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mechanical ventilation newborn

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https://www.readbyqxmd.com/read/29039883/volume-targeted-versus-pressure-limited-ventilation-in-neonates
#1
REVIEW
Claus Klingenberg, Kevin I Wheeler, Naomi McCallion, Colin J Morley, Peter G Davis
BACKGROUND: Damage caused by lung overdistension (volutrauma) has been implicated in the development of bronchopulmonary dysplasia (BPD). Modern neonatal ventilation modes can target a set tidal volume as an alternative to traditional pressure-limited ventilation (PLV) using a fixed inflation pressure. Volume-targeted ventilation (VTV) aims to produce a more stable tidal volume in order to reduce lung damage and stabilise the partial pressure of carbon dioxide (pCO2). OBJECTIVES: To determine whether VTV compared with PLV leads to reduced rates of death and death or BPD in newborn infants and to determine whether use of VTV affected outcomes including air leak, cranial ultrasound findings and neurodevelopment...
October 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29032021/clinical-characteristics-and-survival-outcomes-of-terminally-ill-patients-undergoing-withdrawal-of-mechanical-ventilation
#2
Yu-Shin Hung, Shu-Hui Lee, Chia-Yen Hung, Chao-Hui Wang, Chen-Yi Kao, Hung-Ming Wang, Wen-Chi Chou
BACKGROUND: Withdrawal of mechanical ventilation is an important, but rarely explored issue in Asia during end-of-life care. This study aimed to describe the clinical characteristics and survival outcomes of terminally ill patients undergoing withdrawal of mechanical ventilation in Taiwan. METHODS: One-hundred-thirty-five terminally ill patients who had mechanical ventilation withdrawn between 2013 and 2016, from a medical center in Taiwan, were enrolled. Patients' clinical characteristics and survival outcomes after withdrawal of mechanical ventilation were analyzed...
October 11, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28985401/clinical-characteristics-of-nosocomial-bloodstream-infections-in-neonates-in-two-hospitals-china
#3
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/28973344/effect-of-inhaled-nitric-oxide-on-survival-without-bronchopulmonary-dysplasia-in-preterm-infants-a-randomized-clinical-trial
#4
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/28926832/persistent-pulmonary-hypertension-of-the-newborn-in-twin-twin-transfusion-syndrome-a-case-control-study
#5
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
#6
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/28910311/hearing-impairment-in-premature-newborns-analysis-based-on-the-national-hearing-screening-database-in-poland
#7
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
https://www.readbyqxmd.com/read/28890038/improving-the-efficiency-of-auditory-brainstem-responses-in-newborns-using-a-60clicks-s-stimulation-rate
#8
Lourdes Cubero-Rego, Josefina Ricardo-Garcell, María Corsi-Cabrera, Rogelio Cruz-Martínez, Carlos Rebolledo-Fernández, Gloria Otero-Ojeda, Thalía Harmony
Recent evidence suggests that Auditory Brainstem Responses (ABR), in neonates with risk factors for neurological damage, may show auditory brainstem abnormalities, even in patients with normal hearing. To compare the recording and diagnostic accuracy of neonatal Auditory Brainstem Responses (ABR), using 10 and 60clicks/s stimulation rates, two groups of neonates were prospectively studied: 30 healthy full-term neonates, with no peri- or postnatal complications; and 30 high-risk newborns with two or more of the following conditions: hyperbilirubinemia, use of ototoxic drugs, birth weight inferior to 1500g, perinatal sepsis, intraventricular hemorrhage, and/or mechanical ventilation...
November 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28880260/barriers-to-enrollment-in-a-randomized-controlled-trial-of-hydrocortisone-for-cardiovascular-insufficiency-in-term-and-late-preterm-newborn-infants
#9
K L Watterberg, E Fernandez, M C Walsh, W E Truog, B J Stoll, G M Sokol, K A Kennedy, M V Fraga, S S Beauman, B Carper, A Das, A F Duncan, W F Buss, C Gauldin, C B Lacy, P J Sanchez, S Chawla, S Lakshminrusimha, C M Cotten, K P Van Meurs, B B Poindexter, E F Bell, W A Carlo, U Devaskar, M H Wyckoff, R D Higgins
OBJECTIVE: To analyze reasons for low enrollment in a randomized controlled trial (RCT) of the effect of hydrocortisone for cardiovascular insufficiency on survival without neurodevelopmental impairment (NDI) in term/late preterm newborns. STUDY DESIGN: The original study was a multicenter RCT. Eligibility: ⩾34 weeks' gestation, <72 h old, mechanically ventilated, receiving inotrope. Primary outcome was NDI at 2 years; infants with diagnoses at high risk for NDI were excluded...
September 7, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28856971/a-comparison-of-the-effects-of-invasive-mechanic-ventilation-surfactant-therapy-and-non-invasive-nasal-continuous-positive-airway-pressure-in-preterm-newborns
#10
Muhittin Celik, Ali Bulbul, Sinan Uslu, Mesut Dursun, Omer Guran, Evrim Kıray Bas, Selda Arslan, Umut Zubarioglu
AIMS: This study compared the early-term outcomes of mechanical ventilation (MV)/surfactant treatment with nasal-continuous positive airway pressure (nCPAP) in preterm infants with respiratory distress syndrome (RDS). MATERIALS AND METHODS: Data from newborns born between ≥24 and ≤32 weeks of gestation, hospitalized at our newborn intensive care unit, and diagnosed with RDS between January 2009 and February 2012 were analyzed. RESULTS: Of 193 newborns with RDS who were enrolled in the study, 113 were treated with nCPAP and 80 with MV at a level of 57...
August 31, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28834879/effect-of-acid-base-balance-on-postoperative-course-in-children-with-hypoplastic-left-heart-syndrome-after-the-modified-norwood-procedure
#11
Marcin Gładki, Tomasz Składzień, Rafał Żurek, Elżbieta Broniatowska, Elżbieta Wójcik, Janusz H Skalski
Hypoplastic left heart syndrome (HLHS) is a congenital heart defect that requires 3-stage cardiac surgical treatment and multidirectional specialist care. The condition of newborns in the first postoperative days following the modified Norwood procedure is characterized by considerable hemodynamic instability that may result in a sudden cardiac arrest. It is believed that the most important cause of hemodynamic instability is the fluctuations in redistribution between pulmonary and systemic blood flow.The paper analyzes the postoperative course in 40 neonates with HLHS following the modified Norwood procedure performed under deep hypothermic cardiopulmonary bypass hospitalized in Cardiac Surgical Intensive Care Unit (CSICU) in the years 2014-2015...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28830746/risk-factors-and-molecular-epidemiology-of-acinetobacter-baumannii-bacteremia-in-neonates
#12
Hao-Yuan Lee, Shih-Yun Hsu, Jen-Fu Hsu, Chyi-Liang Chen, Yi-Hsin Wang, Cheng-Hsun Chiu
BACKGROUND: Acinetobacter baumannii infections in neonates are not uncommon but rarely studied. METHODS: Clinical and molecular epidemiology of 40 patients with A. baumannii bacteremia in the neonatal intensive care units (NICUs) of a medical center from 2004 to 2014 was analyzed. RESULTS: Multi-drug resistance was found in only 3 isolates (7.5%). Sequence types (STs) of A. baumannii defined by multilocus sequencing typing were diverse, and 72...
August 8, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28816096/management-of-severe-pulmonary-hemorrhage-in-a-neonate-on-veno-arterial-ecmo-by-the-temporary-clamping-of-the-endotracheal-tube-a-case-report
#13
Vaclav Vobruba, Tomas Grus, Frantisek Mlejnsky, Jan Belohlavek, Jan Hridel, Lukas Lambert
Severe pulmonary hemorrhage in the newborn is an infrequent, but life-threatening, event. A newborn with persistent pulmonary hypertension and a large persistent ductus arteriosus and open foramen ovale presented with hypoxemia and progressive right heart failure shortly after birth, requiring veno-arterial extracorporeal membrane oxygenation (ECMO) support. Twenty minutes after the initiation of ECMO, the patient developed severe pulmonary hemorrhage refractory to conventional treatment. As a last resort, the endotracheal tube was clamped...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28802561/recombinant-human-elafin-promotes-alveologenesis-in-newborn-mice-exposed-to-chronic-hyperoxia
#14
Wenli Han, Xiaomei Li, Han Zhang, Benli Yu, Chunbao Guo, Chun Deng
BACKGROUND/AIMS: Elastase inhibitors reverse elastin degradation and abnormal alveologenesis and attenuate the lung structural abnormalities induced by mechanical ventilation with O2-rich gas. The potential of these molecules to improve endothelial function and to ameliorate severe bronchopulmonary dysplasia (BPD) during lung development is not yet understood. We sought to determine whether the intratracheal treatment of newborn mice with the elastase inhibitor elafin would prevent hyperoxia-induced lung elastin degradation and the cascade of events that cause abnormal alveologenesis...
August 10, 2017: International Journal of Biochemistry & Cell Biology
https://www.readbyqxmd.com/read/28794965/efficacy-of-lung-volume-optimization-maneuver-monitored-by-optoelectronic-pletismography-in-the-management-of-congenital-diaphragmatic-hernia
#15
G Lista, I Bresesti, F Cavigioli, F Castoldi, E Lupo, A LoMauro, A Aliverti
Newborns affected by congenital diaphragmatic hernia (CDH) need cardio-respiratory stabilization before undergoing surgical repair. Open lung strategy is a well-established approach to optimize lung volume in preterm infants with Respiratory Distress Syndrome (RDS), using both High Frequency Oscillatory Ventilation (HFOV) and Conventional Mechanical Ventilation (CMV). We report a case of left CDH with severe lung hypoplasia, managed applying open lung strategy in HFOV (pre-surgery period) and in Assist-Control with Volume Guarantee (post-surgery period), guided by SpO2 changes, TcPO2 and TcPCO2 monitoring...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28789711/does-growth-restriction-increase-the-vulnerability-to-acute-ventilation-induced-brain-injury-in-newborn-lambs-implications-for-future-health-and-disease
#16
B J Allison, S B Hooper, E Coia, G Jenkin, A Malhotra, V Zahra, A Sehgal, M Kluckow, A W Gill, T Yawno, G R Polglase, M Castillo-Melendez, S L Miller
Fetal growth restriction (FGR) and preterm birth are frequent co-morbidities, both are independent risks for brain injury. However, few studies have examined the mechanisms by which preterm FGR increases the risk of adverse neurological outcomes. We aimed to determine the effects of prematurity and mechanical ventilation (VENT) on the brain of FGR and appropriately grown (AG, control) lambs. We hypothesized that FGR preterm lambs are more vulnerable to ventilation-induced acute brain injury. FGR was surgically induced in fetal sheep (0...
August 9, 2017: Journal of Developmental Origins of Health and Disease
https://www.readbyqxmd.com/read/28775070/elevated-airway-liquid-volumes-at-birth-a-potential-cause-of-transient-tachypnea-of-the-newborn
#17
Erin Victoria McGillick, Katie Lee, Shigeo Yamaoka, Arjan B Te Pas, Kelly J Crossley, Megan J Wallace, Marcus John Kitchen, Robert A Lewis, Lauren T Kerr, Philip DeKoninck, Janneke Dekker, Marta Thio, Annie McDougall, Stuart B Hooper
Excessive liquid in airways and/or in distal lung tissue may underpin the respiratory morbidity associated with transient tachypnea of the newborn (TTN). However, its effects on lung aeration and respiratory function following birth are unknown. We investigated the effect of elevated airway liquid volumes on newborn respiratory function. Near term rabbit kittens (30 days gestation; term ~32 days) were delivered, had lung liquid drained and either had no liquid replaced (Control, n=7) or 30 mL/kg of liquid was re-added to the airways (liquid added; LA, n=7)...
August 3, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28768667/trpv4-channels-contribute-to-renal-myogenic-autoregulation-in-neonatal-pigs
#18
Hitesh Soni, Dieniffer Peixoto-Neves, Anberitha T Matthews, Adebowale Adebiyi
Myogenic response, a phenomenon in which resistance size arteries and arterioles swiftly constrict or dilate in response to an acute elevation or reduction, respectively in intravascular pressure is a key component of renal autoregulation mechanisms. Although it is well-established that the renal system is functionally immature in neonates, mechanisms that regulate neonatal renal blood flow (RBF) remain poorly understood. In this study, we investigated the hypothesis that members of the transient receptor potential vanilloid (TRPV) channels are molecular components of renal myogenic constriction in newborns...
August 2, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28742524/early-postnatal-echocardiographic-assessment-of-pulmonary-blood-flow-in-newborns-with-congenital-diaphragmatic-hernia
#19
Florian Kipfmueller, Katrin Heindel, Lukas Schroeder, Christoph Berg, Oliver Dewald, Heiko Reutter, Peter Bartmann, Andreas Mueller
OBJECTIVE: Echocardiography is the most important tool to assess infants with congenital diaphragmatic hernia (CDH) for pulmonary hypertension (PH). The pattern of blood flow in the pulmonary artery [described as time to peak velocity (TPV)/right ventricular ejection time (RVET) ratio] provides distinct information about pulmonary arterial pressure. The aim of our study was to investigate the correlation of TPV/RVET measurements with the most commonly used classification system for PH in CDH newborns and the association of these measurements with outcome parameters...
July 25, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28737191/-stress-in-parents-of-hospitalized-newborns-in-a-neonatal-intensive-care-unit
#20
Elisa Palma I, Fernanda Von Wussow K, Ignacia Morales B, Javier Cifuentes R, Sergio Ambiado T
The birth of a child that requires hospitalization in a Neonatal Intensive Care Unit (NICU) can be very stressful for parents. OBJECTIVE: To determine the stress level of parents of newborns (NB) hospitalized in a level III NICU in Santiago, and its association with clinical and sociodemographic variables. PATIENTS AND METHOD: Descriptive cross-sectional study. 373 admissions were evaluated. The sampling was non-probabilistic and included parents of RN admitted to the UPCN between 7 and 21 days of hospitalization...
June 2017: Revista Chilena de Pediatría
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