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https://www.readbyqxmd.com/read/29791315/incidence-of-early-onset-sepsis-in-infants-born-to-women-with-clinical-chorioamnionitis
#1
Tara M Randis, Madeline Murguia Rice, Leslie Myatt, Alan T N Tita, Kenneth J Leveno, Uma M Reddy, Michael W Varner, John M Thorp, Brian M Mercer, Mara J Dinsmoor, Susan M Ramin, Marshall W Carpenter, Philip Samuels, Anthony Sciscione, Jorge E Tolosa, George Saade, Yoram Sorokin
OBJECTIVE: To determine the frequency of sepsis and other adverse neonatal outcomes in women with a clinical diagnosis of chorioamnionitis. METHODS: We performed a secondary analysis of a multi-center placebo-controlled trial of vitamins C/E to prevent preeclampsia in low risk nulliparous women. Clinical chorioamnionitis was defined as either the "clinical diagnosis" of chorioamnionitis or antibiotic administration during labor because of an elevated temperature or uterine tenderness in the absence of another cause...
May 23, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29789465/efficacy-safety-and-usability-of-remifentanil-as-premedication-for-insure-in-preterm-neonates
#2
Hadiyah Y Audil, Sara Tse, Chad Pezzano, Amy Mitchell-van Steele, Joaquim M B Pinheiro
Background : We previously reported a 67% extubation failure with INSURE (Intubation, Surfactant, Extubation) using morphine as analgosedative premedication. Remifentanil, a rapid- and short-acting narcotic, might be ideal for INSURE, but efficacy and safety data for this indication are limited. Objectives : To assess whether remifentanil premedication increases extubation success rates compared with morphine, and to evaluate remifentanil's safety and usability in a teaching hospital context. Methods : Retrospective review of remifentanil orders for premedication, at a large teaching hospital neonatal intensive care unit (NICU)...
May 22, 2018: Children
https://www.readbyqxmd.com/read/29789056/the-six-hour-window-how-the-community-hospital-nursery-can-optimize-outcomes-of-the-infant-with-suspected-hypoxic-ischemic-encephalopathy
#3
Dafina Ibrani, Shanon Molacavage
Perinatal hypoxia is a devastating event before, during, or immediately after birth that deprives an infant's vital organs of oxygen. This injury at birth often requires a complex resuscitation and increases the newborn's risk of hypoxic-ischemic encephalopathy (HIE). The resuscitation team in a community hospital nursery may have less experience with complex resuscitation and post-resuscitation care of this infant than a NICU. This article provides the neonatal nurse in a Level I or Level II nursery with information about resuscitation and post-resuscitation care of an infant at risk of HIE while awaiting transport to a NICU for therapeutic cooling...
May 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29789053/management-of-meconium-stained-newborns-in-the-delivery-room
#4
Chintan Kiritkumar Gandhi
The approach to the management of meconium-stained newborns in the delivery room has been changing for over 40 years. The goal is to prevent meconium aspiration syndrome (MAS) and complications related to MAS. For decades, airway obstruction was believed to be a major component of MAS and, consequently, suction maneuvers to remove meconium from the airways were recommended to decrease the frequency and severity of MAS. Initial recommendations were based on observational studies. However, the incidence of MAS and mortality related to MAS has declined since the 1970s, mostly because of a decrease in the number of postterm deliveries...
May 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29778994/heart-rate-changes-during-positive-pressure-ventilation-after-asphyxia-induced-bradycardia-in-a-porcine-model-of-neonatal-resuscitation
#5
Maria Liza Espinoza, Po-Yin Cheung, Tze-Fun Lee, Megan O'Reilly, Georg M Schmölzer
BACKGROUND: The Neonatal Resuscitation Program (NRP) states that if adequate positive pressure ventilation (PPV) was given for a low heart rate (HR), the infant's HR should increase within the first 15 s of PPV. OBJECTIVE: To assess changes in HR in piglets with asphyxia-induced bradycardia. METHODS: Term newborn piglets (n=30) were anaesthetised, intubated, instrumented and exposed to 50 min normocapnic hypoxia followed by asphyxia. Asphyxia was achieved by clamping the tube until severe bradycardia (defined as HR at <u><</u>25% of baseline)...
May 19, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29775039/update-on-neonatal-cardiopulmonary-resuscitation
#6
(no author information available yet)
An update of the national recommendations on neonatal resuscitation elaborated by the Neonatal Resuscitation Work Area of the Fetal-Neonatal Studies Committee (CEFEN) of the Argentine Society of Pediatrics (SAP) is presented. These recommendations are original and in their elaboration, we have taken into account the best available evidence gathered by the International Liaison Committee on Resuscitation (ILCOR) as well as an exhaustive review of publications and discussions in the area to define controversial issues...
June 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29773072/formal-procedure-to-facilitate-the-decision-to-withhold-or-withdraw-life-sustaining-interventions-in-a-neonatal-intensive-care-unit-a-seven-year-retrospective-study
#7
G Sorin, R Vialet, B Tosello
BACKGROUND: Neonatal deaths are often associated with the complex decision to limit or withdraw life-sustaining interventions (LSIs) rather than therapeutic impasses. Despite the existence of a law, significant disparities in clinical procedures remain. This study aimed to assess deaths occurring in a Neonatal Intensive Care Unit (NICU) and measure the impact of a traceable Limitation or Withdrawal of Active Treatment (LWAT) file on the treatment of these newborns. METHODS: In this monocentric retrospective study, we reviewed all consecutive neonatal deaths occurring during two three-year periods among patients in the NICU at the North Hospital of Marseille: cohort 1 (from 2009 to 2011 without the LWAT file) and cohort 2 (from 2013 to 2015 after introduction of the LWAT file)...
May 17, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29764391/practice-and-outcomes-of-neonatal-resuscitation-for-newborns-with-birth-asphyxia-at-kakamega-county-general-hospital-kenya-a-direct-observation-study
#8
Duncan N Shikuku, Benson Milimo, Elizabeth Ayebare, Peter Gisore, Gorrette Nalwadda
BACKGROUND: About three - quarters of all neonatal deaths occur during the first week of life, with over half of these occurring within the first 24 h after birth. The first minutes after birth are critical to reducing neonatal mortality. Successful neonatal resuscitation (NR) has the potential to prevent these perinatal mortalities related to birth asphyxia. This study described the practice of NR and outcomes of newborns with birth asphyxia in a busy referral hospital. METHODS: Direct observations of 138 NRs by 28 healthcare providers (HCPs) were conducted using a predetermined checklist adapted from the national pediatric resuscitation protocol...
May 15, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29758442/enhancing-knowledge-and-skills-through-the-delivery-of-a-bespoke-neonatal-resuscitation-training-programme-in-a-developing-country
#9
Faith Cm Kayembe Née Manyema, Jacqueline Wier
No abstract text is available yet for this article.
April 26, 2018: Midwifery
https://www.readbyqxmd.com/read/29757778/a-contemporary-analysis-of-medicolegal-issues-in-obstetric-anesthesia-between-2005-and-2015
#10
Vesela P Kovacheva, Ethan Y Brovman, Penny Greenberg, Ellen Song, Arvind Palanisamy, Richard D Urman
BACKGROUND: Detailed reviews of closed malpractice claims have provided insights into the most common events resulting in litigation and helped improve anesthesia care. In the past 10 years, there have been multiple safety advancements in the practice of obstetric anesthesia. We investigated the relationship among contributing factors, patient injuries, and legal outcome by analyzing a contemporary cohort of closed malpractice claims where obstetric anesthesiology was the principal defendant...
May 10, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29755962/acceptability-of-bedside-resuscitation-with-intact-umbilical-cord-to-clinicians-and-patients-families-in-the-united-states
#11
Anup C Katheria, Samuel R Sorkhi, Kasim Hassen, Arij Faksh, Zahra Ghorishi, Debra Poeltler
Background: While delayed umbilical cord clamping in preterm infants has shown to improve long-term neurological outcomes, infants who are thought to need resuscitation do not receive delayed cord clamping even though they may benefit the most. A mobile resuscitation platform allows infants to be resuscitated at the mother's bedside with the cord intact. The newborn is supplied with placental blood during the resuscitation in view of the mother. The objective of the study is to assess the usability and acceptability of mobile resuscitation platform, LifeStart trolley, among the infants' parents and perinatal providers...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29754417/teaching-paediatric-basic-life-support-in-medical-schools-using-peer-teaching-or-video-demonstration-a-prospective-randomised-trial
#12
Frederik Stephan, Hanjo Groetschel, Anja K Büscher, Deniz Serdar, Kjell A Groes, Rainer Büscher
AIM: The outcome of children with an out-of-hospital cardiac arrest is still poor, but bystander cardiopulmonary resuscitation can increase survival and minimise severe neurological sequelae. While teaching basic life support is standardised in emergency medicine classes, paediatric basic life support (PBLS) in neonates and toddlers is under-represented in paediatric curricula during university education. The appropriate mixture of E-learning and peer teaching lessons remains controversial in teaching paediatric basic skills...
May 13, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29748228/how-to-use-saturation-monitoring-in-newborns
#13
Steven McVea, Michael McGowan, Bharathi Rao
Pulse oximetry is a first-line monitoring tool, used in neonatal medicine routinely as a part of continuous monitoring during intensive care. It is also used to guide response to resuscitation and as a screening tool for congenital heart disease. Despite its widespread use, many healthcare providers are unaware of the underlying principles and limitations of pulse oximetry in neonates. In this article, we will discuss the physiological and technological principles behind the use of saturation monitoring and its use in neonatal practice...
May 10, 2018: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29747889/oxygen-therapy-in-the-delivery-room-what-is-the-right-dose
#14
REVIEW
Vishal Kapadia, Myra H Wyckoff
Oxygen is the most commonly used medicine used during neonatal resuscitation in the delivery room. Oxygen therapy in delivery room should be used judiciously to avoid oxygen toxicity while delivering sufficient oxygen to prevent hypoxia. Measurement of appropriate oxygenation relies on pulse oximetry, but adequate ventilation and perfusion are equally important for oxygen delivery. In this article, we review oxygenation while transitioning from fetal to neonatal life, the importance of appropriate oxygen therapy, its measurement in the delivery room, and current recommendations for oxygen therapy and its limitations...
June 2018: Clinics in Perinatology
https://www.readbyqxmd.com/read/29740194/opinions-of-israeli-neonatologists-about-life-and-death-decisions-in-neonates
#15
Moshe Y Kasirer, Francis B Mimouni, Alona Bin-Nun, Michael S Schimmel
BACKGROUND: In 2005, the Israeli parliament passed the "law of dying patients" legalizing life and death decisions (do not resuscitate) in patients with life expectancy less than 6 months. OBJECTIVE: To determine whether ethnic and religious backgrounds (both religion and religiosity) influence neonatologists' attitudes in simulated clinical situations and opinions about the new law. DESIGN/METHODS: Prospective design, using standard questionnaire sent to all 155 board-certified practising Israeli Neonatologists...
May 8, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29734128/obstetric-and-perinatal-health-outcomes-related-to-schizophrenia-a-national-register-based-follow-up-study-among-finnish-women-born-between-1965-and-1980-and-their-offspring
#16
Laura Simoila, Erkki Isometsä, Mika Gissler, Jaana Suvisaari, Erja Halmesmäki, Nina Lindberg
BACKGROUND: This national register-based study assesses obstetric and perinatal health outcomes in women with schizophrenia and their offspring. METHODS: Using the Care Register for Health Care, we identified Finnish women who were born in 1965- 1980 and diagnosed with schizophrenia. For each case, five age- and place-of-birth- matched controls were obtained from the Central Population Register of Finland. They were followed from the day when the disorder was diagnosed in specialized health-care (the index day) until 31...
May 4, 2018: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/29713811/timing-and-documentation-of-key-events-in-neonatal-resuscitation
#17
Adam Charles Heathcote, Jacqueline Jones, Paul Clarke
Only a minority of babies require extended resuscitation at birth. Resuscitations concerning babies who die or who survive with adverse outcomes are increasingly subject to medicolegal scrutiny. Our aim was to describe real-life timings of key resuscitation events observed in a historical series of newborns who required full resuscitation at birth. Twenty-seven babies born in our centre over a 10-year period had an Apgar score of 0 at 1 min and required full resuscitation. The median (95% confidence interval) postnatal age at achieving key events were commencing cardiac compressions, 2...
April 30, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29705089/effective-ventilation-the-most-critical-intervention-for-successful-delivery-room-resuscitation
#18
REVIEW
Elizabeth E Foglia, Arjan B Te Pas
Lung aeration is the critical first step that triggers the transition from fetal to postnatal cardiopulmonary physiology after birth. When an infant is apneic or does not breathe sufficiently, intervention is needed to support this transition. Effective ventilation is therefore the cornerstone of neonatal resuscitation. In this article, we review the physiology of cardiopulmonary transition at birth, with particular attention to factors the caregiver should consider when providing ventilation. We then summarize the available clinical evidence for strategies to monitor and perform positive pressure ventilation in the delivery room setting...
April 17, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29702710/neonatal-morbidities-among-moderately-preterm-infants-with-and-without-exposure-to-antenatal-corticosteroids
#19
Sanjay Chawla, Girija Natarajan, Dhuly Chowdhury, Abhik Das, Michele Walsh, Edward F Bell, Abbot R Laptook, Krisa Van Meurs, Carl T D'Angio, Barbara J Stoll, Sara B DeMauro, Seetha Shankaran
OBJECTIVE:  We aimed to compare the rates of "surfactant treated respiratory disease" and other neonatal morbidities among moderately preterm (MPT) infants exposed to no, partial, or a complete course of antenatal corticosteroids (ANS). STUDY DESIGN:  This observational cohort study evaluated MPT infants (290/7 -336/7 weeks' gestational age), born between January 2012 and November 2013 and enrolled in the "MPT Registry" of the National Institute of Child Health and Human Development Neonatal Research Network...
April 27, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29702709/neonatal-outcomes-based-on-duration-of-exposure-to-antenatal-corticosteroids-in-indicated-preterm-deliveries
#20
Chase R Cawyer, Spencer G Kuper, Lisa A Dimperio, Alan T Tita, Joseph R Biggio, Lorie M Harper
OBJECTIVE:  To evaluate how duration of exposure to antenatal corticosteroids (ACSs) prior to delivery affects neonatal outcomes in indicated preterm deliveries. STUDY DESIGN:  This is a retrospective cohort of all indicated singleton preterm deliveries (23-34 weeks) in a single tertiary center from 2011 to 2014 comparing those who received ACS 2 to 7 days versus >7 days prior to delivery. The primary neonatal outcome was a composite of arterial cord pH < 7 or base excess ≤ 12, 5-minute Apgar ≤ 3, cardiopulmonary resuscitation, culture-proven neonatal sepsis, intraventricular hemorrhage grade III/IV, necrotizing enterocolitis, and neonatal death...
April 27, 2018: American Journal of Perinatology
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