American journal of perinatology
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Comparative Study Clinical Trial
Effect of Ventilation Support on Oxidative Stress and Ischemia-Modified Albumin in Neonates.
Mechanical ventilation (MV) can induce oxidative stress, which plays a critical role in pulmonary injury in intubated neonates. Ischemia-modified albumin (IMA)-a variant of human serum albumin-is a novel biomarker of myocardial ischemia that occurs due to reactive oxygen species during ischemic insult. This study aimed to investigate IMA production due to oxidative stress induced during MV in neonates. ⋯ SIMV and CPAP activated the oxidative stress and increased the IMA level in neonates; therefore, measurement of IMA and oxidant markers may be useful in the follow-up of lung injury in neonates due to ventilation support. Additional prospective studies are needed to compare the effects of various ventilation methods on oxidative stress and the IMA level in neonates.
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Acute primary profound circulatory failure responsive to glucocorticoid therapy after the first week of age in preterm infants is termed late-onset circulatory collapse (LCC). This study was performed to identify factors that notably increased the incidence of LCC after various management practices were changed. ⋯ Relative hyponatremia was an early sign of imminent LCC. In addition to adrenal prematurity, the antenatal administration of glucocorticoids and fentanyl, which influence adrenal function, might increase the incidence of LCC.
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Unplanned extubation (UE) occurs as an infrequent complication of mechanical ventilation in the neonatal intensive care unit (NICU). Following UE, a trial of noninvasive ventilation (NIV) may be considered if a neonate is showing adequate respiratory effort. This study investigated the success and failure rate of NIV management of neonates experiencing UE. ⋯ A trial of NIV may be considered as a treatment option in preterm and term newborns experiencing UE in the NICU.
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Randomized Controlled Trial Multicenter Study
Preventing Preterm Birth with Progesterone in Women with a Short Cervical Length from a Low-Risk Population: A Multicenter Double-Blind Placebo-Controlled Randomized Trial.
The objective of this study was to evaluate the effectiveness of vaginal progesterone in reducing adverse neonatal outcome due to preterm birth (PTB) in low-risk pregnant women with a short cervical length (CL). ⋯ In women with a short cervix, who are otherwise low risk, we could not show a significant benefit of progesterone in reducing adverse neonatal outcome and PTB.
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Randomized Controlled Trial
Active Warming during Cesarean Delivery: Should We SCIP It?
The purpose of this open, cluster randomized controlled trial was to evaluate whether use of a fiber optic-regulated warming mattress would decrease the incidence of hypothermia in women undergoing cesarean delivery. ⋯ Use of a warming mattress reduced the incidence of maternal hypothermia at the conclusion of surgery; however, on admission to the postanesthesia care unit, these effects had dissipated.