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Meconium aspiration syndrome and ventilation

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https://www.readbyqxmd.com/read/28658507/antibiotics-for-neonates-born-through-meconium-stained-amniotic-fluid
#1
REVIEW
Lauren E Kelly, Sandesh Shivananda, Prashanth Murthy, Ravisha Srinivasjois, Prakeshkumar S Shah
BACKGROUND: Approximately 1 in 10 pregnancies is affected by meconium passage at delivery, which can result in meconium aspiration syndrome (MAS). MAS can cause respiratory complications and, very rarely, death. Antibiotics have been prescribed for neonates exposed to meconium in amniotic fluid, with the intention of preventing infection due to potential bacterial contaminants. OBJECTIVES: We conducted this review to assess the efficacy and safety of antibiotics for:1...
June 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28528140/maternal-and-neonatal-outcomes-of-respiratory-failure-during-pregnancy
#2
Chen-Yiu Hung, Han-Chung Hu, Li-Chung Chiu, Chih-Hao Chang, Li-Fu Li, Chung-Chi Huang, Chuan-Chi Kao, Po-Jen Cheng, Kuo-Chin Kao
BACKGROUND: Obstetric patients comprise a limited portion of intensive care unit patients, but they often present with unfamiliar conditions and exhibit the potential for catastrophic deterioration. This study evaluated the maternal and neonatal outcomes of respiratory failure during pregnancy. METHODS: Information on 71 patients at >25 weeks gestation in the ICU with respiratory failure was recorded between 2009 and 2013. The characteristics and outcomes of mothers and fetuses were determined through a retrospective chart review and evaluated using Student's t test, chi-square test, and Fisher's exact test...
May 17, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28456514/respiratory-distress-in-term-neonates-in-low-resource-settings
#3
REVIEW
Sindhu Sivanandan, Ramesh Agarwal, Amanpreet Sethi
Most neonatal deaths worldwide occur in low- and middle-income countries (LMICs). Respiratory distress is an important cause of neonatal morbidity and mortality. The epidemiology of respiratory distress among term neonates who constitute the vast majority of births is under reported. The scarcely available data from LMICs suggest an incidence of 1.2% to 7.2% among term live births and greater morbidity compared to that in high-income countries. Pneumonia and meconium aspiration syndrome are the predominant causes among outborn neonates, but next only to transient tachypnea among inborn neonates...
April 26, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28411000/meconium-aspiration-or-respiratory-distress-associated-with%C3%A2-meconium-stained-amniotic-fluid
#4
REVIEW
Nestor E Vain, Daniel G Batton
The designation meconium aspiration syndrome (MAS) reflects a spectrum of disorders in infants born with meconium-stained amniotic fluid, ranging from mild tachypnea to severe respiratory distress and significant mortality. The frequency of MAS is highest among infants with post-term gestation, thick meconium, and birth asphyxia. Pulmonary hypertension is an important component in severe cases. Prenatal hypopharyngeal suctioning and postnatal endotracheal intubation and suctioning of vigorous infants are not effective...
August 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28407823/-application-of-humidified-high-flow-nasal-cannula-in-neonates-with-meconium-aspiration-syndrome-and-pulmonary-hypertension-after-extubation
#5
Xiao-Yan Gao, Lin Feng, Yu-Fen Qiu, Xin-Nian Pan
OBJECTIVE: To investigate the clinical value of humidified high-flow nasal cannula (HHFNC) as a respiratory support after extubation by comparing it with nasal continuous positive airway pressure (NCPAP) in neonates with meconium aspiration syndrome (MAS) and persistent pulmonary hypertension of the newborn (PPHN). METHODS: A total of 78 neonates with MAS and PPHN were randomly administered with HHFNC or NCPAP immediately after extubation. The following indices were compared between the two groups: blood gas parameters, duration of noninvasive ventilation, rate of extubation failure, and incidence of complications, such as nasal damage, abdominal distension, and intraventricular hemorrhage...
April 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28391772/intrapartum-fever-and-the-risk-for-perinatal-complications-the-effect-of-fever-duration-and-positive-cultures
#6
Eran Ashwal, Lina Salman, Yossi Tzur, Amir Aviram, Tali Ben-Mayor Bashi, Yariv Yogev, Liran Hiersch
OBJECTIVE: To estimate the association between intrapartum fever and adverse perinatal outcome. METHODS: A retrospective cohort study of women attempting vaginal delivery at term in a tertiary hospital (2012-2015). Perinatal outcome of deliveries complicated by intrapartum fever (≥38.0 °C) were compared to women with no intrapartum fever matched by parity and gestational age at delivery in a 1:2 ratio. Maternal outcome included cesarean section (CS), operative vaginal delivery (OVD), retained placenta or post-partum hemorrhage...
April 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28277364/intrauterine-hyperoxemia-and-risk-of-neonatal-morbidity
#7
Nandini Raghuraman, Lorene A Temming, Molly J Stout, George A Macones, Alison G Cahill, Methodius G Tuuli
OBJECTIVE: To test the hypothesis that intrauterine hyperoxemia is associated with an increased risk of neonatal morbidity. METHODS: This was a secondary analysis of a prospective study of singleton, nonanomalous deliveries at or beyond 37 weeks of gestation at an institution with a universal umbilical cord gas policy from 2010 to 2014. The primary outcome was a composite of neonatal morbidity including neonatal death, meconium aspiration syndrome, intubation, mechanical ventilation, hypoxic-ischemic encephalopathy, and hypothermic therapy...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28225424/committee-opinion-no-689-delivery-of-a-newborn-with-meconium-stained-amniotic-fluid
#8
(no author information available yet)
In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28225419/committee-opinion-no-689-summary-delivery-of-a-newborn-with-meconium-stained-amniotic-fluid
#9
(no author information available yet)
In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28223011/extracorporeal-membrane-oxygenation-support-in-neonates-a-single-medical-center-experience-in-taiwan
#10
Chi-Man Kuok, Po-Nien Tsao, Chien-Yi Chen, Hung-Chieh Chou, Wu-Shiun Hsieh, Shu-Chien Huang, Yih-Sharng Chen, En-Ting Wu
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) was used in neonates with severe cardiopulmonary failure who failed to respond to conventional therapy. We started to apply neck venoarterial ECMO (VA-ECMO) in neonatal patients from 2000. In this study, we have focused on neonates who received ECMO support and described the current status of ECMO in neonates for both cardiac and pulmonary support and the risk factors associated with their outcomes. METHODS: Data were retrieved from our ECMO database for the neonates (age < 28 days) who received neck VA-ECMO support from January 2005 to June 2015...
August 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28151493/surfactant-reduced-the-mortality-of-neonates-with-birth-weight-%C3%A2-1500%C3%A2-g-and-hypoxemic-respiratory-failure-a-survey-from-an-emerging-nicu-network
#11
H Wang, X Gao, C Liu, C Yan, X Lin, Y Dong, B Sun
OBJECTIVE: We evaluated the efficacy of surfactant therapy and assisted ventilation on morbidity and mortality of neonates with birth weight (BW) ⩾1500 g and hypoxemic respiratory failure (HRF). STUDY DESIGN: We retrospectively analyzed 5650 patients with BW ⩾1500 g for incidence, management and outcome of HRF, defined as acute hypoxemia requiring mechanical ventilation and/or nasal continuous positive airway pressure ⩾24 h. The patients were allocated into groups of moderate preterm (1735, 30...
June 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28006947/lung-inflammatory-and-oxidative-alterations-after-exogenous-surfactant-therapy-fortified-with-budesonide-in-rabbit-model-of-meconium-aspiration-syndrome
#12
P Mikolka, J Kopincová, P Košútová, D Čierny, A Čalkovská, D Mokrá
Meconium aspiration syndrome (MAS) triggers inflammatory and oxidative pathways which can inactivate both pulmonary surfactant and therapeutically given exogenous surfactant. Glucocorticoid budesonide added to exogenous surfactant can inhibit inflammation and thereby enhance treatment efficacy. Neonatal meconium (25 mg/ml, 4 ml/kg) was administered intratracheally (i.t.) to rabbits. When the MAS model was prepared, animals were treated with budesonide i.t. (Pulmicort, 0.25 mg/kg, M+B); with surfactant lung lavage (Curosurf®, 10 ml/kg, 5 mg phospholipids/ml, M+S) followed by undiluted Curosurf® i...
December 22, 2016: Physiological Research
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
#13
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
#14
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...
January 2017: 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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