Update on Postnatal Steroids.

Halliday, Neonatology. 2017 Abstract 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…

Continue reading

Umbilical Venous Catheter Malposition Is Associated with Necrotizing Enterocolitis in Premature Infants.

Sulemanji et al, Neonatology, 2017 Abstract OBJECTIVE: The etiology of necrotizing enterocolitis (NEC) remains elusive despite known associations with several factors, including intestinal ischemia related to the effects of umbilical arterial catheterization on the mesenteric circulation. However, the role of the mesenteric venous circulation has yet to be studied as a potential…

Continue reading

Surfactant Need by Gestation for Very Preterm Babies Initiated on Early Nasal CPAP: A Danish Observational Multicentre Study of 6,628 Infants Born 2000-2013.

Wiingreen et al, Neonatology, 2017 Abstract BACKGROUND: In recent years, early nasal continuous positive airway pressure (nCPAP) as respiratory support for preterm infants is being advocated as an alternative to prophylactic surfactant and treatment with mechanical ventilation. A number of infants treated with early nCPAP do not need treatment with surfactant, but…

Continue reading

Use of Transcutaneous Bilirubin to Determine the Need for Phototherapy in Resource-Limited Settings.

Olusanya and Emokpae, Neonatology. 2017  Abstract BACKGROUND: Routine and timely determination of total serum bilirubin (TSB) remains a challenge in many resource-limited countries with substantial burden of severe neonatal hyperbilirubinemia. Limited evidence exists on the potential usefulness of transcutaneous bilirubin (TcB) to identify infants who may require phototherapy based on possible treatment…

Continue reading

Medications That Increase Osmolality and Compromise the Safety of Enteral Feeding in Preterm Infants

Chandran et al, Neonatology, 2017  Abstract BACKGROUND: Medications added to preterm milk feeds have the potential to raise osmolality, causing feed intolerance and necrotizing enterocolitis. OBJECTIVE: The aim of this study was to evaluate changes in the osmolality of milk feeds and water with 14 medications and the diluent amounts required to…

Continue reading

The Effect of Head Positioning and Head Tilting on the Incidence of Intraventricular Hemorrhage in Very Preterm Infants: A Systematic Review

Bijl-Marcus, et al, Neonatology 2017 Abstract Background: Despite advances in neonatal intensive care, germinal matrix-intraventricular hemorrhage (GMH-IVH) remains a frequent, serious complication of premature birth. Neutral head position and head tilting have been suggested to reduce the risk of GMH-IVH in preterm infants during the first 72 h of life.…

Continue reading

Smell and Taste to Improve Nutrition in Very Preterm Infants: A Randomized Controlled Pilot Trial

Beker et al, Neonatology, 2017 Abstract Background: The perception of smell and taste, though present early in development, is not routinely considered in the care of preterm infants. Smell and taste are known to increase gut motility, insulin secretion, and the release of appetite, digestive and metabolic hormones. Objective: We…

Continue reading

Randomized Trial to Compare Renal Function and Ductal Response between Indomethacin and Ibuprofen Treatment in Extremely Low Birth Weight Infants

Lin et al, Neonatology, 2017 Abstract Background: A head to head comparison study on renal function and ductal response between indomethacin and ibuprofen has rarely been conducted in extremely low birth weight (ELBW) infants. Objectives: The aim was to compare renal function and ductal response between indomethacin and ibuprofen in…

Continue reading

Supplemental Iodide for Preterm Infants and Developmental Outcomes at 2 Years: An RCT

Williams et al, Pediatrics, May 2017 Abstract BACKGROUND: The recommendation for enteral iodide intake for preterm infants is 30 to 40 μg/kg per day and 1 μg/kg per day for parenteral intake. Preterm infants are vulnerable to iodide insufficiency and thyroid dysfunction. The hypothesis tested whether, compared with placebo, iodide supplementation of…

Continue reading

Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial

Kaufman et al, BMJ 2017 Objective To determine if a simple stimulation method increases the rate of infant voiding for clean catch urine within five minutes. Gentle suprapubic cutaneous stimulation using gauze soaked in cold fluid is used. Design Randomised controlled trial. Main outcome measures The primary outcome was voiding of urine within five…

Continue reading

Mid-Childhood Bone Mass After Exposure to Repeat Doses of Antenatal Glucocorticoids: A Randomized Trial

Christopher et al, Pediatrics, 2017 Abstract BACKGROUND AND OBJECTIVE: Treatment of women at risk for preterm birth with repeat doses of glucocorticoids reduces neonatal morbidity, but could have adverse effects on skeletal development. We assessed whether exposure to repeat antenatal betamethasone alters bone mass in children whose mothers participated in…

Continue reading

Prophylactic Early Erythropoietin for Neuroprotection in Preterm Infants: A Meta-analysis

Hendrik et al, Pediatrics, April 2017 Abstract CONTEXT: Recombinant human erythropoietin (rhEPO) is a promising pharmacological agent for neuroprotection in neonates. OBJECTIVE: To investigate whether prophylactic rhEPO administration in very preterm infants improves neurodevelopmental outcomes in a meta-analysis of randomized controlled trials (RCTs). DATA SOURCES: Medline, Embase, and the Cochrane…

Continue reading

Body Composition in Very Preterm Infants: Role of Neonatal Characteristics and Nutrition in Achieving Growth Similar to Term Infants

Tremblay et al, Neonatology 2017 Abstract Background: The identification of factors involved in the postnatal growth of preterm infants will help achieve growth similar to that of term infants. Objectives: As per protocol: to compare body composition in very preterm infants at term-corrected age (TCA) with that in term infants, and…

Continue reading