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https://www.readbyqxmd.com/read/28446386/caffeine-citrate-is-it-a-silver-bullet-in-neonatology
#1
REVIEW
Bikash Shrestha, Gaurav Jawa
Caffeine citrate is one of the most prescribed drug in the present day NICU for apnea. Its efficacy, tolerability, wide therapeutic index and safety margin has made it the drug of choice among the methylxanthines. Its therapeutic uses in apnea of prematurity, mechanical ventilation, bronchopulmonary dysplasia has made it a "silver bullet" in neonatology. However, there are still controversies surrounding this drug. This review is aimed to update the reader about the basic pharmacology, current therapeutic uses, adverse effects, controversies as well as present and future research of caffeine...
March 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28503300/how-to-decrease-bronchopulmonary-dysplasia-in-your-neonatal-intensive-care-unit-today-and-tomorrow
#2
REVIEW
Leif D Nelin, Vineet Bhandari
Bronchopulmonary dysplasia, or BPD, is the most common chronic lung disease in infants. Genetic predisposition and developmental vulnerability secondary to antenatal and postnatal infections, compounded with exposure to hyperoxia and invasive mechanical ventilation to an immature lung, result in persistent inflammation, culminating in the characteristic pulmonary phenotype of BPD of impaired alveolarization and dysregulated vascularization. In this article, we highlight specific areas in current management, and speculate on therapeutic strategies that are on the horizon, that we believe will make an impact in decreasing the incidence of BPD in your neonatal intensive care units...
2017: F1000Research
https://www.readbyqxmd.com/read/28389438/management-and-investigation-of-neonatal-encephalopathy-2017-update
#3
Kathryn Martinello, Anthony R Hart, Sufin Yap, Subhabrata Mitra, Nicola J Robertson
This review discusses an approach to determining the cause of neonatal encephalopathy, as well as current evidence on resuscitation and subsequent management of hypoxic-ischaemic encephalopathy (HIE). Encephalopathy in neonates can be due to varied aetiologies in addition to hypoxic-ischaemia. A combination of careful history, examination and the judicious use of investigations can help determine the cause. Over the last 7 years, infants with moderate to severe HIE have benefited from the introduction of routine therapeutic hypothermia; the number needed to treat for an additional beneficial outcome is 7 (95% CI 5 to 10)...
July 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28006936/pathophysiology-of-perinatal-hypoxic-ischemic-encephalopathy-biomarkers-animal-models-and-treatment-perspectives
#4
V Riljak, J Kraf, A Daryanani, P Jiruška, J Otáhal
Hypoxic-ischemic encephalopathy (HIE) is one of the leading pediatric neurological conditions causing long-term disabilities and socio-economical burdens. Nearly 20-50 % of asphyxiated newborns with HIE die within the newborn period and another third will develop severe health consequences and permanent handicaps. HIE is the result of severe systemic oxygen deprivation and reduced cerebral blood flow, commonly occurring in full-term infants. Hypoxic-ischemic changes trigger several molecular and cellular processes leading to cell death and inflammation...
December 22, 2016: Physiological Research
https://www.readbyqxmd.com/read/28331629/congenital-diaphragmatic-hernia-a-review
#5
REVIEW
Praveen Kumar Chandrasekharan, Munmun Rawat, Rajeshwari Madappa, David H Rothstein, Satyan Lakshminrusimha
Congenital Diaphragmatic hernia (CDH) is a condition characterized by a defect in the diaphragm leading to protrusion of abdominal contents into the thoracic cavity interfering with normal development of the lungs. The defect may range from a small aperture in the posterior muscle rim to complete absence of diaphragm. The pathophysiology of CDH is a combination of lung hypoplasia and immaturity associated with persistent pulmonary hypertension of newborn (PPHN) and cardiac dysfunction. Prenatal assessment of lung to head ratio (LHR) and position of the liver by ultrasound are used to diagnose and predict outcomes...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/27432850/observed-effectiveness-of-palivizumab-for-29-36-week-gestation-infants
#6
Harold J Farber, Frederick J Buckwold, Barry Lachman, J Scott Simpson, Ernest Buck, Matha Arun, Adolfo M Valadez, Teresa Ruiz, Joy Alonzo, Andrea Henry, Nneka Cos-Okpalla, Kelsey Nguyen, William Brendel, James Small, William Brendle Glomb
BACKGROUND: Respiratory syncytial virus (RSV) is a common reason for hospitalization of infants. In clinical trials, palivizumab reduced RSV hospitalization rates for premature infants. The 2014 American Academy of Pediatrics clinical practice guideline advised against use of palivizumab for otherwise healthy infants ≥29 weeks' gestation. The aim of this study was to determine the effect of palivizumab administration on hospitalization rates for RSV and bronchiolitis without RSV diagnosis among infants 29 to 36 weeks' gestation who do not have chronic illness...
August 2016: Pediatrics
https://www.readbyqxmd.com/read/28167094/international-consensus-guidelines-for-the-diagnosis-and-management-of-food-protein-induced-enterocolitis-syndrome-executive-summary-workgroup-report-of-the-adverse-reactions-to-foods-committee-american-academy-of-allergy-asthma-immunology
#7
Anna Nowak-Węgrzyn, Mirna Chehade, Marion E Groetch, Jonathan M Spergel, Robert A Wood, Katrina Allen, Dan Atkins, Sami Bahna, Ashis V Barad, Cecilia Berin, Terri Brown Whitehorn, A Wesley Burks, Jean-Christoph Caubet, Antonella Cianferoni, Marisa Conte, Carla Davis, Alessandro Fiocchi, Kate Grimshaw, Ruchi Gupta, Brittany Hofmeister, J B Hwang, Yitzhak Katz, George N Konstantinou, Stephanie A Leonard, Jennifer Lightdale, Sean McGhee, Sami Mehr, Stefano Miceli Sopo, Giovanno Monti, Antonella Muraro, Stacey Katherine Noel, Ichiro Nomura, Sally Noone, Hugh A Sampson, Fallon Schultz, Scott H Sicherer, Cecilia C Thompson, Paul J Turner, Carina Venter, A Amity Westcott-Chavez, Matthew Greenhawt
Food protein-induced enterocolitis (FPIES) is a non-IgE cell- mediated food allergy that can be severe and lead to shock. Despite the potential seriousness of reactions, awareness of FPIES is low; high-quality studies providing insight into the pathophysiology, diagnosis, and management are lacking; and clinical outcomes are poorly established. This consensus document is the result of work done by an international workgroup convened through the Adverse Reactions to Foods Committee of the American Academy of Allergy, Asthma & Immunology and the International FPIES Association advocacy group...
April 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/25220130/evaluation-and-management-of-thrombocytopenic-neonates-in-the-intensive-care-unit
#8
REVIEW
Antonio Del Vecchio
Thrombocytopenia is a very frequent problem among sick neonates, affecting up to 35% of all infants admitted to the neonatal intensive care unit (NICU), and serves as an important indicator of multiple clinical conditions. The cause of the thrombocytopenia is unclear in up to 60% of affected neonates. A clinical classification of thrombocytopenia is based on the time of presentation, early (≤72 hours of life) vs. late (>72 hours of life). Early thrombocytopenia is commonly associated with feto-maternal conditions, is most commonly caused by disorders associated with placental insufficiency, and is generally mild to moderate and resolves spontaneously within 7-10 days without any intervention...
September 2014: Early Human Development
https://www.readbyqxmd.com/read/25301082/neonatal-thrombocytopenia-and-platelet-transfusion-a-uk-perspective
#9
REVIEW
Robert Carr, Anne M Kelly, Lorna M Williamson
Five percent of newborn infants admitted to UK neonatal units during a recent study developed a platelet count <60 × 10(9)/l, and 60% of these were transfused platelets. This review summarises the common causes and mechanisms of thrombocytopenia in the newborn. Relevant evidence relating the platelet count to the risk of haemorrhage is reviewed, and current UK guidance on transfusion thresholds outlined. The UK policy for the provision of platelets for transfusion to neonates is described, including the particular requirements for neonatal allo-immune thrombocytopenia...
2015: Neonatology
https://www.readbyqxmd.com/read/21950766/how-i-manage-neonatal-thrombocytopenia
#10
REVIEW
Subarna Chakravorty, Irene Roberts
Although neonatal thrombocytopenia (platelet count < 150×10(9) /l) is a common finding in hospital practice, a careful clinical history and examination of the blood film is often sufficient to establish the diagnosis and guide management without the need for further investigations. In preterm neonates, early-onset thrombocytopenia (<72h) is usually secondary to antenatal causes, has a characteristic pattern and resolves without complications or the need for treatment. By contrast, late-onset thrombocytopenia in preterm neonates (>72h) is nearly always due to post-natally acquired bacterial infection and/or necrotizing enterocolitis, which rapidly leads to severe thrombocytopenia (platelet count<50×10(9) /l)...
January 2012: British Journal of Haematology
https://www.readbyqxmd.com/read/18433954/thrombocytopenia-in-the-neonate
#11
REVIEW
Irene Roberts, Simon Stanworth, Neil A Murray
Thrombocytopenia is one of the commonest haematological problems in neonates, affecting at least 25% of all admissions to neonatal intensive care units (NICUs) [Murray NA, Howarth LJ, McCloy MP et al. Platelet transfusion in the management of severe thrombocytopenia in neonatal intensive care unit patients. Transfus Med 2002;12:35-41; Garcia MG, Duenas E, Sola MC et al. Epidemiologic and outcome studies of patients who received platelet transfusions in the neonatal intensive care unit. J Perinatol 2001;21:415-20; Del Vecchio A, Sola MC, Theriaque DW et al...
July 2008: Blood Reviews
https://www.readbyqxmd.com/read/26216323/thrombocytopenia-in-small-for-gestational-age-infants
#12
Robert D Christensen, Vickie L Baer, Erick Henry, Gregory L Snow, Allison Butler, Martha C Sola-Visner
BACKGROUND: Thrombocytopenia is common among small-for-gestational-age (SGA) neonates (birth weight <10th percentile reference range), but several aspects of this thrombocytopenia are unclear, including the incidence, typical nadir, duration, association with preeclampsia, mechanism, and risk of death. METHODS: Using 9 years of multihospital records, we studied SGA neonates with ≥2 platelet counts <150,000/μL in their first week. RESULTS: We found first-week thrombocytopenia in 31% (905 of 2891) of SGA neonates versus 10% of non-SGA matched controls (P < ...
August 2015: Pediatrics
https://www.readbyqxmd.com/read/27150977/higher-or-lower-oxygen-for-delivery-room-resuscitation-of-preterm-infants-below-28-completed-weeks-gestation-a-meta-analysis
#13
REVIEW
Ju Lee Oei, Maximo Vento, Yacov Rabi, Ian Wright, Neil Finer, Wade Rich, Vishal Kapadia, Dagfinn Aune, Denise Rook, William Tarnow-Mordi, Ola D Saugstad
OBJECTIVE: To systematically review outcomes of infants ≤28+6 weeks gestation randomised to resuscitation with low (≤0.3) vs high (≥0.6) fraction of inspired oxygen (FiO2) at delivery. DESIGN: Systematic review of randomised controlled trials of low (≤0.3) vs high (≥0.6) FiO2 resuscitation. Information was obtained from databases (Medline/Pub Med, EMBASE, ClinicalTrials.gov, Cochrane) and meeting abstracts between 1990 to 2015. Search index terms: preterm/ resuscitation/oxygen...
January 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28196933/can-i-stop-phototherapy-for-this-baby
#14
Ian M Paul, M Jeffrey Maisels
No abstract text is available yet for this article.
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28196365/the-golden-age-of-probiotics-a-systematic-review-and-meta-analysis-of-randomized-and-observational-studies-in-preterm-infants
#15
Elda Dermyshi, Yizhong Wang, Chongbin Yan, Wenchao Hong, Gang Qiu, Xiaohui Gong, Ting Zhang
BACKGROUND: Over the last few years, probiotics have been one of the most studied interventions in neonatal medicine. OBJECTIVES: The aim of this work was to analyse all studies (randomized controlled trials, RCTs, and observational studies) assessing the use of probiotics in very low birth weight (VLBW) preterm infants. SEARCH METHODS: A systematic literature search was conducted using PubMed, Embase, Cochrane Library, and Web of Science...
2017: Neonatology
https://www.readbyqxmd.com/read/28193791/epinephrine-for-first-aid-management-of-anaphylaxis
#16
Scott H Sicherer, F Estelle R Simons
Anaphylaxis is a severe, generalized allergic or hypersensitivity reaction that is rapid in onset and may cause death. Epinephrine (adrenaline) can be life-saving when administered as rapidly as possible once anaphylaxis is recognized. This clinical report from the American Academy of Pediatrics is an update of the 2007 clinical report on this topic. It provides information to help clinicians identify patients at risk of anaphylaxis and new information about epinephrine and epinephrine autoinjectors (EAs). The report also highlights the importance of patient and family education about the recognition and management of anaphylaxis in the community...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/27940508/persistent-pulmonary-hypertension-of-the-newborn-in-late-preterm-and-term-infants-in-california
#17
Martina A Steurer, Laura L Jelliffe-Pawlowski, Rebecca J Baer, J Colin Partridge, Elizabeth E Rogers, Roberta L Keller
BACKGROUND AND OBJECTIVES: There are limited epidemiologic data on persistent pulmonary hypertension of the newborn (PPHN). We sought to describe the incidence and 1-year mortality of PPHN by its underlying cause, and to identify risk factors for PPHN in a contemporary population-based dataset. METHODS: The California Office of Statewide Health Planning and Development maintains a database linking maternal and infant hospital discharges, readmissions, and birth and death certificates from 1 year before to 1 year after birth...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/28131321/neonatal-pain-management
#18
Brian S Carter, Jessica Brunkhorst
Pain management in the neonatal ICU remains challenging for many clinicians and in many complex care circumstances. The authors review general pain management principles and address the use of pain scales, non-pharmacologic management, and various agents that may be useful in general neonatal practice, procedurally, or at the end of life. Chronic pain and neonatal abstinence are also noted.
March 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/26960919/extubating-extremely-preterm-infants-predictors-of-success-and-outcomes-following-failure
#19
RANDOMIZED CONTROLLED TRIAL
Brett J Manley, Lex W Doyle, Louise S Owen, Peter G Davis
OBJECTIVES: To identify variables that predict extubation success in extremely preterm infants born <28 weeks gestational age (GA), and to compare outcomes between those who had successful or failed extubation. STUDY DESIGN: A secondary analysis of data from a randomized trial of postextubation respiratory support that included 174 extremely preterm infants. "Extubation success" was defined as not requiring reintubation within 7 days, and "extubation failure" the converse...
June 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28125815/patent-ductus-arteriosus-treatment-in-very-preterm-infants-a-european-population-based-cohort-study-epice-on-variation-and-outcomes
#20
Anna-Karin Edstedt Bonamy, Anna Gudmundsdottir, Rolf F Maier, Liis Toome, Jennifer Zeitlin, Mercedes Bonet, Alan Fenton, Asbjørn Børch Hasselager, Arno van Heijst, Ludwig Gortner, David Milligan, Patrick Van Reempts, Elaine M Boyle, Mikael Norman
BACKGROUND: Spontaneous closure of patent ductus arteriosus (PDA) occurs frequently in very preterm infants and despite the lack of evidence for treatment benefits, treatment for PDA is common in neonatal medicine. OBJECTIVES: The aim of this work was to study regional variations in PDA treatment in very preterm infants (≤31 weeks of gestation), its relation to differences in perinatal characteristics, and associations with bronchopulmonary dysplasia (BPD) and survival without major neonatal morbidity...
2017: Neonatology
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