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Neonatal intubation

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https://www.readbyqxmd.com/read/28640930/orotracheal-intubation-in-infants-performed-with-a-stylet-versus-without-a-stylet
#1
REVIEW
Joyce E O'Shea, Jennifer O'Gorman, Aakriti Gupta, Sanjay Sinhal, Jann P Foster, Liam Af O'Connell, C Omar F Kamlin, Peter G Davis
BACKGROUND: Neonatal endotracheal intubation is a common and potentially life-saving intervention. It is a mandatory skill for neonatal trainees, but one that is difficult to master and maintain. Intubation opportunities for trainees are decreasing and success rates are subsequently falling. Use of a stylet may aid intubation and improve success. However, the potential for associated harm must be considered. OBJECTIVES: To compare the benefits and harms of neonatal orotracheal intubation with a stylet versus neonatal orotracheal intubation without a stylet...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28620499/intrauterine-death-following-intraamniotic-triiodothyronine-and-thyroxine-therapy-for-fetal-goitrous-hypothyroidism-associated-with-polyhydramnios-and-caused-by-a-thyroglobulin-mutation
#2
Pradeep Vasudevan, Corrina Powell, Adeline K Nicholas, Ian Scudamore, James Greening, Soo-Mi Park, Nadia Schoenmakers
In the absence of maternal thyroid disease or iodine deficiency, fetal goitre is rare and usually attributable to dyshormonogenesis, for which genetic ascertainment is not always undertaken in the UK. Mechanical complications include tracheal and oesophageal compression with resultant polyhydramnios, malpresentation at delivery and neonatal respiratory distress. We report an Indian kindred in which the proband (first-born son) had congenital hypothyroidism (CH) without obvious neonatal goitre. His mother's second pregnancy was complicated by fetal hypothyroid goitre and polyhydramnios, prompting amniotic fluid drainage and intraamniotic therapy (with liothyronine, T3 and levothyroxine, T4)...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28618745/effects-of-a-closed-system-suction-connector-on-airway-resistance-in-ventilated-neonates
#3
Sezin Ünal, Ebru Ergenekon, Ebru Kazanci, Selma Aktaş, Ferit Kulali, İbrahim Murat Hirfanoğlu, Canan Türkyilmaz, Yıldız Atalay
BACKGROUND/AIM: Increased airway resistance reduces the effectiveness of ventilation treatment. Endotracheal tubes (ETTs) and connectors contribute to resistance. However, the effect of a closed system suction (CSS) connector is not well known. We compared the in vivo resistance occurring with a CSS connector with that of the standard connector. MATERIALS AND METHODS: This prospective study was conducted at Gazi University Hospital's neonatal intensive care unit...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28611429/streptococcus-sp-in-neonatal-endotracheal-tube-biofilms-is-associated-with-ventilator-associated-pneumonia-and-enhanced-biofilm-formation-of-pseudomonas-aeruginosa-pao1
#4
Yun Pan, Sijie Song, Xiaoli Tang, Qing Ai, Danping Zhu, Zhenqiu Liu, Jialin Yu
Ventilator-associated pneumonia (VAP) is a serious complication of mechanical ventilation leading to high morbidity and mortality among intubated neonates in neonatal intensive care units (NICUs). Endotracheal tube (ETT) biofilm flora were considered to be responsible for the occurrence of VAP as a reservoir of pathogens. However, regarding neonates with VAP, little is known about the complex microbial signatures in ETT biofilms. In the present study, a culture-independent approach based on next generation sequencing was performed as an initial survey to investigate the microbial communities in ETT biofilms of 49 intubated neonates with and without VAP...
June 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28601870/restricted-ventilation-associated-with-reduced-neurodevelopmental-impairment-in-preterm-infants
#5
Roseanne J S Vliegenthart, Wes Onland, Aleid G van Wassenaer-Leemhuis, Anne P M De Jaegere, Cornelieke S H Aarnoudse-Moens, Anton H van Kaam
BACKGROUND AND OBJECTIVE: Restrictive use of invasive mechanical ventilation (IMV) in preterm infants reduces the risk of bronchopulmonary dysplasia (BPD). Our objective was to determine its effect on neurodevelopmental impairment (NDI) at 24 months' corrected age (CA). METHODS: This retrospective single-center cohort study included all patients with a gestational age <30 weeks born in 2004/2005 (epoch 1) and 2010/2011 (epoch 2). In epoch 2, we introduced a policy of restriction on IMV and liberalized the use of respiratory stimulants in the delivery room and neonatal intensive care...
June 10, 2017: Neonatology
https://www.readbyqxmd.com/read/28600154/markers-of-successful-extubation-in-extremely-preterm-infants-and-morbidity-after-failed-extubation
#6
Sanjay Chawla, Girija Natarajan, Seetha Shankaran, Benjamin Carper, Luc P Brion, Martin Keszler, Waldemar A Carlo, Namasivayam Ambalavanan, Marie G Gantz, Abhik Das, Neil Finer, Ronald N Goldberg, C Michael Cotten, Rosemary D Higgins
OBJECTIVES: To identify variables associated with successful elective extubation, and to determine neonatal morbidities associated with extubation failure in extremely preterm neonates. STUDY DESIGN: This study was a secondary analysis of the National Institute of Child Health and Human Development Neonatal Research Network's Surfactant, Positive Pressure, and Oxygenation Randomized Trial that included extremely preterm infants born at 24(0/7) to 27(6/7) weeks' gestation...
June 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28598915/anesthetic-and-obstetric-management-of-syringomyelia-during-labor-and-delivery-a-case-series-and-systematic-review
#7
Gráinne Patricia Garvey, Vibhangini S Wasade, Kellie E Murphy, Mrinalini Balki
BACKGROUND: Syringomyelia is a rare, slowly progressive neurological condition characterized by the presence of a syrinx within the spinal cord. Consensus regarding the safest mode of delivery and anesthetic management in patients with syringomyelia remains controversial and presents management dilemmas. This study reviews the cases of syringomyelia at our institution and provides a systematic review of the literature to guide decisions regarding labor and delivery management. METHODS: A retrospective review of cases at our hospital from 2002 to 2014 and a systematic review of the literature from 1946 to 2014 were undertaken...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28597413/late-onset-ornithine-transcarbamylase-deficiency-associated-with-hyperammonemia
#8
Kana Daijo, Tomokazu Kawaoka, Takashi Nakahara, Yuko Nagaoki, Masataka Tsuge, Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami, Hiroshi Aikata, Keiichi Hara, Go Tajima, Masao Kobayashi, Kazuaki Chayama
The urea cycle converts ammonia and produces urea. One form of urea cycle abnormality is ornithine transcarbamylase (OTC) deficiency. This hereditary disorder is associated with hyperammonemia. OTC deficiency commonly appears during neonatal and early childhood life and is rare in adults. We report a 69-year-old man who presented at the local hospital with 3-day loss of appetite, early morning vomiting, and state of confusion. Blood ammonia was 293 μg/dl. At 2-3 h after admission, the patient went into a deep coma...
June 9, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28584350/a-randomised-comparative-study-of-miller-laryngoscope-blade-versus-oxiport-%C3%A2-miller-laryngoscope-blade-for-neonatal-and-infant-intubations
#9
Raylene Dias, Nandini Dave, Rachana Chhabria, Harick Shah, Madhu Garasia
BACKGROUND AND AIMS: Neonates and infants are prone to oxygen desaturation during the induction of general anaesthesia. Pharyngeal oxygen insufflation has been shown to delay the onset of desaturation and hypoxaemia during apnoea. We tested the hypothesis that deep laryngeal oxygenation with Oxiport(®) Miller blade would delay the onset of desaturation compared to laryngoscopy without supplemental oxygen (Miller blade). METHODS: One hundred neonates and infants undergoing general anaesthesia with endotracheal intubation for surgery were recruited and randomly assigned to one of the two groups: Miller or Oxiport group (laryngoscopy performed with Miller or Oxiport(®) blade, respectively)...
May 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28569744/delivery-room-interventions-to-prevent-bronchopulmonary-dysplasia-in-extremely-preterm-infants
#10
E E Foglia, E A Jensen, H Kirpalani
Bronchopulmonary dysplasia (BPD) is the most common chronic respiratory complication of preterm birth. Preterm infants are at risk for acute lung injury immediately after birth, which predisposes to BPD. In this article, we review the current evidence for interventions applied during neonatal transition (delivery room and first postnatal hours of life) to prevent BPD in extremely preterm infants: continuous positive airway pressure (CPAP), sustained lung inflation, supplemental oxygen use during neonatal resuscitation, and surfactant therapy including less-invasive surfactant administration...
June 1, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28557332/impact-of-contrast-exposure-from-computed-tomography-angiography-on-acute-kidney-injury-after-neonatal-cardiopulmonary-bypass-surgery
#11
Waldemar F Carlo, Steven T Clark, Santiago Borasino, Jeffrey A Alten
OBJECTIVE: Acute kidney injury (AKI) is a frequent complication after cardiopulmonary bypass (CBP) for cardiac surgery in neonates. It is unclear if exposure to computed tomography angiography (CTA) in the preoperative period increases the risk of AKI. We hypothesized a short interval between CTA and CPB surgery would be associated with higher rates of AKI in infants. DESIGN: In this single center retrospective review of patients between 2012 and 2015, neonates less than one month old were analyzed if they had CTA prior to cardiac surgery with CPB...
May 30, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28550900/technique-and-perioperative-management-of-left-pneumonectomy-in-neonatal-piglets
#12
Duy T Dao, Lorenzo Anez-Bustillos, Alison A O'Loughlin, Amy Pan, Arthur P Nedder, Dana Bolgen, Charles Jason Smithers, Jill Zalieckas, Craig W Lillehei, Prathima Nandivada, Meredith A Baker, Gillian L Fell, Bennet S Cho, Mark Puder
BACKGROUND: Although commonly performed in adult swine, unilateral pneumonectomy in piglets requires significant modifications in the surgical approach and perioperative care because of their smaller size and limited physiological reserve. METHODS: Nineteen neonatal piglets underwent a left pneumonectomy. They were allowed 5-7 d of preoperative acclimation and nutritional optimization. Preoperative weight gain and laboratory values were obtained before the time of surgery...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28546379/tracheostomy-in-infants-and-children
#13
Karen F Watters
Over the last decade, tracheostomy has been increasingly performed in children, aligned with the improvements in neonatal and pediatric ICU care. Nowadays, the majority of children with tracheostomy represent a very complex cohort of patients with sustained reliance on tracheostomy and related medical technology for long-term survival. Tracheostomy is one of the most commonly performed procedures in the adult ICU. Contrary to adult practice, tracheostomy is a much less common procedure in the pediatric ICU, being performed in < 3% of patients...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28539007/videolaryngoscopy-versus-direct-laryngoscopy-for-tracheal-intubation-in-children-excluding-neonates
#14
REVIEW
Ibtihal S Abdelgadir, Robert S Phillips, Davinder Singh, Michael P Moncreiff, Joanne L Lumsden
BACKGROUND: Direct laryngoscopy is the method currently used for tracheal intubation in children. It occasionally offers unexpectedly poor laryngeal views. Indirect laryngoscopy involves visualizing the vocal cords by means other than obtaining a direct sight, with the potential to improve outcomes. We reviewed the current available literature and performed a meta-analysis to compare direct versus indirect laryngoscopy, or videolaryngoscopy, with regards to efficacy and adverse effects...
May 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28537937/dexmedetomidine-the-new-all-in-one-drug-in-paediatric-anaesthesia
#15
Cedric E Sottas, Brian J Anderson
PURPOSE OF REVIEW: Dexmedetomidine is a drug with sedative, anxiolytic, sympatholytic and analgesic properties, which is finding widespread practice in paediatric anaesthesia and related practices. The present review summarizes its pharmacology and current experience with the drug. RECENT FINDINGS: Dexmedetomidine is proving useful in many diverse areas in paediatric anaesthesia where its sedative properties are useful for premedication, fibreoptic intubation and radiologic procedures...
May 22, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28528221/bronchopulmonary-dysplasia-and-perinatal-characteristics-predict-1-year-respiratory-outcomes-in-newborns-born-at-extremely-low-gestational-age-a-prospective-cohort-study
#16
Roberta L Keller, Rui Feng, Sara B DeMauro, Thomas Ferkol, William Hardie, Elizabeth E Rogers, Timothy P Stevens, Judith A Voynow, Scarlett L Bellamy, Pamela A Shaw, Paul E Moore
OBJECTIVE: To assess the utility of clinical predictors of persistent respiratory morbidity in extremely low gestational age newborns (ELGANs). STUDY DESIGN: We enrolled ELGANs (<29 weeks' gestation) at ≤7 postnatal days and collected antenatal and neonatal clinical data through 36 weeks' postmenstrual age. We surveyed caregivers at 3, 6, 9, and 12 months' corrected age to identify postdischarge respiratory morbidity, defined as hospitalization, home support (oxygen, tracheostomy, ventilation), medications, or symptoms (cough/wheeze)...
May 17, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28518132/mind-the-gap-can-videolaryngoscopy-bridge-the-competency-gap-in-neonatal-endotracheal-intubation-among-pediatric-trainees-a-randomized-controlled-study
#17
S Parmekar, J L Arnold, C Anselmo, M Pammi, J Hagan, C J Fernandes, K Lingappan
BACKGROUND: To study the impact of videolaryngoscopy (VL) on intubation success among pediatric trainees compared with direct laryngoscopy (DL). METHODS: One hundred pediatric residents were enrolled in a randomized, crossover, simulation study comparing VL to DL. Following a didactic session on neonatal intubation, residents intubated a standard neonatal mannequin. Three Neonatal Resuscitation Program (NRP) scenarios were then conducted, followed by a mannequin intubation with the alternate device...
May 18, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28515969/application-of-selective-bronchial-intubation-versus-neurally-adjusted-ventilatory-assist-in-the-management-of-unilateral-pulmonary-interstitial-emphysema-an-illustrative-case-and-the-literature-review
#18
Shing-Yan Robert Lee
In the treatment of left-sided pulmonary interstitial emphysema (PIE) in a 23-week neonate, we used two ventilatory strategies: selective bronchial intubation from day 10 to 15 and neurally adjusted ventilatory assist (NAVA) from day 18 to 26. We compared the effects and adverse effects of these two strategies. On selective bronchial intubation, desaturation was frequent. Fentanyl infusion was required. There was an episode of carbon dioxide retention coupled with hypotension. On NAVA, the neonate was clinically stable without the requirement of sedation...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28492294/effect-of-remifentanil-for-general-anaesthesia-on-parturients-and-newborns-undergoing-caesarean-section-a-meta-analysis
#19
Yunhui Zhang, Hongmei Lu, Zheng Fu, Huijun Zhang, Ye Li, Wei Li, Jingui Gao
BACKGROUND: The results presented by studies investigating the effect of remifentanil on both parturients and newborns during cesarean section differed significantly. Therefore, we performed a meta-analysis to estimate the effect of remifentanil on these patients. METHODS: Potentially eligible studies published before 15 March 2016 were searched through four databases including PubMed, SCOPUS, ISI web of knowledge and EBSCO. Weighted mean difference (WMD) or odds ratios (ORs) and the corresponding 95% confidence interval (CI) were applied to estimate the strength of relationship...
May 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28488361/clonidine-for-sedation-and-analgesia-for-neonates-receiving-mechanical-ventilation
#20
REVIEW
Olga Romantsik, Maria Grazia Calevo, Elisabeth Norman, Matteo Bruschettini
BACKGROUND: Although routine administration of pharmacologic sedation or analgesia during mechanical ventilation in preterm neonates is not recommended, its use in clinical practice remains common. Alpha-2 agonists, mainly clonidine and dexmedetomidine, are used as adjunctive (or alternative) sedative agents alongside opioids and benzodiazepines. Clonidine has not been systematically assessed for use in neonatal sedation during ventilation. OBJECTIVES: To assess whether clonidine administered to term and preterm newborn infants receiving mechanical ventilation reduces morbidity and mortality rates...
May 10, 2017: Cochrane Database of Systematic Reviews
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