Neonatology
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Retinopathy of prematurity (ROP) is a disorder of the preterm newborn characterized by neurovascular disruption in the immature retina that may cause visual impairment and blindness. ⋯ STEP-ROP is a promising screening tool. It is easy to calculate, does not rely on extensive postnatal data collection, and can be calculated early after birth. Early ROP screening may help physicians limit patient exposure to additional risk factors, and may be useful for risk stratification in clinical trials aimed at reducing ROP.
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Multicenter Study Observational Study
Blood Pressure during the Immediate Neonatal Transition: Is the Mean Arterial Blood Pressure Relevant for the Cerebral Regional Oxygenation?
Measurement of mean arterial blood pressure (MABP) is feasible during neonatal transition. ⋯ MABP has an impact on cerebral oxygenation in preterm infants. Therefore, blood pressure monitoring during the immediate neonatal transition might be relevant for improving cerebral oxygenation especially in preterm infants.
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Observational Study
Haemodynamic Transition after Birth: A New Tool for Non-Invasive Cardiac Output Monitoring.
Substantial haemodynamic changes occur during the first minutes after birth. Currently, only heart rate (HR) and arterial oxygen saturation are routinely used to monitor haemodynamic transition after birth. ⋯ The present study was the first using EV for NICOM during the transition period in a larger cohort of newborn infants. Results of NICOM were similar to available echocardiography data. The possibility of NICOM offers continuous CO measurement. The present study supports the idea that CO is closely related to HR in newborn infants.
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In the premature neonate, there is no consensus regarding normal blood pressure (BP). The most common definition used is a mean arterial BP (MAP) less than the gestational age (GA); however, studies indicate that the neuroprotective mechanism of autoregulation is lost below a MAP of 30 mm Hg. ⋯ Neither definition of hypotension independently predicts adverse outcome in multivariate logistic regression. Vasopressor therapy, however, is an independent predictor of IVH and death in premature infants.
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Observational Study
Effects of Breathing and Apnoea during Sustained Inflations in Resuscitation of Preterm Infants.
A sustained inflation (SI) at birth in preterm babies may be ineffective unless the infants breathe. Gain in lung volume is associated with breathing during delivery room non-invasive management. ⋯ Actively breathing infants during an SI at birth showed a gain in lung volume higher than apnoeic infants. Spontaneous breathing during SI seems to be related to GA.