Rohit Anand, Sushma Nangia
INTRODUCTION: Providing adequate nutrition in the management of preterm infants has been challenging. The objective of this secondary analysis of data from the randomized trial comparing "less invasive surfactant therapy (LISA) with InSurE method of surfactant administration" is to demonstrate the feasibility of early total enteral feeding (ETEF) in hemodynamically stable preterm neonates on respiratory support and to examine the factors associated with failure of ETEF. METHODS: Secondary analysis of a randomized controlled trial comparing "LISA versus InSurE among preterm infants between 26 and 34 weeks of gestation" enrolled 150 infants with 117 being hemodynamically stable...
July 17, 2024: Neonatology
Christian A Maiwald, Axel R Franz, Christian F Poets, Laila Springer
INTRODUCTION: The European guideline for treatment of respiratory distress syndrome recommends less invasive surfactant administration (LISA) as the preferred method of surfactant administration in spontaneously breathing preterm infants. However, there is limited evidence on practical aspects such as sedation and catheter types, leading to considerable variability between centers. METHODS: An anonymous online survey (<ext-link ext-link-type="uri" xlink:href="https://www...
July 17, 2024: Neonatology
Mads J B Nordsten, Xudong Yan, Jan B M Secher, Per T Sangild, Thomas Thymann
INTRODUCTION: Birth-related obstruction of umbilical blood flow may induce hypoxic insults that affect postnatal organ adaptation. Using newborn cesarean-delivered pigs, we hypothesized that cord obstruction during delivery negatively affects physiological transition and gut maturation. Further, we investigated if delayed cord clamping (DCC) improves gut outcomes, including sensitivity to formula-induced necrotizing enterocolitis (NEC)-like lesions. METHODS: In experiment 1, preterm (n = 24) and near-term (n = 29) piglets were subjected to umbilical cord obstruction (UCO, 5-7 min in utero), with corresponding pigs delivered without obstruction (CON, n = 17-22)...
June 28, 2024: Neonatology
Christine Silwedel, Mandy Laube, Christian P Speer, Kirsten Glaser
BACKGROUND: Ureaplasma species are considered commensals of the adult urogenital tract. Yet, in pregnancy, Ureaplasma parvum and Ureaplasma urealyticum have been associated with chorioamnionitis and preterm birth. In preterm infants, Ureaplasma respiratory tract colonization has been correlated with the development of bronchopulmonary dysplasia and has been implicated in the pathogenesis of other complications of prematurity. Controversies on the impact of Ureaplasma exposure on neonatal morbidity, however, remain, and recommendations for screening practices and therapeutic management in preterm infants are missing...
June 27, 2024: Neonatology
Vito D'Andrea, Giorgia Prontera, Francesco Cota, Alessandro Perri, Rosellina Russo, Giovanni Barone, Giovanni Vento
INTRODUCTION: The umbilical venous catheter is a vital access device in neonatal intensive care units for preterm and critically ill infants. Correct positioning is crucial, as malpositioning can lead to severe complications. According to international guidelines, the position of the umbilical venous catheter tip must be assessed in real time; traditionally, the catheter is visualized with a thoracoabdominal X-ray, but one of the most effective and safest methods is therefore real-time ultrasound...
June 21, 2024: Neonatology
Miguel Alsina-Casanova, Mathias Lühr-Hansen, Victoria Aldecoa-Bilbao, Ruth Del Rio, Pierre Maton, Kosmas Sarafidis, Pamela Zafra-Rodriguez, Zachary Andrew Vesoulis, Emmanuele Mastretta, Ilia Bresesti, Marta Gomez-Chiari, Mónica Rebollo, Jamil Khamis, Angelos Baltatzidis, Isabel Benavente-Fernandez, Joshua Shimony, Giovanni Morana, Massimo Agosti, Nuria Carreras, Adriana Cuaresma, Ambre Gau, Athanasia Anastasiou, Simón Pedro Lubian-López, Dimitrios Alexopoulos, Paola Sciortino, Francesca Dessimone, Markus Harboe Olsen, Thais Agut, Gorm Greisen
INTRODUCTION: The SafeBoosC-III trial investigated the effect of cerebral oximetry-guided treatment in the first 72 h after birth on mortality and severe brain injury diagnosed by cranial ultrasound in extremely preterm infants (EPIs). This ancillary study evaluated the effect of cerebral oximetry on global brain injury as assessed by magnetic resonance imaging (MRI) at term equivalent age (TEA). METHODS: MRI scans were obtained between 36 and 44.9 weeks PMA. The Kidokoro score was independently evaluated by two blinded assessors...
June 21, 2024: Neonatology
James X Sotiropoulos, Sheeba Binoy, Thy A N Pham, Kylie Yates, Catherine L Allgood, Ansar Kunjunju, Mark Tracy, John Smyth, Ju Lee Oei
INTRODUCTION: Due to concerns of oxidative stress and injury, most clinicians currently use lower levels of fractional inspired oxygen (FiO2, 0.21-0.3) to initiate respiratory support for moderate to late preterm (MLPT, 32-36 weeks gestation) infants at birth. Whether this practice achieves recommended oxygen saturation (SpO2) targets is unknown. METHODS: We aimed to determine SpO2 trajectories of MLPT infants requiring respiratory support at birth. We conducted a prospective, opportunistic, observational study with consent waiver...
June 18, 2024: Neonatology
Cheryl Anne Mackay, Elizabeth A Nathan, Michelle Claire Porter, Damber Shrestha, Rolland Kohan, Tobias Strunk
INTRODUCTION: Neonatal sepsis is associated with significant mortality and morbidity. Low-middle-income countries are disproportionately affected, but late-onset sepsis (LOS) still occurs in up to 20% of infants &lt;28 weeks in high-income countries. Understanding site-specific data is vital to guide management. METHODS: A retrospective cohort study was conducted at King Edward Memorial Hospital (KEMH), Perth. Infants admitted between January 2012 and June 2022 were included...
June 18, 2024: Neonatology
Gil Klinger, Brian Reichman, Mikael Norman, Satoshi Kusuda, Malcolm Battin, Kjell Helenius, Tetsuya Isayama, Kei Lui, Mark Adams, Maximo Vento, Stellan Hakansson, Marc Beltempo, Chiara Poggi, Laura San Feliciano, Liisa Lehtonen, Dirk Bassler, Junmin Yang, Prakesh S Shah
INTRODUCTION: Despite advances in neonatal care, late-onset sepsis remains an important cause of preventable morbidity and mortality. Neonatal late-onset sepsis rates have decreased in some countries, while in others they have not. Our objective was to compare trends in late-onset sepsis rates in 9 population-based networks from 10 countries and to assess the associated mortality within 7 days of late-onset sepsis. METHODS: We performed a retrospective population-based cohort study...
June 18, 2024: Neonatology
Ola Didrik Saugstad, Christian P Speer
No abstract text is available yet for this article.
June 17, 2024: Neonatology
Anton H van Kaam
BACKGROUND: Despite the increasing use of non-invasive support modalities, many preterm infants still need invasive mechanical ventilation. Mechanical ventilation can lead to so-called ventilator-induced lung injury, which is considered an important risk factor in the development of bronchopulmonary dysplasia. Understanding the concepts of lung protective ventilation strategies is imperative to reduce the risk of BPD. SUMMARY: Overdistension, atelectasis, and oxygen toxicity are the most important risk factors for VILI...
June 13, 2024: Neonatology
Kirsten Glaser, Erik A Jensen, Clyde J Wright
BACKGROUND: The rates of major neonatal morbidities, such as bronchopulmonary dysplasia, necrotizing enterocolitis, preterm white matter disease, and retinopathy of prematurity, remain high among surviving preterm infants. Exposure to inflammatory stimuli and the subsequent host innate immune response contribute to the risk of developing these complications of prematurity. Notably, the burden of inflammation and associated neonatal morbidity is inversely related to gestational age - leaving primarily but not exclusively the tiniest babies at highest risk...
June 13, 2024: Neonatology
Ilari Kuitunen, Kati Räsänen, Maria Rosaria Gualano, Daniele De Luca
INTRODUCTION: Randomization and blinding are generally important in randomized trials. In neonatology, blinding of ventilation strategies is unfeasible if not impossible and we hypothesized that its importance has been overestimated, while the peculiarities of the neonatal patient and the specific outcomes have not been considered. METHODS: For this meta-epidemiological review, we searched PubMed and Scopus databases in November 2023. We included all meta-analyses focusing on ventilation, published in past 5 years, and reporting either mortality or bronchopulmonary dysplasia (BPD) as an outcome...
June 11, 2024: Neonatology
Christian Pihl, Anne-Sophie Sillesen, Jakob Boesgaard Norsk, Ruth Ottilia Birgitta Vøgg, Cathrine Vedel, Heather Allison Boyd, Niels Vejlstrup, Anna Axelsson Raja, Henning Bundgaard, Kasper Karmark Iversen
INTRODUCTION: Ventricular septal defect (VSD) is one of the most common congenital heart defects. We aimed to determine the prevalence of VSD in a population-based cohort of newborns and assess the rate of spontaneous closure during the first 12 months of life. METHODS: The Copenhagen Baby Heart Study (CBHS) is a population-based cohort study, including more than 25,000 newborns born in the greater Copenhagen area. Newborns underwent echocardiography within 60 days of birth...
June 10, 2024: Neonatology
Wencke Boerger, Rebeca Mozun, Bernhard Frey, Rabia Liamlahi, Beate Grass, Barbara Brotschi
INTRODUCTION: Blood lactate levels in neonates with hypoxic-ischemic encephalopathy (HIE) vary, and their impact on neurodevelopmental outcome is unclear. We assessed blood lactate course over time in neonates with HIE during therapeutic hypothermia (TH) and investigated if blood lactate values were associated with neurodevelopmental outcome at 2 years of age. METHODS: This is a retrospective cohort study of neonates with HIE born between 2013 and 2019, treated at the University Children's Hospital Zurich...
June 7, 2024: Neonatology
Corline E J Parmentier, Loubna El Bakkali, Elise A Verhagen, Sylke J Steggerda, Thomas Alderliesten, Maarten H Lequin, Laura A van de Pol, Manon J N L Benders, Frank van Bel, Corine Koopman-Esseboom, Timo R de Haan, Linda S de Vries, Floris Groenendaal
INTRODUCTION: Brain injury patterns of preterm infants with perinatal asphyxia (PA) are underreported. We aimed to explore brain magnetic resonance imaging (MRI) findings and associated neurodevelopmental outcomes in these newborns. METHODS: Retrospective multicenter study included infants with gestational age (GA) 24.0-36.0 weeks and PA, defined as ≥2 of the following: (1) umbilical cord pH ≤7.0, (2) 5-min Apgar score ≤5, and (3) fetal distress or systemic effects of PA...
June 5, 2024: Neonatology
Daniele Trevisanuto, Camilla Gizzi, Francesco Cavallin, Artur Beke, Giuseppe Buonocore, Antonia Charitou, Manuela Cucerea, Boris Filipović-Grčić, Nelly Georgieva Jekova, Esin Koç, Joana Saldanha, Dalia Stoniene, Heili Varendi, Giuseppe De Bernardo, John Madar, Marije Hogeveen, Luigi Orfeo, Fabio Mosca, Giulia Vertecchi, Corrado Moretti
INTRODUCTION: Laryngeal mask airway (LMA) use in neonatal resuscitation is limited despite existing evidence and recommendations. This survey investigated the knowledge and experience of healthcare providers on the use of the LMA and explored barriers and solutions for implementation. METHODS: This online, cross-sectional survey on LMA in neonatal resuscitation involved healthcare professionals of the Union of European Neonatal and Perinatal Societies (UENPS). RESULTS: A total of 858 healthcare professionals from 42 countries participated in the survey...
June 4, 2024: Neonatology
Gonzalo Luis Mariani, Pamela Judith Contrera, María de Los Angeles Virasoro, María Constanza Portela, María Ines Urquizu Handal, Aldana Soledad Ávila, Ariel Leonardo Fernández, Patricia Fernandez Riera, Gustavo Cardigni, Néstor Eduardo Vain
INTRODUCTION: Most neonatal deaths in industrialized countries follow a process of redirection of care. The objectives of this study were to describe how neonates die in a middle-income country, whether there was redirection of care, and the reason for this decision. METHODS: This was a prospective, multicenter, cross-sectional study. Neonates who died in the delivery room or in the neonatal intensive care unit in 97 hospitals over a 6-month period were included...
May 27, 2024: Neonatology
Shang-Po Shen, Yin-Ting Chen, Hsiao-Yu Chiu, Ming-Luen Tsai, Hao-Wen Cheng, Kuang-Hua Huang, Yu-Chia Chang, Hung-Chih Lin
INTRODUCTION: Meconium aspiration syndrome (MAS) may cause severe pulmonary and neurologic injuries in affected infants after birth, leading to long-term adverse pulmonary or neurodevelopmental outcomes. METHODS: This retrospective population-based cohort study enrolled 1,554,069 mother-child pairs between 2004 and 2014. A total of 8,049 infants were in the MAS-affected group, whereas 1,546,020 were in the healthy control group. Children were followed up for at least 3 years...
May 24, 2024: Neonatology
Samirah H M Mohamed, Nadja Reissland, Kanwaljeet J S Anand
BACKGROUND: The concept of fetal pain results from procedures conducted without anesthesia in preterm newborns and fetuses, which indicate that it is possible to examine fetal pain based on stress hormone, metabolic, and behavioral changes. Anatomical and physiological data suggest that fetuses become capable of processing nociceptive stimuli around midgestation, although the associated changes in fetal brain development remain unclear. What constitutes fetal pain remains controversial in the light of the definition of pain adopted by the International Association for the Study of Pain (IASP), which posits pain as an "unpleasant sensory and emotional experience...
May 23, 2024: Neonatology
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