prajakta Oak, Tina Pritzke, Isabella Thiel, Markus Koschlig, Daphne S Mous, Anita Windhorst, Noopur Jain, Oliver Eickelberg, Kai Foerster, Andreas Schulze, Wolfgang Goepel, Tobias Reicherzer, Harald Ehrhardt, Robbert J Rottier, Peter Ahnert, Ludwig Gortner, Tushar J Desai, Anne Hilgendorff
Neonatal chronic lung disease (nCLD) affects a significant number of neonates receiving mechanical ventilation with oxygen-rich gas (MV-O2). Regardless, the primary molecular driver of the disease remains elusive. We discover significant enrichment for SNPs in the PDGF-Rα gene in preterms with nCLD and directly test the effect of PDGF-Rα haploinsufficiency on the development of nCLD using a preclinical mouse model of MV-O2 In the context of MV-O2, attenuated PDGF signaling independently contributes to defective septation and endothelial cell apoptosis stemming from a PDGF-Rα-dependent reduction in lung VEGF-A...
September 18, 2017: EMBO Molecular Medicine
https://www.readbyqxmd.com/read/28922269/extubation-failure-is-associated-with-increased-mortality-following-first-stage-single-ventricle-reconstruction-operation
#17
Thomas Scodellaro, Jane M McKenzie, Yves d'Udekem, Warwick Butt, Siva P Namachivayam
OBJECTIVES: To identify the prevalence, causes, risk factors, and outcomes associated with extubation failure following first stage single ventricle reconstruction surgery. DESIGN: Retrospective cohort analysis of neonates who underwent a first stage single ventricle reconstruction operation. Extubation failure was defined as endotracheal reintubation within 48 hours of first extubation attempt. SETTING: The Royal Children's Hospital, Melbourne...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28914722/factors-associated-with-pediatric-ventilator-associated-conditions-in-six-u-s-hospitals-a-nested-case-control-study
#18
Noelle M Cocoros, Gregory Priebe, James E Gray, Philip Toltzis, Gitte Y Larsen, Latania K Logan, Susan Coffin, Julia S Sammons, Kathleen Deakins, Kelly Horan, Matthew Lakoma, Jessica Young, Michael Burton, Michael Klompas, Grace M Lee
OBJECTIVES: A newly proposed surveillance definition for ventilator-associated conditions among neonatal and pediatric patients has been associated with increased morbidity and mortality among ventilated patients in cardiac ICU, neonatal ICU, and PICU. This study aimed to identify potential risk factors associated with pediatric ventilator-associated conditions. DESIGN: Retrospective cohort. SETTING: Six U.S. hospitals PATIENTS:: Children less than or equal to 18 years old ventilated for greater than or equal to 1 day...
September 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28913327/in-vivo-evaluation-of-the-acute-pulmonary-response-to-poractant-alfa-and-bovactant-treatments-in-lung-lavaged-adult-rabbits-and-in-preterm-lambs-with-respiratory-distress-syndrome
#19
Francesca Ricci, Fabrizio Salomone, Elke Kuypers, Daan Ophelders, Maria Nikiforou, Monique Willems, Tobias Krieger, Xabier Murgia, Matthias Hütten, Boris W Kramer, Federico Bianco
BACKGROUND: Poractant alfa (Curosurf(®)) and Bovactant (Alveofact(®)) are two animal-derived pulmonary surfactants preparations approved for the treatment of neonatal respiratory distress syndrome (nRDS). They differ in their source, composition, pharmaceutical form, and clinical dose. How much these differences affect the acute pulmonary response to treatment is unknown. OBJECTIVES: Comparing these two surfactant preparations in two different animal models of respiratory distress focusing on the short-term response to treatment...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28910311/hearing-impairment-in-premature-newborns-analysis-based-on-the-national-hearing-screening-database-in-poland
#20
Katarzyna Wroblewska-Seniuk, Grazyna Greczka, Piotr Dabrowski, Joanna Szyfter-Harris, Jan Mazela
OBJECTIVES: The incidence of sensorineural hearing loss is between 1 and 3 per 1000 in healthy neonates and 2-4 per 100 in high-risk infants. The national universal neonatal hearing screening carried out in Poland since 2002 enables selection of infants with suspicion and/or risk factors of hearing loss. In this study, we assessed the incidence and risk factors of hearing impairment in infants ≤33 weeks' gestational age (wga). METHODS: We analyzed the database of the Polish Universal Newborns Hearing Screening Program from 2010 to 2013...
2017: PloS One
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