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Neonatal intubation

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https://www.readbyqxmd.com/read/29149032/optimal-line-and-tube-placement-in-very-preterm-neonates-an-audit-of-practice
#1
Daragh Finn, Hannah Kinoshita, Vicki Livingstone, Eugene M Dempsey
BACKGROUND: Placement of endotracheal tubes (ETTs) and umbilical catheters (UCs) is essential in very preterm infant care. The aim of this study was to assess the effect of an educational initiative to optimize correct placement of ETTs and UCs in very preterm infants. METHODS: A pre-post study design, evaluating optimal radiological position of ETTs and UCs in the first 72 h of life in infants <32 weeks gestational age (GA) was performed. Baseline data was obtained from a preceding 34-month period...
November 17, 2017: Children
https://www.readbyqxmd.com/read/29135753/prevention-of-neonatal-unplanned-extubations-in-the-neonatal-intensive-care-unit-a-best-practice-implementation-project
#2
Xiaojing Hu, Yuxia Zhang, Yun Cao, Guoying Huang, Yan Hu, Alexa McArthur
BACKGROUND: Adverse events of mechanically ventilated neonates such as unplanned extubations may be associated with serious negative outcomes. Unplanned extubation rates have been monitored by many neonatal intensive care units as a quality of care metric. OBJECTIVES: The objective was to implement evidence-based best practice and assess the effects of these strategies on minimizing unplanned extubation in the neonatal intensive care unit in a large tertiary children's hospital...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29127153/analysis-of-unsuccessful-intubations-in-neonates-using-videolaryngoscopy-recordings
#3
Joyce E O'Shea, Prakash Loganathan, Marta Thio, C Omar Farouk Kamlin, Peter G Davis
OBJECTIVES: Neonatal intubation is a difficult skill to learn and teach. If an attempt is unsuccessful, the intubator and instructor often cannot explain why. This study aims to review videolaryngoscopy recordings of unsuccessful intubations and explain the reasons why attempts were not successful. STUDY DESIGN: This is a descriptive study examining videolaryngoscopy recordings obtained from a randomised controlled trial that evaluated if neonatal intubation success rates of inexperienced trainees were superior if they used a videolaryngoscope compared with a laryngoscope...
November 10, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29117819/role-of-ultrasound-in-confirmation-of-endotracheal-tube-in-neonates-a-review
#4
Deepak Sharma, Seyyed Ahmad Tabatabaii, Nazanin Farahbakhsh
Tracheal intubation is a commonly done procedure in neonatal intensive care unit and delivery room during resuscitation. The confirmation of endotracheal tube (ETT) position should be done quickly as tube malposition is associated with various serious adverse outcomes like hypoxemia, right upper lobe collapse, atelectasis, air leak syndromes and esophageal intubation. ETT position can be confirmed by various methods like clinical sign, chest radiography, capnography, external digital tracheal palpation, ultrasonography (USG), respiratory function monitor, video-laryngoscope and fiberoptic devices...
November 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29102454/reexamining-the-ideal-depth-of-endotracheal-tube-in-neonates
#5
Hao-Wei Chung, Wei-Te Lee, Hsiu-Lin Chen
BACKGROUND: The appropriate endotracheal tube (ET) depth for the newborn with respiratory failure is important. Inappropriate ET depth increases the risk of uneven lung expansion and collapse. This retrospective study aimed to compare the final ideal ET depth with Tochen's formula in Taiwanese intubated neonates, and to determine the correlation between neonatal factors and final ideal ET depth, and to devise an accurate predictive formula for use in Taiwan. METHODS: Data were collected from neonates who required endotracheal intubation and who were admitted to the Neonatal Intensive Care Unit from 2011 to 2015...
October 6, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29099872/a-pilot-randomized-controlled-trial-of-ekg-for-neonatal-resuscitation
#6
Anup Katheria, Kathy Arnell, Melissa Brown, Kasim Hassen, Mauricio Maldonado, Wade Rich, Neil Finer
BACKGROUND: The seventh edition of the American Academy of Pediatrics Neonatal Resuscitation Program recommends the use of a cardiac monitor in infants that need resuscitation. Previous trials have shown that EKG heart rate is available before pulse rate from a pulse oximeter. To date no trial has looked at how the availability of electrocardiogram (EKG) affects clinical interventions in the delivery room. OBJECTIVE: To determine whether the availability of an EKG heart rate value and tracing to the clinical team has an effect on physiologic measures and related interventions during the stabilization of preterm infants...
2017: PloS One
https://www.readbyqxmd.com/read/29097178/delayed-versus-early-umbilical-cord-clamping-for-preterm-infants-a-systematic-review-and-meta-analysis
#7
Michael Fogarty, David A Osborn, Lisa Askie, Anna Lene Seidler, Kylie Hunter, Kei Lui, John Simes, William Tarnow-Mordi
OBJECTIVE: To compare the effects of delayed versus early cord clamping on hospital mortality (primary outcome) and morbidity in preterm infants using Cochrane Collaboration Neonatal Review Group methodology. DATA SOURCES: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Chinese articles, cross-referencing citations, expert informants and trial registries to 31 July 2017. STUDY ELIGIBILITY: RCTs of delayed (≥ 30 seconds) vs early (<30 seconds) clamping in infants born <37 weeks gestation...
October 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29042870/update-of-minimally-invasive-surfactant-therapy
#8
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/29020695/transition-to-routine-premedication-for-nonemergent-intubations-in-a-level-iv-neonatal-intensive-care-unit
#9
Rachel Fleishman, Roschanak Mossabeb, Ogechukwu Menkiti, Megan Young, Vidhy Bains, David Cooperberg
No abstract text is available yet for this article.
October 11, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28987617/mitigation-of-postnatal-ethanol-induced-neuroinflammation-ameliorates-trace-fear-memory-deficits-in-juvenile-rats
#10
Molly J Goodfellow, Youn Ju Shin, Derick H Lindquist
Impairments in behavior and cognition are common in individuals diagnosed with fetal alcohol spectrum disorders (FASD). In this study, FASD model rats were intragastrically intubated with ethanol (5g/kg/day; 5E), sham-intubated (SI), or maintained as naïve controls (NC) over postnatal days (PD) 4-9. Ethanol exposure during this human third trimester-equivalent period induces persistent impairments in hippocampus-dependent learning and memory. The ability of ibuprofen (IBU), a non-steroidal anti-inflammatory drug, to diminish ethanol-induced neuroinflammation and rescue deficits in hippocampus-dependent trace fear conditioning (TFC) was investigated in 5E rats...
October 5, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28985401/clinical-characteristics-of-nosocomial-bloodstream-infections-in-neonates-in-two-hospitals-china
#11
Shanmei Wang, Sheng Chen, Wei Feng, Fengjun Sun, Qian Wang, Ke Zhu, Jie Song
Background: The improvement of medical condition requires prolonged hospital stays, which increase the risk of nosocomial bloodstream infections (BSIs). Methods: All nosocomial BSI newborns in two hospitals were included, and the demographic and clinical characteristics of bacteremia patients were obtained from the information systems. Isolates were identified by biochemical assays. Antimicrobial susceptibility was determined using disk diffusion method. Results: Except for three same risk factors, intubation with mechanical ventilation was a risk factor in Chongqing, while low birth weight was a risk factor in Henan...
July 21, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28974162/antenatal-assessment-and-postnatal-outcome-of-fetal-echogenic-lung-lesions-a-decade-s-experience-at-a-tertiary-referral-hospital
#12
Stefan C Kane, Fabrício Da Silva Costa, Joseph A Crameri, Karen L Reidy, Helen Kaganov, Ricardo Palma-Dias
INTRODUCTION: Fetal echogenic lung lesions (ELL) are the commonest pulmonary pathology diagnosed on antenatal sonography, and include congenital pulmonary airway malformations (CPAMs) and bronchopulmonary sequestrations. This study aimed to evaluate the predictive utility of the CPAM volume ratio (CVR) at presentation in a series of fetuses with ELLs at a tertiary Australian referral hospital. MATERIAL AND METHODS: Retrospective cohort study of all pregnancies with a prenatal diagnosis of an isolated fetal echogenic lung lesion managed at the Royal Women's Hospital, Victoria, Australia, between 2005 and 2015...
October 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28974135/propofol-and-fentanyl-sedation-for-laser-treatment-of-retinopathy-of-prematurity-to-avoid-intubation
#13
Fiammetta Piersigilli, Alessandra Di Pede, Gino Catena, Simona Lozzi, Cinzia Auriti, Iliana Bersani, Irma Capolupo, Anna Lipreri, Vincenzo Di Ciommo, Andrea Dotta, Stefania Sgrò
BACKGROUND: Despite the optimization of neonatal assistance, severe retinopathy of prematurity (ROP, stage III-IV) remains a common condition among preterm infants. Laser photocoagulation usually requires general anesthesia and intubation, but extubation can be difficult and these infants often affected by chronic lung disease. We retrospectively evaluated the clinical charts of 13 neonates that were sedated with propofol in association with fentanyl for the laser treatment of ROP. This protocol was introduced in our unit to avoid intubation and minimize side effects of anesthesia and ventilation...
October 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28958447/an-outbreak-of-bloodstream-infection-due-to-extensively-resistant-acinetobacter-baumannii-among-neonates
#14
Aysegul Ulu-Kilic, Aycan Gundogdu, Fatma Cevahir, Huseyin Kilic, Tamer Gunes, Emine Alp
BACKGROUND: Extensively resistant Acinetobacter baumannii has emerged and spread worldwide as a significant cause of health care-associated infections and outbreaks. It also causes life-threatening infections among neonates, including bacteremia. The aim of this study was to investigate an outbreak of A baumannii bacteremia (ABB) among neonates. MATERIALS AND METHODS: A retrospective, case-control study was conducted from July 2014 to July 2015 in a neonatal intensive care unit (NICU)...
September 25, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28953490/anterior-laryngeal-web-leading-to-unanticipated-difficult-tracheal-intubation-in-a-neonate-diagnosed-and-managed-successfully-with-cmac-video-laryngoscope-a-case-report
#15
Anju Gupta, Nishkarsh Gupta
Anterior laryngeal web is a rare anomaly which is usually asymptomatic in infancy. This translates into a high incidence of unanticipated difficult intubation in these patients with consequent airway morbidity in the form of tracheostomy. We are reporting a case of unsuspected difficult intubation in a neonate due to the presence of a congenital anterior laryngeal web. After multiple failed intubation attempts with direct laryngoscopy, use of CMAC video laryngoscope improved the glottic view, enabled us to diagnose the presence of a thick anterior laryngeal web and intubate the child...
September 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28947918/efficacy-study-of-pulmonary-surfactant-combined-with-assisted-ventilation-for-acute-respiratory-distress-syndrome-management-of-term-neonates
#16
Jinfeng Liu, Gang Liu, Hongwei Wu, Zhenguang Li
The clinical efficacy of pulmonary surfactant (PS) combined with assisted ventilation was assessed for acute respiratory distress syndrome (RDS) management of term neonates. The total sample size was of 60 subjects. Group I: Experimental group, 30 cases were treated with standard of care with tracheal intubation, mechanical ventilation and PS (100-200 mg/kg). In case of hypoxaemia present even after 12 h standard of care was administered again, up to 4 times. Group II: Control group, 30 cases treated with conventional tracheal intubation and mechanical ventilation...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28904810/nasal-high-flow-treatment-in-preterm-infants
#17
REVIEW
Calum T Roberts, Kate A Hodgson
Nasal High Flow (HF) is a mode of 'non-invasive' respiratory support for preterm infants, with several potential modes of action, including generation of distending airway pressure, washout of the nasopharyngeal dead space, reduction of work of breathing, and heating and humidification of inspired gas. HF has several potential advantages over continuous positive airway pressure (CPAP), the most commonly applied form of non-invasive support, such as reduced nasal trauma, ease of use, and infant comfort, which has led to its rapid adoption into neonatal care...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28901997/risk-factors-associated-with-intraventricular-hemorrhage-in-extremely-premature-neonates
#18
Jonathan C Roberts, M Jawad Javed, James R Hocker, Huaping Wang, Michael D Tarantino
: Intraventricular hemorrhage (IVH) is a significant cause of morbidity in extremely premature infants despite many advances in neonatal intensive care. We conducted an institutional retrospective review aimed to correlate risk factors associated with IVH. Clinical variables reported to the Vermont-Oxford Network on less than 30 weeks gestational age infants over a 5-year period were evaluated with Pearson's chi-square and multivariate logistic regression. Of 618 infants born less than 30-week gestational age, 178 (28...
September 8, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28890836/new-diagnosis-of-aids-based-on-salmonella-enterica-subsp-i-enterica-enteritidis-a-meningitis-in-a-previously-immunocompetent-adult-in-the-united-states
#19
Andrew C Elton, James Levin, Matthew P Lazio
Salmonella meningitis is a rare manifestation of meningitis typically presenting in neonates and the elderly. This infection typically associates with foodborne outbreaks in developing nations and AIDS-endemic regions. We report a case of a 19-year-old male presenting with altered mental status after 3-day absence from work at a Wisconsin tourist area. He was febrile, tachycardic, and tachypneic with a GCS of 8. The patient was intubated and a presumptive diagnosis of meningitis was made. Treatment was initiated with ceftriaxone, vancomycin, acyclovir, dexamethasone, and fluid resuscitation...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28883098/randomised-trial-of-estimating-oral-endotracheal-tube-insertion-depth-in-newborns-using-weight-or-vocal-cord-guide
#20
Irwin Gill, Aisling Stafford, Madeleine C Murphy, Aisling R Geoghegan, Miranda Crealey, Eoghan Laffan, Colm Patrick Finbarr O'Donnell
BACKGROUND: When intubating newborns, clinicians aim to position the endotracheal tube (ETT) tip in the midtrachea. The depth to which ETTs should be inserted is often estimated using the infant's weight. ETTs are frequently incorrectly positioned in newborns, most often inserted too far. Using the vocal cord guide (a mark at the distal end of the ETT) to guide insertion depth has been recommended. OBJECTIVE: To determine whether estimating ETT insertion depth using the vocal cord guide rather than weight results in more correctly positioned ETT tips...
September 7, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
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