{"title":"Correction to: Recovery from HPV vaccination deficits caused by the COVID-19 pandemic in Germany: a modeling study of catch-up HPV vaccination among adolescent girls.","authors":"Kunal Saxena, Cornelia Wähner, Agnes Luzak, Thorsten Reuter, Edith Morais, Ya-Ting Chen","doi":"10.1007/s00431-024-05940-6","DOIUrl":"10.1007/s00431-024-05940-6","url":null,"abstract":"","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"118"},"PeriodicalIF":3.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-07DOI: 10.1007/s00431-024-05921-9
Nora Abd El-Alim Ebrahim, Madiha Hassan Bayoumi, Hanan El-Sayed Metwally
Both term and preterm infants are susceptible to pathological jaundice, a frequent condition that can cause long-lasting neurological damage. A novel treatment for indirect pathological hyperbilirubinemia is bilisphere phototherapy, which lowers total serum bilirubin just as well as exchange transfusions. A quasi-experimental research design was utilized in the current study. This study was conducted in Neonatal Intensive Care Unit at Benha Specialized Pediatric Hospital. A convenient sample of all available nurses (60) working in the previously mentioned setting. A purposive sample of neonates (90) with pathological jaundice which would be divided into control and study groups. Three tools were used: Tool I: A structured interview questionnaire sheet, Tool II: observational checklist for caring neonates with pathological jaundice, and Tool III: neonatal outcomes assessment sheet. There was a positive correlation between nurses' total performance regarding pathological jaundice and bilisphere phototherapy at pre-/post-education program implementation. Additionally, there were a positive correlation between neonates' outcomes in the study group and nurses' total performance post-program implementation.Conclusion the education program regarding pathological jaundice was effective in improving nurses' performance and neonates' bilirubin-induced neurological dysfunction post compared to pre-education program implementation. What is Known: • Pathological jaundice had directly effect on neurological status in neonates as aresults of accumulated bilirubin in basal gangelia in brain and bilirubin induced neurological dysfunction score considered important tool to indicate acute bilirubin encephalopathy. What is New: • Education programs and periodic training to medical team provide improvement their performance, nurse had significant role to provide neonates care in NICU. So, improve nurses performance lead to improve neonate outcomes. • Bilisphere phototherapy is an important device which had positive outcomes in pediatrics which improve neonates' health status, but its effect depends on provided effective nursing practice during therapy. • Pathological jaundice management with bilisphere phototherapy and bilirubin induced neurological dysfunction score working together to provide optimal care for neonates, which bilisphere phototherapy decrease bilirubin level and BIND score assess neurological status and detect any abnormalites during therapy.
{"title":"Effect of education program regarding pathological jaundice on nurses' performance and neonates' bilirubin-induced neurological dysfunction.","authors":"Nora Abd El-Alim Ebrahim, Madiha Hassan Bayoumi, Hanan El-Sayed Metwally","doi":"10.1007/s00431-024-05921-9","DOIUrl":"10.1007/s00431-024-05921-9","url":null,"abstract":"<p><p>Both term and preterm infants are susceptible to pathological jaundice, a frequent condition that can cause long-lasting neurological damage. A novel treatment for indirect pathological hyperbilirubinemia is bilisphere phototherapy, which lowers total serum bilirubin just as well as exchange transfusions. A quasi-experimental research design was utilized in the current study. This study was conducted in Neonatal Intensive Care Unit at Benha Specialized Pediatric Hospital. A convenient sample of all available nurses (60) working in the previously mentioned setting. A purposive sample of neonates (90) with pathological jaundice which would be divided into control and study groups. Three tools were used: Tool I: A structured interview questionnaire sheet, Tool II: observational checklist for caring neonates with pathological jaundice, and Tool III: neonatal outcomes assessment sheet. There was a positive correlation between nurses' total performance regarding pathological jaundice and bilisphere phototherapy at pre-/post-education program implementation. Additionally, there were a positive correlation between neonates' outcomes in the study group and nurses' total performance post-program implementation.Conclusion the education program regarding pathological jaundice was effective in improving nurses' performance and neonates' bilirubin-induced neurological dysfunction post compared to pre-education program implementation. What is Known: • Pathological jaundice had directly effect on neurological status in neonates as aresults of accumulated bilirubin in basal gangelia in brain and bilirubin induced neurological dysfunction score considered important tool to indicate acute bilirubin encephalopathy. What is New: • Education programs and periodic training to medical team provide improvement their performance, nurse had significant role to provide neonates care in NICU. So, improve nurses performance lead to improve neonate outcomes. • Bilisphere phototherapy is an important device which had positive outcomes in pediatrics which improve neonates' health status, but its effect depends on provided effective nursing practice during therapy. • Pathological jaundice management with bilisphere phototherapy and bilirubin induced neurological dysfunction score working together to provide optimal care for neonates, which bilisphere phototherapy decrease bilirubin level and BIND score assess neurological status and detect any abnormalites during therapy.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"120"},"PeriodicalIF":3.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-07DOI: 10.1007/s00431-024-05955-z
Hui-Hui Chu, Ru Zhang, Ling-Ling Han, Ji-Feng Yu
{"title":"Correction to: Study on the impact of children's myopia on parental anxiety levels and its related factors.","authors":"Hui-Hui Chu, Ru Zhang, Ling-Ling Han, Ji-Feng Yu","doi":"10.1007/s00431-024-05955-z","DOIUrl":"10.1007/s00431-024-05955-z","url":null,"abstract":"","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"119"},"PeriodicalIF":3.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-07DOI: 10.1007/s00431-024-05963-z
Sapna Dhiman, Ramesh K Goyal, Puneeta Ajmera, Sheffali Gulati
Cerebral palsy (CP) is not just caused by neuromuscular abnormalities; it is also a result of an impaired sensory system. Since there is not a standardized measure to evaluate sensory processing of children with spastic CP, therefore an in-depth assessment of sensory processing deficits in children with spastic CP would require an understanding of the validity and reliability of the Child Sensory Profile-2 (CSP-2) in children with spastic CP. The sample of this study included 230 children with spastic CP aged 3 to 14 years who referred to different paediatric rehabilitation centres of Delhi-NCR from April 2021 and September 2023 by using the snowball sampling procedure. To collect the data, the CSP-2 caregiver questionnaire was used. For validity, face and content validity were determined. For reliability, internal consistency of all the responses was examined using Cronbach's alpha reliability coefficient. For validity, experts involved in the study reported that the organization and design of the questionnaire would be appropriate for the children with spastic CP. All the items of the CSP-2 questionnaire were simple and easy to understand. Internal consistency was also calculated for total items (N = 86) and found to be 0.898 which indicates that all items of the questionnaire are internally consistent and reliable.
Conclusion: According to the findings of our study, the CSP-2 is a valid and reliable measure for evaluating sensory processing in children with spastic CP. Additionally, it may be an appropriate tool for accurately assessing this population's sensory processing deficits.
What is known: • Sensory processing deficits commonly concur with motor deficit in children with CP. Overall prevelance of sensory processing deficit was 83% in children with CP.
What is new: • Child Sensory Profile-2 is a reliable and valid tool for measuring sensory processing abilities in children with CP.
{"title":"Psychometric properties of Child Sensory Profile-2 (CSP-2) among children with spastic cerebral palsy.","authors":"Sapna Dhiman, Ramesh K Goyal, Puneeta Ajmera, Sheffali Gulati","doi":"10.1007/s00431-024-05963-z","DOIUrl":"10.1007/s00431-024-05963-z","url":null,"abstract":"<p><p>Cerebral palsy (CP) is not just caused by neuromuscular abnormalities; it is also a result of an impaired sensory system. Since there is not a standardized measure to evaluate sensory processing of children with spastic CP, therefore an in-depth assessment of sensory processing deficits in children with spastic CP would require an understanding of the validity and reliability of the Child Sensory Profile-2 (CSP-2) in children with spastic CP. The sample of this study included 230 children with spastic CP aged 3 to 14 years who referred to different paediatric rehabilitation centres of Delhi-NCR from April 2021 and September 2023 by using the snowball sampling procedure. To collect the data, the CSP-2 caregiver questionnaire was used. For validity, face and content validity were determined. For reliability, internal consistency of all the responses was examined using Cronbach's alpha reliability coefficient. For validity, experts involved in the study reported that the organization and design of the questionnaire would be appropriate for the children with spastic CP. All the items of the CSP-2 questionnaire were simple and easy to understand. Internal consistency was also calculated for total items (N = 86) and found to be 0.898 which indicates that all items of the questionnaire are internally consistent and reliable.</p><p><strong>Conclusion: </strong>According to the findings of our study, the CSP-2 is a valid and reliable measure for evaluating sensory processing in children with spastic CP. Additionally, it may be an appropriate tool for accurately assessing this population's sensory processing deficits.</p><p><strong>What is known: </strong>• Sensory processing deficits commonly concur with motor deficit in children with CP. Overall prevelance of sensory processing deficit was 83% in children with CP.</p><p><strong>What is new: </strong>• Child Sensory Profile-2 is a reliable and valid tool for measuring sensory processing abilities in children with CP.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"121"},"PeriodicalIF":3.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-06DOI: 10.1007/s00431-024-05950-4
Yunus Yasar, Mehmet Coskun, Elif Yasar, Ela Cem, Miray Celebi-Yilmaz, Sahika Sahinkaya, Ozlem Sarac-Sandal, Hasan Agin
<p><p>This study aimed to evaluate pathological findings on abdominal ultrasonography upon admission of children diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) that were associated with a more severe disease course and the need for intensive care unit (ICU) admission. This retrospective and observational study was conducted between March 2020 and May 2022. Abdominal ultrasonography findings were evaluated in children diagnosed with MIS-C associated with SARS-CoV-2. Ultrasound examinations were conducted within the first 24 h following hospital admission. Clinical severity was categorized as mild-moderate or severe based on the highest clinical severity score observed at any point during hospitalization, using the criteria of dehydration, oxygen or inotropic requirements, cardiac involvement, and respiratory support. The indications of ICU admission were decreased ejection fraction, pulmonary involvement, and any signs of shock. We compared the presence of any individual ultrasonography findings with clinical severity and the need for ICU admission. Multivariable logistic regression analysis was performed to identify independent sonographic predictors of clinical severity and ICU admission. A total of 70 children were included in the study, 16 of whom (23%) were categorized as having severe diseases. ICU admission was required for 14 children (20%), 13 of whom had severe disease. Notably, three children with severe clinical scores did not require ICU admission. The most common ultrasonography findings were intra-abdominal free fluid (41%), hepatomegaly (36%), splenomegaly (33%), mesenteric inflammation (21%) and mesenteric lymphadenopathy (%19). Intra-abdominal free fluid (p < 0.001; OR = 18.20; 95% CI, 3.69-89.86), mesenteric inflammation (p < 0.001; OR = 10.29; 95% CI, 2.80-37.83), mesenteric lymphadenopathy (p = 0.007; OR = 6.22; 95% CI; 1.69-22.88), and hepatosplenomegaly (p = 0.039; OR = 3.89; 95% CI, 1.15-13.17) were substantially associated with severe clinical outcomes. Intra-abdominal free fluid (p < 0.001; OR = 13.76; 95% CI, 2.77-68.29) and hepatosplenomegaly (p = 0.002; OR = 8.00; 95% CI, 2.19-29.25) were significantly more common in children who required ICU admission. Multivariable logistic regression analysis revealed that intra-abdominal free fluid was an independent predictor of severe disease (p = 0.026; OR = 7.41; 95% CI, 1.28-43.00) and ICU admission (p = 0.007; OR = 9.80; 95% CI, 1.88-51.04).</p><p><strong>Conclusion: </strong>Abdominal ultrasonography findings may indicate clinical severity in children with MIS-C. Intra-abdominal free fluid strongly correlates with severe clinical outcomes and the need for intensive care.</p><p><strong>What is known: </strong>• Abdominal ultrasonography findings in children with MIS-C are non-specific and include intra-abdominal free fluid, mesenteric lymphadenopathy, and hepatosplenomegaly. • MIS-C is associated with significant systemic inflammation and can present wit
{"title":"The association between abdominal ultrasound findings and clinical severity in MIS-C children with extracardiac symptoms.","authors":"Yunus Yasar, Mehmet Coskun, Elif Yasar, Ela Cem, Miray Celebi-Yilmaz, Sahika Sahinkaya, Ozlem Sarac-Sandal, Hasan Agin","doi":"10.1007/s00431-024-05950-4","DOIUrl":"10.1007/s00431-024-05950-4","url":null,"abstract":"<p><p>This study aimed to evaluate pathological findings on abdominal ultrasonography upon admission of children diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) that were associated with a more severe disease course and the need for intensive care unit (ICU) admission. This retrospective and observational study was conducted between March 2020 and May 2022. Abdominal ultrasonography findings were evaluated in children diagnosed with MIS-C associated with SARS-CoV-2. Ultrasound examinations were conducted within the first 24 h following hospital admission. Clinical severity was categorized as mild-moderate or severe based on the highest clinical severity score observed at any point during hospitalization, using the criteria of dehydration, oxygen or inotropic requirements, cardiac involvement, and respiratory support. The indications of ICU admission were decreased ejection fraction, pulmonary involvement, and any signs of shock. We compared the presence of any individual ultrasonography findings with clinical severity and the need for ICU admission. Multivariable logistic regression analysis was performed to identify independent sonographic predictors of clinical severity and ICU admission. A total of 70 children were included in the study, 16 of whom (23%) were categorized as having severe diseases. ICU admission was required for 14 children (20%), 13 of whom had severe disease. Notably, three children with severe clinical scores did not require ICU admission. The most common ultrasonography findings were intra-abdominal free fluid (41%), hepatomegaly (36%), splenomegaly (33%), mesenteric inflammation (21%) and mesenteric lymphadenopathy (%19). Intra-abdominal free fluid (p < 0.001; OR = 18.20; 95% CI, 3.69-89.86), mesenteric inflammation (p < 0.001; OR = 10.29; 95% CI, 2.80-37.83), mesenteric lymphadenopathy (p = 0.007; OR = 6.22; 95% CI; 1.69-22.88), and hepatosplenomegaly (p = 0.039; OR = 3.89; 95% CI, 1.15-13.17) were substantially associated with severe clinical outcomes. Intra-abdominal free fluid (p < 0.001; OR = 13.76; 95% CI, 2.77-68.29) and hepatosplenomegaly (p = 0.002; OR = 8.00; 95% CI, 2.19-29.25) were significantly more common in children who required ICU admission. Multivariable logistic regression analysis revealed that intra-abdominal free fluid was an independent predictor of severe disease (p = 0.026; OR = 7.41; 95% CI, 1.28-43.00) and ICU admission (p = 0.007; OR = 9.80; 95% CI, 1.88-51.04).</p><p><strong>Conclusion: </strong>Abdominal ultrasonography findings may indicate clinical severity in children with MIS-C. Intra-abdominal free fluid strongly correlates with severe clinical outcomes and the need for intensive care.</p><p><strong>What is known: </strong>• Abdominal ultrasonography findings in children with MIS-C are non-specific and include intra-abdominal free fluid, mesenteric lymphadenopathy, and hepatosplenomegaly. • MIS-C is associated with significant systemic inflammation and can present wit","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"117"},"PeriodicalIF":3.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Osteosarcoma (OS) bone tumor of childhood although the etiology of OS has not been fully elucidated, there is evidence linking it with factors related to pubertal development. In recent years, plasma CNP concentration and height velocity in children and CNP have been implicated as an emerging new growth marker during childhood. We aimed to determine the serum NT-proCNP levels of patients with pediatric osteosarcoma and its relation with clinical-laboratory growth parameters and look for any correlation of serum NT-proCNP levels with different prognostic factors in childhood osteosarcoma. This study enrolled 15 newly diagnosed OS patients and 31 healthy controls. All subjects were physically examined. Plasma NT-proCNP concentration was measured by enzyme-linked immunosorbent assay. Our results demonstrated that serum NT-proCNP concentration was significantly different between OS patients and control groups. At diagnosis, the OS patient's mean blood NT-proCNP concentration was 49.7 ± 3.3 pmol/l, which was substantially lower than the control group's concentration of 61.4 ± 3.10 pmol/l (p < 0.005). No significant correlation was found between serum NT-proCNP concentration and growth parameters.
Conclusion: In conclusion, we found that the serum NT-proCNP concentration was significantly different between OS patients and control groups. It is predicted that our results will contribute to osteosarcoma biology.
What is known: • Osteosarcoma (OS) is the most common malignant bone tumor of childhood, affecting rapidly growing bones with factors associated with rapid bone growth, although its etiology is not fully understood. • The current literature suggests that the main role of the CNP/NPR-B signaling pathway is associated with endochondral bone development and related growth in long bones.
What is new: • We demonstrated that serum NT-proCNP concentration was significantly different between OS patients and control groups and could be used as a potential biomarker. • To our knowledge, this is the first clinical study evaluating the relation of serum serum NT-proCNP levels with anthropometric parameters in osteosarcoma patient with a particular interest to identify the possible role of CNP in pediatric osteosarcoma and its relationship with prognostic factors.
{"title":"Investigation of serum C-type natriuretic peptide concentration at diagnosis and remission in pediatric osteosarcomas.","authors":"Sonay İncesoy Özdemir, Gülben Akcan, Ahmet Çevik Tufan, Arzu Yazal Erdem, Selma Çakmakcı, Derya Özyörük, Neriman Sarı, Naciye Lale Şatıroğlu Tufan, İnci Ergürhan İlhan","doi":"10.1007/s00431-024-05949-x","DOIUrl":"10.1007/s00431-024-05949-x","url":null,"abstract":"<p><p>Osteosarcoma (OS) bone tumor of childhood although the etiology of OS has not been fully elucidated, there is evidence linking it with factors related to pubertal development. In recent years, plasma CNP concentration and height velocity in children and CNP have been implicated as an emerging new growth marker during childhood. We aimed to determine the serum NT-proCNP levels of patients with pediatric osteosarcoma and its relation with clinical-laboratory growth parameters and look for any correlation of serum NT-proCNP levels with different prognostic factors in childhood osteosarcoma. This study enrolled 15 newly diagnosed OS patients and 31 healthy controls. All subjects were physically examined. Plasma NT-proCNP concentration was measured by enzyme-linked immunosorbent assay. Our results demonstrated that serum NT-proCNP concentration was significantly different between OS patients and control groups. At diagnosis, the OS patient's mean blood NT-proCNP concentration was 49.7 ± 3.3 pmol/l, which was substantially lower than the control group's concentration of 61.4 ± 3.10 pmol/l (p < 0.005). No significant correlation was found between serum NT-proCNP concentration and growth parameters.</p><p><strong>Conclusion: </strong>In conclusion, we found that the serum NT-proCNP concentration was significantly different between OS patients and control groups. It is predicted that our results will contribute to osteosarcoma biology.</p><p><strong>What is known: </strong>• Osteosarcoma (OS) is the most common malignant bone tumor of childhood, affecting rapidly growing bones with factors associated with rapid bone growth, although its etiology is not fully understood. • The current literature suggests that the main role of the CNP/NPR-B signaling pathway is associated with endochondral bone development and related growth in long bones.</p><p><strong>What is new: </strong>• We demonstrated that serum NT-proCNP concentration was significantly different between OS patients and control groups and could be used as a potential biomarker. • To our knowledge, this is the first clinical study evaluating the relation of serum serum NT-proCNP levels with anthropometric parameters in osteosarcoma patient with a particular interest to identify the possible role of CNP in pediatric osteosarcoma and its relationship with prognostic factors.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"116"},"PeriodicalIF":3.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-04DOI: 10.1007/s00431-024-05947-z
Allan Jenkinson, Theodore Dassios, Nandiran Ratnavel, Anne Greenough
Infants requiring interhospital transfer for a higher level of care in the neonatal period are at increased risk of adverse outcomes. Optimising respiratory management is an important priority. The aim of this survey was to investigate current respiratory support strategies in neonatal transport and identify opportunities for the optimisation of clinical care and future research. A survey of all 18 transport groups in Ireland and the UK was performed. A 10-item structured questionnaire was administered through consultant neonatologists or lead nurses from each transport group between May and June 2024. There was a 100% response rate. There was variation in the types of neonatal ventilator used, and they differed from those on NICUs. A variety of invasive strategies were used, but volume-targeted ventilation was the most common, although different ventilators can deliver different volumes despite apparently the same settings. Non-invasive strategies were used by all, with humidified high flow nasal cannula (HHFNC) being the most common. Continuous carbon dioxide (CO2) monitoring was used by most teams (94%): endotracheal CO2 assessments by 94% and transcutaneous monitoring by 70%. Only two teams employed closed loop automated oxygen control (CLAC).
Conclusion: There is heterogeneity in the ventilators and respiratory strategies used by transport groups. Future research opportunities should include the comparison of those strategies on short- and long-term outcomes, as well as whether continuous CO2 monitoring and CLAC have important benefits.
What is known: • Nearly one quarter of neonatal transfers in the UK and Ireland are in infants mechanically ventilated. • Optimising respiratory support strategies and reporting respiratory outcomes are research priorities in neonatal transport.
What is new: • Volume targeted ventilation is the most common respiratory support strategy used in neonatal transport groups in the UK and Ireland, with a heterogeneity of ventilators in use in neonatal transport versus in NICUs. • There is a paucity of data reporting respiratory outcomes following neonatal transport including outcomes related to mode of ventilation, continuous carbon dioxide monitoring and closed loop automated oxygen control.
{"title":"Respiratory support strategies in neonatal transport in the UK and Ireland.","authors":"Allan Jenkinson, Theodore Dassios, Nandiran Ratnavel, Anne Greenough","doi":"10.1007/s00431-024-05947-z","DOIUrl":"10.1007/s00431-024-05947-z","url":null,"abstract":"<p><p>Infants requiring interhospital transfer for a higher level of care in the neonatal period are at increased risk of adverse outcomes. Optimising respiratory management is an important priority. The aim of this survey was to investigate current respiratory support strategies in neonatal transport and identify opportunities for the optimisation of clinical care and future research. A survey of all 18 transport groups in Ireland and the UK was performed. A 10-item structured questionnaire was administered through consultant neonatologists or lead nurses from each transport group between May and June 2024. There was a 100% response rate. There was variation in the types of neonatal ventilator used, and they differed from those on NICUs. A variety of invasive strategies were used, but volume-targeted ventilation was the most common, although different ventilators can deliver different volumes despite apparently the same settings. Non-invasive strategies were used by all, with humidified high flow nasal cannula (HHFNC) being the most common. Continuous carbon dioxide (CO<sub>2</sub>) monitoring was used by most teams (94%): endotracheal CO<sub>2</sub> assessments by 94% and transcutaneous monitoring by 70%. Only two teams employed closed loop automated oxygen control (CLAC).</p><p><strong>Conclusion: </strong>There is heterogeneity in the ventilators and respiratory strategies used by transport groups. Future research opportunities should include the comparison of those strategies on short- and long-term outcomes, as well as whether continuous CO<sub>2</sub> monitoring and CLAC have important benefits.</p><p><strong>What is known: </strong>• Nearly one quarter of neonatal transfers in the UK and Ireland are in infants mechanically ventilated. • Optimising respiratory support strategies and reporting respiratory outcomes are research priorities in neonatal transport.</p><p><strong>What is new: </strong>• Volume targeted ventilation is the most common respiratory support strategy used in neonatal transport groups in the UK and Ireland, with a heterogeneity of ventilators in use in neonatal transport versus in NICUs. • There is a paucity of data reporting respiratory outcomes following neonatal transport including outcomes related to mode of ventilation, continuous carbon dioxide monitoring and closed loop automated oxygen control.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"115"},"PeriodicalIF":3.0,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-02DOI: 10.1007/s00431-024-05948-y
Paola Roca-LLabrés, Melissa Fontalvo-Acosta, Victoria Aldecoa-Bilbao, Ana Alarcón
Purpose: Perinatal hypoxic-ischemic encephalopathy (HIE) is a significant cause of neonatal brain injury. Therapeutic hypothermia (TH) is the standard treatment for term neonates, but its safety and efficacy in neonates < 36 weeks gestational age (GA) remains unclear. This case series aimed to evaluate the outcomes of preterm infants with HIE treated with TH.
Methods: Retrospective analysis of preterm infants (< 36w GA) treated with TH (01/2019-06/2024). Data on demographics, clinical complications, coagulation profiles, brain magnetic resonance imaging (MRI), and neurodevelopment outcomes were analyzed.
Results: Seventeen patients were included (range 32.5-35.5w, median 34.4; birthweight range 1556-2493 g, median 2300 g), 58.8% were male. Placental abruption was identified in 7 cases (41.2%), and 8 (47.1%) required advanced resuscitation. Thirteen patients (76.5%) presented anemia, 12 (70.6%) coagulopathy, 9 (52.9%) thrombocytopenia, and 9 (52.9%) acute liver failure. Hypofibrinogenemia (< 1 g/L) was significantly associated with severe intracranial hemorrhage (ICH), defined as extracerebral, intraventricular or parenchymal hemorrhage causing mass effect. MRI findings were classified based on the predominant lesion: I- hypoxic-ischemic injury, II- severe ICH, or III- normal/mild findings. Severe ICH was the predominant lesion in 4 cases (23.5%). White matter injury was seen in 12 (76%). Death occurred in 8 cases (47.1%). Of the 9 surviving patients, at 2 years, 6 (66.7%) had normal neurodevelopment, while 1 (11.1%) had severe disability.
Conclusion: Coagulation abnormalities, particularly hypofibrinogenemia, significantly increase the risk of severe ICH in < 36w infants treated with TH. The safety and efficacy of TH in this population require further investigation.
{"title":"Therapeutic hypothermia in preterm infants under 36 weeks: Case series on outcomes and brain MRI findings.","authors":"Paola Roca-LLabrés, Melissa Fontalvo-Acosta, Victoria Aldecoa-Bilbao, Ana Alarcón","doi":"10.1007/s00431-024-05948-y","DOIUrl":"10.1007/s00431-024-05948-y","url":null,"abstract":"<p><strong>Purpose: </strong>Perinatal hypoxic-ischemic encephalopathy (HIE) is a significant cause of neonatal brain injury. Therapeutic hypothermia (TH) is the standard treatment for term neonates, but its safety and efficacy in neonates < 36 weeks gestational age (GA) remains unclear. This case series aimed to evaluate the outcomes of preterm infants with HIE treated with TH.</p><p><strong>Methods: </strong>Retrospective analysis of preterm infants (< 36w GA) treated with TH (01/2019-06/2024). Data on demographics, clinical complications, coagulation profiles, brain magnetic resonance imaging (MRI), and neurodevelopment outcomes were analyzed.</p><p><strong>Results: </strong>Seventeen patients were included (range 32.5-35.5w, median 34.4; birthweight range 1556-2493 g, median 2300 g), 58.8% were male. Placental abruption was identified in 7 cases (41.2%), and 8 (47.1%) required advanced resuscitation. Thirteen patients (76.5%) presented anemia, 12 (70.6%) coagulopathy, 9 (52.9%) thrombocytopenia, and 9 (52.9%) acute liver failure. Hypofibrinogenemia (< 1 g/L) was significantly associated with severe intracranial hemorrhage (ICH), defined as extracerebral, intraventricular or parenchymal hemorrhage causing mass effect. MRI findings were classified based on the predominant lesion: I- hypoxic-ischemic injury, II- severe ICH, or III- normal/mild findings. Severe ICH was the predominant lesion in 4 cases (23.5%). White matter injury was seen in 12 (76%). Death occurred in 8 cases (47.1%). Of the 9 surviving patients, at 2 years, 6 (66.7%) had normal neurodevelopment, while 1 (11.1%) had severe disability.</p><p><strong>Conclusion: </strong>Coagulation abnormalities, particularly hypofibrinogenemia, significantly increase the risk of severe ICH in < 36w infants treated with TH. The safety and efficacy of TH in this population require further investigation.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"113"},"PeriodicalIF":3.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-02DOI: 10.1007/s00431-024-05923-7
F M Kemme, E L van den Berg, A Meij-de Vries, R K Gigengack, M D Cuijpers, M E van Baar, M K Nieuwenhuis, P P M van Zuijlen, C H van der Vlies, E Bosma, A Pijpe
Knowledge about trends and epidemiology of pediatric burns is useful to identify patterns, to advance medical research, and to design prevention programs and resource allocation. The aim of this study is to describe the epidemiology and trends of pediatric burns between 2009 and 2022 in the three Dutch burn centers. A secondary objective of this study is to evaluate the influence of the COVID-19 pandemic on the pattern of pediatric burns. A register-based cohort study was conducted based on data from the Dutch Burn Repository R3. Patients between 0 and 17 years at the time of the burn injury admitted between 2009 and 2022 to one of the three burn centers were included. Descriptive statistics were used to investigate the incidence and patient, burn, and treatment characteristics. The COVID-19 pandemic years (2020-2021) were compared with the pooled results from pre-COVID-19 years (2017-2019). A total of 4017 patients were included in this study, of which 3085 (77%) were overnight admissions. The incidence and absolute number of pediatric burn admissions gradually increased over the years, with a small temporary decrease in 2020-2021. Patient and burn characteristics remained relatively consistent over the years. Three quarters of all patients were between 0 and 3 years old, and the majority were boys (59%). A decreasing ratio of length of stay per % total burned surface area and an increase in day admissions was observed since 2016 onwards, which intensified during the COVID-19 pandemic.
Conclusions: There was a slight increase in the number of pediatric admissions to the burn centers between 2009 and 2022. Young children (0-3 years) remain the most frequently affected group. A shorter relative length of stay was observed, as well as an increase in day admissions, which was reinforced by the COVID-19 pandemic.
What is known: • Burns are a leading cause of death and disability among children globally. The largest group affected are young children (0-3 years) and most are scald burns. • In the Netherlands, since the late nineties there has been a trend towards more admissions to specialized burn centers, especially for young children with less severe burns.
What is new: • There was a slight increase in the number of pediatric admissions to the burn centers between 2009 and 2022, with a temporary decrease during the COVID-19 pandemic (2020-2021). • Admissions now tend to be shorter per percentage total burned surface area (TBSA), with an increase in day admissions, which intensified during the COVID-19 years.
{"title":"Trends and epidemiology of children treated in specialized burn centers in the Netherlands between 2009 and 2022.","authors":"F M Kemme, E L van den Berg, A Meij-de Vries, R K Gigengack, M D Cuijpers, M E van Baar, M K Nieuwenhuis, P P M van Zuijlen, C H van der Vlies, E Bosma, A Pijpe","doi":"10.1007/s00431-024-05923-7","DOIUrl":"10.1007/s00431-024-05923-7","url":null,"abstract":"<p><p>Knowledge about trends and epidemiology of pediatric burns is useful to identify patterns, to advance medical research, and to design prevention programs and resource allocation. The aim of this study is to describe the epidemiology and trends of pediatric burns between 2009 and 2022 in the three Dutch burn centers. A secondary objective of this study is to evaluate the influence of the COVID-19 pandemic on the pattern of pediatric burns. A register-based cohort study was conducted based on data from the Dutch Burn Repository R3. Patients between 0 and 17 years at the time of the burn injury admitted between 2009 and 2022 to one of the three burn centers were included. Descriptive statistics were used to investigate the incidence and patient, burn, and treatment characteristics. The COVID-19 pandemic years (2020-2021) were compared with the pooled results from pre-COVID-19 years (2017-2019). A total of 4017 patients were included in this study, of which 3085 (77%) were overnight admissions. The incidence and absolute number of pediatric burn admissions gradually increased over the years, with a small temporary decrease in 2020-2021. Patient and burn characteristics remained relatively consistent over the years. Three quarters of all patients were between 0 and 3 years old, and the majority were boys (59%). A decreasing ratio of length of stay per % total burned surface area and an increase in day admissions was observed since 2016 onwards, which intensified during the COVID-19 pandemic.</p><p><strong>Conclusions: </strong>There was a slight increase in the number of pediatric admissions to the burn centers between 2009 and 2022. Young children (0-3 years) remain the most frequently affected group. A shorter relative length of stay was observed, as well as an increase in day admissions, which was reinforced by the COVID-19 pandemic.</p><p><strong>What is known: </strong>• Burns are a leading cause of death and disability among children globally. The largest group affected are young children (0-3 years) and most are scald burns. • In the Netherlands, since the late nineties there has been a trend towards more admissions to specialized burn centers, especially for young children with less severe burns.</p><p><strong>What is new: </strong>• There was a slight increase in the number of pediatric admissions to the burn centers between 2009 and 2022, with a temporary decrease during the COVID-19 pandemic (2020-2021). • Admissions now tend to be shorter per percentage total burned surface area (TBSA), with an increase in day admissions, which intensified during the COVID-19 years.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"114"},"PeriodicalIF":3.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-30DOI: 10.1007/s00431-024-05951-3
Ee Yin Kok, Satvinder Kaur, Nurul Husna Mohd Shukri, Nurliyana Abdul Razak, Masaki Takahashi, Swee Chai Teoh, Janice Ee Fang Tay, Shigenobu Shibata
Environmental light exposure plays a role in the entrainment of the infant circadian rhythm, which is crucial for growth and development. This scoping review aims to evaluate existing literature linking the role of light exposure in the development of the infant circadian rhythm. This scoping review is conducted in accordance with the PRISMA-ScR guidelines. The search strategy was conducted in a total of six databases (PubMed, Cochrane Database of Systematic Reviews, Science Direct, Google Scholar, Taylor and Francis, and Wiley) as of August 2024. Reviews, narrative studies, observational studies, and experimental studies published from 2012 to 2024 were extracted. These studies discussed the role of light exposure on the development of infant circadian rhythm. A total of 25 studies were retrieved (3 observational studies, 6 experimental studies, and 16 reviews). Evidence showed that cycled lighting is beneficial for the entrainment of the infant circadian rhythm according to the 24-h light-dark cycle. Cycled lighting improved nighttime sleep and daytime wakefulness, promoting optimum growth and development. Limited experimental studies were conducted due to the ethical considerations of infants as study participants. Conclusions: Given the benefits of cycled lighting in the development of the circadian rhythm development, it should be implemented in both healthcare and home settings to promote optimum growth and development of the infant.
环境光暴露在婴儿昼夜节律的干扰中起着重要作用,这对生长发育至关重要。本综述的目的是评估现有的文献链接的作用,光暴露在婴儿昼夜节律的发展。该范围审查是根据PRISMA-ScR指南进行的。截至2024年8月,共在六个数据库(PubMed、Cochrane Database of Systematic Reviews、Science Direct、b谷歌Scholar、Taylor and Francis和Wiley)中进行了搜索策略。选取2012年至2024年发表的综述、叙述性研究、观察性研究和实验研究。这些研究讨论了光照在婴儿昼夜节律发育中的作用。共纳入25项研究(3项观察性研究、6项实验研究和16项综述)。有证据表明,根据24小时的光暗循环,循环照明有利于婴儿昼夜节律的引导。循环照明改善夜间睡眠和白天清醒,促进最佳生长和发育。由于婴儿作为研究参与者的伦理考虑,进行了有限的实验研究。结论:鉴于循环照明对昼夜节律发育的益处,应在医疗保健和家庭环境中实施,以促进婴儿的最佳生长发育。
{"title":"The role of light exposure in infant circadian rhythm establishment: A scoping review perspective.","authors":"Ee Yin Kok, Satvinder Kaur, Nurul Husna Mohd Shukri, Nurliyana Abdul Razak, Masaki Takahashi, Swee Chai Teoh, Janice Ee Fang Tay, Shigenobu Shibata","doi":"10.1007/s00431-024-05951-3","DOIUrl":"10.1007/s00431-024-05951-3","url":null,"abstract":"<p><p>Environmental light exposure plays a role in the entrainment of the infant circadian rhythm, which is crucial for growth and development. This scoping review aims to evaluate existing literature linking the role of light exposure in the development of the infant circadian rhythm. This scoping review is conducted in accordance with the PRISMA-ScR guidelines. The search strategy was conducted in a total of six databases (PubMed, Cochrane Database of Systematic Reviews, Science Direct, Google Scholar, Taylor and Francis, and Wiley) as of August 2024. Reviews, narrative studies, observational studies, and experimental studies published from 2012 to 2024 were extracted. These studies discussed the role of light exposure on the development of infant circadian rhythm. A total of 25 studies were retrieved (3 observational studies, 6 experimental studies, and 16 reviews). Evidence showed that cycled lighting is beneficial for the entrainment of the infant circadian rhythm according to the 24-h light-dark cycle. Cycled lighting improved nighttime sleep and daytime wakefulness, promoting optimum growth and development. Limited experimental studies were conducted due to the ethical considerations of infants as study participants. Conclusions: Given the benefits of cycled lighting in the development of the circadian rhythm development, it should be implemented in both healthcare and home settings to promote optimum growth and development of the infant.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"112"},"PeriodicalIF":3.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}