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Neonatal respiratory care

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https://www.readbyqxmd.com/read/28230835/sudden-versus-gradual-pressure-wean-from-nasal-cpap-in-preterm-infants-a-randomized-controlled-trial
#1
S Amatya, M Macomber, A Bhutada, D Rastogi, S Rastogi
OBJECTIVE: In preterm infants, nasal continuous positive airway pressure (NCPAP) is widely used for treatment of respiratory distress syndrome. However, the strategies for successfully weaning infants off NCPAP are still not well defined and there remains considerable variation between the methods. The objective of this study is to determine whether gradual weaning of NCPAP pressure is more successful than sudden weaning off NCPAP to room air. STUDY DESIGN: A randomized controlled trial was conducted in a level 3 neonatal intensive care unit on 70 preterm neonates who were born between 26 and 32 weeks gestation and required NCPAP for at least 48 h...
February 23, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28228969/prevention-and-treatment-of-neonatal-nosocomial-infections
#2
REVIEW
Jayashree Ramasethu
Nosocomial or hospital acquired infections threaten the survival and neurodevelopmental outcomes of infants admitted to the neonatal intensive care unit, and increase cost of care. Premature infants are particularly vulnerable since they often undergo invasive procedures and are dependent on central catheters to deliver nutrition and on ventilators for respiratory support. Prevention of nosocomial infection is a critical patient safety imperative, and invariably requires a multidisciplinary approach. There are no short cuts...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28226048/fetal-and-neonatal-deaths-of-children-of-patients-classified-as-near-miss
#3
Daniele Marin Nardello, Alzira Maria D Avila Nery Guimarães, Ikaro Daniel de Carvalho Barreto, Ricardo Queiroz Gurgel, Eleonora Ramos de Oliveira Ribeiro, Cristiane Franca Lisboa Gois
Objective: identify the epidemiological aspects of early fetal and neonatal deaths in children of patients classified with near miss and the factors associated with this outcome. Method: a cross-sectional study of 79 women identified with near miss and their newborns. The variables were analyzed using Fisher's exact test. Risk factors were estimated based on unadjusted and adjusted odds ratios, and by means of multiple correspondence analysis, with significance for p <0...
January 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28225424/committee-opinion-no-689-delivery-of-a-newborn-with-meconium-stained-amniotic-fluid
#4
(no author information available yet)
In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28225419/committee-opinion-no-689-summary-delivery-of-a-newborn-with-meconium-stained-amniotic-fluid
#5
(no author information available yet)
In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28224121/immunological-defects-in-neonatal-sepsis-and-potential-therapeutic-approaches
#6
REVIEW
Steven L Raymond, Julie A Stortz, Juan C Mira, Shawn D Larson, James L Wynn, Lyle L Moldawer
Despite advances in critical care medicine, neonatal sepsis remains a major cause of morbidity and mortality worldwide, with the greatest risk affecting very low birth weight, preterm neonates. The presentation of neonatal sepsis varies markedly from its presentation in adults, and there is no clear consensus definition of neonatal sepsis. Previous work has demonstrated that when neonates become septic, death can occur rapidly over a matter of hours or days and is generally associated with inflammation, organ injury, and respiratory failure...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28222717/causes-of-death-in-very-preterm-infants-cared-for-in-neonatal-intensive-care-units-a-population-based-retrospective-cohort-study
#7
Tim Schindler, Louise Koller-Smith, Kei Lui, Barbara Bajuk, Srinivas Bolisetty
BACKGROUND: While there are good data to describe changing trends in mortality and morbidity rates for preterm populations, there is very little information on the specific causes and pattern of death in terms of age of vulnerability. It is well established that mortality increases with decreasing gestational age but there are limited data on the specific causes that account for this increased mortality. The aim of this study was to establish the common causes of hospital mortality in a regional preterm population admitted to a neonatal intensive care unit (NICU)...
February 21, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28214925/missed-opportunities-in-neonatal-deaths-in-rwanda-applying-the-three-delays-model-in-a-cross-sectional-analysis-of-neonatal-death
#8
Efua Wilmot, Marcel Yotebieng, Alison Norris, Fidele Ngabo
Objective Administered in a timely manner, current evidence-based interventions could reduce neonatal deaths from infections, intrapartum injuries and complications due to prematurity. The three delays model (delay in seeking care, in arriving at a health facility, and in receiving adequate care), which has been applied to understanding maternal deaths, may be useful for understanding neonatal deaths. We assess the main causes of neonatal deaths in Rwanda and their associated delays. Methods Using a cross-sectional study design, we evaluated data from 2012 from 40 facilities in which babies were delivered...
February 18, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28209998/cervical-pessary-for-prevention-of-preterm-birth-a-meta-analysis
#9
Xin-Hang Jin, Dan Li, Li-Li Huang
To investigate the efficacy of cervical pessary placement in preventing preterm birth and perinatal morbidity and mortality in asymptomatic women with a singleton pregnancy and a short cervix, we searched literature in relevant databases. The meta-analysis of the 3 included trials (1412 women) showed cervical pessary placement did not reduce the risk of spontaneous preterm birth <34 weeks in these women (risk ratio (RR), 0.71; 95% confidence interval (CI), 0.21-2.43, P = 0.59; I(2) = 90%). The sensitivity analyses by excluding one trial at one time showed the same results...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28208965/long-term-outcomes-of-kangaroo-mother-care-in-very-low-birth-weight-infants
#10
Sunil Gavhane, Deepak Eklare, Haseeb Mohammad
INTRODUCTION: Kangaroo Mother Care (KMC) has been gaining acceptance as an effective alternative to incubator based Conventional Medical Care (CMC) in preterm or Low Birth Weight (LBW) infants especially in resource scarce developing countries. AIM: To report and analyse the long-term effects of KMC for relatively stable Very Low Birth Weight (VLBW) infants on nutritional indicators and feeding conditions at 6-12 months of corrected age. MATERIALS AND METHODS: This randomized controlled trial was done at a Level III Neonatal Intensive Care Unit (NICU) of a teaching institution in southern India...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
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
#11
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/28203255/the-influencing-factors-on-procalcitonin-values-in-newborns-with-noninfectious-conditions-during-the-first-week-of-life
#12
Jueseong Lee, Yong Hyeon Bang, Eun Hee Lee, Byung Min Choi, Young Sook Hong
PURPOSE: Although procalcitonin (PCT) level is useful for the diagnosis of neonatal sepsis, PCT reliability is inconsistent because of the varied conditions encountered in neonatal intensive care units. This study aimed to investigate PCT levels and factors influencing increased PCT levelin newborns without bacterial infection during the first week of life. METHODS: In newborns hospitalized between March 2013 and October 2015, PCT levels were measured on the first, third, and seventh days after birth...
January 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28195841/multiple-perspectives-of-symptoms-and-suffering-at-end-of-life-in-the-nicu
#13
Emily L Shultz, Mary Switala, Adrien M Winning, Madelaine C Keim, Amy E Baughcum, Cynthia A Gerhardt, Christine A Fortney
BACKGROUND: Despite technological advances in the neonatal intensive care unit, not all infants survive. Limited research has focused on infants' symptoms and suffering at end of life (EOL) from multiple perspectives. PURPOSE: To compare retrospective parent report and electronic medical record (EMR) documentation of symptoms and to examine associations with parent perceptions of infants suffering at EOL. METHODS/SEARCH STRATEGY: Bereaved parents of 40 infants (40 mothers and 27 fathers) retrospectively reported on their perceptions of infant symptoms and suffering during the last week of life...
February 13, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28176327/women-treated-for-epilepsy-during-pregnancy-outcomes-from-a-nationwide-population-based-cohort-study
#14
Miia Artama, Jemina Ahola, Jani Raitanen, Jukka Uotila, Mika Gissler, Jouko Isojärvi, Anssi Auvinen
INTRODUCTION: Women with epilepsy (WWE) are generally treated as a risk group during pregnancy, but over 90% of pregnant WWE have favorable pregnancies. However, the risk of some pregnancy and delivery complications may be increased among WWE, especially regarding those on antiepileptic drugs. MATERIAL AND METHODS: This nationwide, retrospective population-based cohort study includes WWE who gave birth in Finland during 1987-2008 (n=1737) and the reference cohort of random sample of women without epilepsy (n=4357)...
February 7, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28175990/starplasty-tracheostomy-case-series-and-literature-review
#15
Yehuda Schwarz, Nidal Muhanna, David Raveh, Chanan Shaul, Sarit Shahroor, Uri Peleg, Pierre Attal, Jean-Yves Sichel
OBJECTIVES: The starplasty tracheostomy (SPT) technique has been suggested to reduce the short-term complications of tracheostomy, including accidental decannulation and pneumothorax. The aim of the present study was to conduct a review of key parameters prior to and following treatment of neonates and children with the SPT technique, including indications, complications, perioperative department stay, and overall length of stay in one University-Affiliated Medical Center. METHODS: A retrospective chart review of all children under the age of 18 underwent SPT in a single center between February 2006 and January 2012...
February 7, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28168999/palliative-care-approaches-to-neonates-with-chronic-respiratory-failure
#16
Nicolas F M Porta
Neonates with chronic respiratory failure have uncertain prognosis and can face significant treatment burden. As the trajectory of the illness becomes more concerning, consultation with a pediatric palliative service should be considered, especially as therapeutic options shift from standard to "innovative." Benefits include as follows: supporting emotionally conflicted providers and parents, maintaining transparency in determination of goals, and balancing medical progress with each individual patient's and family's best interests...
February 3, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28168591/neonatal-abstinence-syndrome-trend-and-expenditure-in-louisiana-medicaid-2003-2013
#17
Ekwutosi M Okoroh, Rebekah E Gee, Baogong Jiang, Melissa B McNeil, Beverly A Hardy-Decuir, Amy L Zapata
Objectives Determine trends in incidence and expenditure for perinatal drug exposure and neonatal abstinence syndrome (NAS) among Louisiana's Medicaid population. We also describe the maternal characteristics of NAS affected infants. Methods Retrospective cohort analysis using linked Medicaid and vital records data from 2003 to 2013. Conducted incidence and cost trends for drug exposed infants with and without NAS. Also performed comparison statistics among drug exposed infants with and without NAS and those not drug exposed...
February 6, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28167860/the-effect-of-the-treatment-with-heated-humidified-high-flow-nasal-cannula-on-neonatal-respiratory-distress-syndrome-in-china-a-single-center-experience
#18
Ge Zheng, Xiao-Qiu Huang, Hui-Hui Zhao, Guo-Xing Jin, Bin Wang
Background. Noninvasive respiratory support is considered the optimal method of providing assistance to preterm babies with breathing problems, including nasal continuous positive airway pressure (NCPAP) and humidified high flow nasal cannula (HHHFNC). The evidence of the efficacy and safety of HHHFNC used as the primary respiratory support for respiratory distress syndrome (RDS) is insufficient in low- and middle-income countries. Objective. To investigate the effect of heated humidified high flow nasal cannula on neonatal respiratory distress syndrome compared with nasal continuous positive airway pressure...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28152330/randomized-controlled-trial-on-effect-of-intermittent-early-versus-late-kangaroo-mother-care-on-human-milk-feeding-in-low-birth-weight-neonates
#19
Dhaarani Jayaraman, Kanya Mukhopadhyay, Anil Kumar Bhalla, Lakhbir Kaur Dhaliwal
BACKGROUND: Breastfeeding at discharge among sick low-birth-weight (LBW) infants is low despite counseling and intervention like kangaroo mother care (KMC). Research aim: The aim was to study the effects of early initiation of KMC on exclusive human milk feeding, growth, mortality, and morbidities in LBW neonates compared with late initiation of KMC during the hospital stay and postdischarge. METHODS: A randomized controlled trial was conducted in level 2 and 3 areas of a tertiary care neonatal unit over 15 months...
February 1, 2017: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
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
#20
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
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