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Neonatal respiratory care

Megan O'Reilly, Bernard Thébaud
Preterm birth occurs in approximately 11 % of all births worldwide. Advances in perinatal care have enabled the survival of preterm infants born as early as 23-24 weeks of gestation. However, many are affected by bronchopulmonary dysplasia (BPD)-a common respiratory complication of preterm birth, which has life-long consequences for lung health. Currently, there is no specific treatment for BPD. Recent advances in stem cell research have opened new therapeutic avenues for prevention/repair of lung damage...
October 22, 2016: Cell and Tissue Research
Bryan M Corbett, Charles O'Connell, Mallory A Boutin, Nabil I Fatayerji, Charles W Sauer
BACKGROUND Methylergonovine is an ergot alkaloid used to treat post-partum hemorrhage secondary to uterine atony. Mistaking methylergonovine for vitamin K with accidental administration to the neonate is a rare iatrogenic illness occurring almost exclusively in the delivery room setting. Complications of ergot alkaloids in neonates include respiratory depression, seizures, and death. CASE REPORT A term infant was inadvertently given 0.1 mg of methylergonovine intramuscularly in the right thigh. The error was only noted when the vial of medication was scanned, after administration, identifying it as methylergonovine rather than vitamin K...
October 21, 2016: American Journal of Case Reports
Kai König, Katelyn J Guy, Claudia A Nold-Petry, Charles P Barfield, Geraldine Walsh, Sandra M Drew, Alex Veldman, Marcel F Nold, Dan M Casalaz
Bronchopulmonary dysplasia (BPD) is often complicated by pulmonary hypertension (PH). We investigated three biomarkers potentially suitable as screening markers for extremely preterm infants at risk of BPD-associated PH. In this prospective observational cohort study conducted in a tertiary neonatal intensive care unit, 83 preterm infants with BPD born <28 weeks gestation and still inpatients at 36 weeks corrected age received an echocardiogram and blood tests of B-type natriuretic peptide (BNP), troponin I, and YKL-40...
October 19, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
Jessica H Rankin, Marsha Elkhunovich, Dina Seif, Mikaela Chilstrom
Neonatal respiratory distress is an emergent condition with a wide differential diagnosis. A 12-day-old newborn presented to the emergency department in respiratory distress. Point-of-care ultrasound allowed clinicians to rapidly exclude cardiac disease and pneumothorax as possible causes of the patient's respiratory distress, and expedited the identification of congenital diaphragmatic hernia. The ultrasound findings and technique, epidemiology, pathophysiology, and radiological diagnosis of congenital diaphragmatic hernia are reviewed...
October 2016: Pediatric Emergency Care
Xiang Kong, Yan Kong, Fangyuan Zhang, Tingting Wang, Jin Yan
BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is a specific pregnancy-related disorder without standard medical therapies. Ursodeoxycholic acid (UDCA) is the most used medicine, but the efficacy and safety of UDCA remain uncertain. Several meta-analyses had been made to assess the effects of UDCA in ICP. However, the samples were not large enough to convince obstetricians to use UDCA. We conducted a meta-analysis to evaluate the effects and safety of UDCA in patients with ICP, which included only randomized controlled trials (RCTs)...
October 2016: Medicine (Baltimore)
Namita Chandra, Sanjay Kumar, Vaibhav Raj, Pawan Kumar Vishwakarma, Sheela Sinha, Ram Prakash Saha
BACKGROUND Jarcho-Levin syndrome, also known as spondylothoracic dysplasia and spondylocostal dysplasia, is characterized by varieties of vertebrae and rib anomalies. Jarcho-Levin syndrome is a clinical-radiological diagnosis with clinical evidence of short neck, short trunk, normal-sized limbs, or increased arm span, and vertebral and rib defects on the skeletal survey. CASE REPORT About 400 cases have been reported in world literature and 18 in our Indian literature. We report the case of a one-day-old female baby with a short trunk, short neck, low hairline, apparently long limbs, protuberant abdomen, mild midfacial dysmorphism, low-set ears, and a high-arched palate...
October 14, 2016: American Journal of Case Reports
Dilek Ulubaş-Işık, Sara Erol, Nihal Demirel, Yusuf Kale, İstemi Han Çelik, Ömer Lütfi Tapısız, Bülent Yırcı, Ahmet Yağmur Baş
Early-term infants incur higher risks for neonatal morbidities compared to full-term infants. In this study, we investigated the neonatal morbidities in early-term infants admitted to a neonatal intensive care unit (NICU). Early-term (37 0/7 and 38 6/7 weeks of gestation) and full-term (39 0/7 and 41 6/7 weeks of gestation) infants born between January 2013 and December 2014 were enrolled in this study. Early-term deliveries accounted for 8,026 (25.7%) of all live births (n = 31,170). The admission rate of early-term infants to the NICU was 7...
November 2015: Turkish Journal of Pediatrics
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
Pilar Anton-Martin, Vinai Modem, Donna Taylor, Donald Potter, Cindy Darnell-Bowens
INTRODUCTION: The purpose of this study is to describe the sedative and analgesic requirements identifying factors associated with medication escalation in neonates and children supported on ECMO. METHOD: Observational retrospective cohort study in a tertiary pediatric intensive care unit from June 2009 to June 2013. RESULTS: One hundred and sixty patients were included in the study. Fentanyl and midazolam were the first line agents used while on ECMO...
October 10, 2016: Perfusion
Shinya Miura, Nao Hamamoto, Masaki Osaki, Satoshi Nakano, Chisato Miyakoshi
BACKGROUND: The purpose of this study was to explore the prevalence, etiology, and risk factors of extubation failure (EF) in post-cardiac surgery neonates. METHODS: Neonates (30 days old or younger) who underwent cardiac surgery and were admitted to the cardiac intensive care unit between September 2010 and February 2016 were included. The prevalence and etiology of EF, defined as reintubation within 48 hours, were reviewed. Demographic, operative, and perioperative data were retrospectively collected...
October 6, 2016: Annals of Thoracic Surgery
Sezin Unal, Ebru Ergenekon, Selma Aktas, Serdar Beken, Nilgun Altuntas, Ebru Kazanci, Ferit Kulali, Ibrahim M Hirfanoglu, Esra Onal, Canan Turkyilmaz, Esin Koc, Yildiz Atalay
BACKGROUND: Perfusion index (PI) is becoming a part of clinical practice in neonatology to monitor peripheral perfusion noninvasively. Hemodynamic and respiratory changes occur in newborns during the transition period after birth in which peripheral perfusion may be affected. Tachypnea is a frequent symptom during this period. While some tachypneic newborns get well in less than 6 h and diagnosed as "delayed transition", others get admitted to intensive care unit which transient tachypnea of newborn (TTN) being the most common diagnosis among them...
October 7, 2016: BMC Pediatrics
R Sahni, X Ameer, K Ohira-Kist, J-T Wung
OBJECTIVES: Inhaled nitric oxide (iNO) is effective in conjunction with tracheal intubation (TI) and mechanical ventilation (MV) for treating arterial pulmonary hypertension and hypoxemic respiratory failure (HRF) in near-term and term newborns. Non-invasive respiratory support with nasal continuous positive airway pressure (CPAP) is increasingly used to avoid morbidity associated with TI and MV, yet the effectiveness of iNO delivery via nasal CPAP remains unknown. To evaluate the effectiveness of iNO delivered via the bubble nasal CPAP system in term and preterm newborns with HRF...
October 6, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Mariya Angelova, Emil Kovachev, Veselina Tsankova, Iliana Koleva, Silvia Mangarova
AIM: The aim of this study was to assess the prevalence of chlamydial infection among pregnant women and to determine the role of this infection in the fetus. MATERIAL AND METHODS: In the first phase of this study were reported 58 pregnant women with a positive test for active chlamydial infection by applying immunofluorescence. In the second phase of the study were reported pregnant with premature burst membranes (PBM), postnatal complications associated with chlamydial infection as puerperal endometritis, and newborns are monitored for low birth weight and growth retardation at birth...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
Sae Yun Kim, Seung Han Shin, Han-Suk Kim, Young Hwa Jung, Ee-Kyung Kim, Jung-Hwan Choi
OBJECTIVE: To describe the clinical course and risk factors for pulmonary arterial hypertension (PAH) after ibuprofen treatment to close patent ductus arteriosus. STUDY DESIGN: All neonates weighing < 1500 g at birth who received ibuprofen to close patent ductus arteriosus and were admitted to Seoul National University Children's Hospital's neonatal intensive care unit in 2010-2014 were eligible for this study. The study population was divided into the PAH and non-PAH groups, and medical records were retrospectively reviewed...
September 28, 2016: Journal of Pediatrics
Sarah H Koning, Klaas Hoogenberg, Kirsten A Scheuneman, Mick G Baas, Fleurisca J Korteweg, Krystyna M Sollie, Bertine J Schering, Aren J van Loon, Bruce H R Wolffenbuttel, Paul P van den Berg, Helen L Lutgers
BACKGROUND: To evaluate the neonatal and obstetric outcomes of pregnancies complicated by gestational diabetes mellitus (GDM). Screening and treatment - diet-only versus additional insulin therapy - were based on the 2010 national Dutch guidelines. METHODS: Retrospective study of the electronic medical files of 820 singleton GDM pregnancies treated between January 2011 and September 2014 in a university and non-university hospital. Pregnancy outcomes were compared between regular care treatment regimens -diet-only versus additional insulin therapy- and pregnancy outcomes of the Northern region of the Netherlands served as a reference population...
September 29, 2016: BMC Endocrine Disorders
Welcy Cassiano de Oliveira Tobinaga, Cirlene de Lima Marinho, Vera Lucia Barros Abelenda, Paula Morisco de Sá, Agnaldo José Lopes
Background. In the neonatal intensive care unit (NICU) environment, preterm newborns are subject to environmental stress and numerous painful interventions. It is known that hydrokinesiotherapy promotes comfort and reduces stress because of the physiological properties of water. Objective. To evaluate the short-term effects of hydrokinesiotherapy on reducing stress in preterm newborns admitted to the NICU. Materials and Methods. Fifteen preterm newborns underwent salivary cortisol measurement, pain evaluation using the Neonatal Infant Pain Scale (NIPS), and heart rate, respiratory rate, and peripheral oxygen saturation measurements before and after the application of hydrokinesiotherapy...
2016: Rehabilitation Research and Practice
H Le Liepvre, A Dinh, B Idiard-Chamois, E Chartier-Kastler, V Phé, A Even, G Robain, P Denys
STUDY DESIGN: A retrospective observational study. OBJECTIVE: To describe specificities of pregnancy in a traumatic spinal cord-injured (SCI) population managed by a coordinated medical care team involving physical medicine and rehabilitation (PMR) physicians, urologists, infectious diseases' physicians, obstetricians and anaesthesiologists. SETTING: NeuroUrology Department in a University Hospital, France. METHODS: All consecutive SCI pregnant women managed between 2001 and 2014 were included...
September 27, 2016: Spinal Cord
Chien-Yi Chen, An-Kuo Chou, Yu-Lien Chen, Hung-Chieh Chou, Po-Nien Tsao, Wu-Shiun Hsieh
BACKGROUND: Nasal continuous positive airway pressure (NCPAP) therapy is widely used in neonates, but the clinical practice varies. However, nursing practice differs among individuals, and an inappropriate application method may delay the respiratory therapy, influence the beneficial effect of NCPAP, and increase complications. We introduced a quality improvement project to expedite the application of NCPAP therapy and decrease the incidence of nasal trauma. METHODS: A new strategy of mobile NCPAP cart with prepacked fixation kits and a written protocol was implemented from April 2006...
July 26, 2016: Pediatrics and Neonatology
Alain Amblard, Marie Reymond, Sandrine Champrenault, Pierre-Louis Leger, Jérôme Rambaud
A mobile paediatric circulatory support unit has been set up within the paediatric and neonatal intensive care service at the Armand-Trousseau Hospital in Paris (AP-HP, 75). It is in place for situations of refractory respiratory and/or circulatory failure and can intervene in a radius of several hundred kilometres, in order to establish long-term extracorporeal circulation. In this delicate context, transporting children requires specific skills, coordination between all intervening parties and faultless organisation...
September 2016: Soins. Pédiatrie, Puériculture
Sébastien Julliand, Noëlla Lodé
The paediatric mobile emergency and intensive care service care teams have expertise in taking care of children in life-threatening circumstances. At the Robert-Debré Hospital in Paris, the paediatric Smur is multi-skilled, specialising particularly in transporting neonates and infants with severe cardiac or respiratory difficulties. The pathologies handled are very varied and include both neonatal pathologies and trauma pathologies in older children.
September 2016: Soins. Pédiatrie, Puériculture
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