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Management bronchopulmonary dysplasia

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https://www.readbyqxmd.com/read/29746007/preterm-growth-restriction-and-bronchopulmonary-dysplasia-the-vascular-hypothesis-and-related-physiology
#1
Arvind Sehgal, Stella M Gwini, Samuel Menahem, Beth J Allison, Suzanne L Miller, Graeme R Polglase
KEY POINTS: Approximately 5-10% pregnancies are affected by fetal growth restriction. Preterm infants affected by fetal growth restriction have a higher incidence of bronchopulmonary dysplasia. This study is the first to measure pulmonary artery thickness and stiffness. It highlights that impaired vasculogenesis may be a contributory factor in the higher incidence of bronchopulmonary dysplasia in preterm growth restricted infants. The study addresses the mechanistic link between fetal programming and vascular architecture and mechanics...
May 10, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29734948/inhaled-corticosteroids-in-ventilated-preterm-neonates-a-non-randomized-dose-ranging-study
#2
Kamini Raghuram, Michael Dunn, Krista Jangaard, Maureen Reilly, Elizabeth Asztalos, Edmond Kelly, Michael Vincer, Vibhuti Shah
BACKGROUND: Inhaled corticosteroids (ICS) offer targeted treatment for bronchopulmonary dysplasia (BPD) with minimal systemic effects compared to systemic steroids. However, dosing of ICS in the management of infants at high-risk of developing BPD is not well established. The objective of this study was to determine an effective dose of ICS for the treatment of ventilator-dependent infants to facilitate extubation or reduce fractional inspired oxygen concentration. METHODS: Forty-one infants born at < 32 weeks gestational age (GA) or < 1250 g who were ventilator-dependent at 10-28 days postnatal age were included...
May 7, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29695207/polysomnography-for-the-management-of-oxygen-supplementation-therapy-in-infants-with-chronic-lung-disease-of-prematurity
#3
Gaurav Kulkarni, Koert de Waal, Sally Grahame, Adam Collison, Laurence Roddick, Jodi Hilton, Tanya Gulliver, Bruce Whitehead, Joerg Mattes
Some infants with bronchopulmonary dysplasia (BPD) may require oxygen supplementation at home but a role for overnight polysomnography (PSG) in the management of home oxygen therapy has been rarely described. Forty-one infants with BPD born at less than 30 weeks gestational age were discharged with continuous home oxygen supplementation therapy between 2010 and 2013. PSG data were recorded on oxygen supplementation versus room air at median post conceptual age of 2 months (range 1-5.5 months) (first PSG after discharge to home)...
April 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29694989/is-less-invasive-surfactant-administration-necessary-or-only-helpful-or-just-a-fashion
#4
Gianluca Lista, Ilia Bresesti, Laura Fabbri
In the 1990s, the most relevant pillars in the treatment of neonatal respiratory distress syndrome (RDS) have been improvements in ventilation strategies, the introduction of exogenous surfactant replacement therapy, and the use of antenatal steroids. Lately, in addition to the standard INSURE (INtubation-SURfactant administration-Extubation) method to administer surfactant, a new technique has been gaining increasing popularity. It is the so-called less invasive surfactant administration (LISA) method, which has shown promising results in preventing bronchopulmonary dysplasia development and in reducing mortality in preterm neonates...
May 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29687659/effectiveness-and-safety-of-nasal-mask-versus-binasal-prongs-for-providing-continuous-positive-airway-pressure-in-preterm-infants-a-systematic-review-and-meta-analysis
#5
REVIEW
Bonny Jasani, Abu Ismail, Shripada Rao, Sanjay Patole
Continuous positive airway pressure (CPAP) delivered via binasal prongs has been the cornerstone of respiratory management in preterm infants. Though effective, the use of binasal prongs is associated with nasal trauma, and CPAP failure. To overcome these issues, nasal masks are increasingly used to deliver CPAP in preterm infants. The aim was to conduct a systematic review of randomized controlled trials (RCTs) comparing nasal mask versus binasal prongs to deliver CPAP in preterm infants. Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing, and Allied Health Literature, and E-abstracts from the Pediatric Academic Society meetings were searched in May 2017...
April 23, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29622720/infant-pulmonary-function-testing-and-phenotypes-in-severe-bronchopulmonary-dysplasia
#6
Edward G Shepherd, Brian J Clouse, Kathryn A Hasenstab, Swetha Sitaram, Daniel T Malleske, Leif D Nelin, Sudarshan R Jadcherla
BACKGROUND: The definition of severe bronchopulmonary dysplasia (sBPD) is based on respiratory support needs. The management of a patient with sBPD remains empirical and is highly variable among providers. Our objective in this study was to test the hypothesis that infant pulmonary function testing (iPFT) would reveal distinct phenotypes in patients with established sBPD during the initial NICU stay. METHODS: A prospective cohort study with data prospectively collected on infants with sBPD from May 1, 2003, to June 30, 2016...
May 2018: Pediatrics
https://www.readbyqxmd.com/read/29605813/association-between-asthma-and-lung-function-in-adolescents-born-very-preterm-results-of-the-epipage-cohort-study
#7
Alice Hadchouel, Jessica Rousseau, Jean-Christophe Rozé, Catherine Arnaud, Adèle Bellino, Laure Couderc, Stéphane Marret, Marie Mittaine, Didier Pinquier, Marie Verstraete, Pierre-Yves Ancel, Christophe Delacourt
Prematurity and bronchopulmonary dysplasia (BPD) affect long-term lung function. We studied the respiratory outcome of adolescents born very preterm and controls from the Etude EPIdémiologique sur les Petits Ages Gestationnels cohort and analysed their current lung function in relation to asthma symptoms (categorised in three age groups) from birth. In models including BPD, asthma at each age and confounding factors in the preterm group, BPD and preschool wheeze were the only independent variables associated with FEV1 Preschool wheeze is an independent factor associated with FEV1 impairment in adolescents born very preterm...
March 31, 2018: Thorax
https://www.readbyqxmd.com/read/29601449/antifungal-treatment-and-outcome-in-very-low-birth-weight-infants-a-population-based-observational-study-of-the-german-neonatal-network
#8
Ingmar Fortmann, Annika Hartz, Pia Paul, Ferdinand Pulzer, Andreas Müller, Ralf Böttger, Hans Proquitté, Kristin Dawczynski, Arne Simon, Jan Rupp, Egbert Herting, Wolfgang Göpel, Christoph Härtel
INTRODUCTION: The diagnostic proof of fungal infection in preterm infants is difficult. Antifungal treatment (AFT) is often initiated empirically when infants with suspected infection do not improve despite broad spectrum antibiotic therapy. It was the aim of our study to determine the rate of exposure to empirical AFT in a large cohort of very low birth weight infants (VLBWI) of the German Neonatal Network (GNN) and to address associated risks and outcomes. METHODS: The epidemiological database consisted of n= 13...
March 29, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29546045/ventilator-flow-data-predict-bronchopulmonary-dysplasia-in-extremely-premature-neonates
#9
Mariann H Bentsen, Trond Markestad, Thomas Halvorsen
Early prediction of bronchopulmonary dysplasia (BPD) may facilitate tailored management for neonates at risk. We investigated whether easily accessible flow data from a mechanical ventilator can predict BPD in neonates born extremely premature (EP). In a prospective population-based study of EP-born neonates, flow data were obtained from the ventilator during the first 48 h of life. Data were logged for >10 min and then converted to flow-volume loops using custom-made software. Tidal breathing parameters were calculated and averaged from ≥200 breath cycles, and data were compared between those who later developed moderate/severe and no/mild BPD...
January 2018: ERJ Open Research
https://www.readbyqxmd.com/read/29514147/update-on-vitamin-e-and-its-potential-role-in-preventing-or-treating-bronchopulmonary-dysplasia
#10
Cosby A Stone, Cindy T McEvoy, Judy L Aschner, Ashudee Kirk, Christian Rosas-Salazar, Joan M Cook-Mills, Paul E Moore, William F Walsh, Tina V Hartert
Vitamin E is obtained only through the diet and has a number of important biological activities, including functioning as an antioxidant. Evidence that free radicals may contribute to pathological processes such as bronchopulmonary dysplasia (BPD), a disease of prematurity associated with increased lung injury, inflammation and oxidative stress, led to trials of the antioxidant vitamin E (α-tocopherol) to prevent BPD with variable results. These trials were all conducted at supraphysiologic doses and 2 of these trials utilized a formulation containing a potentially harmful excipient...
March 7, 2018: Neonatology
https://www.readbyqxmd.com/read/29502385/nutritional-problems-of-children-with-bronchopulmonary-dysplasia-after-hospital-discharge
#11
Gianluca Lista, Fabio Meneghin, Ilia Bresesti, Francesco Cavigioli
The last decades have seen significant improvements in the care of premature infants. The introduction of new approaches, especially in the ventilatory management, have led to significant increase of survival rate of low and extremely low gestational age infants. These populations of neonates, however, often experience prolonged mechanical ventilation, which is widely recognized to be closely related to bronchopulmonary dysplasia (BPD) development. The management of BPD, which is a multifactorial disease, requires a multidisciplinary approach and remains challenging for all the physicians involved...
December 22, 2017: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
https://www.readbyqxmd.com/read/29470837/past-present-and-future-approaches-to-the-prevention-and-treatment-of-respiratory-syncytial-virus-infection-in-children
#12
REVIEW
Eric A F Simões, Louis Bont, Paolo Manzoni, Brigitte Fauroux, Bosco Paes, Josep Figueras-Aloy, Paul A Checchia, Xavier Carbonell-Estrany
INTRODUCTION: The REGAL (RSV Evidence - A Geographical Archive of the Literature) series has provided a comprehensive review of the published evidence in the field of respiratory syncytial virus (RSV) in Western countries over the last 20 years. This seventh and final publication covers the past, present and future approaches to the prevention and treatment of RSV infection among infants and children. METHODS: A systematic review was undertaken of publications between January 1, 1995 and December 31, 2017 across PubMed, Embase and The Cochrane Library...
March 2018: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29246209/airway-administration-of-corticosteroids-for-prevention-of-bronchopulmonary-dysplasia-in-premature-infants-a-meta-analysis-with-trial-sequential-analysis
#13
Zhi-Qun Zhang, Ying Zhong, Xian-Mei Huang, Li-Zhong Du
BACKGROUND: Uncertainly prevails with regard to the use of inhalation or instillation steroids to prevent bronchopulmonary dysplasia in preterm infants. The meta-analysis with sequential analysis was designed to evaluate the efficacy and safety of airway administration (inhalation or instillation) of corticosteroids for preventing bronchopulmonary dysplasia (BPD) in premature infants. METHODS: We searched MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL from their inceptions to February 2017...
December 15, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29234146/practices-surrounding-pulmonary-hypertension-and-bronchopulmonary-dysplasia-amongst-neonatologists-caring-for-premature-infants
#14
Gabriel Altit, Henry C Lee, Susan Hintz, Theresa A Tacy, Jeffrey A Feinstein, Shazia Bhombal
OBJECTIVE: Pulmonary hypertension (PH) is associated with bronchopulmonary dysplasia (BPD). Screening strategies, a thorough investigation of co-morbidities, and multidisciplinary involvement prior to anti-PH medications have been advocated by recent guidelines. We sought to evaluate current practices of neonatologists caring for premature infants with PH. DESIGN: Electronic survey of American Academy of Pediatrics neonatology members. RESULTS: Among 306 neonatologist respondents, 38% had an institutional screening protocol for patients with BPD; 83% screened at 36 weeks for premature neonates on oxygen/mechanical ventilation...
December 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29229093/bronchopulmonary-dysplasia-a-review-of-pathogenesis-and-pathophysiology
#15
REVIEW
Renjithkumar Kalikkot Thekkeveedu, Milenka Cuevas Guaman, Binoy Shivanna
Bronchopulmonary dysplasia (BPD) is a chronic lung disease of primarily premature infants that results from an imbalance between lung injury and repair in the developing lung. BPD is the most common respiratory morbidity in preterm infants, which affects nearly 10, 000 neonates each year in the United States. Over the last two decades, the incidence of BPD has largely been unchanged; however, the pathophysiology has changed with the substantial improvement in the respiratory management of extremely low birth weight (ELBW) infants...
November 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29113524/how-does-preeclampsia-affect-neonates-highlights-in-the-disease-s-immunity
#16
Lina R Marins, Leonardo B Anizelli, Mariana D Romanowski, Ana L Sarquis
INTRODUCTION: Preeclampsia (PE) is the primary obstetrical cause in one of the four perinatal deaths. Although the etiology and pathogenesis of preeclampsia is not fully known, a proinflammatory immune state prevails and can disrupt fetal hematopoiesis. Some of the effects on the newborn include neonatal thrombocytopenia, neutropenia, a reduction in T regulatory cells, and an increased cytotoxic natural killer cell profile. METHODS: Electronic databases were searched, and defined criteria were applied to select articles for review...
November 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29073918/a-first-description-of-the-colombian-national-registry-for-rare-diseases
#17
Heidi Eliana Mateus, Ana María Pérez, Martha Lucía Mesa, Germán Escobar, Jubby Marcela Gálvez, José Ivo Montaño, Martha Lucía Ospina, Paul Laissue
OBJECTIVE: Orphan diseases must be considered a public health concern, underlying country-specific challenges for their accurate and opportune diagnosis, classification and management. Orphan disease registries have not yet been created in South America, a continent having a population of ~ 415 million inhabitants. In Colombia ~ 3 million of patients are affected by rare diseases. The aim of the present study was to establish the first Colombian national registry for rare diseases. The registry was created after the establishment of laws promoting the development of clinical guidelines for diagnosis, management, census and registry of patients suffering rare diseases...
October 26, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29063585/early-8-days-systemic-postnatal-corticosteroids-for-prevention-of-bronchopulmonary-dysplasia-in-preterm-infants
#18
REVIEW
Lex W Doyle, Jeanie L Cheong, Richard A Ehrenkranz, Henry L Halliday
BACKGROUND: Bronchopulmonary dysplasia remains a major problem in neonatal intensive care units. Persistent inflammation in the lungs is the most likely underlying pathogenesis. Corticosteroids have been used to prevent or treat bronchopulmonary dysplasia because of their potent anti-inflammatory effects. OBJECTIVES: To examine the relative benefits and adverse effects of systemic postnatal corticosteroids commenced within the first seven days of life for preterm infants at risk of developing bronchopulmonary dysplasia...
October 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29042870/update-of-minimally-invasive-surfactant-therapy
#19
REVIEW
Gyu-Hong Shim
To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death...
September 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29041034/inhaled-versus-systemic-corticosteroids-for-preventing-bronchopulmonary-dysplasia-in-ventilated-very-low-birth-weight-preterm-neonates
#20
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
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