Pub Date : 2016-02-18DOI: 10.4172/2167-0897.1000E114
Y. Singh, S. Everden
Yogen Singh1* and Serenydd Everden2 1Department of Neonatology and Paediatric Cardiology, Cambridge University Hospitals, UK 2Department of Clinical Medical School, University of Cambridge, UK *Corresponding author: Yogen Singh, Consultant Neonatologist and Special Expertise in Paediatric Cardiology, Box 402, NICU, Addenbrooke’s Hospital, Cambridge University Hospitals, Cambridge, UK, Tel: +44 1223 216240; Fax: +44 1223 586794; E-mail: Yogen.Singh@nhs.net
{"title":"Pulse Oximetry Screening for Detection of Critical Congenital Heart Defects: Why to Bother?","authors":"Y. Singh, S. Everden","doi":"10.4172/2167-0897.1000E114","DOIUrl":"https://doi.org/10.4172/2167-0897.1000E114","url":null,"abstract":"Yogen Singh1* and Serenydd Everden2 1Department of Neonatology and Paediatric Cardiology, Cambridge University Hospitals, UK 2Department of Clinical Medical School, University of Cambridge, UK *Corresponding author: Yogen Singh, Consultant Neonatologist and Special Expertise in Paediatric Cardiology, Box 402, NICU, Addenbrooke’s Hospital, Cambridge University Hospitals, Cambridge, UK, Tel: +44 1223 216240; Fax: +44 1223 586794; E-mail: Yogen.Singh@nhs.net","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"5 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-0897.1000E114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-10DOI: 10.4172/2167-0897.1000212
A. Kurt, A. N. C. Kurt, Ä°smail Åengül, Erdal Yılmaz, YaÅar DoÄan, D. Aygün
Cantrell syndrome is a rare syndrome of congenital defects involving the abdominal wall, sternum, diaphragm, pericardium and the heart. The spectrum of anomalies varies widely. Less than 160 cases have been described in the world literature. We reported a premature infant, with the syndrome. The case with a rare congenital malformation consisting of a pentad of findings: ectopia cordis and absent pericardium and a midline supraumbilical wall defect, evisceration of the intestines and liver, and short sternum. We presented this case because of its rarity and discuss the pathologic findings.
{"title":"Cantrell Syndrome: A Rare Case Report","authors":"A. Kurt, A. N. C. Kurt, Ä°smail Åengül, Erdal Yılmaz, YaÅar DoÄan, D. Aygün","doi":"10.4172/2167-0897.1000212","DOIUrl":"https://doi.org/10.4172/2167-0897.1000212","url":null,"abstract":"Cantrell syndrome is a rare syndrome of congenital defects involving the abdominal wall, sternum, diaphragm, pericardium and the heart. The spectrum of anomalies varies widely. Less than 160 cases have been described in the world literature. We reported a premature infant, with the syndrome. The case with a rare congenital malformation consisting of a pentad of findings: ectopia cordis and absent pericardium and a midline supraumbilical wall defect, evisceration of the intestines and liver, and short sternum. We presented this case because of its rarity and discuss the pathologic findings.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"5 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-0897.1000212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70813717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-08DOI: 10.4172/2167-0897.1000211
Charissa L Manuat, S. Yong, P. Dechristopher, C. Kwong, L. Glynn, O. Habeeb, Tricia L. Thomson, J. Muraskas
Objectives: To determine the presence of A and B blood group antigens on vascular endothelial cells of intestinal tissue and compare tissue resected for necrotizing enterocolitis (NEC) with tissues resected for non-NEC pathologies (spontaneous intestinal perforation (SIP), intussusception, Hirschsprung disease, intestinal atresia, etc.) in an effort to implicate blood group antigen expression on bowel endothelium as a mechanism of bowel injury in NEC via a humoral immune-mediated inflammatory response. Methods :Intestinal tissue from 21 patients with NEC and 23 non-NEC patients (5 of which were SIP) was stained with monoclonal antibodies against blood group antigens A and B. Vascular endothelial lined spaces were examined for expression of these blood group antigens and graded as 0 (no staining) to 3 (marked staining). Results: Control group birth gestational age (GA) ranged from 26 to 40 weeks (Mdn=36.4-37.0). Both NEC and SIP groups had birth GA ranging from 24 to 37 weeks (Mdn=29.3 and Mdn=27.6, respectively). Overall, A and B blood group antigens were appropriately expressed on the endothelium of all intestinal tissue regardless of the presence of NEC. The A antigen appeared to stain more intensely than the B antigen in most tissue, except for the NEC sample from an AB blood type patient in which A and B antigens stained equally intense (grade 3). Multivariate regression analysis confirms the significantly inverse relationship between gestational age and NEC, but a significant relationship could not be established between blood group or IHC scoring of the blood group antigen expression and NEC. 1.4 Conclusions: Blood group antigens, A more than B or AB together, may increase the risk of a neonate to develop NEC in the presence of passively or actively transferred isoagglutinins.
{"title":"Immunohistochemical Demonstration of Blood Group Antigen Expression in Intestinal Endothelium Links Blood Type and Necrotizing Enterocolitis","authors":"Charissa L Manuat, S. Yong, P. Dechristopher, C. Kwong, L. Glynn, O. Habeeb, Tricia L. Thomson, J. Muraskas","doi":"10.4172/2167-0897.1000211","DOIUrl":"https://doi.org/10.4172/2167-0897.1000211","url":null,"abstract":"Objectives: To determine the presence of A and B blood group antigens on vascular endothelial cells of intestinal tissue and compare tissue resected for necrotizing enterocolitis (NEC) with tissues resected for non-NEC pathologies (spontaneous intestinal perforation (SIP), intussusception, Hirschsprung disease, intestinal atresia, etc.) in an effort to implicate blood group antigen expression on bowel endothelium as a mechanism of bowel injury in NEC via a humoral immune-mediated inflammatory response. \u0000Methods :Intestinal tissue from 21 patients with NEC and 23 non-NEC patients (5 of which were SIP) was stained with monoclonal antibodies against blood group antigens A and B. Vascular endothelial lined spaces were examined for expression of these blood group antigens and graded as 0 (no staining) to 3 (marked staining). \u0000Results: Control group birth gestational age (GA) ranged from 26 to 40 weeks (Mdn=36.4-37.0). Both NEC and SIP groups had birth GA ranging from 24 to 37 weeks (Mdn=29.3 and Mdn=27.6, respectively). Overall, A and B blood group antigens were appropriately expressed on the endothelium of all intestinal tissue regardless of the presence of NEC. The A antigen appeared to stain more intensely than the B antigen in most tissue, except for the NEC sample from an AB blood type patient in which A and B antigens stained equally intense (grade 3). Multivariate regression analysis confirms the significantly inverse relationship between gestational age and NEC, but a significant relationship could not be established between blood group or IHC scoring of the blood group antigen expression and NEC. 1.4 Conclusions: Blood group antigens, A more than B or AB together, may increase the risk of a neonate to develop NEC in the presence of passively or actively transferred isoagglutinins.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"5 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2016-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-30DOI: 10.4172/2167-0897.1000210
A. Kurt, A. N. C. Kurt, D. Benzer, A. Aygün, B. Ustundag, Y. Doğan, O. Erel
Purpose: Smoking during pregnancy has several effects and risks on the neonates. The aim is to assess the effects of exposure to environmental tobacco smoke during pregnancy on the antioxidant status of their neonates. Design: In cord blood samples of 116 healthy newborns which were classified into groups according to mothers smoking status (active, passive or non-smoker), the activities of paraoxanase 1 and aryl esterase, concentrations of free sulfhydryl groups and total antioxidant response were studied using appropriate methods. Results: Different parameters indicating antioxidant status had similar values in cord blood of term and preterm neonates of active or passive smoke or non-smoker mothers. Only, concentrations of total antioxidant response were statistically different between cord blood of neonates of active or passive smoker mothers and cord blood of term or preterm neonates of non-smoker mothers (1.12 ± 0.1, 1.10 ± 0.08 and 1.28 ± 0.12 mmol trolox equivalent/L, for term neonates, 0.95 ± 0.0, 1.07 ± 0.13 and 1.22 ± 0.02 mmol trolox equivalent/L, for preterm neonates, respectively). Conclusions: Neonates of active or passive smoker mothers have decreased antioxidant levels in cord blood and may be exposed to an oxidative stress greater.
{"title":"Exposure to Environmental Tobacco Smoke during Pregnancy Restrain the Antioxidant Response of their Neonates","authors":"A. Kurt, A. N. C. Kurt, D. Benzer, A. Aygün, B. Ustundag, Y. Doğan, O. Erel","doi":"10.4172/2167-0897.1000210","DOIUrl":"https://doi.org/10.4172/2167-0897.1000210","url":null,"abstract":"Purpose: Smoking during pregnancy has several effects and risks on the neonates. The aim is to assess the effects of exposure to environmental tobacco smoke during pregnancy on the antioxidant status of their neonates. \u0000Design: In cord blood samples of 116 healthy newborns which were classified into groups according to mothers smoking status (active, passive or non-smoker), the activities of paraoxanase 1 and aryl esterase, concentrations of free sulfhydryl groups and total antioxidant response were studied using appropriate methods. \u0000Results: Different parameters indicating antioxidant status had similar values in cord blood of term and preterm neonates of active or passive smoke or non-smoker mothers. Only, concentrations of total antioxidant response were statistically different between cord blood of neonates of active or passive smoker mothers and cord blood of term or preterm neonates of non-smoker mothers (1.12 ± 0.1, 1.10 ± 0.08 and 1.28 ± 0.12 mmol trolox equivalent/L, for term neonates, 0.95 ± 0.0, 1.07 ± 0.13 and 1.22 ± 0.02 mmol trolox equivalent/L, for preterm neonates, respectively). \u0000Conclusions: Neonates of active or passive smoker mothers have decreased antioxidant levels in cord blood and may be exposed to an oxidative stress greater.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"5 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2016-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-28DOI: 10.4172/2167-0897.1000209
M. E. Frargy, A. E. R. M. E. Mashad, A. A. El-Enin
Background: Neonatal hyperglycemia is a common problem in preterm neonates. Patient and methods: A prospective cohort study was conducted on 200 neonates in neonatal intensive care unit (NICU) at Tanta University Hospital from June 2012 to June 2014. Group I: Included 100 preterm neonates that were given intravenous amino acids starting from the 3rd day of birth and lasting for 5 consecutive days and tested for serum albumin, total proteins and random blood glucose levels. Group II: Included 100 preterm neonates of matched gestational age as a control group. Results There was no statistically significant difference between case and control in the 1st three days of life before the AAs infusion as both groups were liable to hyperglycemia while there was statistically significant decrease in the number of hyperglycemic and hypoglycemic patient with euglycemia starting from the fourth day of life after the amino acids infusion. There was no significant difference in the 1st reading of TSP level on the 3rd day of life between cases and control while there was significant difference in the 2nd reading on the 8th day of life. Conclusion: Amino acids infusion in preterm neonates cause improvement of glycemic variability and cause stimulation of protein synthesis.
{"title":"Study the Effect of Early Administration of Amino Acid Infusion onPreterm Neonate","authors":"M. E. Frargy, A. E. R. M. E. Mashad, A. A. El-Enin","doi":"10.4172/2167-0897.1000209","DOIUrl":"https://doi.org/10.4172/2167-0897.1000209","url":null,"abstract":"Background: Neonatal hyperglycemia is a common problem in preterm neonates. Patient and methods: A prospective cohort study was conducted on 200 neonates in neonatal intensive care unit (NICU) at Tanta University Hospital from June 2012 to June 2014. \u0000Group I: Included 100 preterm neonates that were given intravenous amino acids starting from the 3rd day of birth and lasting for 5 consecutive days and tested for serum albumin, total proteins and random blood glucose levels. \u0000Group II: Included 100 preterm neonates of matched gestational age as a control group. Results There was no statistically significant difference between case and control in the 1st three days of life before the AAs infusion as both groups were liable to hyperglycemia while there was statistically significant decrease in the number of hyperglycemic and hypoglycemic patient with euglycemia starting from the fourth day of life after the amino acids infusion. There was no significant difference in the 1st reading of TSP level on the 3rd day of life between cases and control while there was significant difference in the 2nd reading on the 8th day of life. \u0000Conclusion: Amino acids infusion in preterm neonates cause improvement of glycemic variability and cause stimulation of protein synthesis.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"5 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2016-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-0897.1000209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-12DOI: 10.4172/2167-0897.1000208
R. Bora
The World Health Organisation recommends exclusive breast feeding till six months of age followed by breast feeding along with complementary feeding thereafter for optimal growth of children. Thirteen percent of under five mortality can be averted globally each year by breast feeding alone. Despite recognition of this benefit, rates of exclusive breastfeeding for WHO recommended period is poor, especially in developing countries where the need is most. Several studies have shown that educational interventions significantly increased breastfeeding rates. Structured combined individual and group counselling seems to be the best method of improving breast feeding rates at this time.
{"title":"Breast Feeding in Developing Countries: Is There a Scope forImprovement","authors":"R. Bora","doi":"10.4172/2167-0897.1000208","DOIUrl":"https://doi.org/10.4172/2167-0897.1000208","url":null,"abstract":"The World Health Organisation recommends exclusive breast feeding till six months of age followed by breast feeding along with complementary feeding thereafter for optimal growth of children. Thirteen percent of under five mortality can be averted globally each year by breast feeding alone. Despite recognition of this benefit, rates of exclusive breastfeeding for WHO recommended period is poor, especially in developing countries where the need is most. Several studies have shown that educational interventions significantly increased breastfeeding rates. Structured combined individual and group counselling seems to be the best method of improving breast feeding rates at this time.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"57 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2016-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-0897.1000208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-05DOI: 10.4172/2167-0897.1000206
M. Narvey, R. Soni
Right sided Congenital Diaphragmatic Hernia (CDH) has been previously associated with venous or lymphatic obstruction of vessels by the herniated liver. We report an unusual case of direct cardiac atrial compression by the liver causing limitation of preload and resultant fetal non-immune hydrops fetalis.
{"title":"Hydrops Fetalis due to Direct Hepatic Compression of the Right Atrium ina Newborn with Right Congenital Diaphragmatic Hernia","authors":"M. Narvey, R. Soni","doi":"10.4172/2167-0897.1000206","DOIUrl":"https://doi.org/10.4172/2167-0897.1000206","url":null,"abstract":"Right sided Congenital Diaphragmatic Hernia (CDH) has been previously associated with venous or lymphatic obstruction of vessels by the herniated liver. We report an unusual case of direct cardiac atrial compression by the liver causing limitation of preload and resultant fetal non-immune hydrops fetalis.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"5 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-12-30DOI: 10.4172/2167-0897.1000207
Imteyaz Ahmad, Arif Ahmed, S. Roy
Objective: The acid base abnormalities are common in neonates with birth asphyxia and sepsis leading to considerable morbidity and mortality and timely assessment and management of these acid-base derangements leads to a better outcome. So, we did a observational study to assess acid base disorders in neonates by using Boston, Copenhagen approach and Stewart approach and the role of the various variables on predicting the acid base status and the worst outcome in neonates. Study design and methods: An observational study was conducted on the samples provided from the neonates with birth asphyxia and sepsis admitted to neonatal intensive care unit (NICU) in the Post Graduate Institute of Medical Education and Research (PGIMER) and Dr Ram Manohar Lohia (Dr RML) Hospital, New Delhi, India. The blood gas analysis, electrolytes, albumin, lactate levels were compared in the two ailments. The presence of acid base disorders were calculated using Copenhagen approach and Stewart method; and the influence of various variables on acid base disorders and outcome were analyzed. Results: The metabolic acidosis and alkalosis were seen in 1 and 10 patients as per Boston approach and in 18 and 18 patients with Copenhagen approach. The increased anion gap (AG), and low and high strong ion difference (SID) as measured by Stewart approach were seen in 23,21 and 23 neonates respectively. The acid-base status determined by both Copenhagen and Stewart approach were found to be interrelated. For detecting metabolic acidosis the sensitivity of high for high anion gap (66.67%) and hyponatremia (57.89 %) , whereas the specificity is high for lactic acidosis (94.74 %), hyperchloraemia (86.99%) and hyponatremia (81.08%). The low PaCO2 (89.4%) and low SID (73.68%) has a high sensitivity for predicting the non-survival , whereas the lactic acidosis(94.74%) has the high specificity of predicting the non-survival , followed by hyponatremia (81.08%), low SID (75.68%), hypoalbuminaemia (70.27%) and low PaCO2 (70.27%). Conclusion: In neonates with birth asphyxia and sepsis, acid-base disorders are common. Both the approaches are good in determining the acid-base status, but in complicated situation strong ion difference and strong ion gap works better in determining acid-base status. Derangements like low PaCO2, low SID, hypoalbuminaemia, lactic acidosis and hyponatremia are predictors of worst outcome.
{"title":"Acid Base Disorders in Critically Ill Neonatal Intensive Care Patients and Predicting Survival by the Presence of Deranged Acid-Base Variables","authors":"Imteyaz Ahmad, Arif Ahmed, S. Roy","doi":"10.4172/2167-0897.1000207","DOIUrl":"https://doi.org/10.4172/2167-0897.1000207","url":null,"abstract":"Objective: The acid base abnormalities are common in neonates with birth asphyxia and sepsis leading to considerable morbidity and mortality and timely assessment and management of these acid-base derangements leads to a better outcome. So, we did a observational study to assess acid base disorders in neonates by using Boston, Copenhagen approach and Stewart approach and the role of the various variables on predicting the acid base status and the worst outcome in neonates. \u0000Study design and methods: An observational study was conducted on the samples provided from the neonates with birth asphyxia and sepsis admitted to neonatal intensive care unit (NICU) in the Post Graduate Institute of Medical Education and Research (PGIMER) and Dr Ram Manohar Lohia (Dr RML) Hospital, New Delhi, India. The blood gas analysis, electrolytes, albumin, lactate levels were compared in the two ailments. The presence of acid base disorders were calculated using Copenhagen approach and Stewart method; and the influence of various variables on acid base disorders and outcome were analyzed. \u0000Results: The metabolic acidosis and alkalosis were seen in 1 and 10 patients as per Boston approach and in 18 and 18 patients with Copenhagen approach. The increased anion gap (AG), and low and high strong ion difference (SID) as measured by Stewart approach were seen in 23,21 and 23 neonates respectively. The acid-base status determined by both Copenhagen and Stewart approach were found to be interrelated. For detecting metabolic acidosis the sensitivity of high for high anion gap (66.67%) and hyponatremia (57.89 %) , whereas the specificity is high for lactic acidosis (94.74 %), hyperchloraemia (86.99%) and hyponatremia (81.08%). The low PaCO2 (89.4%) and low SID (73.68%) has a high sensitivity for predicting the non-survival , whereas the lactic acidosis(94.74%) has the high specificity of predicting the non-survival , followed by hyponatremia (81.08%), low SID (75.68%), hypoalbuminaemia (70.27%) and low PaCO2 (70.27%). \u0000Conclusion: In neonates with birth asphyxia and sepsis, acid-base disorders are common. Both the approaches are good in determining the acid-base status, but in complicated situation strong ion difference and strong ion gap works better in determining acid-base status. Derangements like low PaCO2, low SID, hypoalbuminaemia, lactic acidosis and hyponatremia are predictors of worst outcome.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"5 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2015-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-0897.1000207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-12-15DOI: 10.4172/2167-0897.1000205
Lata Bhat, Kavita Khanijo, Supriya Bisht, A. Wadhawan, Mahendra Singh, V. Bhat
Objectives: To evaluate the clinical course and outcome in preterm babies with RDS using higher PEEP and FiO2 as appropriate on bubble CPAP as the primary mode of respiratory support. CPAP failure and oxygen requirement by 28 days of life were primary outcome. Incidence of pneumothorax, hypotension, NEC, IVH and ROP and survival till discharge were thesecondary outcomes measured. Method: Preterm babies (gestation 26 to 36 weeks) admitted to tertiary level NICU (both inborn and outborn) with RDS were managed with bubble CPAP as a primary mode of respiratory support. Higher pressure upto 8-10 cm of water and FiO2 upto 80-100% was given (if required) during CPAP. Results: Total 73 neonates were studied, out of which 52% received antenatal steroids and 54.8% received surfactant. Overal CPAP success rate was 95.9% with success in severe, moderate and mild RDS cases 84.6%, 97.5% and 100% respectively. Among <28 week age-group, 85.7% cases were successful. Peak CPAP pressure of ≥ 8cm water was given to 21.4% babies in success group. Conclusions: Bubble CPAP may be considered as a primary mode of respiratory support in RDS even in very preterm and ELBW babies irrespective of the severity. Early CPAP and surfactant, peak pressure upto 8-10 cm H2O and FiO2 100% with trained and committed staff with 1:1 care can lead to higher success rate. CPAP is safe even in very preterm infants with RDS and associated with lesser lung injury and other complications.
目的:评价以气泡CPAP为主要呼吸支持方式，酌情提高PEEP和FiO2对RDS早产儿的临床病程和结局。CPAP失败和生命28天的需氧量是主要结局。次要指标为气胸、低血压、NEC、IVH和ROP的发生率以及出院前的生存率。方法:采用气泡CPAP作为主要的呼吸支持方式，对新生儿重症监护病房收治的早产儿(妊娠26 ~ 36周)(包括先天性和先天性)进行RDS治疗。在CPAP期间(如果需要)给予高达8-10厘米的高压水和高达80-100%的FiO2。结果:73例新生儿接受产前类固醇治疗的占52%，表面活性剂治疗的占54.8%。CPAP总成功率为95.9%，其中重度、中度和轻度RDS的成功率分别为84.6%、97.5%和100%。<28周龄组，成功率85.7%。成功组21.4%患儿给予峰值CPAP压力≥8cm水。结论:气泡CPAP可以被认为是RDS的主要呼吸支持模式，即使是非常早产儿和ELBW婴儿，无论其严重程度如何。早期CPAP和表面活性剂，峰值压力高达8-10 cm H2O和FiO2 100%，训练有素和忠诚的工作人员以1:1的护理可以提高成功率。CPAP即使对患有RDS的早产儿也是安全的，并且与较小的肺损伤和其他并发症相关。
{"title":"Can Higher PEEP and FiO2 with Bubble CPAP Reduce Need for Invasive Ventilation in Preterm Babies with Respiratory Distress Syndrome","authors":"Lata Bhat, Kavita Khanijo, Supriya Bisht, A. Wadhawan, Mahendra Singh, V. Bhat","doi":"10.4172/2167-0897.1000205","DOIUrl":"https://doi.org/10.4172/2167-0897.1000205","url":null,"abstract":"Objectives: To evaluate the clinical course and outcome in preterm babies with RDS using higher PEEP and FiO2 as appropriate on bubble CPAP as the primary mode of respiratory support. CPAP failure and oxygen requirement by 28 days of life were primary outcome. Incidence of pneumothorax, hypotension, NEC, IVH and ROP and survival till discharge were thesecondary outcomes measured. \u0000Method: Preterm babies (gestation 26 to 36 weeks) admitted to tertiary level NICU (both inborn and outborn) with RDS were managed with bubble CPAP as a primary mode of respiratory support. Higher pressure upto 8-10 cm of water and FiO2 upto 80-100% was given (if required) during CPAP. \u0000Results: Total 73 neonates were studied, out of which 52% received antenatal steroids and 54.8% received surfactant. Overal CPAP success rate was 95.9% with success in severe, moderate and mild RDS cases 84.6%, 97.5% and 100% respectively. Among <28 week age-group, 85.7% cases were successful. Peak CPAP pressure of ≥ 8cm water was given to 21.4% babies in success group. \u0000 Conclusions: Bubble CPAP may be considered as a primary mode of respiratory support in RDS even in very preterm and ELBW babies irrespective of the severity. Early CPAP and surfactant, peak pressure upto 8-10 cm H2O and FiO2 100% with trained and committed staff with 1:1 care can lead to higher success rate. CPAP is safe even in very preterm infants with RDS and associated with lesser lung injury and other complications.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"5 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2015-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-0897.1000205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-11-26DOI: 10.4172/2167-0897.1000204
E. Wiberg-Itzel, Hampus Josephson, N. Wiberg, L. Olson, B. Winbladh, Mathias Karlsson
Background: LDH may be a valuable marker for some of the most important diseases in newborns, and umbilical cord blood is a non-invasive and easy way to obtain blood for analysis. Aims of this study were to define interval for LDH in arterial and venous cord blood at delivery in truly healthy newborns. Method: a prospective observational study was performed at Soder Hospital, Stockholm, Sweden during 2011-2012. Umbilical cord blood was collected at delivery, and value of LDH was analysed in 549 healthy infants >37 weeks of gestation, born after an uncomplicated pregnancy from a healthy mother. Results: The 2.5th and 97.5th percentile for arterial LDH was 162-612 u/L and 252-636 u/L for venous LDH. Instrumental delivery and acute caesarian section showed significantly higher intervals and elective caesarian section significantly lower than vaginal delivery. Haemolysis (>0.3g/l) disqualified a 13-41% of the samples. Conclusion: Reported LDH levels are in accordance with earlier studies and appear to be a sensitive marker for intrapartal stress factors. The absence of an arterial/venous difference makes the sampling of cord blood easier but frequent haemolysis is a problem when using the standard method of analyses.
{"title":"Lactic Dehydrogenase in Umbilical Cord Blood in Healthy Infants after Different Modes of Delivery","authors":"E. Wiberg-Itzel, Hampus Josephson, N. Wiberg, L. Olson, B. Winbladh, Mathias Karlsson","doi":"10.4172/2167-0897.1000204","DOIUrl":"https://doi.org/10.4172/2167-0897.1000204","url":null,"abstract":"Background: LDH may be a valuable marker for some of the most important diseases in newborns, and umbilical cord blood is a non-invasive and easy way to obtain blood for analysis. Aims of this study were to define interval for LDH in arterial and venous cord blood at delivery in truly healthy newborns. \u0000Method: a prospective observational study was performed at Soder Hospital, Stockholm, Sweden during 2011-2012. Umbilical cord blood was collected at delivery, and value of LDH was analysed in 549 healthy infants >37 weeks of gestation, born after an uncomplicated pregnancy from a healthy mother. \u0000Results: The 2.5th and 97.5th percentile for arterial LDH was 162-612 u/L and 252-636 u/L for venous LDH. Instrumental delivery and acute caesarian section showed significantly higher intervals and elective caesarian section significantly lower than vaginal delivery. Haemolysis (>0.3g/l) disqualified a 13-41% of the samples. Conclusion: Reported LDH levels are in accordance with earlier studies and appear to be a sensitive marker for intrapartal stress factors. The absence of an arterial/venous difference makes the sampling of cord blood easier but frequent haemolysis is a problem when using the standard method of analyses.","PeriodicalId":73850,"journal":{"name":"Journal of neonatal biology","volume":"4 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2015-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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