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…

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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…

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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…

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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…

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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…

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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.…

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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…

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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…

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Doxapram Treatment for Apnea of Prematurity: A Systematic Review

Vliegen­thart et al, Neona­tol­ogy, Octo­ber, 2016 Abstract Back­ground: Apnea of pre­ma­tu­ri­ty (AOP) is a com­mon com­pli­ca­tion of preterm birth, for which caf­feine is the first treat­ment of choice. In case of per­sis­tent AOP, doxapram has been advo­cat­ed as an addi­tion­al ther­a­py. Objec­tive: To iden­ti­fy and appraise all exist­ing evi­dence regard­ing effi­ca­cy and…

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Factors Associated With Provider Burnout in the NICU

Taw­fik et al, Pedi­atrics, April 2017 Abstract BACKGROUND: NICUs vary great­ly in patient acu­ity and vol­ume and rep­re­sent a wide array of orga­ni­za­tion­al struc­tures, but the effect of these dif­fer­ences on NICU providers is unknown. This study sought to test the rela­tion between provider burnout preva­lence and orga­ni­za­tion­al fac­tors in…

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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…

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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…

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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…

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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…

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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…

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Vitamin D for the management of asthma.

Mar­tineau et al, Cochrane Review, Sep­tem­ber 2016 Abstract Back­ground: Sev­er­al clin­i­cal tri­als of vit­a­min D to pre­vent asth­ma exac­er­ba­tion and improve asth­ma con­trol have been con­duct­ed in chil­dren and adults, but a meta-analy­sis restrict­ed to dou­ble-blind, ran­domised, place­bo-con­trolled tri­als of this inter­ven­tion is lack­ing. Authors’ con­clu­sions: Whilst we are con­fi­dent that Vit­a­min D reduced…

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Association Between Early Low-Dose Hydrocortisone Therapy in Extremely Preterm Neonates and Neurodevelopmental Outcomes at 2 Years of Age

Baud et al,  JAMA. 2017 Dex­am­etha­sone to pre­vent bron­chopul­monary dys­pla­sia in very preterm neonates was asso­ci­at­ed with adverse neu­rode­vel­op­men­tal events. Ear­ly low-dose hydro­cor­ti­sone treat­ment has been report­ed to improve sur­vival with­out bron­chopul­monary dys­pla­sia but its safe­ty with regard to neu­rode­vel­op­ment remains to be assessed. In an explorato­ry analy­sis of sec­ondary…

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Bacteremia in Children 3 to 36 Months Old After Introduction of Conjugated Pneumococcal Vaccines

Green­how et al, Pedi­atrics, March 2017 Abstract BACKGROUND AND OBJECTIVES: In June 2010, Kais er Per­ma­nente North­ern Cal­i­for­nia replaced all 7-valent pneu­mo­coc­cal con­ju­gate vac­cine (PCV7) vac­cines with the 13-valent pneu­mo­coc­cal con­ju­gate vac­cine (PCV13). Our objec­tives were to com­pare the inci­dence of bac­teremia in chil­dren 3 to 36 months old by 3…

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Increasing ED Use of Jet Injection of Lidocaine for IV-Related Pain Management

Jain et al, Pedi­atrics, March 2017 Abstract BACKGROUND AND OBJECTIVE: Venipunc­ture is a lead­ing cause of pro­ce­dur­al pain for chil­dren. Jet injec­tion of lido­caine (JIL; J-Tip) has been demon­strat­ed to be effec­tive in con­trol­ling intra­venous (IV) placement–related pain and, due to its rapid onset, is par­tic­u­lar­ly suit­ed to emer­gency depart­ment (ED) use.…

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Diet diversity, growth and adiposity in healthy breastfed infants fed homemade complementary foods

Mok et al, Inter­na­tion­al Jour­nal of Obe­si­ty advance online pub­li­ca­tion, March 2017 Background/Objectives: Infant com­ple­men­tary feed­ing is impor­tant for estab­lish­ing food pref­er­ences. Few stud­ies exist on the effects of infant com­ple­men­tary feed­ing choic­es (food prepa­ra­tion meth­ods) on dietary intake, growth or adi­pos­i­ty. We exam­ined whether pro­vi­sion of home­made com­ple­men­tary food is…

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Fish oil-derived fatty acids in pregnancy and wheeze and asthma in offspring

Bis­gaard et al. N Engl J Med, 2016 Abstract Back­ground Reduced intake of n-3 long-chain polyun­sat­u­rat­ed fat­ty acids (LCP­U­FAs) may be a con­tribut­ing fac­tor to the increas­ing preva­lence of wheez­ing dis­or­ders. We assessed the effect of sup­ple­men­ta­tion with n-3 LCP­U­FAs in preg­nant women on the risk of p ersis­tent wheeze and…

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The Role of Hydrocortisone in the Management of Bronchopulmonary Dysplasia

Monds, Pedi­atr Pharm. 2016; Although the clin­i­cal land­scape of bron­chopul­monary dys­pla­sia (BPD) has shift­ed over the years, BPD remains the most com­mon form of chron­ic lung dis­ease in infants. His­tor­i­cal­ly BPD was seen in preterm infants who had suf­fered vaso­trau­ma from aggres­sive mechan­i­cal ven­ti­la­tion. With advance­ments in med­ical care and the resul­tant sur­vival…

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Modifying the Infant’s Diet to Prevent Food Allergy.

Arch Dis Child. 2017 Rec­om­men­da­tions and guide­lines on the pre­ven­tion of food aller­gy have changed in recent decades. The aim of this review of the cur­rent evi­dence and ongo­ing stud­ies is to pro­vide a com­pre­hen­sive and up to date pic­ture of pre­ven­tion of food aller­gy for health­care pro­fes­sion­als. The review was…

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A Clinical Prediction Rule for Rebound Hyperbilirubinemia Following Inpatient Phototherapy

Chang et al, Pedi­atrics, Feb­ru­ary 2017 Abstract OBJECTIVES: The Amer­i­can Acad­e­my of Pedi­atrics pro­vides lit­tle guid­ance on when to dis­con­tin­ue pho­tother­a­py in new­borns treat­ed for hyper­biliru­bine­mia. We sought to devel­op a pre­dic­tion rule to esti­mate the prob­a­bil­i­ty of rebound hyper­biliru­bine­mia after inpa­tient pho­tother­a­py. METHODS: Sub­jects for this ret­ro­spec­tive cohort study were…

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Does Topical Lidocaine Reduce the Pain Associated With the Insertion of Nasal Continuous Positive Airway Pressure Prongs in Preterm Infants?: A Randomized, Controlled Pilot Trial.

Soli­man, Elsharkawy & Abdel-Hady. Clin J Pain. 2016 Nov Abstract OBJECTIVE: To eval­u­ate the effi­ca­cy of top­i­cal lido­caine 2% gel in reduc­ing the pain asso­ci­at­ed with the inser­tion of nasal con­tin­u­ous pos­i­tive air­way pres­sure (nCPAP) prongs in preterm infants. DISCUSSION: Data sug­gest that top­i­cal lido­caine did not reduce the pain asso­ci­at­ed…

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