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https://www.readbyqxmd.com/read/28438477/apnea-in-the-term-infant
#1
REVIEW
Mary Elaine Patrinos, Richard J Martin
Whereas apnea of prematurity has been well defined and its pathophysiology extensively studied, apnea in the term infant remains a greater challenge. Unfortunately, clear diagnostic criteria are lacking and pathogenesis and management vary widely. In this review we have arbitrarily organized the discussion chronologically into earlier and later postnatal periods. In the first days of life, presumed apnea may reflect physiologic events such as positional or feeding etiologies, or may be a manifestation of serious pathophysiology, such as a seizure disorder...
April 21, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28434651/neonatal-sepsis
#2
REVIEW
Andi L Shane, Pablo J Sánchez, Barbara J Stoll
Neonatal sepsis is the cause of substantial morbidity and mortality. Precise estimates of neonatal sepsis burden vary by setting. Differing estimates of disease burden have been reported from high-income countries compared with reports from low-income and middle-income countries. The clinical manifestations range from subclinical infection to severe manifestations of focal or systemic disease. The source of the pathogen might be attributed to an in-utero infection, acquisition from maternal flora, or postnatal acquisition from the hospital or community...
April 20, 2017: Lancet
https://www.readbyqxmd.com/read/28034548/acute-kidney-injury-in-the-fetus-and-neonate
#3
REVIEW
Arwa Nada, Elizabeth M Bonachea, David J Askenazi
Acute kidney injury (AKI) is an under-recognized morbidity of neonates; the incidence remains unclear due to the absence of a unified definition of AKI in this population and because previous studies have varied greatly in screening for AKI with serum creatinine and urine output assessments. Premature infants may be born with less than half of the nephrons compared with term neonates, predisposing them to chronic kidney disease (CKD) early on in life and as they age. AKI can also lead to CKD, and premature infants with AKI may be at very high risk for long-term kidney problems...
April 2017: Seminars in Fetal & Neonatal Medicine
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
#4
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/28389438/management-and-investigation-of-neonatal-encephalopathy-2017-update
#5
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)...
April 6, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28331629/congenital-diaphragmatic-hernia-a-review
#6
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/28109705/renal-function-in-the-fetus-and-neonate-the-creatinine-enigma
#7
REVIEW
Justin T Kastl
The use of serum creatinine levels to estimate glomerular function in infants is admittedly fraught with inherent inaccuracies which are both physiological and methodological in nature. This characteristic can understandably reduce the neonatal clinician's confidence in the ability of serum creatinine levels to provide useful information relevant to their patients' medical care. The aim of this review is to provide further insight into the peculiarities of serum creatinine trends in both premature and term infants with special focus on the maturational and developmental changes occurring in the kidney during this crucial time-period...
January 18, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28114678/revisiting-the-definition-of-bronchopulmonary-dysplasia-effect-of-changing-panoply-of-respiratory-support-for-preterm-neonates
#8
Tetsuya Isayama, Shoo K Lee, Junmin Yang, David Lee, Sibasis Daspal, Michael Dunn, Prakesh S Shah
Importance: Several definitions of bronchopulmonary dysplasia are clinically used; however, their validity remains uncertain considering ongoing changes in the panoply of respiratory support treatment strategies used within neonatal units. Objective: To identify the optimal definition of bronchopulmonary dysplasia that best predicts respiratory and neurodevelopmental outcomes in preterm infants. Design, Setting, and Participants: Retrospective cohort study at tertiary neonatal intensive care units...
March 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28044040/charge-syndrome
#9
EDITORIAL
Alexandra Hudson, Carrie-Lee Trider, Kim Blake
No abstract text is available yet for this article.
January 2017: Pediatrics in Review
https://www.readbyqxmd.com/read/28075515/the-limitations-of-pulse-oximetry-for-critical-congenital-heart-disease-screening-in-the-neonatal-intensive-care-units
#10
LETTER
Nithi Fernandes, Satyan Lakshminrusimha
No abstract text is available yet for this article.
June 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28046188/comparative-effectiveness-of-nonsteroidal-anti-inflammatory-drug-treatment-vs-no-treatment-for-patent-ductus-arteriosus-in-preterm-infants
#11
Jonathan L Slaughter, Patricia B Reagan, Thomas B Newman, Mark A Klebanoff
Importance: Patent ductus arteriosus (PDA) is associated with increased mortality and worsened respiratory outcomes, including bronchopulmonary dysplasia (BPD), in preterm infants. Nonsteroidal anti-inflammatory drugs (NSAIDs) are efficacious in closing PDA, but the effectiveness of NSAID-mediated PDA closure in improving mortality and preventing BPD is unclear. Objective: To determine the effectiveness of NSAID treatment for PDA in reducing mortality and moderate/severe BPD at 36 weeks postmenstrual age...
March 6, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/27733360/antenatal-corticosteroids-for-maturity-of-term-or-near-term-fetuses-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#12
REVIEW
Gabriele Saccone, Vincenzo Berghella
OBJECTIVE:  To evaluate the effectiveness of antenatal corticosteroids given at ≥34 weeks' gestation. DESIGN:  Systematic review with meta-analysis. DATA SOURCES:  Electronic databases were searched from their inception to February 2016. ELIGIBILITY CRITERIA FOR STUDY SELECTION:  Randomized clinical trials comparing antenatal corticosteroids with placebo or no treatment in women with a singleton pregnancy at ≥34 weeks' gestation...
October 12, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27456511/oxygen-targeting-in-extremely-low-birth-weight-infants
#13
James J Cummings, Richard A Polin
The use of supplemental oxygen plays a vital role in the care of the critically ill preterm infant, but the unrestricted use of oxygen can lead to unintended harms, such as chronic lung disease and retinopathy of prematurity. An overly restricted use of supplemental oxygen may have adverse effects as well. Ideally, continuous monitoring of tissue and cellular oxygen delivery would allow clinicians to better titrate the use of supplemental oxygen, but such monitoring is not currently feasible in the clinical setting...
August 2016: Pediatrics
https://www.readbyqxmd.com/read/27355828/chorioamnionitis-and-five-year-neurodevelopmental-outcome-in-preterm-infants
#14
Milla Ylijoki, Liisa Lehtonen, Annika Lind, Eeva Ekholm, Helena Lapinleimu, Harry Kujari, Leena Haataja
BACKGROUND: Chorioamnionitis, a risk factor for preterm delivery, has been suggested to be associated with suboptimal neurological development in premature infants. OBJECTIVE: To evaluate the association between chorioamnionitis and neurodevelopment in preterm infants at 5 years of age. Methods Very low birth weight and very low gestational age infants (n = 197) were recruited. Placental samples (n = 117) were evaluated for histological chorioamnionitis. Fetal histological chorioamnionitis was analyzed as a subgroup...
2016: Neonatology
https://www.readbyqxmd.com/read/27344149/a-prognostic-neonatal-neuroimaging-scale-for-symptomatic-congenital-cytomegalovirus-infection
#15
Ana Alarcon, Miriam Martinez-Biarge, Fernando Cabañas, Jose Quero, Alfredo García-Alix
BACKGROUND: Congenital cytomegalovirus (cCMV) can cause brain inflammation/destruction and teratogenic effects. The only validated neuroimaging prognostic categorization for symptomatic cCMV available is based on destructive lesions seen on computed tomography (CT). OBJECTIVE: The aim of this study was to establish the predictive ability of a comprehensive neonatal neuroimaging scale in symptomatic cCMV. METHODS: Twenty-six infants were studied by neonatal cranial ultrasound scans (US; n = 25), CT (n = 11) and magnetic resonance imaging (MRI; n = 9)...
2016: Neonatology
https://www.readbyqxmd.com/read/27254035/nonactivated-protein-c-in-the-treatment-of-neonatal-sepsis-a-retrospective-analysis-of-outcome
#16
Ryszard Lauterbach, Barbara Wilk, Agata Bocheńska, Joanna Hurkała, Renata Radziszewska
BACKGROUND: Previously, we found that plasma protein C (PC) activity ≤10% significantly increased the probability of the occurrence of death during neonatal sepsis. Accordingly, if the activity of plasma PC declined during the course of sepsis to ≤10%, we administered a nonactivated PC zymogen to increase a PC activity. The aim of that retrospective analysis was to explore treatment effects of PC zymogen supplementation in septic infants, with plasma PC activity ≤10%. METHODS: A database was used to locate 85 newborns treated with PC from among 458 analyzed infants with confirmed sepsis...
September 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27251645/retinopathy-of-prematurity-therapeutic-strategies-based-on-pathophysiology
#17
Rowena Cayabyab, Rangasamy Ramanathan
Retinopathy of prematurity (ROP) continues to be a major preventable cause of blindness and visual handicaps globally. With improved perinatal care, improved survival of moderately preterm infants, and limited resources for oxygen delivery and monitoring, more mature preterm infants are developing severe ROP in developing countries. The pathophysiology of ROP is characterized by two phases. Phase I ROP is due to vaso-obliteration beginning immediately after birth secondary to a marked decrease in vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF-1)...
2016: Neonatology
https://www.readbyqxmd.com/read/27251453/synchronized-nasal-intermittent-positive-pressure-ventilation-of-the-newborn-technical-issues-and-clinical-results
#18
Corrado Moretti, Camilla Gizzi, Francesco Montecchia, Caterina Silvia Barbàra, Fabio Midulla, Manuel Sanchez-Luna, Paola Papoff
Although mechanical ventilation via an endotracheal tube has undoubtedly led to improvement in neonatal survival in the last 40 years, the prolonged use of this technique may predispose the infant to development of many possible complications including bronchopulmonary dysplasia. Avoiding mechanical ventilation is thought to be a critical goal, and different modes of noninvasive respiratory support beyond nasal continuous positive airway pressure, such as nasal intermittent positive pressure ventilation and synchronized nasal intermittent positive pressure ventilation, are also available and may reduce intubation rate...
2016: Neonatology
https://www.readbyqxmd.com/read/27251312/advances-in-neonatal-pulmonary-hypertension
#19
Robin H Steinhorn
Persistent pulmonary hypertension of the newborn (PPHN) is a surprisingly common event in the neonatal intensive care unit, and affects both term and preterm infants. Recent studies have begun to elucidate the maternal, fetal and genetic risk factors that trigger PPHN. There have been numerous therapeutic advances over the last decade. It is now appreciated that oxygen supplementation, particularly for the goal of pulmonary vasodilation, needs to be approached as a therapy that has risks and benefits. Administration of surfactant or inhaled nitric oxide (iNO) therapy at a lower acuity of illness can decrease the risk of extracorporeal membrane oxygenation/death, progression of disease and duration of hospital stay...
2016: Neonatology
https://www.readbyqxmd.com/read/27238078/repeated-courses-of-oral-ibuprofen-in-premature-infants-with-patent-ductus-arteriosus-efficacy-and-safety
#20
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...
February 2017: Pediatrics and Neonatology
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