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Surfactant neonate

Mao-Jun Li, Qing Wu, Wei Shi, Qian Yang, Bin-Zhi Tang, Chang-Hui Chen
OBJECTIVE: To study clinical features of respiratory distress syndrome (RDS) in neonates of different gestational ages (GA). METHODS: According to GA, 133 neonates with RDS were classified into GA <34 weeks group (n=66), GA 34-36 weeks group (late preterm neonates; n=31), and GA ≥37 weeks group (full-term neonates; n=36). The mothers' medical history during pregnancy and the condition of the neonates at birth were retrospectively analyzed, and the clinical data were compared between groups...
October 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
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
F Cau, E Pisu, C Gerosa, G Senes, F Ronchi, C Botta, E Di Felice, F Uda, V Marinelli, G Faa, V Fanos, C Moretti, D Fanni
The surfactant complex, thanks to its multiple actions including decrease of surface- tension and antimicrobial activity, plays a fundamental role in newborn survival, lowering the risk of respiratory distress syndrome. The aim of this work was to determine if the synthesis of two surfactant proteins (SP), SPA and pro-SPB, shows some inter-individual variability during lung development in the intrauterine life. Immunoreactivity for SPA and pro-SPB was investigated in the lungs of  40 subjects, including 15 fetuses, ranging from 14 to 22 weeks of gestation, and 25 neonates, from 24 to 41 weeks...
September 26, 2016: European Journal of Histochemistry: EJH
Gabriele Saccone, Vincenzo Berghella
OBJECTIVE:  To evaluate the effectiveness of antenatal corticosteroids given at ≥34 weeks' gestation. DESIGN:  Systematic review with meta-analysis. DATA SOURCES:  Electronic databases were searched from their inception to February 2016. ELIGIBILITY CRITERIA FOR STUDY SELECTION:  Randomized clinical trials comparing antenatal corticosteroids with placebo or no treatment in women with a singleton pregnancy at ≥34 weeks' gestation...
October 12, 2016: BMJ: British Medical Journal
Smeeta Sardesai, Manoj Biniwale, Fiona Wertheimer, Arlene Garingo, Rangasamy Ramanathan
Respiratory distress syndrome (RDS) due to surfactant deficiency is the most common cause of respiratory failure in preterm infants. Tremendous progress has been made since the original description that surfactant deficiency is the major cause of RDS. Surfactant therapy has been extensively studied in preterm infants and has been shown to significantly decrease air leaks and neonatal and infant mortality. Synthetic and animal-derived surfactants from bovine as well as porcine origin have been evaluated in randomized controlled trials...
October 5, 2016: Pediatric Research
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
Harry Pachajoa, Felipe Ruiz-Botero, Luis Enrique Meza-Escobar, Vania Alexandra Villota-Delgado, Adriana Ballesteros, Ivan Padilla, Diana Duarte
BACKGROUND: Pulmonary surfactant is a complex mixture of lipids and proteins. Mutations in surfactant protein-C, surfactant protein-D, and adenosine triphosphate-binding cassette subfamily A member 3 have been related to surfactant dysfunction and neonatal respiratory failure in full-term babies. Adenosine triphosphate-binding cassette subfamily A member 3 facilitates the transfer of lipids to lamellar bodies. We report the case of patient with a homozygous intronic ABCA3 mutation. CASE PRESENTATION: We describe a newborn full-term Colombian baby boy who was the son of non-consanguineous parents of mixed race ancestry (Mestizo), who was delivered with severe respiratory depression...
September 26, 2016: Journal of Medical Case Reports
L Zhang, Y Qiu, B Yi, L Ni, L Zhang, Pulati Taxi, H Li, Q Zhang, W Wang, Z Liu, L Li, L Zhao, H Wang, B Sun
OBJECTIVES: We aimed to evaluate the efficacy of respiratory support and surfactant in incidence, management and outcome of neonatal hypoxemic respiratory failure (NRF) in Chinese emerging regional neonatal-perinatal care system in the era of universal health insurance policy. STUDY DESIGN: Clinical data of NRF were prospectively collected in 12 consecutive months from 2011 to 2012 in 12 neonatal intensive care units (NICU) in major cities of Northwest China. NRF was defined as hypoxemia requiring nasal continuous positive airway pressure (nCPAP) or intratracheal ventilation combined with surfactant for at least 24 h, with associated risk factors, mortality rate and major co-morbidities analyzed...
October 9, 2016: Journal of Maternal-fetal & Neonatal Medicine
Carole R Mendelson, Alina P Montalbano, Lu Gao
Preterm birth remains the major cause of neonatal morbidity and mortality throughout the world. This is due, in part, to our incomplete understanding of the mechanisms that underlie the maintenance of pregnancy and the initiation of parturition at term. In this article, we review our current knowledge of the complex, interrelated and concerted mechanisms whereby progesterone maintains myometrial quiescence throughout most of pregnancy, as well as those that mediate the upregulation of the inflammatory response and decline in progesterone receptor function leading to parturition...
September 11, 2016: Journal of Steroid Biochemistry and Molecular Biology
Sneha K Taylor, Reiko Sakurai, Tokusho Sakurai, Virender K Rehan
INTRODUCTION: The physiologic vitamin D (VD), 1α,25(OH)2D3 (1,25D) is a local paracrine/autocrine effecter of fetal lung maturation. By stimulating alveolar type II cell and lipofibroblast proliferation and differentiation, parenterally administered 1,25D has been shown to enhance neonatal lung maturation; but due to the potential systemic side effects of the parenteral route, the translational value of these findings might be limited. To minimize the possibility of systemic toxicity, we examined the effects of VD on neonatal lung maturation, when delivered directly to lungs via nebulization...
September 10, 2016: Lung
Anne Smits, Liesbeth Thewissen, Alexander Caicedo, Gunnar Naulaers, Karel Allegaert
OBJECTIVE: To define the effective dose for 50% of patients (ED50) of propofol for successful intubation and to determine the rate of successful extubation in those patients with planned intubation, surfactant administration, and immediate extubation (INSURE procedure). In addition, pharmacodynamic effects were assessed. STUDY DESIGN: Neonates (n = 50) treated with propofol for (semi-)elective endotracheal intubation were stratified in 8 strata by postmenstrual and postnatal age...
September 2, 2016: Journal of Pediatrics
Zsanett Renáta Csoma, Angéla Meszes, Rita Ábrahám, Lajos Kemény, Gyula Tálosi, Péter Doró
BACKGROUND/OBJECTIVES: Recent technological advances and diagnostic and therapeutic innovations have resulted in an impressive improvement in the survival of newborn infants requiring intensive care. Consequently, with the use of modern invasive diagnostic and therapeutic procedures, the incidence of iatrogenic events has also increased. The aim of this study was to assess various iatrogenic complications in neonates requiring intensive care and determine possible contributing factors to the injuries...
September 2016: Pediatric Dermatology
Nutan Agarwal, Shikha Bathwal, Alka Kriplani, Ashok Deorari, Neerja Bhatla
OBJECTIVE: To assess the efficacy of intra-amniotic administration of surfactants in reducing the incidence and severity of respiratory distress syndrome (RDS), and the need for postnatal endotracheal surfactant during preterm delivery. METHODS: A prospective pilot study enrolled pregnant women at 28-34 weeks of pregnancy between July 1, 2013 and December 31, 2014 who were randomly assigned in a 1:1 ratio to a control group or to receive intra-amniotic surfactant (3mL) administered under ultrasonography guidance within 2-8 hours of expected delivery...
November 2016: International Journal of Gynaecology and Obstetrics
J M Ismawan, C Abdallah
Surfactant catheters are used to administer exogenous surfactant as a preventive and therapeutic measure for surfactant deficiency in premature neonates. We describe the case of a retained surfactant catheter in a 700 g premature neonate with associated pneumothorax.
September 16, 2016: Journal of Neonatal-perinatal Medicine
Katherine C Wai, Roberta L Keller, Leslie A Lusk, Roberta A Ballard, Dylan K Chan
Importance: Tracheotomy is sometimes performed in extremely low gestational age newborns requiring prolonged ventilation. Studies suggest better neurodevelopmental outcomes in preterm newborns undergoing earlier tracheotomy (<120 days); however, guidelines for who should undergo tracheotomy and when to perform tracheotomy are unclear regarding infants receiving long-term positive-pressure support. Objective: To determine the characteristics associated with tracheotomy in high-risk, extremely low gestational age newborns...
September 1, 2016: JAMA Otolaryngology—Head & Neck Surgery
Sine Lykkedegn, Grith Lykke Sorensen, Signe Sparre Beck-Nielsen, Bartosz Pilecki, Lars Duelund, Niels Marcussen, Henrik Thybo Christesen
Animal studies suggest a role of vitamin D in fetal lung development although not studied in preterm animals. We tested the hypothesis that vitamin D depletion aggravates respiratory insufficiency in preterm rat offspring. Furthermore, the effects of vitamin D depletion on growth and lung surfactant were investigated. Female Sprague-Dawley rats were randomly assigned low vitamin D (VDL) or control diet before mating and followed with serum 25-hydroxyvitamin D (s-25(OH)D) determinations. After cesarean section at gestational day 19 (E19) or day 22 (E22), placental weight, birth weight, crown-rump-length (CRL), oxygenation (SaO2) at 30 min and survival time were recorded...
2016: PloS One
Jute Richter, Julio Jimenez, Taro Nagatomo, Jaan Toelen, Paul Brady, Thomas Salaets, Flore Lesage, Jeroen Vanoirbeek, Jan Deprest
BACKGROUND: The administration of supplemental oxygen to treat ventilatory insufficiency may lead to the formation of reactive oxygen species and subsequent tissue damage. Cytochrome P4501A1 (CYP1A1) can modulate hyperoxic lung injury by a currently unknown mechanism. Our objective was to evaluate the effect of administration of omeprazole on the induction of CYP1A1 and its influence on hyperoxic lung injury in an established preterm rabbit model. METHODS: Omeprazole was administered either (1) directly to the fetus, (2) to the mother or (3) after birth to the pups in different doses (2-10 or 20 mg/kg)...
2016: Journal of Translational Medicine
Carlo Caffarelli, Francesca Santamaria, Dora Di Mauro, Carla Mastrorilli, Virginia Mirra, Sergio Bernasconi
This review focuses key advances in different pediatric fields that were published in Italian Journal of Pediatrics and in international journals in 2015. Weaning studies continue to show promise for preventing food allergy. New diagnostic tools are available for identifying the allergic origin of allergic-like symptoms. Advances have been reported in obesity, short stature and autoimmune endocrine disorders. New molecules are offered to reduce weight gain and insulin-resistance in obese children. Regional investigations may provide suggestions for preventing short stature...
August 27, 2016: Italian Journal of Pediatrics
Dimitrios Konstantelos, Jürgen Dinger, Sascha Ifflaender, Mario Rüdiger
BACKGROUND: Over the past years, research on neonatal resuscitation has focused on single interventions. The present study was performed to analyze the process quality of delivery room management of preterm infants born by c-section in our institution. METHODS: We performed a cross-sectional study of videos of preterm infants born by c-section. Videos were analyzed according to time point, duration and number of performed medical interventions. The study period occurred between January 2012 and December 2013...
2016: BMC Pregnancy and Childbirth
Kishwar Azad, Jiji Mathews
Preterm births (PTBs), defined as births before 37 weeks of gestation account for the majority of deaths in the newborn period. Prediction and prevention of PTB is challenging. A history of preterm labour or second trimester losses and accurate measurement of cervical length help to identify women who would benefit from progesterone and cerclage. Fibronectin estimation in the cervicovaginal secretions of a symptomatic woman with an undilated cervix can predict PTB within 10 days of testing. Antibiotics should be given to women with preterm prelabour rupture of membranes but tocolysis has a limited role in the management of preterm labour...
June 24, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
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