The use of the anticoagulant antithrombin to reduce the risk of intraventricular hemorrhage in very preterm infants

Bruschettini et al, 21 March 2016, Cochrane review Review question: Does antithrombin reduce the risk of intraventricular hemorrhage (i.e. bleeding in the brain) and mortality in very preterm infants? Background: Antithrombin is a drug that modulates blood coagulation together with other factors. Very low birth weight newborn infants (i.e. those neonates with a gestational age less than 32…

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Effect of Early Prophylactic High-Dose Recombinant Human Erythropoietin in Very Preterm Infants on Neurodevelopmental Outcome at 2 Years

Importance  Very preterm infants are at risk of developing encephalopathy of prematurity and long-term neurodevelopmental delay. Erythropoietin treatment is neuroprotective in animal experimental and human clinical studies. Objective  To determine whether prophylactic early high-dose recombinant human erythropoietin (rhEPO) in preterm infants improves neurodevelopmental outcome at 2 years’ corrected age. Main…

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Frequency of suctioning inside the tube that is used to ventilate newborn babies

Bruschettini et al, 6 March 2016, Cochrane review Review question: We reviewed the evidence about the effects of different strategies in the frequency of suctioning of newborn babies that are on ventilators. Our main interest was prevention of lung damage. Background: Newborns might need help with breathing as their lungs are still maturing.…

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The usefulness of protocols for reducing the time newborn infants spend on mechanical ventilation in the neonatal intensive care unit

Wielenga et al, 21 March 2016, Cochrane review Review question: Are protocols useful for reducing the time newborn infants spend on mechanicalventilation in the neonatal intensive care unit? Background: Mechanical ventilation is used to help newborns to breath when they are too sick or born too premature to breath on their own. However, mechanical ventilation is not without risk, and can…

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Propranolol in the Treatment of Infantile Haemangiomas

Wedgeworth et al, The British Journal of Dermatology. 2016 Abstract Background Oral propranolol is widely prescribed as first-line treatment for infantile haemangiomas (IHs). Anecdotally, prescribing practice differs widely between centres. Objectives The Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce was founded to establish patterns of use of propranolol in IHs.…

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Association Between Laboratory Calibration of a Serum Bilirubin Assay, Neonatal Bilirubin Levels, and Phototherapy Use

Kuzniewicz et al, JAMA Pediatr. April 11, 2016 Importance  The American Academy of Pediatrics treatment recommendations for neonatal jaundice are based on age-specific total serum bilirubin (TSB) levels. In May 2012, Ortho Clinical Diagnostics adjusted the calibrator values for Vitros Chemistry Products BuBc Slides (Ortho Clinical Diagnostics), a widely used method…

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Impact of antenatal steroids on intraventricular hemorrhage in very-low-birth weight infants

Wei et al, Journal of Perinatology, March 2016 Objective: To determine the association between antenatal steroids administration and intraventricular hemorrhage rates. Results: In 25 979 very-low-birth weight infants, antenatal steroid use was associated with a reduction in incidence of any grade of intraventricular hemorrhage (odds ratio=0.68, 95% confidence interval: 0.62, 0.75) and a reduction in…

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Neuroimaging identifies increased manganese deposition in infants receiving parenteral nutrition.

Aschner et al, Am J Clin Nutr. 2015 Dec Abstract BACKGROUND: Manganese, an essential metal for normal growth and development, is neurotoxic on excessive exposure. Standard trace element-supplemented neonatal parenteral nutrition (PN) has a high manganese content and bypasses normal gastrointestinal absorptive control mechanisms, which places infants at risk of manganese…

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Failed endotracheal intubation and adverse outcomes among extremely low birth weight infants.

Wallenstein et al, J Perinatol. 2016 Feb Abstract OBJECTIVE: To quantify the importance of successful endotracheal intubation on the first attempt among extremely low birth weight (ELBW) infants who require resuscitation after delivery. RESULTS: The study sample included 88 ELBW infants. Forty percent were intubated on the first attempt and 60%…

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Pathogen-Specific Clustering of Nosocomial Blood Stream Infections in Very Preterm Infants

Reichert et al, Pediatrics, March 2016 Abstract BACKGROUND AND OBJECTIVES: Nosocomial infections in NICUs tend to cluster, sometimes as devastating outbreaks, but pathogen-specific transmission probabilities are unknown. We aimed to quantify the pathogen-specific risk of a blood stream infection (BSI) in preterm infants after an index case with that pathogen…

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A Multifaceted Approach to Improving Outcomes in the NICU: The Pediatrix 100 000 Babies Campaign

Ellsbury et al, Pediatrics, April, 2016 Abstract BACKGROUND AND OBJECTIVE: Despite advances in neonatal medicine, infants requiring neonatal intensive care continue to experience substantial morbidity and mortality. The purpose of this initiative was to generate large-scale simultaneous improvements in multiple domains of care in a large neonatal network through a…

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Effect of early low-dose hydrocortisone on survival without bronchopulmonary dysplasia in extremely preterm infants (PREMILOC): a double-blind, placebo-controlled, multicentre, randomised trial

Baud et al, Lancet, February, 2016 Abstract BACKGROUND: Bronchopulmonary dysplasia, a major complication of extreme prematurity, has few treatment options. Postnatal steroid use is controversial, but low-dose hydrocortisone might prevent the harmful effects of inflammation on the developing lung. In this study, we aimed to assess whether low-dose hydrocortisone improved…

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Rumpel-Leede Phenomenon Associated With Tourniquet-like Forces of Baby Carriers in Otherwise Healthy Infants Baby Carrier Purpura

Naguyen et al, JAMA Dermatol. 2016 Feb 17. A case report described acute-onset lower-extremity petechiae and purpura caused by dermal capillary rupture from a baby carrier in otherwise healthy infants (Rumpel-Leede phenomenon). Acute-onset, localized petechiae and purpura of the lower extremities occurred in 3 otherwise healthy infants following recent exposure to baby…

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Total Duration of Breastfeeding, Vitamin D Supplementation, and Serum Levels of 25-Hydroxyvitamin D

Darmawikarta et al, Am J Public Health. 2016 Apr OBJECTIVES: To determine the association between total breastfeeding duration and serum 25-hydroxyvitamin D (25-OHD) and to explore whethervitamin D supplementation influences this association. RESULTS: Each 1-month increase in total breastfeeding duration was associated with a 0.12 nanograms per milliliter lower median serum…

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Prenatal exposure to antibiotics and wheezing in infancy: a birth cohort study

Popovic et al, Eur Respir J. 2016 Mar Abstract The role of prenatal antibiotic exposure in the development of childhood wheezing is debated. We evaluated whether this association could potentially be explained by confounding factors.Antibiotic use in the first and third trimester of pregnancy, wheezing in children aged ≤18 months and confounding…

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Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants

Pediatrics, April 2016, From the American Academy of Pediatrics, Clinical Practice Guideline This is the first clinical practice guideline from the American Academy of Pediatrics that specifically applies to patients who have experienced an apparent life-threatening event (ALTE). This clinical practice guideline has 3 objectives. First, it recommends the replacement of the…

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Early removal versus expectant management of central venous catheters in newborn infants with bloodstream infection

Vasudevan et al, 20 April 2016,Cochrane review Review question: In newborn infants with a bloodstream infection who have a central venous catheter in place, does early removal of the catheter reduce the riskof complications, including death and long-term disability? Background: Infection in the bloodstream is a frequent and harmful complication for newborn infants who have a central venous catheter (a cannula that extends several…

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