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Newborn Resuscitation

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https://www.readbyqxmd.com/read/28802345/tackling-quality-improvement-in-the-delivery-room
#1
REVIEW
Wannasiri Lapcharoensap, Henry C Lee
Implementation of standardized practices in the delivery room fosters a safe environment to ensure that newborn infants are cared for optimally, whether or not they require extensive resuscitation. Quality improvement (QI) is an excellent methodology for implementation of standardized practices due to the multidisciplinary nature of the delivery room, complexity of tasks involved, and opportunities to track processes and outcomes. This article discusses how the delivery room is a unique environment and presents examples on how to approach delivery room QI...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802261/how-do-different-brands-of-size-1-laryngeal-mask-airway-compare-with-face-mask-ventilation-in-a-dedicated-laryngeal-mask-airway-teaching-manikin
#2
Mark Brian Tracy, Archana Priyadarshi, Dimple Goel, Krista Lowe, Jacqueline Huvanandana, Murray Hinder
BACKGROUND: International neonatal resuscitation guidelines recommend the use of laryngeal mask airway (LMA) with newborn infants (≥34 weeks' gestation or >2 kg weight) when bag-mask ventilation (BMV) or tracheal intubation is unsuccessful. Previous publications do not allow broad LMA device comparison. OBJECTIVE: To compare delivered ventilation of seven brands of size 1 LMA devices with two brands of face mask using self-inflating bag (SIB). DESIGN: 40 experienced neonatal staff provided inflation cycles using SIB with positive end expiratory pressure (PEEP) (5 cmH2O) to a specialised newborn/infant training manikin randomised for each LMA and face mask...
August 11, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28780389/atropine-use-may-lead-to-post-operative-respiratory-acidosis-in-neonates-receiving-ductal-ligation-a-retrospective-cohort-study
#3
Szu-Ling Chang, Wen-Li Lin, Chien-Hsiang Weng, Shye-Jao Wu, Hsin-Jung Tsai, Shwu-Meei Wang, Chun-Chih Peng, Jui-Hsing Chang
BACKGROUND: Patent ductus arteriosus (PDA) is one of the most common cardiac conditions in preterm infants. Closure of the PDA in symptomatic patients can be achieved medically or surgically. Atropine is commonly administered in general anesthesia as a premedication in this age group but with limited evidence addressing the effect of its use. Our study examined the association of the use of atropine as a premedication in PDA ligation and the risk of post-operative respiratory complications...
July 20, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28768280/chest-compressions-during-sustained-inflations-improve-recovery-when-compared-to-a-3-1-compression-ventilation-ratio-during-cardiopulmonary-resuscitation-in-a-neonatal-porcine-model-of-asphyxia
#4
Elliott S Li, Immanuel Görens, Po-Yin Cheung, Tze-Fun Lee, Min Lu, Megan O'Reilly, Georg M Schmölzer
BACKGROUND: Recently, sustained inflations (SI) during chest compression (CC) (CC+SI) have been suggested as an alternative to the current approach during neonatal resuscitation. No previous study compared CC+SI using CC rates of 90/min to the current 3:1 compression:ventilation ratio (C:V). OBJECTIVE: To determine whether CC+SI versus a 3:1 C:V reduces the time to the return of spontaneous circulation (ROSC) and improves hemodynamic recovery in newborn piglets with asphyxia-induced bradycardia...
August 3, 2017: Neonatology
https://www.readbyqxmd.com/read/28751533/fifteen-minute-consultation-stabilisation-of-the-high-risk-newborn-infant-beside-the-mother
#5
Natalie Batey, Charles W Yoxall, Joe A Fawke, Lelia Duley, Jon Dorling
Paediatric and adult resuscitation is often performed with family present. Current guidelines recommend deferred umbilical cord clamping as part of immediate neonatal care, requiring neonatal assessment next to the mother. This paper describes strategies for providing care beside the mother using both standard resuscitation equipment and a trolley designed for this purpose.
July 27, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28742678/committee-opinion-no-713-antenatal-corticosteroid-therapy-for-fetal-maturation
#6
(no author information available yet)
Corticosteroid administration before anticipated preterm birth is one of the most important antenatal therapies available to improve newborn outcomes. A single course of corticosteroids is recommended for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation who are at risk of preterm delivery within 7 days, including for those with ruptured membranes and multiple gestations. It also may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, based on a family's decision regarding resuscitation, irrespective of membrane rupture status and regardless of fetal number...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742672/committee-opinion-no-713-summary-antenatal-corticosteroid-therapy-for-fetal-maturation
#7
(no author information available yet)
Corticosteroid administration before anticipated preterm birth is one of the most important antenatal therapies available to improve newborn outcomes. A single course of corticosteroids is recommended for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation who are at risk of preterm delivery within 7 days, including for those with ruptured membranes and multiple gestations. It also may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, based on a family's decision regarding resuscitation, irrespective of membrane rupture status and regardless of fetal number...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28734809/-severe-poisoning-by-traditional-medication-in-the-newborn
#8
A Oulmaati, F Hmami, S Achour, A Bouharrou
The use of traditional products for therapeutic purposes in the newborn cause many cases of severe poisoning, especially in newborns. The aim of this study was to identify the main medicinal plants causing poisoning and emphasize the seriousness of poisonous plants. We report a series of eight newborns admitted for intake of poisonous medicinal plants admitted to the neonatal unit and neonatal intensive care unit at the Fez (Morocco) Hassan II University Hospital in 2014. The reasons for use were dominated by the infant's refusing to suckle...
July 19, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28726790/improvements-in-the-delivery-of-resuscitation-and-newborn-care-after-helping-babies-breathe-training
#9
B D Kamath-Rayne, S Josyula, A R L Rule, J C Vasquez
BACKGROUND: To evaluate changes in neonatal resuscitation and postnatal care following Helping Babies Breathe (HBB) training at a community hospital in rural Honduras. We hypothesized that HBB training would improve resuscitation and essential newborn care interventions. METHODS: Direct observation and video recording of delivery room care spanned before and after an initial HBB workshop held in August 2013. Rates of essential newborn care interventions were compared in resuscitations performed by individuals who had and had not received HBB training, and run charts recording performance of newborn care practices over time were developed...
July 20, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28716351/effect-of-provision-of-home-based-curative-health-services-by-public-sector-health-care-providers-on-neonatal-survival-a-community-based-cluster-randomised-trial-in-rural-pakistan
#10
Sajid Soofi, Simon Cousens, Ali Turab, Yaqub Wasan, Shah Mohammed, Shabina Ariff, Zaid Bhatti, Imran Ahmed, Steve Wall, Zulfiqar A Bhutta
BACKGROUND: Although the effectiveness of community mobilisation and promotive care delivered by community health workers in reducing perinatal and neonatal mortality is well established, evidence in support of home-based neonatal resuscitation and infection management is mixed. We assessed the effectiveness of adding training in neonatal bag and mask resuscitation and oral antibiotic therapy for suspected neonatal infections to a basic preventive and promotive interventions package delivered by public sector community-based lady health workers (LHWs) in rural Pakistan...
August 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28707404/sustained-versus-standard-inflations-during-neonatal-resuscitation-to-prevent-mortality-and-improve-respiratory-outcomes
#11
REVIEW
Matteo Bruschettini, Colm Pf O'Donnell, Peter G Davis, Colin J Morley, Lorenzo Moja, Simona Zappettini, Maria Grazia Calevo
BACKGROUND: At birth, infants' lungs are fluid-filled. For newborns to have a successful transition, this fluid must be replaced by air to enable effective breathing. Some infants are judged to have inadequate breathing at birth and are resuscitated with positive pressure ventilation (PPV). Giving prolonged (sustained) inflations at the start of PPV may help clear lung fluid and establish gas volume within the lungs. OBJECTIVES: To assess the efficacy of an initial sustained (> 1 second duration) lung inflation versus standard inflations (≤ 1 second) in newly born infants receiving resuscitation with intermittent PPV...
July 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28688610/-materials-for-the-paediatric-resuscitation-trolley-or-backpack-expert-recommendations
#12
Jesús López-Herce Cid, Antonio Rodríguez Núñez, Ángel Carrillo Álvarez, Gonzalo Zeballos Serrato, Cecilia Martínez Fernández-Llamazares, Custodio Calvo Macías
Cardio-respiratory arrest (CPA) is infrequent in children, but it can occur in any place and at any time. This fact means that every health care facility must always have the staff and material ready to resuscitate a child. These recommendations are the consensus of experts of the Spanish Paediatric and Neonatal Resuscitation Group on the material and medication for paediatric and neonatal resuscitation and their distribution and use. CPR trolleys and backpacks must include the essential material to quickly and efficiently perform a paediatric CPR...
July 5, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28670801/australian-and-new-zealand-committee-on-resuscitation-neonatal-resuscitation-guidelines-2016
#13
Helen G Liley, Lindsay Mildenhall, Peter Morley
New Australian and New Zealand Neonatal Resuscitation guidelines reflect recent advances in neonatal resuscitation science, as critically appraised by the International Liaison Committee on Resuscitation. Substantial changes since the 2010 guidelines include: (i) updates to the Newborn Resuscitation Flowchart to include a greater emphasis on maintaining normal body temperature, and to emphasise the importance of beginning assisted ventilation by 1 min in infants who have absent or ineffective spontaneous breathing; (ii) updates to the physiology of the normal perinatal transition that resuscitation is trying to restore; (iii) recommendations for more frequent reinforcement of training, and for structured feedback for resuscitation training instructors; (iv) new guidance in relation to the timing of cord clamping for preterm newborn infants; (v) recommendation to monitor body temperature on admission to newborn units as a resuscitation quality indicator; (vi) suggestion to consider electrocardiographic (ECG) monitoring (as an adjunct to oximetry) to obtain more rapid and accurate estimation of heart rate during resuscitation; (vii) removal of previous suggestions to intubate meconium-exposed, non-vigorous term infants to suction the trachea; and (viii) suggestion to establish vascular access to enable administration of intravenous adrenaline (epinephrine) as soon as chest compressions are deemed to be needed...
July 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28661972/continuous-chest-compressions-during-sustained-inflations-in-a-perinatal-asphyxial-cardiac-arrest-lamb-model
#14
Payam Vali, Praveen Chandrasekharan, Munmun Rawat, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, Bobby Mathew, Sara Berkelhamer, Jayasree Nair, Satyan Lakshminrusimha
OBJECTIVE: Continuous chest compressions are more effective during resuscitation in adults. Sustained inflation rapidly establishes functional residual capacity in fluid-filled lungs at birth. We sought to compare the hemodynamics and success in achieving return of spontaneous circulation in an asphyxial cardiac arrest lamb model with transitioning fetal circulation and fluid-filled lungs between subjects receiving continuous chest compressions during sustained inflation and those receiving conventional 3:1 compression-to-ventilation resuscitation...
August 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28660179/monitoring-cerebral-and-renal-oxygenation-status-during-neonatal-digestive-surgeries-using-near-infrared-spectroscopy
#15
Jonathan Beck, Gauthier Loron, Claire Masson, Marie-Laurence Poli-Merol, Eliane Guyot, Camille Guillot, Nathalie Bednarek, Caroline François
BACKGROUND: Depending on the initial pathology, hypovolemia, intra-abdominal hypertension, and sepsis are often encountered in neonatal digestive surgery. Accurate newborn monitoring during and after surgery is essential to adapt resuscitation protocols. Near infrared spectroscopy (NIRS) is non-invasive and can detect hypoperfusion which indicates a low circulatory blood flow, regardless of the cause. OBJECTIVE: Evaluating changes in cerebral and renal regional oxygen saturation during neonatal digestive surgeries, conducted according to normal practices, with commonly used monitoring parameters...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28659193/feasibility-of-a-prototype-newborn-resuscitation-monitor-to-study-transition-at-birth-measuring-heart-rate-and-ventilator-parameters-an-animal-experimental-study
#16
Jørgen E Linde, Joar Eilevstjønn, Knut Øymar, Hege L Ersdal
BACKGROUND: Every year, an estimated 10 million babies are born, non-breathing and in need of resuscitation. Advances in management have been made over the past decades, however, approximately 700.000 yearly deaths result from this global problem. A prototype newborn resuscitation monitor (NRM) (Laerdal Global Health, Stavanger, Norway) has been developed with the purpose of studying newborn resuscitation. The monitor has the ability to continuously display HR using dry electrode ECG technology, to measure tidal volume, pressure and end tidal CO2, and to store the results for later analysis...
June 28, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28606716/the-relation-between-given-volume-and-heart-rate-during-newborn-resuscitation
#17
J E Linde, J Schulz, J M Perlman, K Øymar, L Blacy, H Kidanto, H L Ersdal
BACKGROUND: During delivery room resuscitation of depressed newborns, provision of appropriate tidal volume (TV) with establishment of functional residual capacity (FRC) is essential for circulatory recovery. Effective positive pressure ventilation (PPV) is associated with a rapid increase in heart rate (HR). The relationship between delivery of TV and HR responses remains unclear. OBJECTIVES: The study objectives were to determine (1) the relationship between a given TV during initial PPV and HR responses of depressed newborns, and (2) the optimal delivered TV associated with a rapid increase in HR...
June 9, 2017: Resuscitation
https://www.readbyqxmd.com/read/28600392/physical-stimulation-of-newborn-infants-in-the-delivery-room
#18
Vincent D Gaertner, Sophie A Flemmer, Laila Lorenz, Peter G Davis, C Omar Farouk Kamlin
OBJECTIVE: Neonatal resuscitation guidelines recommend that newborn infants are stimulated to assist with the establishment of regular respirations. The mode, site of application and frequency of stimulations are not stipulated in these guidelines. The effectiveness of stimulation in improving neonatal transition outcomes is poorly described. METHODS: We conducted a retrospective review of video recordings of neonatal resuscitation at a tertiary perinatal centre...
June 9, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28595292/neonatal-outcomes-associated-with-placental-abruption
#19
Katheryne L Downes, Edmond D Shenassa, Katherine L Grantz
Placental abruption, early separation of the placenta, is associated with preterm birth and perinatal mortality, but associations with other neonatal morbidities remains under-studied. We examined the association between abruption and newborn outcomes. We analyzed n = 223,341 singleton deliveries from the Consortium on Safe Labor Study, a retrospective, multi-site, observational study (2002-2008) of electronic medical records in the U.S. Adjusted relative risks (RR), incident ratio ratios and 99% confidence intervals (CI) were estimated...
June 8, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28592938/thermal-burn-in-a-30-minute-old-newborn-report-on-the-youngest-patient-with-iatrogenic-burn-injury
#20
L Abboud, G Ghanimeh
Burns in infants are rare. The majority of neonatal burns occur in the hospital setting. The immaturity of their immune system, their fragile and thin skin, difficulties in resuscitation, engraftment paucity limited by donor sites, and long-term complications make taking care of burned newborns extremely difficult. We present the case of a newborn burned 30 minutes after his birth over a total body surface of 35%, when the hot water bottle used in the hospital accidentally burst. This is the earliest iatrogenic burn in a newborn reported to date...
March 31, 2017: Annals of Burns and Fire Disasters
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