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

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. Babies with RDS should be giv­en a nat­ur­al sur­fac­tant prepa­ra­tion (A1). 2.A pol­i­cy of ear­ly res­cue  sur­fac­tant (with­in 2 hours of birth) should be stan­dard (A1) but there are occa­sions when sur­fac­tant should be admin­is­tered in the deliv­ery suite, such as those who…

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DELIVERY ROOM STABILIZATION. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1.If pos­si­ble delay clamp­ing the umbil­i­cal cord for at least 60 sec­onds to pro­mote pla­centofe­tal trans­fu­sion (B1). 2.Oxygen for resus­ci­ta­tion should be con­trolled using a blender. An ini­tial con­cen­tra­tion of 30%-60% oxy­gen is appro­pri­ate for babies <28 weeks’ ges­ta­tion and 21–30% for those of…

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

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. Moth­ers at high risk of preterm birth <34 weeks’ ges­ta­tion should be trans­ferred to peri­na­tal cen­ters with expe­ri­ence in the man­age­ment of RDS (C1) 2.Clinicians should offer a sin­gle course of pre­na­tal cor­ti­cos­teroids to all women at risk of preterm deliv­ery, from when…

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Effect of Prophylactic Indomethacin in Extremely Low Birth Weight Infants Based on the Predicted Risk of Severe Intraventricular Hemorrhage

Foglia et al, Neona­tol­ogy 2018 Abstract Back­ground: Pro­phy­lac­tic indomethacin reduces the risk of severe intra­ven­tric­u­lar hem­or­rhage (IVH) but does not reduce death or neu­rode­vel­op­men­tal impair­ment (NDI) among extreme­ly low birth weight (ELBW) infants. Some inves­ti­ga­tors have sug­gest­ed that pro­phy­lac­tic indomethacin may have a greater treat­ment effect on severe IVH among infants at high…

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Diagnosis and Management of Necrotizing Enterocolitis: An International Survey of Neonatologists and Pediatric Surgeons

Val­pa­cos et al, Neona­tol­ogy 2018 Abstract Back­ground: Necro­tiz­ing ente­ro­col­i­tis (NEC) is a seri­ous com­pli­ca­tion of pre­ma­tu­ri­ty. Cur­rent­ly, there is lim­it­ed evi­dence to guide inves­ti­ga­tion and treat­ment strate­gies.  Objec­tives: To eval­u­ate the para­me­ters used to diag­nose or exclude NEC, and to iden­ti­fy dif­fer­ences between neona­tol­o­gists and pedi­atric sur­geons.  Con­clu­sion: Results indi­cate a wide vari­a­tion in…

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The Laryngeal Mask Airway and Its Use in Neonatal Resuscitation: A Critical Review of Where We Are in 2017/2018

Bansal et al, Neona­tol­ogy 2018 Abstract Stud­ies using video­tape record­ings and res­pi­ra­to­ry func­tion mon­i­tor­ing have shown that both face mask (FM) appli­ca­tion and endo­tra­cheal tube (ETT) place­ment rep­re­sent a chal­lenge for resus­ci­ta­tors. Hence, there is a strong need for devices that can large­ly be used inde­pen­dent­ly of indi­vid­ual oper­a­tor train­ing lev­els,…

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Topical Coconut Oil in Very Preterm Infants: An Open-Label Randomised Controlled Trial

Strunk et al, Neona­tol­ogy 2018 Abstract Back­ground: The imma­ture frag­ile skin of preterm infants rep­re­sents an inad­e­quate pro­tec­tive bar­ri­er. The emol­lient and anti-infec­tive prop­er­ties of coconut oil make it a poten­tial­ly ben­e­fi­cial top­i­cal agent for this pop­u­la­tion.  Objec­tives: Our aim was to eval­u­ate fea­si­bil­i­ty, safe­ty, and the effects of top­i­cal coconut oil on…

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Early Use of Mother’s Own Raw Milk, Maternal Satisfaction, and Breastfeeding Continuation in Hospitalised Neonates: A Prospective Cohort Study

Fis­ch­er Fumeaux et al, Neona­tol­ogy 2018 Abstract Back­ground: Despite the crit­i­cal impor­tance of breast milk for preterm and sick neonates, there is no con­sen­sus regard­ing the use of raw mother’s own milk (MOM) in neona­tal units.  Objectives:This study aimed to describe the use of raw MOM in hos­pi­talised neonates before day 7…

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BMI Is a Better Body Proportionality Measure than the Ponderal Index and Weight-for-Length for Preterm Infants

Fer­gu­son et al, Neona­tol­ogy 2018 Abstract Back­ground: Clin­i­cians have observed preterm infants in the neona­tal inten­sive care unit grow­ing dis­pro­por­tion­al­ly; how­ev­er, the only growth charts that have been avail­able were from preterm infants born in the 1950s which uti­lized the pon­der­al index. Pri­or to cre­at­ing the recent­ly pub­lished BMI curves, we found only 1…

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Early Nutrition and Growth until the Corrected Age of 2 Years in Extremely Preterm Infants

Hiltunen et al, Neona­tol­ogy 2018   Abstract Back­ground: Extreme­ly preterm birth is asso­ci­at­ed with a high risk of extrauter­ine growth retar­da­tion, which has been linked with adverse devel­op­men­tal out­comes.    Objec­tive: We inves­ti­gat­ed whether nutri­tion­al man­age­ment dur­ing the first 7 days of life affects growth pat­terns until the cor­rect­ed age of 2 years…

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The Cerebellar-Cerebral Microstructure Is Disrupted at Multiple Sites in Very Preterm Infants with Cerebellar Haemorrhage

Neubauer et al, Neona­tol­ogy 2018   Abstract Back­ground:  Recent advances in mag­net­ic res­o­nance imag­ing (MRI) tech­niques have prompt­ed recon­sid­er­a­tion of the anatom­i­cal cor­re­lates of adverse out­comes in preterm infants. The impor­tance of the con­tri­bu­tion made by the cere­bel­lum is now increas­ing­ly appre­ci­at­ed. The effect of cere­bel­lar haem­or­rhage (CBH)on the microstruc­ture of the…

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Hypoxemia Episodes during Day and Night and Their Impact on Oxygen Saturation Targeting in Mechanically Ventilated Preterm Infants

Neona­tol­ogy 2018 Abstract Back­ground: Hypox­emia episodes (HE) occur fre­quent­ly in ven­ti­lat­ed preterm infants and hin­der the achieve­ment of arte­r­i­al oxy­gen sat­u­ra­tion (SpO2) tar­gets. These episodes may increase the risk for retinopa­thy of pre­ma­tu­ri­ty and neu­rode­vel­op­men­tal dis­abil­i­ty. There are no data on the vari­a­tion in HE and SpO2 tar­get­ing between day…

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Efficacy of Antenatal Corticosteroid Treatment on Neurodevelopmental Outcome according to Head Circumference at Birth

Bas­set et al, Neona­tol­ogy 2018 Abstract Back­ground: There are con­cerns about the effi­ca­cy of ante­na­tal cor­ti­cos­teroid treat­ment (ACT) in the growth-restrict­ed fetus. Objec­tive: To eval­u­ate the effect of ACT on neu­rode­vel­op­men­tal out­come at 2 years of cor­rect­ed age accord­ing to the z score of birth head cir­cum­fer­ence (ZS HC) in…

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Temperature Probe Placement during Preterm Infant Resuscitation: A Randomised Trial

Ben­sou­da et al, Neona­tol­ogy 2018 Abstract Back­ground: Hypother­mia on admis­sion to inten­sive care is asso­ci­at­ed with poor out­comes in preterm infants. The neona­tal resus­ci­ta­tion pro­gram rec­om­mends the use of ser­vo-con­trol ther­moreg­u­la­tion dur­ing resus­ci­ta­tion. Very lit­tle evi­dence exists to guide opti­mal tem­per­a­ture probe place­ment in the deliv­ery room. Objec­tive: The aim…

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The Impact of Maternal Gestational Hypertension and the Use of Anti-Hypertensives on Neonatal Myocardial Performance

Breat­nach et al, Neona­tol­ogy 2018 Abstract Back­ground: Assess­ment of myocar­dial per­for­mance in neonates using advanced tech­niques such as defor­ma­tion imag­ing and rota­tion­al mechan­ics has gained con­sid­er­able inter­est. The applic­a­bil­i­ty of these tech­niques for elu­ci­dat­ing abnor­mal myocar­dial per­for­mance in var­i­ous clin­i­cal sce­nar­ios is becom­ing estab­lished. We hypoth­e­sise that term infants born…

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Impact of Minimally Invasive Surfactant Therapy in Preterm Infants at 29–32 Weeks Gestation

Dar­gav­ille et al, Neona­tol­ogy 2018 Abstract Back­ground: Most preterm infants born at 29–32 weeks ges­ta­tion now avoid intu­ba­tion in ear­ly life, and thus lack the usu­al con­duit through which exoge­nous sur­fac­tant is giv­en if need­ed. Objec­tive: The aim of this work was to exam­ine whether a tech­nique of min­i­mal­ly inva­sive…

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First Trimester Vaginal Ureaplasma Biovar Colonization and Preterm Birth: Results of a Prospective Multicenter Study

Wald­ho­er et al, Neona­tol­ogy 2018 Back­ground: While there is a proven asso­ci­a­tion of upper gen­i­tal tract Ure­aplas­ma infec­tion dur­ing preg­nan­cy with adverse preg­nan­cy out­come, the effect of vagi­nal Ure­aplas­ma col­o­niza­tion on preterm deliv­ery has been con­tro­ver­sial­ly debat­ed. Objec­tives: We hypoth­e­sized that women with iso­la­tion of vagi­nal U. parvum but not…

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Parenteral Nutrition in Critically Ill Children

Nilesh and Mehta, N Engl J Med 2016 Ade­quate nutri­ent deliv­ery may help to off­set the cata­bol­ic bur­den imposed by crit­i­cal ill­ness, pre­vent­ing nutri­tion­al dete­ri­o­ra­tion and improv­ing out­comes. How­ev­er, ques­tions regard­ing the most appro­pri­ate dose of macronu­tri­ents, the route of deliv­ery, and par­tic­u­lar­ly the tim­ing of sup­ple­men­tal par­enter­al nutri­tion in crit­i­cal­ly…

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Newborn Bilirubin Screening for Biliary Atresia

Bil­iary atre­sia accounts for approx­i­mate­ly 60% of the liv­er trans­plan­ta­tions in infants younger than 1 year of age. These com­pli­cat­ed ear­ly trans­plan­ta­tions can be pre­vent­ed only with the use of the Kasai hepato­por­toen­teros­to­my. The suc­cess of the Kasai pro­ce­dure is var­ied, but a good out­come is more like­ly if the…

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Incidence of neonatal necrotising enterocolitis in high-income countries: a systematic review

Bat­ters­by et al, Arch Dis Child Fetal Neona­tal Ed. 2018 Jan Abstract The ear­ly sur­vival of preterm babies has increased in high-resource set­tings, and as a con­se­quence, the num­ber at risk of seri­ous com­pli­ca­tions that com­mon­ly occur in the neona­tal peri­od, such as necro­tis­ing ente­ro­col­i­tis (NEC), is increas­ing. NEC is now one of the…

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Nasal High-Flow Therapy for Primary Respiratory Support in Preterm Infants

Roberts  et al, N Engl J Med. 2016 Sep  Abstract BACKGROUND: Treat­ment with nasal high-flow ther­a­py has effi­ca­cy sim­i­lar to that of nasal con­tin­u­ous pos­i­tive air­way pres­sure (CPAP) when used as pos­tex­tu­ba­tion sup­port in neonates. The effi­ca­cy of high-flow ther­a­py as the pri­ma­rymeans of res­pi­ra­to­ry sup­port for preterm infants with res­pi­ra­to­ry dis­tress has not been proved.   CONCLUSIONS: When used as pri­ma­ry sup­port for preterm infants with res­pi­ra­to­ry dis­tress, high-flow ther­a­py result­ed in a sig­nif­i­cant­ly high­er rate of treat­ment fail­ure than did…

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Benefits and Risks of Antiretroviral Therapy for Perinatal HIV Prevention

Fowler et al, N Engl J Med. 2016 Nov   Abstract BACKGROUND: Ran­dom­ized-tri­al data on the risks and ben­e­fits of anti­retro­vi­ral ther­a­py (ART) as com­pared with zidovu­dine and sin­gle-dose nevi­rap­ine to pre­vent trans­mis­sion of the human immun­od­e­fi­cien­cy virus (HIV) in HIV-infect­ed preg­nant women with high CD4 counts are lack­ing. CONCLUSIONS: Ante­na­tal ART result­ed in sig­nif­i­cant­ly low­er rates of ear­ly HIV trans­mis­sion than…

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Survival and Neurodevelopmental Outcomes among Periviable Infants

Younge et al, N Engl J Med. 2017 Feb Abstract BACKGROUND: Data report­ed dur­ing the past 5 years indi­cate that rates of sur­vival have increased among infants born at the bor­der­line of via­bil­i­ty, but less is known about how increased rates of sur­vival among these infants relate to ear­ly child­hood neu­rode­vel­op­men­tal out­comes.   CONCLUSIONS: The rate of sur­vival with­out neu­rode­vel­op­men­tal impair­ment increased between 2000 and 2011 in this…

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 “عظماء أبو الريش الراحلون من ظلمات صندوق النسيان إلى أضواء المعرفة والعرفان”

  السيدات والسادة الزملاء الأفاضل السلام عليكم ورحمة الله وبركاته،،،  وفاء للوعد الذى قطعه عل نفسه ا.د. صلاح نصار الأستاذ المتفرغ بقسم طب الأطفال بكلية طب قصر العينى — جامعة القاهرة، والخادم العاشق فى محراب “البيت الكبير”، فقد وفقنا الله سبحانه وتعالى، إلى وضع استرتيجية، وأهداف وخطة تنفيذ الكتاب، الذى…

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