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David G Sweet, Virgilio Carnielli, Gorm Greisen, Mikko Hallman, Eren Ozek, Richard Plavka, Ola Didrik Saugstad, Umberto Simeoni, Christian P Speer, Máximo Vento, Gerard H A Visser, Henry L Halliday
Advances in the management of respiratory distress syndrome (RDS) ensure that clinicians must continue to revise current practice. We report the third update of the European Guidelines for the Management of RDS by a European panel of expert neonatologists including input from an expert perinatal obstetrician based on available literature up to the beginning of 2016. Optimizing the outcome for babies with RDS includes consideration of when to use antenatal steroids, and good obstetric practice includes methods of predicting the risk of preterm delivery and also consideration of whether transfer to a perinatal centre is necessary and safe...
September 21, 2016: Neonatology
David H Adamkin
A consistent definition for neonatal hypoglycemia in the first 48 h of life continues to elude us. Enhanced understanding of metabolic disturbances and genetic disorders that underlie alterations in postnatal glucose homeostasis has added useful information to understanding transitional hypoglycemia. This growth in knowledge still has not led to what we need to know: "How low is too low and for how long?" This article reviews the current state of understanding of neonatal hypoglycemia and how different approaches reach different "expert" opinions...
September 4, 2016: Seminars in Fetal & Neonatal Medicine
A L Solevåg, T-F Lee, M Lu, G M Schmölzer, P-Y Cheung
OBJECTIVE: To determine the distending pressure needed to achieve sufficient tidal volume (VT) delivery during continuous chest compressions (CC) superimposed by sustained inflation (SI) (CC+SI). DESIGN: Randomised animal/manikin trial. SETTING: University laboratory. SUBJECTS: Cadaver piglets/manikin. INTERVENTIONS: SI distending pressures of 5, 10, 15, 20, 25 and 30 cm H2O were delivered in random order during CC+SI for 2 min each...
August 26, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Dan Stewart, William Benitz
Postpartum infections remain a leading cause of neonatal morbidity and mortality worldwide. A high percentage of these infections may stem from bacterial colonization of the umbilicus, because cord care practices vary in reflection of cultural traditions within communities and disparities in health care practices globally. After birth, the devitalized umbilical cord often proves to be an ideal substrate for bacterial growth and also provides direct access to the bloodstream of the neonate. Bacterial colonization of the cord not infrequently leads to omphalitis and associated thrombophlebitis, cellulitis, or necrotizing fasciitis...
September 2016: Pediatrics
Thomas Alderliesten, Linda S de Vries, Liza Staats, Ingrid C van Haastert, Lauren Weeke, Manon J N L Benders, Corine Koopman-Esseboom, Floris Groenendaal
BACKGROUND: Previous studies have demonstrated the association of abnormalities on diffusion-weighted MRI (DW-MRI) and proton magnetic resonance spectroscopy ((1)H-MRS) in infants with perinatal asphyxia. The use of therapeutic hypothermia might change this association. AIM: To study the association between DW-MRI and (1)H-MRS and outcome after perinatal asphyxia and therapeutic hypothermia in infants with a gestational age of ≥36 weeks. PATIENTS AND METHODS: Infants with perinatal asphyxia and therapeutic hypothermia (n=88) were included when an MR examination was performed within 7 days after birth...
August 23, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Jane M Hawdon, Jeanette Beer, Deborah Sharp, Michele Upton
OBJECTIVES: Neonatal hypoglycaemia is a potential cause of neonatal morbidity, and on rare but tragic occasions causes long-term neurodevelopmental harm with consequent emotional and practical costs for the family. The organisational cost to the NHS includes the cost of successful litigation claims. The purpose of the review was to identify themes that could alert clinicians to common pitfalls and thus improve patient safety. DESIGN: The NHS Litigation Authority (NHS LA) Claims Management System was reviewed to identify and review 30 claims for injury secondary to neonatal hypoglycaemia, which were notified to the NHS LA between 2002 and 2011...
August 23, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Sadaf I Bhayat, Harsha M S Gowda, Michael Eisenhut
AIM: To determine if dopamine is effective in treating neonatal hypotension and safe to use comparing to other inotropes. METHODS: This is a review of evidence on inotropic treatment of neonatal hypotension. Databases searched were MEDLINE and the Cochrane Library, a total of 134 studies were identified. Only studies with high quality evidence (level 1a and b and 2a) were included. After review, only eight studies were included in the final analysis. Pooled risk ratios derived for each outcome [Mantel-Haenzel (M-H) fixed effect] with CI, as reported in the Cochrane reviews were plotted in forest plot form...
May 8, 2016: World Journal of Clinical Pediatrics
Rima Fawaz, Ulrich Baumann, Udeme Ekong, Björn Fischler, Nedim Hadzic, Cara L Mack, Valérie A McLin, Jean P Molleston, Ezequiel Neimark, Vicky Lee Ng, Saul J Karpen
Cholestatic jaundice in infancy affects approximately 1 in every 2500 term infants and is infrequently recognized by primary providers in the setting of physiologic jaundice. Cholestatic jaundice is always pathologic and indicates hepatobiliary dysfunction. Early detection by the primary care physician and timely referrals to the pediatric gastroenterologist/hepatologist are important contributors to optimal treatment and prognosis. The most common causes of cholestatic jaundice in the first months of life are biliary atresia (BA, 25-40%) followed by an expanding list of monogenic disorders (25%), plus many unknown or multifactorial (e...
July 16, 2016: Journal of Pediatric Gastroenterology and Nutrition
Siddarth Ramji
No abstract text is available yet for this article.
September 2015: Indian Pediatrics
K Nagel, R Tuckuviene, B Paes, A K Chan
BACKGROUND: Neonatal aortic thrombosis is a rare occurrence, but can be fatal. Treatment of this condition is hampered by the lack of large studies involving this pediatric population. Reporting of this condition is also not standardized. METHODS: The purpose of this review is to collate available literature on the incidence, risk factors, presentation, treatment and outcome of neonatal aortic thrombosis as well as suggest a treatment model. RESULTS: A Medline search of PubMed, OVID and Cochrane databases was undertaken using the key words "neonatal", "infant", "aorta", "aortic", "thrombosis", "thrombus" and "clot"...
May 2010: Klinische Pädiatrie
Jill Baley
“Kangaroo mother care” was first described as an alternative method of caring for low birth weight infants in resource-limited countries, where neonatal mortality and infection rates are high because of overcrowded nurseries, inadequate staffing, and lack of equipment. Intermittent skin-to-skin care (SSC), a modified version of kangaroo mother care, is now being offered in resource-rich countries to infants needing neonatal intensive care, including those who require ventilator support or are extremely premature...
September 2015: Pediatrics
Paal Helge Haakonsen Lindenskov, Albert Castellheim, Ola Didrik Saugstad, Tom Eirik Mollnes
Does meconium cause meconium aspiration syndrome (MAS) or is meconium discharge only a marker of fetal hypoxia? This dispute has lasted for centuries, but since the 1960s, detrimental effects of meconium itself on the lungs have been demonstrated in animal experiments. In clinical MAS, persistent pulmonary hypertension of the newborn is the leading cause of death in MAS. Regarding the complex chemical composition of meconium, it is difficult to identify a single agent responsible for the pathophysiology. However, considering that meconium is stored in the intestines, partly unexposed to the immune system, aspirated meconium could be recognized as ‘danger', representing damaged self...
2015: Neonatology
Tore Curstedt, Henry L Halliday, Mikko Hallman, Ola D Saugstad, Christian P Speer
No abstract text is available yet for this article.
2015: Neonatology
Mikko Hallman
Antenatal glucocorticoid has proven to be one of the most successful single therapeutic approaches for preventing serious consequences after preterm birth. The fetal compartment is protected against endogenous corticosteroid by the high endogenous 11β-hydroxysteroid dehydrogenase type 2 that converts cortisol to cortisone and by the poor responsiveness of the fetal hypothalamus to corticotropin-releasing hormone. High corticosteroid activity acutely enhances the functional maturity of the fetus. Persistently high fetal glucocorticoid activity has adverse effects on the growth and differentiation of the fetal brain and other organs...
2015: Neonatology
Dirk Bassler
Survival of extremely preterm infants has increased over recent years, but bronchopulmonary dysplasia (BPD) remains a major cause of morbidity. In the USA, BPD is the most common chronic respiratory disorder of infancy and affects the pulmonary and overall health of 10,000 preterm infants annually. Preclinical and clinical studies suggest a crucial role for lung inflammation and host immune response in the pathogenesis of BPD. Inflammation may result from, amongst others, chorioamnionitis, postnatal infection, ventilation, and the administration of oxygen...
2015: Neonatology
Ola Didrik Saugstad
Delivery room management, especially in the first 'golden' minute, is of the utmost importance. An exact and universal definition of when a baby is born is needed to obtain agreement on what is meant by the first minute of life. Education of young girls is a basic requirement to optimize the health of the mother and baby. Interventions in pregnancy should as far as possible be evidence based. Antenatal care, the selection of birth mode and antenatal steroid therapy when indicated also contribute to obtaining the best outcome...
2015: Neonatology
Deborah L Harris, Philip J Weston, Matthew Signal, J Geoffrey Chase, Jane E Harding
BACKGROUND: Neonatal hypoglycaemia is common, and a preventable cause of brain damage. Dextrose gel is used to reverse hypoglycaemia in individuals with diabetes; however, little evidence exists for its use in babies. We aimed to assess whether treatment with dextrose gel was more effective than feeding alone for reversal of neonatal hypoglycaemia in at-risk babies. METHODS: We undertook a randomised, double-blind, placebo-controlled trial at a tertiary centre in New Zealand between Dec 1, 2008, and Nov 31, 2010...
December 21, 2013: Lancet
Sanja Zivanovic, Janet Peacock, Mireia Alcazar-Paris, Jessica W Lo, Alan Lunt, Neil Marlow, Sandy Calvert, Anne Greenough
BACKGROUND: Results from an observational study involving neonates suggested that high-frequency oscillatory ventilation (HFOV), as compared with conventional ventilation, was associated with superior small-airway function at follow-up. Data from randomized trials are needed to confirm this finding. METHODS: We studied 319 adolescents who had been born before 29 weeks of gestation and had been enrolled in a multicenter, randomized trial that compared HFOV with conventional ventilation immediately after birth...
March 20, 2014: New England Journal of Medicine
Yacov Rabi, Nalini Singhal, Alberto Nettel-Aguirre
OBJECTIVE: We conducted a blinded, prospective, randomized control trial to determine which oxygen-titration strategy was most effective at achieving and maintaining oxygen saturations of 85% to 92% during delivery-room resuscitation. METHODS: Infants born at 32 weeks' gestation or less were resuscitated either with a static concentration of 100% oxygen (high-oxygen group) or using an oxygen-titration strategy starting from a concentration of 100% (moderate-oxygen group), or 21% oxygen (low-oxygen group)...
August 2011: Pediatrics
Shahnaz Pourarian, Faranak Takmil, Sirous Cheriki, Hamid Amoozgar
OBJECTIVE: The aim of this study is to compare the efficacy and possible adverse effects of the oral high-dose ibuprofen regimen to that of standard regimen in closing patent ductus arteriosus (PDA). STUDY DESIGN: This clinical trial study was performed from April 2012 to May 2013 on preterm infants with gestational age<37 weeks and postnatal age 3 to 7 days with echocardiographic diagnosis of hemodynamically significant PDA. These neonates were randomly assigned to two treatment groups that respectively received high dose (20-10-10 mg/kg/d) and standard dose (10-5-5 mg/kg/d) oral ibuprofen regimen for 3 days...
October 2015: American Journal of Perinatology
2015-06-07 19:15:20
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