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Charles E Ahlfors
Poor plasma bilirubin binding increases the risk of bilirubin neurotoxicity in newborns with hyperbilirubinemia. New laboratory tests may soon make it possible to obtain a complete bilirubin binding panel when evaluating these babies. The 3 measured components of the panel are the plasma total bilirubin concentration (BTotal), which is currently used to guide clinical care; the bilirubin binding capacity (BBC); and the concentration of non-albumin bound or free bilirubin (BFree). The fourth component is the bilirubin-albumin equilibrium dissociation constant, KD, which is calculated from BTotal, BBC, and BFree The bilirubin binding panel is comparable to the panel of components used in the Henderson-Hasselbalch approach to acid-base assessment...
September 8, 2016: Pediatrics
Hye Won Kwon, Han-Suk Kim, Hyo Soon An, Bo Sang Kwon, Gi Beom Kim, Seung Han Shin, Ee-Kyung Kim, Eun Jung Bae, Chung Il Noh, Jung-Hwan Choi
BACKGROUND: The long-term cardiovascular outcomes of pulmonary hypertension (PH) in preterm infants with bronchopulmonary dysplasia (BPD) are uncertain. OBJECTIVES: The purpose of this study was to assess outcomes of PH in prematurely born children diagnosed with moderate to severe BPD. METHODS: We retrospectively reviewed the medical records of patients born before 32 weeks of gestation and diagnosed with moderate to severe BPD from June 2004 to April 2008...
2016: Neonatology
Xiao-Jing Hu, Qu-Ming Zhao, Xiao-Jing Ma, Wei-Li Yan, Xiao-Ling Ge, Bing Jia, Fang Liu, Lin Wu, Ming Ye, Guo-Ying Huang
AIM: Limited data have been available regarding critical congenital heart disease (CHD) screening in neonatal intensive care unit (NICUs). This study evaluated the feasibility of screening for CHD by adding pulse oximetry (POX) to clinical evaluation in a NICU in Shanghai, China. METHODS: We screened 4128 eligible consecutive NICU admissions using POX plus clinical evaluation. Infants with positive screening results were then evaluated with echocardiography. Those with negative screening results were put under observation, and they also underwent echocardiography if their oxygen saturation fell below 95% on room air during hospitalisation...
November 2016: Acta Paediatrica
Silvia Martini, Arianna Aceti, Mario Lima, Michela Maffi, Giacomo Faldella, Luigi Corvaglia
Necrotizing enterocolitis (NEC) is the most severe gastrointestinal complication of prematurity. Surgery, either peritoneal drainage placement or laparotomy with resection of the intestinal necrotic tracts, is the definitive treatment of perforated NEC; however, when clinical conditions contraindicate surgical approaches, little is known about medical treatments adjuvant or alternative to surgery. Octreotide is a synthetic somatostatin analog that inhibits pancreatic secretion and leads to splanchnic vasoconstriction...
August 2016: Pediatrics
Lorraine Dugoff, Mary E Norton, Jeffrey A Kuller
Chromosomal microarray analysis is a high-resolution, whole-genome technique used to identify chromosomal abnormalities, including those detected by conventional cytogenetic techniques, as well as small submicroscopic deletions and duplications referred to as copy number variants. Because chromosomal microarray analysis has a greater resolution than conventional karyotyping, it can detect deletions and duplications down to a 50- to 100-kb level. The purpose of this document is to discuss the technique, advantages, and disadvantages of chromosomal microarray analysis and its indications and limitations...
October 2016: American Journal of Obstetrics and Gynecology
Emily A Kieran, Eoghan E Laffan, Colm P F O'Donnell
AIM: Newborns are placed supine for umbilical venous catheter insertion, and catheter tip position is confirmed with X-ray. Umbilical venous catheters are considered correctly positioned when the tip is in the inferior vena cava; however, frequently, the catheter tip enters the portal venous circulation. We wished to determine whether placing infants on their right side, rather than on the back, for umbilical venous catheter insertion results in more correctly placed catheters. METHODS: Newborns were randomised to be placed on their back, or turned onto their right side for catheter insertion...
October 2016: Acta Paediatrica
Mark L Hudak
No abstract text is available yet for this article.
July 2016: Pediatrics
Daniele De Luca, Valentina Dell'Orto
Non-invasive high-frequency oscillatory ventilation (NHFOV) consists of the application of a bias flow generating a continuous distending positive pressure with superimposed oscillations, which have constant frequency and active expiratory phase. NHFOV matches together the advantages of high-frequency ventilation (no need for synchronisation, high efficacy in removing CO2) and nasal continuous positive airway pressure (CPAP) (non-invasive interface, increase in functional residual capacity allowing oxygenation to improve)...
June 28, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Tsu F Yeh, Chung M Chen, Shou Y Wu, Zahid Husan, Tsai C Li, Wu S Hsieh, Chang H Tsai, Hung C Lin
RATIONALE: Bronchopulmonary dysplasia (BPD) is an important complication of mechanical ventilation in preterm infants, and no definite therapy can eliminate this complication. Pulmonary inflammation plays a crucial role in its pathogenesis, and glucocorticoid is one potential therapy to prevent BPD. OBJECTIVES: To compare the effect of intratracheal administration of surfactant/budesonide with that of surfactant alone on the incidence of death or BPD. METHODS: A clinical trial was conducted in three tertiary neonatal centers in the United States and Taiwan, in which 265 very-low-birth-weight infants with severe respiratory distress syndrome who required mechanical ventilation and inspired oxygen (fraction of inspired oxygen, ≥50%) within 4 hours of birth were randomly assigned to one of two groups (131 intervention and 134 control)...
January 1, 2016: American Journal of Respiratory and Critical Care Medicine
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
Haşim Olgun, Naci Ceviz, İbrahim Kartal, İbrahim Caner, Mehmet Karacan, Ayhan Taştekin, Necip Becit
BACKGROUND: There are limited data about the results of repeated oral ibuprofen (OIBU) treatment. This study aimed to describe patent ductus arteriosus (PDA) closure rates and adverse events after repeated courses of OIBU in premature infants with PDA. METHODS: Preterm infants with hemodynamically significant (hs)PDA were enrolled in the study. If the first course of OIBU treatment failed, a second and, if required, third course was administered. RESULTS: A total of 100 patients received OIBU...
April 29, 2016: Pediatrics and Neonatology
J R Bowen, I Callander, R Richards, K B Lindrea
OBJECTIVE: To decrease the incidence of bloodstream infection (BSI) for neonates <29 weeks gestation through quality improvement. DESIGN: Commencing in September 2011, eight neonatal intensive care units (NICUs) in New South Wales and Australian Capital Territory, Australia participated in the Sepsis Prevention in NICUs Group project, a multicentre quality improvement initiative to reduce neonatal infection through implementation of potentially better practices and development of teaching resources...
May 2, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
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,, Cochrane) and meeting abstracts between 1990 to 2015. Search index terms: preterm/ resuscitation/oxygen...
May 5, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
L Uggla, L O Bonde, B M Svahn, M Remberger, B Wrangsjö, B Gustafsson
AIM: Paediatric recipients of haematopoietic stem cell transplants (HSCT) are at increased risk of developing post-traumatic stress disorder (PTSD), and there is a need to identify interventions that can alleviate stress in this group. The aim of this study was to examine the previously unexplored effect of music therapy on children undergoing HSCT, by analysing physiological parameters and comparing them with a control group. METHODS: We performed a randomised clinical pilot study of 24 patients up to the age of 16 undergoing HSCT at Karolinska University Hospital, Huddinge, Sweden...
October 2016: Acta Paediatrica
Bonnie Kaplan
Electronic health records, data sharing, big data, data mining, and secondary use are enabling exciting opportunities for improving health and healthcare while also exacerbating privacy concerns. Two court cases about selling prescription data, the Sorrell case in the U.S. and the Source case in the U.K., raise questions of what constitutes "privacy" and "public interest"; they present an opportunity for ethical analysis of data privacy, commodifying data for sale and ownership, combining public and private data, data for research, and transparency and consent...
April 2016: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
Rebecca J Scharf, Graham J Scharf, Annemarie Stroustrup
• On the basis of observational studies (level C), preterm birth is a leading cause of neurodevelopmental disabilities in children, and the degree of neurodevelopmental disability is inversely correlated with gestational age at birth. When comparing performance of preterm children to developmental norms, “corrected age” or age from due date rather than birth date should be used for the first 24 to 36 months. • On the basis of observational studies (level C), clinicians should pay specific attention to sensory function in children born preterm because the incidence of visual and hearing impairments is higher in preterm than term children...
January 2016: Pediatrics in Review
Mangesh Deshmukh, Hari Balasubramanian, Sanjay Patole
BACKGROUND: A delayed passage of meconium is considered as a risk factor for feed intolerance in preterm neonates. OBJECTIVES: The aim of this study was to review the effects of different therapeutic agents for meconium evacuation on feed tolerance in preterm neonates. METHODS: A systematic review of randomised controlled trials (RCTs) of different therapeutic agents for meconium evacuation in preterm neonates (gestation <32 weeks and/or birth weight <1,500 g) using the Cochrane systematic review methodology was undertaken...
2016: Neonatology
Alison Kent, Christina Kortsalioudaki, Irene M Monahan, Julia Bielicki, Timothy D Planche, Paul T Heath, Mike Sharland
BACKGROUND: Neonatal gram-negative (GN) infections are associated with high mortality and morbidity. Early appropriate antibiotic treatment is vital and gentamicin is the most frequently used antibiotic on neonatal units (NNUs). Antimicrobial breakpoints are predominantly based on adult data and the relationship between minimum inhibitory concentrations (MICs) and outcome in neonates is unclear. We aimed to determine the MIC of GN pathogens causing neonatal infections and relate this to clinical outcomes...
March 7, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Katlyn E McGrattan, Maneesha Sivalingam, Kathryn A Hasenstab, Lai Wei, Sudarshan R Jadcherla
AIM: Although the coordination of sucking and swallowing is critical for successful oral intake in neonates, the mechanisms that facilitate this coordination are not well understood. This investigation sought to clarify the mechanisms that facilitate this coordination, by comparing sucks that were coordinated with swallows and sucks that were completed in isolation. METHODS: Ten neonates with a median gestational age of 28.2 weeks, ranging from 27.0 to 35.0 weeks, were recruited from the neonatal nurseries at Nationwide Children's Hospital, Columbus, Ohio, USA...
July 2016: Acta Paediatrica
Sarah U Morton, Vincent C Smith
Apnoea of prematurity (AOP) affects almost all infants born at <28 weeks gestation or with birth weight <1000 g. When untreated, AOP may be associated with negative outcomes. Because of these negative outcomes, effective treatment for AOP is an important part of optimising care of preterm infants. Standard treatment usually involves xanthine therapy and respiratory support. Cutting-edge work with stochastic vibrotactile stimulation and new pharmaceutical agents continues to expand therapeutic options...
July 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
2016-04-01 16:46:08
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