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Meconium aspiration syndrome and ventilation

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https://www.readbyqxmd.com/read/27817768/-clinical-effect-of-high-frequency-oscillatory-ventilation-combined-with-pulmonary-surfactant-in-treatment-of-neonatal-severe-meconium-aspiration-syndrome-complicated-by-pulmonary-hemorrhage
#1
Jing Huang, Xin-Zhu Lin, Zhi Zheng
OBJECTIVE: To study the clinical effect and safety of high-frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) in the treatment of neonatal severe meconium aspiration syndrome (MAS) complicated by neonatal pulmonary hemorrhage (NPH). METHODS: A total of 48 children with severe MAS complicated by NPH were enrolled, and a retrospective analysis was performed for the clinical effects of HFOV+PS (trial group, 25 children) and HFOV alone (control group, 23 children)...
November 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/27711045/non-invasive-inhaled-nitric-oxide-in-the-treatment-of-hypoxemic-respiratory-failure-in-term-and-preterm-infants
#2
R Sahni, X Ameer, K Ohira-Kist, J-T Wung
OBJECTIVES: Inhaled nitric oxide (iNO) is effective in conjunction with tracheal intubation (TI) and mechanical ventilation (MV) for treating arterial pulmonary hypertension and hypoxemic respiratory failure (HRF) in near-term and term newborns. Non-invasive respiratory support with nasal continuous positive airway pressure (CPAP) is increasingly used to avoid morbidity associated with TI and MV, yet the effectiveness of iNO delivery via nasal CPAP remains unknown. To evaluate the effectiveness of iNO delivered via the bubble nasal CPAP system in term and preterm newborns with HRF...
October 6, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27670556/management-of-patients-with-gastroschisis-requiring-extracorporeal-membrane-oxygenation-for-concurrent-respiratory-failure
#3
Alykhan Lalani, P Benson Ham, Linda J Wise, John M Daniel, K Christian Walters, Walter L Pipkin, Brian Stansfield, Robyn M Hatley, Jatinder Bhatia
Treatment of gastroschisis often requires multiple surgical procedures to re-establish abdominal domain, reduce abdominal contents, and eventually close the abdominal wall. In patients who have concomitant respiratory failure requiring extracorporeal membrane oxygenation (ECMO), this process becomes further complicated. This situation is rare and only five such cases have been reported in the ECMO registry database. Management of three of the five patients along with results and implications for future care of similar patients is discussed here...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27464019/maternal-super-obesity-and-neonatal-morbidity-after-term-cesarean-delivery
#4
Marcela C Smid, Catherine J Vladutiu, Sarah K Dotters-Katz, Tracy A Manuck, Kim A Boggess, David M Stamilio
Objective To estimate the association between maternal super obesity (body mass index [BMI] ≥ 50 kg/m(2)) and neonatal morbidity among neonates born via cesarean delivery (CD). Methods Retrospective cohort of singleton neonates delivered via CD ≥ 37 weeks in the Maternal-Fetal Medicine Unit Cesarean Registry. Maternal BMI at delivery was stratified as 18.5 to 29.9 kg/m(2), 30 to 39.9 kg/m(2), 40 to 49.9 kg/m(2), and ≥ 50 kg/m(2). Primary outcomes included acute (5-minute Apgar score < 5, cardiopulmonary resuscitation and ventilator support < 24 hours, neonatal injury, and/or transient tachypnea of the newborn) and severe (grade 3 or 4 intraventricular hemorrhage, necrotizing enterocolitis, seizure, respiratory distress syndrome, hypoxic ischemic encephalopathy, meconium aspiration, ventilator support ≥ 2 days, sepsis and/or neonatal death) neonatal morbidity...
October 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27283193/antiinflammatory-effect-of-n-acetylcysteine-combined-with-exogenous-surfactant-in-meconium-induced-lung-injury
#5
P Mikolka, J Kopincova, L Tomcikova Mikusiakova, P Kosutova, A Calkovska, D Mokra
Neonatal meconium aspiration syndrome (MAS) can be treated by exogenous surfactant (S). However, aspirated meconium initiates local inflammation and oxidation which may inactivate surfactant and reduce its action. This experimental study estimated whether combined use of surfactant and the antioxidant N-acetylcysteine (NAC) can enhance effectiveness of therapy. Meconium-instilled rabbits were non-treated (M), treated with monotherapies (M + S, M + NAC), combined therapy (M + S + NAC), or received saline instead of meconium (controls, C)...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27266360/erythropoietin-may-attenuate-lung-inflammation-in-a-rat-model-of-meconium-aspiration-syndrome
#6
Ali Haydar Turhan, Aytuğ Atici, Necati Muşlu, Ayşe Polat, Mehmet Ali Sungur
BACKGROUND: Inflammation is believed to play a key role in the pathophysiology of meconium aspiration syndrome (MAS). PURPOSE OF THE STUDY: The objective was to determine whether the recombinant human Erythropoietin (rhEPO) pretreatment could attenuate meconium-induced inflammation. MATERIALS AND METHODS: In this study, 24 ventilated adult male rats were studied to examine the effects of recombinant human EPO (rhEPO) on meconium-induced inflammation...
May 2016: Experimental Lung Research
https://www.readbyqxmd.com/read/27220313/lung-ultrasound-as-a-predictor-of-mechanical-ventilation-in-neonates-older-than-32-weeks
#7
Javier Rodríguez-Fanjul, Carla Balcells, Victoria Aldecoa-Bilbao, Julio Moreno, Martín Iriondo
BACKGROUND: The prognosis of neonatal respiratory distress may be difficult to estimate at admission. Lung ultrasound is a useful diagnostic tool that is quick, requires little training, and is radiation free. OBJECTIVE: This study aims to analyze whether early lung ultrasound can predict respiratory failure. METHODS: From January to December 2014, lung ultrasound was performed on neonates admitted with breathing difficulties if they were older than 32 weeks and not intubated...
2016: Neonatology
https://www.readbyqxmd.com/read/27206687/current-concepts-in-the-management-of-meconium-aspiration-syndrome
#8
REVIEW
Subhash Chettri, B Vishnu Bhat, B Adhisivam
In developing countries, meconium aspiration syndrome (MAS) is an important cause of morbidity and mortality among neonates. The concepts of pathophysiology and management of meconium stained amniotic fluid (MSAF) and meconium aspiration syndrome have undergone tremendous change in recent years. Routine intranatal and postnatal endotracheal suctioning of meconium in vigorous infants is no longer recommended. Recent studies have challenged its role even in non-vigorous infants. Supportive therapy like oxygen supplementation, mechanical ventilation and intravenous fluids are the cornerstone in the management of meconium aspiration syndrome...
October 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27109092/surfactant-therapy-and-antibiotics-in-neonates-with-meconium-aspiration-syndrome-a-systematic-review-and-meta-analysis
#9
C K Natarajan, M J Sankar, K Jain, R Agarwal, V K Paul
Meconium aspiration syndrome (MAS), a common cause of respiratory failure in neonates, is associated with high mortality and morbidity. The objectives of this review were to evaluate the effects of administration of (a) surfactant-either as lung lavage (SLL) or bolus surfactant (BS) and (b) antibiotics on mortality and severe morbidities in neonates with MAS. We searched the following databases: MEDLINE via PubMed, Cochrane CENTRAL, WHOLIS and CABI using sensitive search strategies. We included eight studies on use of surfactant and three studies on use of antibiotics...
May 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27010895/effects-of-surfactant-budesonide-therapy-on-oxidative-modifications-in-the-lung-in-experimental-meconium-induced-lung-injury
#10
P Mikolka, J Kopincova, L Tomcikova Mikusiakova, P Kosutova, M Antosova, A Calkovska, D Mokra
Meconium aspiration syndrome (MAS) is a serious condition, which can be treated with exogenous surfactant and mechanical ventilation. However, meconium-induced inflammation, lung edema and oxidative damage may inactivate delivered surfactant and thereby reduce effectiveness of the therapy. As we presumed that addition of anti-inflammatory agent into the surfactant may alleviate inflammation and enhance efficiency of the therapy, this study was performed to evaluate effects of surfactant therapy enriched with budesonide versus surfactant-only therapy on markers of oxidative stress in experimental model of MAS...
February 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/26987323/high-frequency-jet-ventilation-against-small-volume-conventional-mechanical-ventilation-in-the-rabbit-models-of-neonatal-acute-lung-injury
#11
D Mokra, L Tomcikova Mikusiakova, P Mikolka, P Kosutova, M Jurcek, M Kolomaznik, A Calkovska
Patients with acute lung injury are ventilated by conventional mechanical ventilation (CMV) rather than high-frequency jet ventilation (HFJV). This study estimated the potential usefulness of HFJV in acute lung injury. The issue was addressed by comparing the effects on lung function of CMV and HFJV in two rabbit models of neonatal acute lung injury: repetitive saline lung lavage (LAV) and meconium aspiration syndrome (MAS) induced by intratracheal meconium instillation. The animals were then ventilated with either HFJV or CMV for 4 h...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/26959212/umbilical-cord-venous-lactate-for-predicting-arterial-lactic-acidemia-and-neonatal-morbidity-at-term
#12
Methodius G Tuuli, Molly J Stout, George A Macones, Alison G Cahill
OBJECTIVE: To estimate the utility of umbilical venous lactate, more readily available than umbilical cord arterial lactate, for predicting arterial lactic acidemia and neonatal outcomes at term. METHODS: This was a prospective cohort study of consecutive, nonanomalous, singleton, term births after labor in a large academic medical center (2009-2014). Umbilical arterial and venous lactate were measured immediately after delivery, before knowledge of neonatal outcomes...
April 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26866711/continuous-end-tidal-carbon-dioxide-monitoring-during-resuscitation-of-asphyxiated-term-lambs
#13
Praveen Kumar Chandrasekharan, Munmun Rawat, Jayasree Nair, Sylvia F Gugino, Carmon Koenigsknecht, Daniel D Swartz, Payam Vali, Bobby Mathew, Satyan Lakshminrusimha
BACKGROUND: The Neonatal Resuscitation Program (NRP) recommends close monitoring of oxygenation during the resuscitation of newborns using a pulse oximeter. However, there are no guidelines for monitoring carbon dioxide (CO2) to assess ventilation. Considering that cerebral blood flow (CBF) correlates directly with PaCO2, continuous capnography monitoring of end-tidal CO2 (ETCO2) may limit fluctuations in PaCO2 and, therefore, CBF during resuscitation of asphyxiated infants. OBJECTIVE: To evaluate whether continuous monitoring of ETCO2 with capnography during resuscitation of asphyxiated term lambs with meconium aspiration will prevent fluctuations in PaCO2 and carotid arterial blood flow (CABF)...
2016: Neonatology
https://www.readbyqxmd.com/read/26760414/newborn-respiratory-distress
#14
Christian L Hermansen, Anand Mahajan
Newborn respiratory distress presents a diagnostic and management challenge. Newborns with respiratory distress commonly exhibit tachypnea with a respiratory rate of more than 60 respirations per minute. They may present with grunting, retractions, nasal flaring, and cyanosis. Common causes include transient tachypnea of the newborn, respiratory distress syndrome, meconium aspiration syndrome, pneumonia, sepsis, pneumothorax, persistent pulmonary hypertension of the newborn, and delayed transition. Congenital heart defects, airway malformations, and inborn errors of metabolism are less common etiologies...
December 1, 2015: American Family Physician
https://www.readbyqxmd.com/read/26663621/inflammatory-indices-in-meconium-aspiration-syndrome
#15
Nora Hofer, Katharina Jank, Volker Strenger, Jasmin Pansy, Bernhard Resch
INTRODUCTION: Meconium aspiration syndrome (MAS) is linked to inflammation, but data on the patterns of hematological indices and C-reactive protein (CRP) in MAS are lacking. The aim of the study was to evaluate CRP, white blood cell count (WBC), absolute neutrophil count (ANC), and immature-to-total neutrophil ratio (IT-ratio) in MAS and to assess their association with disease severity. METHODS: Retrospective cross-sectional study including 239 consecutively admitted neonates with MAS to a level III NICU...
June 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/26633188/treatment-of-neonates-with-meconium-aspiration-syndrome-by-proportional-assist-ventilation-and-synchronized-intermittent-mandatory-ventilation-a-comparison-study
#16
Rong Wu, Zhao-Fang Tian, Guo-Fang Zheng, Su-Fang Din, Zi-Bo Gao, Zhi-Chun Feng
BACKGROUND: This study aimed to compare the relevant clinical parameters of neonates with MAS who are supported by proportion assisted ventilation (PAV) and synchronized intermittent mandatory ventilation (SIMV). METHODS: Forty neonates diagnosed as MAS who required mechanical ventilation were divided randomly into PAV group and SIMV group (N.=20). The respiratory rate (RR), heart rate (HR), peak inspiratory pressure (PIP), mean arterial blood pressure (MABP), arterial-to-alveolar oxygen tension ratio (a/APO2), fraction of inspiration oxygen (FiO2), mean airway pressure (MAP) and tidal volume (VT) were measured before the ventilation, 1,12, 24, 48 hours after the ventilation and before weaning...
August 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/26599471/planned-early-delivery-versus-expectant-management-of-the-term-suspected-compromised-baby-for-improving-outcomes
#17
REVIEW
Diana M Bond, Adrienne Gordon, Jon Hyett, Bradley de Vries, Angela E Carberry, Jonathan Morris
BACKGROUND: Fetal compromise in the term pregnancy is suspected when the following clinical indicators are present: intrauterine growth restriction (IUGR), decreased fetal movement (DFM), or when investigations such as cardiotocography (CTG) and ultrasound reveal results inconsistent with standard measurements. Pathological results would necessitate the need for immediate delivery, but the management for 'suspicious' results remains unclear and varies widely across clinical centres. There is clinical uncertainty as to how to best manage women presenting with a suspected term compromised baby in an otherwise healthy pregnancy...
2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26550439/efficiency-of-high-frequency-oscillatory-ventilation-combined-with-pulmonary-surfactant-in-the-treatment-of-neonatal-meconium-aspiration-syndrome
#18
Dong-Mei Chen, Lian-Qiang Wu, Rui-Quan Wang
The aim of this study was to investigate the clinical efficiency of the use high-frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) for the treatment of neonatal meconium aspiration syndrome (MAS). Clinical data of 53 MAS patients admitted to neonatal intensive care unit (NICU) was collected and the patients were divided into 3 groups according to the different treatment approach: group 1 conventional mechanical ventilation (CMV); group 2 HFOV; group 3 HFOV + PS. By monitoring the changes in oxygenation function indicators such as inhaled oxygen concentration (FiO2), oxygenation index (OI) and arterial oxygen tension/alveolar arterial oxygen tension (a/ApO2) of three groups after 2, 12, 24, 48 h of treatment, the usage of the ventilator, duration of hospitalization, changes in clinical manifestations and outcomes of three groups were analyzed...
2015: International Journal of Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/26421487/histologic-evidence-of-intrapulmonary-bronchopulmonary-anastomotic-pathways-in-neonates-with-meconium-aspiration-syndrome
#19
Noorjahan Ali, Steven H Abman, Csaba Galambos
We examined lung histology from 8 infants who died with meconium aspiration syndrome in order to determine the presence of intrapulmonary bronchopulmonary anastomotic pathways. Each infant required mechanical ventilation to treat hypoxemic respiratory distress. Lung histology from each infant shows evidence of prominent bronchopulmonary vascular connections.
December 2015: Journal of Pediatrics
https://www.readbyqxmd.com/read/26291301/atypical-acute-respiratory-disorder-in-late-preterm-and-term-newborn-infants
#20
Seung Hyun Lee, Chang Won Choi, Yeon Kyun Oh, Beyong Il Kim
OBJECTIVE: We were to describe the clinical characteristics of late preterm and term newborn infants who needed invasive or non-invasive ventilation for respiratory distress but did not meet the diagnostic criteria of common neonatal respiratory disorders (atypical acute respiratory disorder; aRD). METHODS: We retrospectively reviewed electronic medical records of 242 late preterm and term newborn infants born who were admitted to the neonatal intensive care unit for acute respiratory distress developed within 24 h after birth...
2016: Journal of Maternal-fetal & Neonatal Medicine
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