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Management bronchopulmonary dysplasia

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https://www.readbyqxmd.com/read/27917436/looking-ahead-where-to-next-for-animal-models-of-bronchopulmonary-dysplasia
#1
REVIEW
Claudio Nardiello, Ivana Mižíková, Rory E Morty
Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth, with appreciable morbidity and mortality in a neonatal intensive care setting. Much interest has been shown in the identification of pathogenic pathways that are amenable to pharmacological manipulation (1) to facilitate the development of novel therapeutic and medical management strategies and (2) to identify the basic mechanisms of late lung development, which remains poorly understood. A number of animal models have therefore been developed and continue to be refined with the aim of recapitulating pathological pulmonary hallmarks noted in lungs from neonates with BPD...
December 5, 2016: Cell and Tissue Research
https://www.readbyqxmd.com/read/27853329/high-flow-nasal-cannulae-versus-nasal-continuous-positive-airway-pressure-in-neonates-with-respiratory-distress-syndrome-managed-with-insure-method-a-randomized-clinical-trial
#2
Maliheh Kadivar, Ziba Mosayebi, Nosrat Razi, Shahin Nariman, Razieh Sangsari
BACKGROUND: In recent years, various noninvasive respiratory support (NRS) of ventilation has been provided more in neonates. The aim of this study was to compare the effect of HFNC with NCPAP in post-extubation of preterm infants with RDS after INSURE method (intubation, surfactant, extubation). METHODS: A total of 54 preterm infants with RDS (respiratory distress syndrome) were enrolled in this study. Using a randomized sequence, they were assigned into two groups after INSURE method...
November 2016: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27783043/progressive-vascular-functional-and-structural-damage-in-a-bronchopulmonary-dysplasia-model-in-preterm-rabbits-exposed-to-hyperoxia
#3
Julio Jiménez, Jute Richter, Taro Nagatomo, Thomas Salaets, Rozenn Quarck, Allard Wagennar, Hongmei Wang, Jeroen Vanoirbeek, Jan Deprest, Jaan Toelen
Bronchopulmonary dysplasia (BPD) is caused by preterm neonatal lung injury and results in oxygen dependency and pulmonary hypertension. Current clinical management fails to reduce the incidence of BPD, which calls for novel therapies. Fetal rabbits have a lung development that mimics humans and can be used as a translational model to test novel treatment options. In preterm rabbits, exposure to hyperoxia leads to parenchymal changes, yet vascular damage has not been studied in this model. In this study we document the early functional and structural changes of the lung vasculature in preterm rabbits that are induced by hyperoxia after birth...
October 24, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27780154/maternal-and-neonatal-outcomes-following-expectant-management-of-preterm-prelabour-rupture-of-membranes-before-viability
#4
Winnie Huiyan Sim, Edward Araujo Júnior, Fabricio Da Silva Costa, Penelope Marie Sheehan
AIM: To assess the contemporary maternal and neonatal outcomes following expectant management of preterm premature rupture of membranes (PPROM) prior to 24 weeks' gestation and to identify prognostic indicators of this morbid presentation. METHODS: We performed a systematic review in the Pubmed and EMBASE databases to identify the primary (perinatal mortality, severe neonatal morbidity and serious maternal morbidity) and secondary (neonatal survival and morbidity) outcomes following expectant management of previable PPROM...
October 25, 2016: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27742002/prevention-and-management-of-bronchopulmonary-dysplasia-lessons-learned-from-the-neonatal-research-network
#5
Kathleen A Kennedy, C Michael Cotten, Kristi L Watterberg, Waldemar A Carlo
Despite remarkable improvements in survival of extremely premature infants, the burden of BPD among survivors remains a frustrating problem for parents and caregivers. Advances, such as antenatal steroids and surfactant replacement, which have dramatically improved survival, have not reduced BPD among survivors. Other advances that have significantly improved the combined outcome of death or BPD, such as vitamin A and avoidance of mechanical ventilation, have had smaller magnitude effects on the outcome of BPD alone...
October 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27737654/effectiveness-and-cost-effectiveness-of-routine-third-trimester-ultrasound-screening-for-intrauterine-growth-restriction-study-protocol-of-a-nationwide-stepped-wedge-cluster-randomized-trial-in-the-netherlands-the-iris-study
#6
Jens Henrichs, Viki Verfaille, Laura Viester, Myrte Westerneng, Bert Molewijk, Arie Franx, Henriette van der Horst, Judith E Bosmans, Ank de Jonge, Petra Jellema
BACKGROUND: Intrauterine growth retardation (IUGR) is a major risk factor for perinatal mortality and morbidity. Thus, there is a compelling need to introduce sensitive measures to detect IUGR fetuses. Routine third trimester ultrasonography is increasingly used to detect IUGR. However, we lack evidence for its clinical effectiveness and cost-effectiveness and information on ethical considerations of additional third trimester ultrasonography. This nationwide stepped wedge cluster-randomized trial examines the (cost-)effectiveness of routine third trimester ultrasonography in reducing severe adverse perinatal outcome through subsequent protocolized management...
October 13, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27678511/surfactant-instillation-in-spontaneously-breathing-preterm-infants-a-systematic-review-and-meta-analysis
#7
Vincent Rigo, Caroline Lefebvre, Isabelle Broux
: Less invasive surfactant therapies (LIST) use surfactant instillation through a thin tracheal catheter in spontaneously breathing infants. This review and meta-analysis investigates respiratory outcomes for preterm infants with respiratory distress syndrome treated with LIST rather than administration of surfactant through an endotracheal tube. Randomised controlled trial (RCT) full texts provided outcome data for bronchopulmonary dysplasia (BPD), death or BPD, early CPAP failure, invasive ventilation requirements and usual neonatal morbidities...
September 27, 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27665322/sildenafil-pulmonary-hypertension-and-bronchopulmonary-dysplasia
#8
S Herbert, R Tulloh
Pulmonary hypertension (PH) secondary to bronchopulmonary dysplasia (BPD) in infants remains a serious concern and continues to cause significant morbidity despite improvements in both quality of life and survival for patients. One of the potential agents that might help is sildenafil citrate, a phosphodiesterase-V inhibitor used a first line therapy for idiopathic PH. However, only limited evidence exists for its use as either monotherapy or part of a combination approach towards the management of PH in BPD...
September 21, 2016: Early Human Development
https://www.readbyqxmd.com/read/27649293/trends-and-outcomes-of-patent-ductus-arteriosus-treatment-in-very-preterm-infants-in-canada
#9
Armend Lokku, Lucia Mirea, Shoo K Lee, Prakeshkumar S Shah
Objective To assess trends in patent ductus arteriosus (PDA) management and examine concurrent changes in neonatal mortality and morbidities. Methods This retrospective observational study examined infants born at 23 to 32 weeks' gestational age with PDA and admitted to a neonatal unit during 2006 to 2012. Multivariable logistic regression assessed trends in yearly PDA treatment rates and compared a composite outcome of mortality or any severe morbidity (bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity, or necrotizing enterocolitis) between and within time periods and PDA treatments...
September 20, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27603531/respiratory-outcome-after-preterm-birth-a-long-and-difficult-journey
#10
Elena Priante, Laura Moschino, Veronica Mardegan, Paolo Manzoni, Sabrina Salvadori, Eugenio Baraldi
Despite notable advances in the survival and management of preterm infants in recent decades, chronic lung disease remains a common complication. Approximately one in three infants born preterm (< 32 weeks of gestation) are hospitalized with respiratory problems (mainly due to infections) in their first 2 years of life, and the risk of childhood wheezing is three times higher in this population. By comparison with infants born at term, there seems to be a higher incidence of respiratory morbidity in those born preterm, even in the absence of bronchopulmonary dysplasia (BPD) and in late-preterm babies...
September 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27559539/where-are-we-now-with-the-role-of-steroids-in-the-management-of-bronchopulmonary-dysplasia-in-extremely-premature-babies
#11
Matthew Hurley, Jayesh Mahendra Bhatt
No abstract text is available yet for this article.
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27547966/an-elevation-of-serum-ferritin-level-might-increase-clinical-risk-for-the-persistence-of-patent-ductus-arteriosus-sepsis-and-bronchopulmonary-dysplasia-in-erythropoietin-treated-very-low-birth-weight-infants
#12
Masayuki Ochiai, Hiroaki Kurata, Hirosuke Inoue, Koichi Tanaka, Yuki Matsushita, Junko Fujiyoshi, Yoshifumi Wakata, Kiyoko Kato, Tomoaki Taguchi, Hidetoshi Takada
BACKGROUND: The substantial risk of iron overload is not routinely monitored in most of the neonatal intensive care units (NICUs) in Japan; however, blood transfusion is an essential strategy for successfully treating preterm low-birth-weight infants. OBJECTIVE: The aim of this study was to investigate the iron status and clinical features of infants with a birth weight of <1,500 g, i.e. very-low-birth-weight infants (VLBWIs). METHODS: This prospective observational study enrolled 176 (82...
August 23, 2016: Neonatology
https://www.readbyqxmd.com/read/27509008/trends-and-variation-in-management-and-outcomes-of-very-low-birth-weight-infants-with-patent-ductus-arteriosus
#13
James I Hagadorn, Elizabeth A Brownell, Jennifer M Trzaski, Kendall R Johnson, Shabnam Lainwala, Brendan T Campbell, Katherine W Herbst
BACKGROUND: We examined recent trends and interhospital variation in use of indomethacin, ibuprofen, and surgical ligation for patent ductus arteriosus (PDA) in very-low-birth-weight (VLBW) infants. METHODS: Included in this retrospective study of the Pediatric Hospital Information System database were 13,853 VLBW infants from 19 US children's hospitals, admitted at age < 3 d between 1 January 2005 and 31 December 2014. PDA management and in-hospital outcomes were examined for trends and variation...
December 2016: Pediatric Research
https://www.readbyqxmd.com/read/27500013/effectiveness-of-synchronized-noninvasive-ventilation-to-prevent-intubation-in-preterm-infants
#14
Cristina Ramos-Navarro, Manuel Sanchez-Luna, Ester Sanz-López, Elena Maderuelo-Rodriguez, Elena Zamora-Flores
BACKGROUND: Noninvasive ventilation is being increasingly used on preterm infants to reduce ventilator lung injury and bronchopulmonary dysplasia. The aim of this study was to evaluate the effectiveness of synchronized nasal intermittent positive pressure ventilation (SNIPPV) to prevent intubation in premature infants. METHODS: Prospective observational study of SNIPPV use on preterm infants of less than 32 weeks' gestation. All patients were managed using a prospective protocol intended to reduce invasive mechanical ventilation (iMV) use...
July 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27458992/pulmonary-mri-of-neonates-in-the-intensive-care-unit-using-3d-ultrashort-echo-time-and-a-small-footprint-mri-system
#15
Andrew D Hahn, Nara S Higano, Laura L Walkup, Robert P Thomen, Xuefeng Cao, Stephanie L Merhar, Jean A Tkach, Jason C Woods, Sean B Fain
PURPOSE: To determine the feasibility of pulmonary magnetic resonance imaging (MRI) of neonatal lung structures enabled by combining two novel technologies: first, a 3D radial ultrashort echo time (UTE) pulse sequence capable of high spatial resolution full-chest imaging in nonsedated quiet-breathing neonates; and second, a unique, small-footprint 1.5T MRI scanner design adapted for neonatal imaging and installed within the neonatal intensive care unit (NICU). MATERIALS AND METHODS: Ten patients underwent MRI within the NICU, in accordance with an approved Institutional Review Board protocol...
July 26, 2016: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/27429203/alveolar-formation-is-dysregulated-by-restricted-nutrition-but-not-excess-sedation-in-preterm-lambs-managed-by-non-invasive-support
#16
Lisa A Joss-Moore, Synneva J Hagen-Lillevik, Calan Yost, Jennifer Jewell, Robert D Wilkinson, Sydney Bowen, Mar Janna Dahl, Li Dong, Zhengming Wang, Angela P Presson, Chong Zhang, Donald M Null, Bradley A Yoder, Kurt H Albertine
BACKGROUND: Preterm birth and respiratory support with invasive mechanical ventilation frequently leads to bronchopulmonary dysplasia (BPD). A hallmark feature of BPD is alveolar simplification. For our preterm lamb model of BPD, invasive mechanical ventilation is associated with postnatal feeding intolerance (reduced nutrition) and sedation. In contrast, preterm lambs managed by non-invasive support (NIS) have normal alveolar formation, appropriate postnatal nutrition, and require little sedation...
July 18, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27400016/outcomes-of-pregnancies-complicated-by-preterm-premature-rupture-of-membranes-between-20-and-24-weeks-of-gestation
#17
Mia Kibel, Elizabeth Asztalos, Jon Barrett, Michael S Dunn, Carly Tward, Alex Pittini, Nir Melamed
OBJECTIVE: To assess the natural history and contemporary outcomes in pregnancies complicated by previable preterm premature rupture of membranes (PROM). METHODS: Retrospective study of all women with a singleton or twin pregnancy admitted to a single tertiary referral center who experienced preterm PROM between 20 and 23 6/7 weeks of gestation during 2004-2014 and underwent expectant management. Women electing termination of pregnancy and pregnancies complicated by major fetal anomalies were excluded...
August 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27365307/incidence-and-outcome-of-cpap-failure-in-preterm-infants
#18
Peter A Dargaville, Angela Gerber, Stefan Johansson, Antonio G De Paoli, C Omar F Kamlin, Francesca Orsini, Peter G Davis
BACKGROUND AND OBJECTIVES: Data from clinical trials support the use of continuous positive airway pressure (CPAP) for initial respiratory management in preterm infants, but there is concern regarding the potential failure of CPAP support. We aimed to examine the incidence and explore the outcomes of CPAP failure in Australian and New Zealand Neonatal Network data from 2007 to 2013. METHODS: Data from inborn preterm infants managed on CPAP from the outset were analyzed in 2 gestational age ranges (25-28 and 29-32 completed weeks)...
July 2016: Pediatrics
https://www.readbyqxmd.com/read/27355979/retrospective-analysis-of-an-interdisciplinary-ventilator-care-program-intervention-on-survival-of-infants-with-ventilator-dependent-bronchopulmonary-dysplasia
#19
Jason Gien, John Kinsella, Jodi Thrasher, Alicia Grenolds, Steven H Abman, Christopher D Baker
Background The clinical needs of infants with severe bronchopulmonary dysplasia (BPD) that remain ventilator-dependent are complex, and management strategies that optimize survival and long-term outcomes controversial. We hypothesized that an interdisciplinary ventilator care program (VCP), committed to the care of this population will improve survival through standardized approaches to cardiopulmonary care and related comorbidities, enhanced communication, and continuity of care. Methods Retrospective chart reviews were performed on patients at Children's Hospital Colorado's neonatal intensive care unit, who underwent tracheostomy placement between 2000 and 2013...
June 29, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27351566/respiratory-management-of-extremely-low-birth-weight-infants-survey-of-neonatal-specialists
#20
Sumesh Parat, Maroun Jean Mhanna
BACKGROUND: To investigate strategies used for the management of respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) in extremely low birth weight (ELBW) infants. METHODS: A survey of neonatal specialists working in US academic institutions with fellowship training programs. RESULTS: Eighty percent (72/89) of the identified academic institutions had at least one physician who responded to the survey. Among respondents, 85% (171/201) agreed or strongly agreed to use continuous positive airway pressure (CPAP) initially for the management of RDS, and the majority agreed or strongly agreed to use a fraction of inspired oxygen (FiO2) ≥0...
August 2016: World Journal of Pediatrics: WJP
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