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https://www.readbyqxmd.com/read/28538237/update-on-postnatal-steroids
#1
Henry L Halliday
Antenatal steroid treatment to enhance fetal lung maturity and surfactant treatment to prevent or treat respiratory distress syndrome have been major advances in perinatal medicine in the past 40 years contributing to improved outcomes for preterm infants. Use of postnatal steroids to prevent or treat chronic lung disease in preterm infants has been less successful and associated with adverse neurodevelopmental outcomes. Although early (in the first week of life) postnatal steroid treatment facilitates earlier extubation and reduces the risk of chronic lung disease, it is associated with adverse effects, such as hyperglycemia, hypertension, gastrointestinal bleeding and perforation, hypertrophic cardiomyopathy, growth failure, and cerebral palsy, and cannot be recommended...
2017: Neonatology
https://www.readbyqxmd.com/read/28795220/achieving-and-maintaining-lung-volume-in-the-preterm-infant-from-the-first-breath-to-the-nicu
#2
REVIEW
Gianluca Lista, Andrés Maturana, Fernando R Moya
The main goal for the neonatologist is to facilitate the adaptation to extra-uterine life during initial transition, while minimizing lung injury opening and protecting the premature lung from the first breath onwards. An appropriate management from birth should lead to the achievement of an early functional residual capacity (FRC), and the following steps should aim at maintaining an adequate lung volume. To date, different strategies are available to optimize fetal-neonatal transition and promote lung recruitment...
August 10, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28802347/using-quality-improvement-tools-to-reduce-chronic-lung-disease
#3
REVIEW
Alan Peter Picarillo, Waldemar Carlo
Rates of chronic lung disease (CLD) in very low birthweight infants have not decreased at the same pace as other neonatal morbidities over the past 20 years. Multifactorial causes of CLD make this common morbidity difficult to reduce, although there have been several successful quality improvement (QI) projects in individual neonatal intensive care units. QI projects have become a mainstay of neonatal care over the past decade, with an increasing number of publications devoted to this topic. A specific QI project for CLD must be based on best available evidence in the medical literature, expert recommendations, or based on work by previous QI initiatives...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/27940717/inhaled-corticosteroids-for-bronchopulmonary-dysplasia-a-meta-analysis
#4
REVIEW
Eric S Shinwell, Igor Portnov, Joerg J Meerpohl, Tanja Karen, Dirk Bassler
CONTEXT: Bronchopulmonary dysplasia (BPD) in preterm infants remains a major health burden despite many therapeutic interventions. Inhaled corticosteroids (IC) may be a safe and effective therapy. OBJECTIVE: To assess the safety and efficacy of IC for prevention or treatment of BPD or death in preterm infants. DATA SOURCES: PubMed, the Cochrane Library, Embase, and CINAHL from their inception until November 2015 together with other relevant sources...
December 2016: Pediatrics
https://www.readbyqxmd.com/read/28734731/postnatal-corticosteroids-to-prevent-or-treat-bronchopulmonary-dysplasia-who-might-benefit
#5
REVIEW
Lex W Doyle, Jeanie L Y Cheong
Newborn infants born very preterm are at high risk of developing bronchopulmonary dysplasia, which is associated with not only mortality but also adverse long-term neurological and respiratory outcomes in survivors. Postnatal corticosteroids might reduce the risk of developing bronchopulmonary dysplasia, or reduce its severity. However, it is important to minimize exposure to the potentially harmful effects of corticosteroids, particularly on the developing brain. Systemic corticosteroids started after the first week of life have shown the most benefit in infants at highest risk of developing bronchopulmonary dysplasia, whereas inhaled corticosteroids have little effect in children with established lung disease...
October 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28807545/bronchopulmonary-dysplasia-myths-of-pharmacologic-management
#6
REVIEW
Steven M Donn
Bronchopulmonary dysplasia (BPD) is the leading cause of long-term respiratory morbidity in newborns who require respiratory support at birth. BPD is a multifactorial disorder, and infants are frequently subjected to treatment with multiple pharmacologic agents of dubious efficacy and questionable safety, including diuretics, bronchodilators, corticosteroids, anti-reflux medications, and pulmonary vasodilators. These agents, with narrow therapeutic indices, are widely used despite the lack of an evidence base, and some may do more harm than good...
October 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28589122/the-future-of-bronchopulmonary-dysplasia-emerging-pathophysiological-concepts-and-potential-new-avenues-of-treatment
#7
REVIEW
Jennifer J P Collins, Dick Tibboel, Ismé M de Kleer, Irwin K M Reiss, Robbert J Rottier
Yearly more than 15 million babies are born premature (<37 weeks gestational age), accounting for more than 1 in 10 births worldwide. Lung injury caused by maternal chorioamnionitis or preeclampsia, postnatal ventilation, hyperoxia, or inflammation can lead to the development of bronchopulmonary dysplasia (BPD), one of the most common adverse outcomes in these preterm neonates. BPD patients have an arrest in alveolar and microvascular development and more frequently develop asthma and early-onset emphysema as they age...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28569744/delivery-room-interventions-to-prevent-bronchopulmonary-dysplasia-in-extremely-preterm-infants
#8
E E Foglia, E A Jensen, H Kirpalani
Bronchopulmonary dysplasia (BPD) is the most common chronic respiratory complication of preterm birth. Preterm infants are at risk for acute lung injury immediately after birth, which predisposes to BPD. In this article, we review the current evidence for interventions applied during neonatal transition (delivery room and first postnatal hours of life) to prevent BPD in extremely preterm infants: continuous positive airway pressure (CPAP), sustained lung inflation, supplemental oxygen use during neonatal resuscitation, and surfactant therapy including less-invasive surfactant administration...
June 1, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28258680/bronchopulmonary-dysplasia-in-very-and-extremely-low-birth-weight-infants-analysis-of-selected-risk-factors
#9
Przemysław Kiciński, Marcin Kęsiak, Marek Nowiczewski, Ewa Gulczyńska
AIM: The aim of the study was to analyze the role of specific risk factors affecting the development and clinical course of BPD in infants born before 32 weeks of gestation with a birth weight ≤ 1500g. MATERIALS AND METHODS: The study included 222 infants born and hospitalized at the Department of Neonatology, Polish Mother's Memorial Hospital-Research Institute. At their 28-th day of life, the patients were divided into two groups: with and without BPD. The grade of BPD severity was determined at 36 weeks of postmenstrual age...
February 20, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28456800/inhaled-glucocorticoids-and-pneumonia-in-preterm-infants-post-hoc-results-from-the-neurosis-trial
#10
Alexander Koch, Karen Kreutzer, Gabriele von Oldershausen, Christian F Poets, Dirk Bassler
BACKGROUND: Inhaled glucocorticoids may increase the risk of pneumonia in adults. Thus, respiratory infections may be a potential explanation for the non-significantly increased mortality seen in the glucocorticoid group in the largest randomized trial on inhaled glucocorticoids for preventing bronchopulmonary dysplasia in preterm infants published to date (NEuroSIS). OBJECTIVE: To evaluate the effect of inhaled budesonide on the risk of death due to respiratory infections in the NEuroSIS trial...
2017: Neonatology
https://www.readbyqxmd.com/read/28396025/prophylactic-indomethacin-compared-with-delayed-conservative-management-of-the-patent-ductus-arteriosus-in-extremely-preterm-infants-effects-on-neonatal-outcomes
#11
Melissa Liebowitz, Ronald I Clyman
OBJECTIVE: To determine whether prophylactic indomethacin (PINDO) has more or less morbidity than delayed conservative management of the moderate-to-large patent ductus arteriosus (PDA). STUDY DESIGN: We performed a prospective double cohort controlled study of infants delivered at ≤27(6/7) weeks gestation (n = 397). From January 2005 through April 2011, all infants were treated with PINDO (n = 247). From May 2011 through August 2016, no infant was treated with indomethacin until at least 8 postnatal days (conservative epoch, n = 150)...
August 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28409755/serum-cytokine-concentrations-chorioamnionitis-and-the-onset-of-bronchopulmonary-dysplasia-in-premature-infants
#12
M Kaneko, M Sato, K Ogasawara, T Imamura, K Hashimoto, N Momoi, M Hosoya
OBJECTIVE: To investigate the relationships between serum cytokine concentrations and chorioamnionitis (CAM) and CAM-related bronchopulmonary dysplasia (BPD) in premature infants. METHODS: Serum was collected at 0 and 7 days after birth from 36 premature infants born at <32 weeks of gestation. We examined the relationships between 30 cytokine concentrations and CAM, BPD, and other perinatal factors. RESULTS: On day 0, GM-CSF, IL-15, IL-17, IL-2, IL-2R, VEGF, and MIG concentrations were significantly higher in the CAM group (n = 17) than in the non-CAM group (n = 19)...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28304322/endothelin-1-as-a-predictor-marker-for-bronchopulmonary-dysplasia-in-preterm-neonates-with-respiratory-distress-syndrome
#13
M S El Shemi, S Tawfik, S M Khafagy, M T Hamza, A M A Youssef
OBJECTIVE: We aimed to investigate if endothelin 1 concentration at day 3 postnatal age could be used as a predictive marker for development of bronchopulmonary dysplasia in preterm neonates with respiratory distress syndrome. METHODS: This prospective observational study was done on 69 preterm neonates with gestational ages between 28 and 34 weeks and diagnosed as having respiratory distress syndrome. Serum concentrations of endothelin 1 was measured for all patients at day 3 of life and they were divided into BPD and No-BPD groups according to whether they developed bronchopulmonary dysplasia or not...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28165675/intratracheal-administration-of-budesonide-surfactant-in-prevention-of-bronchopulmonary-dysplasia-in-very-low-birth-weight-infants-a-systematic-review-and-meta-analysis
#14
REVIEW
Rohini Venkataraman, Majeeda Kamaluddeen, Shabih U Hasan, Helen Lee Robertson, Abhay Lodha
Despite the near universal adaptation of gentle mechanical ventilation, surfactant use and non-invasive respiratory support, bronchopulmonary dysplasia (BPD) remains one of the most common respiratory morbidities in very low birth weight (VLBW) infants. Thus, the objective of this review was to evaluate the efficacy of intra-tracheal administration of budesonide-surfactant mixture in preventing bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) infants. MEDLINE, EMBASE, and PubMed were searched for randomized clinical trials in which intra-tracheal administration of budesonide-surfactant was used to prevent BPD in infants...
July 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28141913/systemic-corticosteroid-regimens-for-prevention-of-bronchopulmonary-dysplasia-in-preterm-infants
#15
REVIEW
Wes Onland, Anne Pmc De Jaegere, Martin Offringa, Anton van Kaam
BACKGROUND: Cochrane systematic reviews show that systemic postnatal corticosteroids reduce the risk of bronchopulmonary dysplasia (BPD) in preterm infants. However, corticosteroids have also been associated with an increased risk of neurodevelopmental impairment. It is unknown whether these beneficial and adverse effects are modulated by differences in corticosteroid treatment regimens. OBJECTIVES: To assess the effects of different corticosteroid treatment regimens on mortality, pulmonary morbidity, and neurodevelopmental outcome in very low birth weight (VLBW) infants...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27908652/antibiotic-exposure-and-risk-for-death-or-bronchopulmonary-dysplasia-in-very-low-birth-weight-infants
#16
Joseph B Cantey, Landon W Huffman, Abirami Subramanian, Anderson S Marshall, A Rebecca Ballard, Cassandra Lefevre, Malvika Sagar, Jessica E Pruszynski, Lea H Mallett
We assessed the association between antibiotic exposure in the first 2 weeks of life and development of bronchopulmonary dysplasia in a cohort of very low birth weight infants. After controlling for the severity of illness, each additional day of antibiotic therapy was associated with both an increased risk for and severity of bronchopulmonary dysplasia.
February 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28067830/bronchopulmonary-dysplasia-chronic-lung-disease-of-infancy-and-long-term-pulmonary-outcomes
#17
REVIEW
Lauren M Davidson, Sara K Berkelhamer
Bronchopulmonary dysplasia (BPD) is a chronic lung disease most commonly seen in premature infants who required mechanical ventilation and oxygen therapy for acute respiratory distress. While advances in neonatal care have resulted in improved survival rates of premature infants, limited progress has been made in reducing rates of BPD. Lack of progress may in part be attributed to the limited therapeutic options available for prevention and treatment of BPD. Several lung-protective strategies have been shown to reduce risks, including use of non-invasive support, as well as early extubation and volume ventilation when intubation is required...
January 6, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27893721/biomarkers-associated-with-bronchopulmonary-dysplasia-mortality-in-premature-infants
#18
Jessica Balena-Borneman, Namasivayam Ambalavanan, Hemant K Tiwari, Russell L Griffin, Brian Halloran, David Askenazi
BACKGROUND: Bronchopulmonary dysplasia (BPD) portends lifelong organ impairment and death. Our ability to predict BPD in first days of life is limited, but could be enhanced using novel biomarkers. METHODS: Using an available clinical and urine biomarker database obtained from a prospective 113 infant cohort (birth weight ≤1,200 g and/or gestational age ≤31 wk), we evaluated the independent association of 14 urine biomarkers with BPD/mortality. RESULTS: Two of the 14 urine biomarkers were independently associated with BPD/mortality after controlling for gestational age (GA), small for gestational age (SGA), and intubation status...
March 2017: Pediatric Research
https://www.readbyqxmd.com/read/28052185/early-administration-of-inhaled-corticosteroids-for-preventing-chronic-lung-disease-in-very-low-birth-weight-preterm-neonates
#19
REVIEW
Vibhuti S Shah, Arne Ohlsson, Henry L Halliday, Michael Dunn
BACKGROUND: Chronic lung disease (CLD) remains a common complication among preterm infants. There is increasing evidence that inflammation plays an important role in the pathogenesis of CLD. Due to their strong anti-inflammatory properties, corticosteroids are an attractive intervention strategy. However, there are growing concerns regarding short- and long-term effects of systemic corticosteroids. Theoretically, administration of inhaled corticosteroids may allow for beneficial effects on the pulmonary system with a lower risk of undesirable systemic side effects...
January 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28045472/inhaled-nitric-oxide-for-respiratory-failure-in-preterm-infants
#20
REVIEW
Keith J Barrington, Neil Finer, Thomas Pennaforte
BACKGROUND: Inhaled nitric oxide (iNO) is effective in term infants with hypoxic respiratory failure. The pathophysiology of respiratory failure and the potential risks of iNO differ substantially in preterm infants, necessitating specific study in this population. OBJECTIVES: To determine effects of treatment with inhaled nitric oxide (iNO) on death, bronchopulmonary dysplasia (BPD), intraventricular haemorrhage (IVH) or other serious brain injury and on adverse long-term neurodevelopmental outcomes in preterm newborn infants with hypoxic respiratory failure...
January 3, 2017: Cochrane Database of Systematic Reviews
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