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Mashup Score: 18
Less invasive surfactant administration (LISA) is an increasingly popular technique to deliver surfactant to spontaneously breathing preterm infants with respiratory distress syndrome. The optimal method of alleviating the pain and discomfort associated with LISA, either pharmacological or non-pharmacological, while maintaining spontaneous respiration remains unclear. There is limited evidence to guide clinicians, resulting in wide variations in practice. The aim of this article is to summarise the current knowledge and evidence gaps regarding the use of premedication prior to LISA.
Source: fn.bmj.comCategories: General Medicine News, General Journals & SocietTweet
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Mashup Score: 2
Background Prematurity is a significant risk for bronchopulmonary dysplasia related pulmonary artery pressure. Objective To determine the association between pulmonary artery pressure in the early days of life and the development of bronchopulmonary dysplasia or mortality. Methods This prospective observational cohort study included infants born at <32 weeks and weighing 0.5 (pulmonary hypertension criterion-1). Infants were categorised into pulmonary hypertension and non-pulmonary hypertension groups. The primary endpoint was bronchopulmonary dysplasia or mortality. Receiver operating characteristic analysis established a new threshold value for predicting bronchopulmonary dysplasia or mortality (pulmonary hypertension criterion-2). Infants were reanalysed accord
Source: fn.bmj.comCategories: General Medicine News, General Journals & SocietTweet-
Association between early pulmonary arterial pressure and BPD or mortality in very preterm infants Prospective cohort study🇹🇷 @museakin https://t.co/6zuf4rB3qX https://t.co/tC6qYDd9p3
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Mashup Score: 2Intermittent sigh breaths during high-frequency oscillatory ventilation in preterm infants: a randomised crossover study - 2 month(s) ago
Objective To determine if combining high-frequency oscillatory ventilation (HFOV) with additional sigh breaths would improve end-expiratory lung volume (EELV) and oxygenation in preterm infants. Design Prospective interventional crossover study. Setting Neonatal intensive care unit. Patients Ventilated preterm infants <36 weeks corrected gestational age receiving HFOV. Interventions Infants were randomly assigned to receive HFOV with sigh breaths followed by HFOV-only (or vice versa) for four alternating periods. Sigh breaths were delivered with an inspiratory time of 1 s, peak inspiratory pressure of 30 cmH20 and frequency of three breaths/min. Main outcome measures Electrical impedance tomography measured the effect of sigh breaths on EELV and ventilation distribution. Physiological variables were recorded to monitor oxygenation. Measurements were taken at 30 and 60 min postchange of HFOV mode and compared with baseline. Results Sixteen infants (10 males, 6 females) with a median (ra
Source: fn.bmj.comCategories: General Medicine News, General Journals & SocietTweet-
Can combining HFOV with additional sigh breaths improve end-expiratory lung volume (EELV) and oxygenation in preterm infants? Randomised crossover study @JudyHough5 https://t.co/ZJnbVQLEso https://t.co/zYc6BWpsIc
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Mashup Score: 7Case–control study of milk curd obstruction in newborn infants in a tertiary surgical neonatal intensive care unit - 2 month(s) ago
Background Milk curd obstruction (MCO), in which milk becomes inspissated, is a rare, serious, complication of preterm birth. Case reports implicate male sex and bovine-derived human milk fortifier (HMF) use as predisposing factors. We investigated this through a case–control study. Methods MCO cases in the Starship Child Health neonatal database between 2008 and 2020 were matched with controls in a 1:2 ratio based on gestational age (±1 week), birth weight (±200 g) and date of birth (±1 month). Data were analysed using the Student’s t-test, Mann-Whitney U-test or χ² test as appropriate. Data are median (IQR) or n (%). Results Of 20 MCO cases, gestation was 26.1 (24.5–28.1) weeks, birth weight was 822 (713–961) g, 15 (75%) were male. 40 controls were well-matched for gestation (26.1 (24.8–27.9) weeks) and birth weight (849 (690–1066) g) but only 18 (45%) were male (p=0.05). MCO occurred at 21 (15–33) days; 6 (30%) cases died compared with 3 (7.5%) controls (p=0.06). HMF was commenced a
Source: fn.bmj.comCategories: General Medicine News, General Journals & SocietTweet-
Heard about milk curd obstruction in newborns? Occurred mean 21 days 30% mortality Not associated with human milk fortifier Single centre case–control study🇳🇿 https://t.co/WV7Izn2ups
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Mashup Score: 6Fetal haemoglobin and oxygen requirement in preterm infants: an observational study - 3 month(s) ago
Objective To investigate the relationship between the fraction of fetal haemoglobin (HbF(%)) and oxygen requirement as determined by the fraction of inspired oxygen (FiO2) and alveolar–arterial gradient (A–a gradient). Increased alveolar exposure to oxygen may explain the association between decreased HbF(%) and the development of bronchopulmonary dysplasia (BPD). Design Longitudinal, retrospective, observational study. Setting Tertiary-level neonatal intensive care unit, referral centre for southern Sweden. Patients Four hundred forty very preterm infants born before gestational week 30, 2009–2015. Intervention Regular clinical practice. Main outcome measures The FiO2 and A–a gradient were determined at the time-point of 10 015 arterial blood gas analyses obtained during postnatal days 1–7. The relationship between HbF(%) and FiO2 and A–a gradient and the modifying influence of other factors affecting haemoglobin oxygen affinity were evaluated. Results We found a significant relations
Source: fn.bmj.comCategories: General Medicine News, General Journals & SocietTweet-
Low HbF(%) is associated with increased oxygen requirement in preterm infants Single centre observational study 🇸🇪 @MBruschettini @tommyulinder https://t.co/PrmNA2FEA4 https://t.co/3aXd0HgAMN
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Mashup Score: 12
Globally, demand for donor human milk (DHM) is increasing with WHO guidelines recommending DHM as the first line nutrition for premature infants in the absence or shortfall of maternal milk. Policymakers and clinicians currently have limited knowledge regarding costs incurred by human milk banks (HMBs) making the planning and resourcing of these services challenging. This study aimed to evaluate costs in a national network of HMBs in the UK. Design and setting All 14 UK HMBS were invited to complete a bottom-up microcosting survey from 1 April 2021 to 31 March 2022 covering four key areas: Staffing, equipment, donor screening and incidental costs. Total annual salary costs included on-costs (ie, national insurance, pensions), qualifications, overheads (ie, non-staff costs) and capital overheads. The annual equivalent costs for each equipment item were based on the total cost over its useful life and discounted at 3.5%. Results 10 out of 14 milk banks provided responses with more comple
Source: fn.bmj.comCategories: General Medicine News, General Journals & SocietTweet-
Cost of operating a human milk bank in the UK Total annual cost £200K Cost per litre averaged £173 Microcosting analysis of 10 milk banks @DrNShenker https://t.co/oCRmKFpjwP
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Mashup Score: 0Early and extended erythropoietin monotherapy after hypoxic ischaemic encephalopathy: a multicentre double-blind pilot randomised controlled trial - 3 month(s) ago
Objective To examine the feasibility of early and extended erythropoietin monotherapy after hypoxic ischaemic encephalopathy (HIE). Design Double-blind pilot randomised controlled trial. Setting Eight neonatal units in South Asia. Patients Neonates (≥36 weeks) with moderate or severe HIE admitted between 31 December 2022 and 3 May 2023. Interventions Erythropoietin (500 U/kg daily) or to the placebo (sham injections using a screen) within 6 hours of birth and continued for 9 days. MRI at 2 weeks of age. Main outcomes and measures Feasibility of randomisation, drug administration and assessment of brain injury using MRI. Results Of the 154 neonates screened, 56 were eligible; 6 declined consent and 50 were recruited; 43 (86%) were inborn. Mean (SD) age at first dose was 4.4 (1.2) hours in erythropoietin and 4.1 (1.0) hours in placebo. Overall mortality at hospital discharge occurred in 5 (19%) vs 11 (46%) (p=0.06), and 3 (13%) vs 9 (40.9%) (p=0.04) among those with moderate encephalopat
Source: fn.bmj.comCategories: General Medicine News, General Journals & SocietTweet-
Early (<6hrs) and extended (9d) erythropoietin after HIE - pilot study Feasible Suggest lower mortality Time for full trial Multicentre double-blind pilot RCT 🇮🇳 🇧🇩 @PavanHapat https://t.co/BsvdAeLPd6 https://t.co/8wDPi3iNIL
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Mashup Score: 6Cerebral injury and retinopathy as risk factors for blindness in extremely preterm infants - 3 month(s) ago
Objective This study investigates whether and to what extent cerebral injury is associated with bilateral blindness in extremely preterm infants, which has been attributed mainly to retinopathy of prematurity (ROP). Design Multicentre analysis of children born from 1994 to 2021 at gestational age 22 0/7 to 28 6/7 weeks with follow-up at 18–26 months. Logistic regression examined the adjusted association of bilateral blindness with severe ROP and/or cerebral injury among extremely preterm infants. Exposures Severe ROP and cerebral injury, the latter defined as any of the following on cranial imaging: ventriculomegaly; blood/increased echogenicity in the parenchyma; cystic periventricular leukomalacia. Main outcome measures Bilateral blindness, defined as a follow-up examination meeting criteria of ‘blind—some functional vision’ or ‘blind—no useful vision’ in both eyes. Results The 19 863 children included had a mean gestational age of 25.6±1.7 weeks, mean birth weight of 782±158 g and 2
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Cerebral injury and retinopathy as risk factors for blindness in extremely preterm infants Severe ROP - Odds ratio 8 Cerebral injury - Odds ratio 8 Multicentre cohort analysis 🇺🇸 @_BenHonan @ambaln @HopeEArnold @SusanHintzMD https://t.co/BNKUMabDOW
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Mashup Score: 18Fetal haemoglobin and oxygen requirement in preterm infants: an observational study - 3 month(s) ago
Objective To investigate the relationship between the fraction of fetal haemoglobin (HbF(%)) and oxygen requirement as determined by the fraction of inspired oxygen (FiO2) and alveolar–arterial gradient (A–a gradient). Increased alveolar exposure to oxygen may explain the association between decreased HbF(%) and the development of bronchopulmonary dysplasia (BPD). Design Longitudinal, retrospective, observational study. Setting Tertiary-level neonatal intensive care unit, referral centre for southern Sweden. Patients Four hundred forty very preterm infants born before gestational week 30, 2009–2015. Intervention Regular clinical practice. Main outcome measures The FiO2 and A–a gradient were determined at the time-point of 10 015 arterial blood gas analyses obtained during postnatal days 1–7. The relationship between HbF(%) and FiO2 and A–a gradient and the modifying influence of other factors affecting haemoglobin oxygen affinity were evaluated. Results We found a significant relations
Source: fn.bmj.comCategories: General Medicine News, PediatricsTweet-
Great read of an article talking about HbF, oxygen affinity, ROS and BPD. Ulinder et al look back at 440 <30wk infants and their gases in @adc_bmj https://t.co/mGXFHrpVzF @MBruschettini #EBNEOalerts #neoEBM #neotwitter https://t.co/ZsK8QPfSlI
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Mashup Score: 4Trends in sex differences in neurodevelopmental outcomes among extremely preterm infants - 3 month(s) ago
Objective To examine whether changes in survival without moderate or severe neurodevelopmental impairment (NDI) at 18–26 months’ corrected age from 1999 to 2018 differed between male and female infants. Design This retrospective cohort study used data from the NICHD Neonatal Research Network hospitals. Robust Poisson regression models were used to estimate adjusted relative risks (aRRs) and 95% CIs for survival without moderate or severe NDI between males and females. Interactions between sex and time were assessed to evaluate temporal differences in the outcome by sex. Variables adjusted for included centre, maternal age, ethnicity/race, gestational age and small for gestational age. Patients Inborn infants with gestational age of 22–26 weeks at NICHD Neonatal Research Network hospitals from 1999 to 2018. Main outcome measure Change over time in survival without moderate or severe NDI at 18–26 months’ corrected age between male and female infants. Results Of 26 307 infants, 13 045 (49
Source: fn.bmj.comCategories: General Medicine News, General Journals & SocietTweet-
Trends in sex differences in neurodevelopmental outcomes among extremely preterm infants Similar survival without moderate or severe NDI between male and female Multicentre retrospective cohort 🇺🇸 @SusanHintzMD https://t.co/9ucNhwpcxd
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Premedication for less invasive surfactant administration Narrative review nicely summarises current knowledge and evidence gaps @claire_anne_neo, @shaliniojha7, @DrCGale https://t.co/YRfOw706Tm