Early Caffeine Administration and Neurodevelopmental Outcomes in Preterm Infants

Lod­ha et al, Pedi­atrics. 2018 Dec BACKGROUND: Although caf­feine use for apnea of pre­ma­tu­ri­ty is well stud­ied, the long-term safe­ty and ben­e­fit of rou­tine ear­ly caf­feine admin­is­tra­tion has not been explored. Our objec­tive was to deter­mine the asso­ci­a­tion between ear­ly (with­in 2 days of birth) ver­sus late caf­feine expo­sure and neu­rode­vel­op­men­tal out­comes…

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Behavioral problems are associated with cognitive and language scores in toddlers born extremely preterm

Lowe et al, Ear­ly Hum Dev. 2018 Dec OBJECTIVE:To eval­u­ate the rela­tion­ship of par­ent-report­ed child behav­iors on the Child Behav­ior Check­list (CBCL) to cog­ni­tion, lan­guage, and motor skills on the Bay­ley Scales of Infant and Tod­dler Devel­op­ment — III (Bay­ley-III) in tod­dlers born extreme­ly preterm. This study showed that par­ent report­ed behav­ior prob­lems were…

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Neonatal interventions for preventing cerebral palsy

Salam et al, Cochrane Sys­tem­at­ic Review.20 June 2018 Back­ground Cere­bral pal­sy is an umbrel­la term that encom­pass­es dis­or­ders of move­ment and pos­ture attrib­uted to non‐progressive dis­tur­bances occur­ring in the devel­op­ing foetal or infant brain. As there are diverse risk fac­tors and aeti­olo­gies, no one strat­e­gy will pre­vent cere­bral pal­sy. There­fore, there…

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Update on Vitamin E and Its Potential Role in Preventing or Treating Bronchopulmonary Dysplasia

Stone et al, Neona­tol­ogy, 2018 Abstract Vit­a­min E is obtained only through the diet and has a num­ber of impor­tant bio­log­i­cal activ­i­ties, includ­ing func­tion­ing as an antiox­i­dant. Evi­dence that free rad­i­cals may con­tribute to patho­log­i­cal process­es such as bron­chopul­monary dys­pla­sia (BPD), a dis­ease of pre­ma­tu­ri­ty asso­ci­at­ed with increased lung injury,…

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The Neuroprotective Effects of Hypothermia on Bilirubin-Induced Neurotoxicity in vitro

Kuter et al, Neona­tol­ogy, 2018 Back­ground: In high-risk new­borns indi­rect hyper­biliru­bine­mia can lead to acute biliru­bin encephalopa­thy and ker­nicterus. Despite the cur­rent ther­a­peu­tic modal­i­ties, pre­vent­ing or revers­ing the neu­ro­tox­i­c­i­ty can­not be achieved in all infants. Objec­tive: To inves­ti­gate the neu­ro­pro­tec­tive effects of hypother­mia on biliru­bin-induced tox­i­c­i­ty in pri­ma­ry mouse neu­ronal…

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Newborn Plasma Glucose Concentration Nadirs by Gestational-Age Group

Kaiser et al, Neona­tol­ogy, 2018 Abstract Back­ground: The glu­cose con­cen­tra­tions and times to nadir for new­borns of all ges­ta­tion­al ages when intra­partum glu­cose-con­tain­ing solu­tions are not rou­tine­ly pro­vid­ed are unknown. Objec­tive: To char­ac­ter­ize and com­pare pat­terns of ini­tial glu­cose con­cen­tra­tion nadirs by ges­ta­tion­al-age groups. Meth­ods: A cross-sec­tion­al cohort study of…

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Enteral Feeding as an Adjunct to Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy

Chang et al, Neona­tol­ogy 2018 Abstract Back­ground: With­hold­ing enter­al feed­ings dur­ing hypother­mia lacks sup­port­ing evi­dence. Objec­tives: We aimed to deter­mine if min­i­mal enter­al nutri­tion (MEN) dur­ing hypother­mia in patients with hypox­ic-ischemic encephalopa­thy was asso­ci­at­ed with a reduced dura­tion of par­enter­al nutri­tion, time to full oral feeds, and length of stay,…

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High-Dose Erythropoietin for Asphyxia and Encephalopathy (HEAL): A Randomized Controlled Trial – Background, Aims, and Study Protocol

Juul et al, Neona­tol­ogy 2018 Abstract Back­ground: Hypox­ic-ischemic encephalopa­thy (HIE) remains an impor­tant cause of neona­tal death and fre­quent­ly leads to sig­nif­i­cant long-term dis­abil­i­ty in sur­vivors. Ther­a­peu­tic hypother­mia, while ben­e­fi­cial, still leaves many treat­ed infants with life­long dis­abil­i­ties. Adjunc­tive ther­a­pies are need­ed, and ery­thro­poi­etin (Epo) has the poten­tial to pro­vide…

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Vitamin D and Its Role in Neonatal Hypoxic-Ischemic Brain Injury

Stess­man & Peeples, Neona­tol­ogy 2018 Abstract Emerg­ing evi­dence has demon­strat­ed that vit­a­min D plays an impor­tant role in many adult neu­ro­log­ic dis­or­ders, but is also crit­i­cal in neu­ronal devel­op­ment and prun­ing in the neona­tal and pedi­atric pop­u­la­tions. Neonates are at a par­tic­u­lar­ly high risk of vit­a­min D defi­cien­cy, in part due…

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High-Flow Nasal Cannula versus Nasal Continuous Positive Airway Pressure for Primary Respiratory Support in Preterm Infants with Respiratory Distress: A Randomized Controlled Trial

Mur­ki et al, Neona­tol­ogy 2018  Abstract Background:Nasal con­tin­u­ous pos­i­tive air­way pres­sure (nCPAP) is the stan­dard non­in­va­sive res­pi­ra­to­ry sup­port for new­borns with res­pi­ra­to­ry dis­tress. Evi­dence for high-flow nasal can­nu­la (HFNC) as an alter­na­tive mode of res­pi­ra­to­ry sup­port is incon­clu­sive. Objec­tive: The aim of this work was to eval­u­ate whether HFNC is not infe­ri­or…

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Gastro-Oesophageal Reflux and Apnoea: Is There a Temporal Relationship?

Rossor et al, Neona­tol­ogy 2018 Abstract Back­ground: Gas­tro-oesophageal reflux (GOR) and apnoea are com­mon in infants; whether there is a causal rela­tion­ship is con­tro­ver­sial.  Objec­tives: To deter­mine whether there  was a tem­po­ral rela­tion­ship between GOR and apnoea, in par­tic­u­lar, the fre­quen­cy of obstruc­tive apnoeas and if the fre­quen­cy of GOR episodes cor­re­lat­ed with…

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Low- versus High-Dose and Early versus Late Parenteral Amino-Acid Administration in Very-Low-Birth-Weight Infants: A Systematic Review and Meta-Analysis

Leen­ders et al, Neona­tol­ogy 2018 Abstract Objec­tives: Pro­vid­ing par­enter­al amino acids to very-low-birth-weight infants dur­ing the first weeks of life is crit­i­cal for ade­quate growth and neu­rode­vel­op­ment. How­ev­er, there is no con­sen­sus about what dose is appro­pri­ate or when to ini­ti­ate sup­ple­men­ta­tion. As a result, dai­ly prac­tice varies among neona­tal inten­sive care…

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Atraumatic versus conventional lumbar puncture needles: a systematic review and meta-analysis

Nath et al, The Lancet March 2018  Sum­ma­ry Back­ground Atrau­mat­ic nee­dles have been pro­posed to low­er com­pli­ca­tion rates after lum­bar punc­ture. How­ev­er, sev­er­al sur­veys indi­cate that clin­i­cal adop­tion of these nee­dles remains poor. We did a sys­tem­at­ic review and meta-analy­sis to com­pare patient out­comes after lum­bar punc­ture with atrau­mat­ic nee­dles…

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Human milk is perhaps the single most under-rated strategy to prevent bronchopulmonary dysplasia

Verd & Gino­vart, archdis­child-2018 Poets and Lorenz have pub­lished a thor­ough review on strate­gies (Arch Dis Child Fetal Neona­tal Ed 2018) like­ly to reduce bron­chopul­monary dys­pla­sia (BPD). They present an overview of the effec­tive­ness and safe­ty of inter­ven­tions backed by ran­domised con­trolled tri­als (RCT) and aimed at pre­vent­ing BPD. Their study con­cludes with…

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Afternoon napping during pregnancy and low birth weight: the Healthy Baby Cohort study

Song et al, Sleep Med. 2018 Apr 27 Abstract OBJECTIVE: Although after­noon nap­ping is very com­mon, par­tic­u­lar­ly in Chi­na, there are lim­it­ed data regard­ing the poten­tial health effects of after­noon nap­ping dur­ing preg­nan­cy on peri­na­tal out­comes. We aimed to inves­ti­gate the rela­tion­ship between after­noon­nap­ping dur­ing late preg­nan­cy and low birth weight (LBW). METHODS: A total of 10,111 women aged 15–50 years were recruit­ed from the ongo­ing Healthy Baby Cohort study in Chi­na, in 2012–2014.…

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Improved nutrition for extremely preterm infants — A population based observational study

West­in V, et al. Clin Nutr ESPEN. 2018. Abstract BACKGROUND AND AIMS: Extreme­ly preterm (EPT) infants are at high risk for mal­nu­tri­tion due to imma­tu­ri­ty and med­ical com­pli­ca­tions and they often accu­mu­late nutri­tion­al deficits and expe­ri­ence growth fal­ter­ing dur­ing treat­ment at neona­tal inten­sive care units (NICUs). Enhanced intake of ener­gy…

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Neonatal Hemodynamics: From Developmental Physiology to Comprehensive Monitoring

Vranck­en, et al, Front Pedi­atr. 2018 Apr (Depart­ment of Peri­na­tol­ogy (Neona­tol­ogy), Amalia Children’s Hos­pi­tal, Rad­boud Insti­tute for Health Sci­ences, Rad­boud Uni­ver­si­ty Med­ical Cen­ter, Nijmegen, Nether­lands) Main­te­nance of neona­tal cir­cu­la­to­ry home­osta­sis is a real chal­lenge, due to the com­plex phys­i­ol­o­gy dur­ing post­na­tal tran­si­tion and the inher­ent imma­tu­ri­ty of the car­dio­vas­cu­lar sys­tem…

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Management of term infants at increased risk for early-onset bacterial sepsis

Jef­feries, Pae­di­a­tr Child Health. 2017 Jul;22 (Cana­di­an Pae­di­atric Soci­ety, Fetus and New­born Com­mit­tee, Ottawa, Ontario) Back­ground Ear­ly-onset neona­tal bac­te­r­i­al sep­sis (EOS) has been defined as sep­sis occur­ring with­in the first sev­en days of life; most infants become symp­to­matic with­in 24 h of birth. EOS usu­al­ly results from ver­ti­cal trans­mis­sion and,…

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Effect of Atropine With Propofol vs Atropine With Atracurium and Sufentanil on Oxygen Desaturation in Neonates Requiring Nonemergency Intubation

A Ran­dom­ized Clin­i­cal Tri­al Dur­rmey­er, et al (the PRETTINEO Research Group) JAMA. 2018 Ques­tion  Does pre­med­ica­tion with propo­fol reduce the fre­quen­cy of pro­longed desat­u­ra­tion dur­ing naso­tra­cheal intu­ba­tion in neonates com­pared with the com­bi­na­tion of a rapid-onset short-act­ing opi­oid and a mus­cle relax­ant? Find­ings  In this ran­dom­ized clin­i­cal tri­al involv­ing 173…

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Miscellaneous. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. Sur­fac­tant can be used for RDS com­pli­cat­ed by con­gen­i­tal pneu­mo­nia (C1). 2. Sur­fac­tant ther­a­py can be used to improve oxy­gena­tion fol­low­ing pul­monary hem­or­rhage (C1). 3. The use of iNO in preterm babies should be lim­it­ed to those in clin­i­cal tri­als or those with…

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Pain and Sedation. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. The rou­tine use of mor­phine infu­sions in ven­ti­lat­ed preterm infants is not rec­om­mend­ed (C2). 2. Opi­oids should be used selec­tive­ly, when indi­cat­ed by clin­i­cal judge­ment and eval­u­a­tion of pain indi­ca­tors (D1). 3. Sucrose anal­ge­sia and oth­er non-phar­ma­co­log­i­cal meth­ods may be employed to reduce…

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Managing Blood Pressure and Perfusion.The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. Treat­ment of hypoten­sion is rec­om­mend­ed when it is con­firmed by evi­dence of poor tis­sue per­fu­sion such as olig­uria, aci­do­sis and poor cap­il­lary return rather than pure­ly on numer­i­cal val­ues (C2). 2. Hb con­cen­tra­tion should be main­tained with­in nor­mal lim­its. A sug­gest­ed Hb thresh­old…

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Monitoring and Supportive Care. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1.Body tem­per­a­ture should be main­tained at 36.5–37.5°C at all times (C1). 2.Most babies should be start­ed on intra­venous flu­ids of 70–80 ml/kg/day while being kept in a humid­i­fied incu­ba­tor although some very imma­ture babies may need more (B2). Flu­ids must be tai­lored indi­vid­u­al­ly accord­ing…

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Prophylactic treatment for sepsis. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. Infec­tion con­trol mea­sures should be strict­ly applied  2. Antibi­otics are often start­ed in babies with RDS until sep­sis has been ruled out, but poli­cies should be in place to nar­row the spec­trum and min­i­mize unnec­es­sary expo­sure. A com­mon reg­i­men includes peni­cillin or ampi­cillin in…

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