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https://www.readbyqxmd.com/read/29346141/caffeine-controversies
#1
Samuel J Gentle, Colm P Travers, Waldemar A Carlo
PURPOSE OF REVIEW: Caffeine use in preterm infants has endured several paradigms: from standard of care to possible neurotoxin to one of the few medications for which there is evidence of bronchopulmonary dysplasia (BPD) risk reduction. The purpose of the review is to analyze this dynamic trajectory and discuss controversies that still remain after decades of caffeine use. RECENT FINDINGS: Following concerns for caffeine safety in preterm infants, a large randomized controlled trial demonstrated a reduction in BPD and treatment for patent ductus arteriosus...
January 17, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29343586/a-case-of-cardiomyopathy-due-to-premature-ductus-arteriosus-closure-the-flip-side-of-paracetamol
#2
Ingrid Anne Mandy Schierz, Mario Giuffrè, Ettore Piro, Simona La Placa, Giovanni Corsello
Paracetamol (acetaminophen or N-acetyl-p-aminophenol) is considered a safe analgesic and antipyretic nonsteroidal antiinflammatory drug commonly used during pediatric ages and during pregnancy. We report on a term neonate with closed ductus arteriosus, severe cardiomyopathy, right ventricular dysfunction, and functional stenosis of pulmonary arteries at birth after maternal self-medication with paracetamol and consumption of polyphenol-rich foods in late pregnancy. This drug, especially when associated with other vasoconstrictors (such as polyphenols), interferes with prostaglandin metabolism, which seriously accentuates the intrauterine ductus arteriosus constriction and leads to pharmacologic adverse events...
January 17, 2018: Pediatrics
https://www.readbyqxmd.com/read/29333220/outcomes-of-left-ventricular-function-according-to-treatment-response-for-a-patent-ductus-arteriosus-in-preterm-infants
#3
Soo Jung Kang, Young Sun Cho, Seo Jung Hwang, Hyo Jin Kim
Background: To evaluate the outcomes of left ventricular (LV) function according to treatment response for a hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. Methods: Echocardiograms of 21 preterm infants born at gestational age < 31 weeks obtained at term-equivalent age were retrospectively studied. Among preterm infants with a hsPDA, 9 underwent ligation after failure of pharmacological closure (ligation group) and 6 experienced successful pharmacological closure (medication group)...
December 2017: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/29331554/potential-role-of-transfontanelle-ultrasound-for-infants-undergoing-modified-blalock-taussig-shunt
#4
Eun-Hee Kim, Ji-Hyun Lee, In-Kyung Song, Hee-Soo Kim, Young-Eun Jang, Woong-Han Kim, Jae-Gun Kwak, Jin-Tae Kim
OBJECTIVE: Transfontanelle ultrasound is a noninvasive method for assessing cerebral blood flow in neonates and infants. The authors applied this technique as a point-of-care tool, before and after modified Blalock-Taussig shunt procedure, to evaluate cerebral perfusion. DESIGN: Retrospective, observational study. SETTING: Tertiary care children's hospital. PARTICIPANTS: Ten infants undergoing modified Blalock-Taussig shunt procedure...
December 11, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29313560/surgical-closure-of-patent-ductus-arteriosus-in-extremely-low-birth-weight-infants-less-than-750-grams
#5
Tomasz Stankowski, Sleiman Sebastian Aboulhassan, Dirk Fritzsche, Marcin Misterski, Jakub Marczak, Anna Szymańska, Lukasz Szarpak, Cyprian Augustyn, Romuald Cichoń, Bartłomiej Perek
BACKGROUND: Patent ductus arteriosus (PDA) occurs more frequently in premature infants. Depending on the degree of prematurity, these children often have other serious comorbidities that could significantly impact on surgical outcome. AIM: This study aimed to evaluate clinical results of the surgical ligation of PDA in extremely low body weight preterm infants with birth weight below 750 grams and to identify risk factors of mortality. METHODS: A total of 31 preterm infants with birth weight below 750 grams and significant PDA were operated between 2006 and 2016 through posterolateral thoracotomy (n=16) or with the use of video-assisted thoracoscopic (VATS) method (n = 15)...
January 9, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29306492/outcomes-of-surgical-ligation-after-unsuccessful-pharmacotherapy-for-patent-ductus-arteriosus-in-neonates-born-extremely-preterm
#6
Dany E Weisz, Lucia Mirea, Maura H F Resende, Linh Ly, Paige T Church, Edmond Kelly, S Joseph Kim, Amish Jain, Patrick J McNamara, Prakesh S Shah
A retrospective cohort study of neonates born extremely preterm with persistent patent ductus arteriosus after unsuccessful pharmacologic closure compared outcomes between 166 surgically ligated and 142 nonligated neonates. After adjustment for confounders, ligation was not associated with the composite outcome of death or neurodevelopmental impairment, neurodevelopmental impairment alone, chronic lung disease, or retinopathy of prematurity among survivors.
January 3, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29298359/compatibility-of-intravenous-ibuprofen-with-lipids-and-parenteral-nutrition-for-use-as-a-continuous-infusion
#7
Jowell Garcia, Alka Garg, Yunmei Song, Ambados Fotios, Chad Andersen, Sanjay Garg
There is increasing interest to administer ibuprofen as a continuous infusion instead of a traditional bolus for treating Patent Ductus Arteriosus (PDA). However, its compatibility data with commonly used drugs in the neonatal period, including parenteral nutrition (PN) and lipids is unavailable. The aim is to determine the compatibility of intravenous ibuprofen lysine with various ANZNN parenteral nutrition consensus group standard neonatal PN formulations and lipids. The PN and lipid solutions used in a tertiary neonatal unit were obtained...
2018: PloS One
https://www.readbyqxmd.com/read/29296069/tuberous-sclerosis-presenting-as-neonatal-cyanosis-because-of-rhabdomyoma-causing-tricuspid-valve-obstruction-needing-a-blalock-taussig-shunt
#8
Monther Obeidat, Yazan Qawasmeh, Hani Tarawneh, Ibrahim Sawalhah, Ala'a Tawalbeh
We report a newborn female baby who presented at 6 hours of age with cyanosis without any signs of respiratory distress. Cardiovascular and systemic examination was unremarkable apart from cyanosis (saturation 75%). An echocardiogram showed multiple echogenic and homogeneous masses in the interventricular septum, one of which was big and protruding through the tricuspid valve causing right ventricular inflow obstruction. There was a small atrial septal defect (ASD) shunting right to left and patent ductus arteriosus (PDA) shunting left to right...
January 2018: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/29295636/caffeine-prevents-bilirubin-induced-cytotoxicity-in-cultured-newborn-rat-astrocytes
#9
Mehmet Deliktaş, Hacer Ergin, Aydın Demiray, Hakan Akça, Özmert M A Özdemir, Mehmet Bülent Özdemir
OBJECTIVE: Unconjugated bilirubin (UCB) may cause neurotoxicity in preterm neonates due to immaturity of UGT1A1 leading to bilirubin accumulation in the brain. Caffeine used in the treatment of apnea of prematurity was reported to decrease mechanical ventilation requirement, the frequencies of bronchopulmonary dysplasia, patent ductus arteriosus, cerebral palsy and neurodevelopmental disorders in very low birth weight infants. However, the effect of caffeine on hyperbilirubinemia was not yet clarified...
January 2, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29290747/acetaminophen-for-patent-ductus-arteriosus-in-extremely-low-birth-weight-neonates
#10
Caitlyn M Luecke, Caren J Liviskie, Brandy N Zeller, Zachary A Vesoulis, Christopher McPherson
OBJECTIVE: Although non-steroidal anti-inflammatory drugs (NSAIDs) are the current standard therapy for the treatment of patent ductus arteriosus (PDA), many neonates have contraindications to receiving or may fail NSAID therapy. To avoid surgical ligation, these patients may benefit from an alternative therapy. The objective of this research is to report the efficacy and safety of acetaminophen for the treatment of PDA in a cohort of premature neonates. METHODS: Demographics and clinical course were retrospectively evaluated for all neonates admitted during the study period who received acetaminophen for the treatment of PDA...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29287141/isolated-coarctation-of-the-aorta-in-the-fetus-a-diagnostic-challenge
#11
Joshua A Kailin, Alexia B Santos, Betul Yilmaz Furtun, S Kristen Sexson Tejtel, Regina Lantin-Hermoso
Isolated coarctation of the aorta (CoA) is estimated by the Centers for Disease Control and Prevention to account for 4%-6% of all congenital heart disease (CHD) in the United States, with a reported prevalence of ~4 per 10 000 live births. Prenatal recognition of coarctation is important as it may improve neonatal survival and reduce morbidity. However, despite advances in imaging and the trend toward detailed aortic arch assessment as part of a comprehensive fetal echocardiogram, isolated CoA may still elude prenatal detection, with potentially lethal consequences if the diagnosis is not suspected and the patent ductus arteriosus (PDA) closes spontaneously in postnatal life...
December 2017: Echocardiography
https://www.readbyqxmd.com/read/29286939/clinical-profile-and-pattern-of-congenital-heart-disease-in-infants-of-diabetic-mother-and-infants-of-non-diabetic-mother-at-a-tertiary-care-hospital
#12
Suraiya Begum, Sanjoy Kumar Dey
OBJECTIVES: To assess the clinical manifestations and pattern of congenital heart diseases (CHD) in infants of diabetic mothers (IDMs) and infants of non-diabetic mothers. METHODS: A prospective cross sectional study was carried out at tertiary care center over a period of thirty months. All neonates were included in this study if CHD were identified by echocardiography within this study period. Chi-square test and Fisher's exact test were used to compare between groups...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29282094/nasal-high-flow-therapy-in-very-low-birth-weight-infants-with-mild-respiratory-distress-syndrome-a-single-center-experience
#13
Antonio Di Mauro, Manuela Capozza, Sergio Cotugno, Silvio Tafuri, Francesco Paolo Bianchi, Federico Schettini, Raffaella Panza, Nicola Laforgia
BACKGROUND: Pulmonary disorders and respiratory failure represent one of the most common morbidities of preterm newborns admitted to neonatal intensive care units (NICUs). The use of nasal high-flow therapy (nHFT) has been more recently introduced into the NICUs as a non-invasive respiratory (NIV) support. METHODS: We performed a retrospective study to evaluate safety and effectiveness of nHFT as primary support for infants born < 29 weeks of gestation and/or VLBW presenting with mild Respiratory Distress Syndrome (RDS)...
December 28, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29261723/shifting-the-boundaries-for-early-caffeine-initiation-in-neonatal-practice-results-of-a-prospective-multicenter-study-on-very-preterm-infants-with-respiratory-distress-syndrome
#14
Maria Katarzyna Borszewska-Kornacka, Roman Hożejowski, Magdalena Rutkowska, Ryszard Lauterbach
BACKGROUND: There is growing evidence that supports the benefits of early use of caffeine in preterm neonates with RDS; however, no formal recommendations specifying the exact timing of therapy initiation have been provided. OBJECTIVES: We compared neonatal outcomes in infants receiving early (initial dose on the 1st day of life) and late (initial dose on day 2+ of life) caffeine therapy. METHODS: Using data from a prospective, cohort study, we identified 986 infants ≤32 weeks' gestation with RDS and assessed the timing of caffeine therapy initiation, need for ventilatory support, mortality and incidence of typical complications of prematurity...
2017: PloS One
https://www.readbyqxmd.com/read/29243317/il-17-in-neonatal-health-and-disease
#15
Shelley M Lawrence, Jessica Lauren Ruoss, James L Wynn
Over the last few years, scientific interest in the cytokine IL-17A has intensified as its role in human health and disease has been elucidated. Discovered almost a quarter century ago, IL-17A is known to have poor biologic activity when acting alone, but attains robust actions when working synergistically with potent mediators of proinflammatory immune responses, such as IL-6 and IL-8. IL-17A is produced by specialized innate immune cells that protect host barriers from the outside world. Like sentries, these innate immune cells can "sound the alarm" through increased production of IL-17A, causing activation and recruitment of primed neutrophils and monocytes when pathogens escape initial host defenses...
December 15, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/29242415/bronchopulmonary-dysplasia-in-preterm-neonates-in-a-level-iii-neonatal-unit-in-india
#16
Savita Bhunwal, Kanya Mukhopadhyay, Shalmoli Bhattacharya, Pranab Dey, Lakhbir Kaur Dhaliwal
OBJECTIVE: To find out the incidence and associations of bronchopulmonary dysplasia (BPD) in preterm neonates. DESIGN: Prospective, observational. METHODS: All consecutively born neonates <33 weeks gestation requiring oxygen or respiratory support first 3 days of life were enrolled from a level III neonatal unit in Chandigarh, India. Those with malformations were excluded. Placenta was examined for histological chorioamnionitis in preterm rupture of membranes and/or preterm spontaneous onset of labour...
December 14, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/29239259/oral-paracetamol-versus-oral-ibuprofen-for-treatment-of-patent-ductus-arteriosus
#17
Manar Al-Lawama, Iyad Alammori, Tariq Abdelghani, Eman Badran
Objective This study was performed to investigate the safety and efficacy of oral paracetamol versus oral ibuprofen in the treatment of patent ductus arteriosus (PDA) in premature infants. Methods Premature infants with PDA with a gestational age of ≤32 weeks or birth weight of ≤1500 g were included in this randomized study. Results A total of 120 premature infants fulfilled the inclusion criteria. Of these 120 infants, 34 fulfilled the treatment criteria and 22 were finally randomized. We found no significant difference in the mortality or primary closure rates between the two groups...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29234596/exploring-the-multiple-hit-hypothesis-of-preterm-white-matter-damage-using-diffusion-mri
#18
Madeleine L Barnett, Nora Tusor, Gareth Ball, Andrew Chew, Shona Falconer, Paul Aljabar, Jessica A Kimpton, Nigel Kennea, Mary Rutherford, A David Edwards, Serena J Counsell
Background: Preterm infants are at high risk of diffuse white matter injury and adverse neurodevelopmental outcome. The multiple hit hypothesis suggests that the risk of white matter injury increases with cumulative exposure to multiple perinatal risk factors. Our aim was to test this hypothesis in a large cohort of preterm infants using diffusion weighted magnetic resonance imaging (dMRI). Methods: We studied 491 infants (52% male) without focal destructive brain lesions born at < 34 weeks, who underwent structural and dMRI at a specialist Neonatal Imaging Centre...
2018: NeuroImage: Clinical
https://www.readbyqxmd.com/read/29234148/quality-improvement-to-reduce-chronic-lung-disease-rates-in-very-low-birth-weight-infants-high-compliance-with-a-respiratory-care-bundle-in-a-small-nicu
#19
Zuzanna Kubicka, Eyad Zahr, Tamara Rousseau, Henry A Feldman, John Fiascone
OBJECTIVE: Reduce chronic lung disease by 10% among very-low birth weight infants by implementing a consistent respiratory care bundle. STUDY DESIGN: Prospective quality improvement study of infants below 32 weeks gestation in a small neonatal intensive care unit. A respiratory care bundle to eliminate inter-provider variability and minimize use of mechanical ventilation was implemented. This included: defining delivery room management with use of continuous positive airway pressure/nasal intermittent positive pressure ventilation, uniform intubation/extubation criteria, and standardizing ventilation/post-extubation support...
December 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29224772/resolution-of-vocal-fold-immobility-in-preterm-infants
#20
Jad Jabbour, Thomas Robey
INTRODUCTION: Vocal fold immobility (VFI) is an important sequela of preterm birth due to patent ductus arteriosus (PDA) ligation and invasive ventilation. A minority of these patients experience VFI resolution. The purpose of this study is to determine factors associated with VFI resolution in preterm infants. METHODS: This is a case control study of preterm (<37 weeks gestation) infants admitted to a metropolitan Level IV neonatal intensive care unit from 2006 to 2012...
December 2017: International Journal of Pediatric Otorhinolaryngology
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