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Meconium aspiration management

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https://www.readbyqxmd.com/read/27751699/comparing-the-effectiveness-of-a-novel-suction-set-up-using-an-adult-endotracheal-tube-connected-to-a-meconium-aspirator-vs-a-traditional-yankauer-suction-instrument
#1
Jonathan Kei, Donald P Mebust
BACKGROUND: It has been suggested that an adult 8.0 endotracheal tube (ETT) connected to a neonatal meconium aspirator would improve suctioning during emergent endotracheal intubation compared to the Yankauer suction instrument, the standard tool used by emergency physicians. OBJECTIVES: This study was designed to compare the effectiveness of a Yankauer vs. an ETT-meconium aspirator set-up in suctioning liquids of different viscosities. METHODS: The Yankauer and ETT-meconium aspirator device underwent a head-to-head timed comparison, suctioning 250 mL of three different fluids, varying in viscosity...
October 14, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27695207/scrotal-abscess-varied-etiology-associations-and-management
#2
Raghu S Ramareddy, Anand Alladi
AIM: To report a series of scrotal abscess, a rare problem, their etiology, and management. MATERIALS AND METHODS: A retrospective study of children who presented with scrotal abscess between January 2010 and March 2015, analyzed with respect to clinical features, pathophysiology of spread and management. RESULTS: Eight infants and a 3-year-old phenotypically male child presented with scrotal abscess as a result of abdominal pathologies which included mixed gonadal dysgenesis (MGD) [1]; three anorectal malformations with ectopic ureter [1], urethral stricture [1], and neurogenic bladder [1]; meconium peritonitis with meconium periorchitis [2], ileal atresia [1], and intra-abdominal abscess [1]; posturethroplasty for Y urethral duplication with metal stenosis [1] and idiopathic pyocele [1]...
October 2016: Journal of Indian Association of Pediatric Surgeons
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/27206687/current-concepts-in-the-management-of-meconium-aspiration-syndrome
#4
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/27062200/oligohydramnios-in-complicated-and-uncomplicated-pregnancies-a-systematic-review-and-meta-analysis
#5
Nader Rabie, Everett Magann, Susan Steelman, Song Ounpraseuth
OBJECTIVE: We aimed to evaluate adverse outcomes of singleton pregnancies diagnosed with oligohydramnios through a systematic review and meta-analysis of controlled trials. METHODS: We searched electronic databases via OVID, EBSCO, Web of Science, Google Scholar, and others from 1980 - present. We included prospective and retrospective studies with a control group. We stratified the meta-analysis into two groups, the former including studies of oligohydramnios with comorbid conditions (e...
April 7, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/26802394/extracorporeal-membrane-oxygenation-in-the-nicu
#6
Kelli Beckvermit Prine, Kimberly Goracke, Lori Baas Rubarth
Extracorporeal membrane oxygenation (ECMO) was developed for adults but has been used in neonates as a life-saving rescue therapy for infants with respiratory failure and/or cardiac collapse as a result of congenital diaphragmatic hernia, meconium aspiration syndrome, persistent pulmonary hypertension, or systemic sepsis. ECMO has been proven to increase the survival rate for these diseases. This article provides an overview of neonatal ECMO: the history and development of neonatal ECMO, patient selection criteria, clinical management, the ECMO circuit, weaning from ECMO, and possible complications of ECMO...
2015: Neonatal Network: NN
https://www.readbyqxmd.com/read/26785887/a-case-report-of-an-asymptomatic-late-term-abdominal-pregnancy-with-a-live-birth-at-41-weeks-of-gestation
#7
Mercy Nkuba Nassali, Tadele Melese Benti, Moreri Bandani-Ntsabele, Elly Musinguzi
BACKGROUND: Despite advances in diagnostic imaging and focused antenatal care, cases of undiagnosed abdominal pregnancies at term are still reported in obstetric practice. It is atypical and very rare for a patient to be asymptomatic late in pregnancy and for the pregnancy to result in a live birth with no evidence of intrauterine growth restriction despite the unfavourable implantation site. This late term asymptomatic presentation despite routine antenatal care demonstrates a diagnostic challenge...
2016: BMC Research Notes
https://www.readbyqxmd.com/read/26783388/persistent-pulmonary-hypertension-of-the-newborn
#8
Satyan Lakshminrusimha, Martin Keszler
Persistent pulmonary hypertension of the newborn (PPHN) is often secondary to parenchymal lung disease (such as meconium aspiration syndrome) or lung hypoplasia (with congenital diaphragmatic hernia) but can also be idiopathic. PPHN is characterized by elevated pulmonary vascular resistance, resulting in right-to-left shunting of blood and hypoxemia. The diagnosis of PPHN is based on clinical evidence of labile hypoxemia often associated with differential cyanosis and confirmed by echocardiography. Lung volume recruitment with optimal use of positive end-expiratory pressure or mean airway pressure and/or surfactant is very important in secondary PPHN due to parenchymal lung disease...
December 2015: NeoReviews
https://www.readbyqxmd.com/read/26760414/newborn-respiratory-distress
#9
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/26599471/planned-early-delivery-versus-expectant-management-of-the-term-suspected-compromised-baby-for-improving-outcomes
#10
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/26160089/frequency-causes-and-outcome-of-neonates-with-respiratory-distress-admitted-to-neonatal-intensive-care-unit-national-institute-of-child-health-karachi
#11
Arit Parkash, Nighat Haider, Zubair Ahmed Khoso, Abdul Sattar Shaikh
OBJECTIVE: To determine the frequency, aetiology and outcome of respiratory distress in neonates in intensive care unit. METHODS: The descriptive cross-sectional study was conducted at the Neonatal Intensive Care Unit, National Institute of Child Health, Karachi, from October 2009 to March 2010. It comprised neonates aged day 0 to 28 who were admitted to Neonatal Intensive Care Unit. The neonates were screened first for respiratory distress and presence of one or more signs and symptoms...
July 2015: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/25738789/tidal-volume-requirement-in-mechanically-ventilated-infants-with-meconium-aspiration-syndrome
#12
Saumya Sharma, Shane Clark, Kabir Abubakar, Martin Keszler
OBJECTIVE: The aim of the study is to test the hypothesis that increased physiologic dead space and functional residual capacity seen in meconium aspiration syndrome (MAS) results in higher tidal volume (VT) requirement to achieve adequate ventilation. STUDY DESIGN: Retrospective review of infants with MAS admitted to our hospital from 2000 to 2010 managed with conventional ventilation. Demographics, ventilator settings, VT, respiratory rate (RR), and blood gas values were recorded...
August 2015: American Journal of Perinatology
https://www.readbyqxmd.com/read/25322992/methylmalonic-acidemia-presenting-as-persistent-pulmonary-hypertension-of-the-newborn
#13
R Agarwal, G L Feldman, J Poulik, D W Stockton, B G Sood
Persistent pulmonary hypertension of the newborn (PPHN) results from disruption of the normal fetal-neonatal circulatory transition and may be associated with meconium aspiration, group B streptococcal sepsis, pneumonia, respiratory distress syndrome, congenital diaphragmatic hernia and pulmonary hypoplasia. Seventeen percent of cases are considered idiopathic since there is no identifiable cause. Although it is recognized that acidosis and hypoxia from any cause in neonates may produce pulmonary vasoconstriction and maintain pulmonary hypertension, PPHN has not been reported in inborn errors of metabolism (IEM) associated with metabolic acidosis like methyl malonic acidemia (MMA)...
January 1, 2014: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/25286746/oesophageal-atresia-with-tracheo-oesophageal-fistula-in-a-preterm-neonate-in-limbe-cameroon-case-report-brief-literature-review
#14
REVIEW
Leopold N Aminde, Veronica N Ebenye, Walters T Arrey, Noah F Takah, George Awungafac
BACKGROUND: Oesophageal atresia is a congenital anomaly in which there is interruption of the oesophageal lumen resulting in an upper and lower segment. We present the case of a rare sub-type of Oesophageal atresia with proximal trachea-oesophageal fistula associated with Meconium Aspiration Syndrome. This is the first case reported in literature in the South West Region of Cameroon. CASE PRESENTATION: A 2 day old preterm male baby who presented as an emergency with difficulty breathing, fever and refusal to feed...
2014: BMC Research Notes
https://www.readbyqxmd.com/read/25274969/respiratory-distress-in-the-newborn
#15
REVIEW
Suzanne Reuter, Chuanpit Moser, Michelle Baack
Respiratory distress presents as tachypnea, nasal flaring, retractions, and grunting and may progress to respiratory failure if not readily recognized and managed. Causes of respiratory distress vary and may not lie within the lung. A thorough history, physical examination, and radiographic and laboratory findings will aid in the differential diagnosis. Common causes include transient tachypnea of the newborn, neonatal pneumonia, respiratory distress syndrome (RDS), and meconium aspiration syndrome (MAS). Strong evidence reveals an inverse relationship between gestational age and respiratory morbidity...
October 2014: Pediatrics in Review
https://www.readbyqxmd.com/read/25220126/lung-ultrasound-findings-in-meconium-aspiration-syndrome
#16
COMPARATIVE STUDY
Marco Piastra, Nadya Yousef, Roselyne Brat, Paolo Manzoni, Mostafa Mokhtari, Daniele De Luca
Meconium aspiration syndrome (MAS) is a rare and life-threatening neonatal lung injury induced by meconium in the lung and airways. Lung ultrasound (LUS) is a quick, easy and cheap imaging technique that is increasingly being used in critical care settings, also for newborns. In this paper we describe ultrasound findings in MAS. Six patients with MAS of variable severity were examined by LUS during the first hours of life. Chest X-rays were used as reference. The following dynamic LUS signs were seen in all patients: (1) B-pattern (interstitial) coalescent or sparse; (2) consolidations; (3) atelectasis; (4) bronchograms...
September 2014: Early Human Development
https://www.readbyqxmd.com/read/25084971/role-of-prophylactic-antibiotics-in-neonates-born-through-meconium-stained-amniotic-fluid-msaf-a-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Ankita Goel, Sushma Nangia, Arvind Saili, Akanksha Garg, Sunita Sharma, V S Randhawa
UNLABELLED: The objective of the study was to evaluate the effect of administering prophylactic antibiotics on the development of neonatal sepsis in term neonates born through meconium-stained amniotic fluid (MSAF). Two hundred and fifty eligible neonates were randomized to study group (Antibiotic group-receiving first-line antibiotics for 3 days) and control group (No Antibiotic group). Both groups were evaluated clinically and by laboratory parameters (sepsis screen and blood cultures) for development of sepsis...
February 2015: European Journal of Pediatrics
https://www.readbyqxmd.com/read/24983547/-hyperglycemia-as-a-risk-factor-for-mortality-in-critically-ill-neonates
#18
Horacio Márquez-González, Mireya Cleotilde Muñoz-Ramírez, Miguel Angel Ramírez-García, María Fernanda Pineda-Frutos, Claudia Hernández-Ramírez, Antonio Rafael Villa-Romero, Ana Carolina Sepúlveda-Vildósola
BACKGROUND: The sick neonate is susceptible to uncontrolled hyperglycemia by several factors. Our objective was to determine the mortality-predictive role of hyperglycemia in critically ill neonates. METHODS: A cohort study was conducted in neonates admitted during the first hour of life in the intensive care unit. Prenatal and perinatal variables were recorded including ventilatory management, comorbidities, arterial blood gas, blood chemistry and blood count. Serum glucose greater than or equal to 126 mg/dL and greater than or equal to 180 mg/dL was considered consistent with hyperglycemia in neonates born at term and preterm infants, respectively...
2014: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/24949543/interpreting-category-ii-fetal-heart-rate-tracings-does-meconium-matter
#19
Heather A Frey, Methodius G Tuuli, Anthony L Shanks, George A Macones, Alison G Cahill
OBJECTIVE: Category II fetal heart rate (FHR) tracings are considered indeterminate; thus, improved risk stratification of category II FHR tracings is needed. We estimated whether the presence of meconium increased the risk of adverse neonatal outcomes. STUDY DESIGN: This study was conducted within a prospective cohort of 5000 women with singleton pregnancies who were admitted in labor at term. Pregnancies with category II FHR in the 60 minutes before delivery were included...
December 2014: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/24907163/severe-hypercalcaemia-due-to-subcutaneous-fat-necrosis-presentation-management-and-complications
#20
Daniel E Shumer, Vidhu Thaker, George A Taylor, Ari J Wassner
OBJECTIVE: Subcutaneous fat necrosis (SCFN) is a rare form of panniculitis in infants that generally occurs following birth trauma, meconium aspiration, or therapeutic cooling. Severe hypercalcaemia occurs in a subset of patients, but data on its presentation, management and outcomes are limited. This report details the clinical course and complications of infants treated for severe hypercalcaemia (peak serum calcium ≥3.0 mmol/L) due to SCFN. DESIGN: Chart review of all infants with SCFN seen at a single paediatric centre over a 13-year period...
September 2014: Archives of Disease in Childhood. Fetal and Neonatal Edition
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