Archives of disease in childhood. Fetal and neonatal edition
-
Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2011
Early versus late MRI in asphyxiated newborns treated with hypothermia.
The purposes of this feasibility study were to assess: (1) the potential utility of early brain MRI in asphyxiated newborns treated with hypothermia; (2) whether early MRI predicts later brain injury observed in these newborns after hypothermia has been completed; and (3) whether early MRI indicators of brain injury in these newborns represent reversible changes. ⋯ MRI scans obtained on DOL 2-3 during hypothermia seem to predict later brain injuries in asphyxiated newborns. Brain injuries identified during this early time appear to represent irreversible changes. Early MRI scans might also be useful to demonstrate unexpected findings not related to hypoxic-ischaemic encephalopathy, which could potentially be exacerbated by induced hypothermia. Additional studies with larger numbers of patients will be useful to confirm these results.
-
Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2011
Ethical and practical issues relating to the global use of therapeutic hypothermia for perinatal asphyxial encephalopathy.
In intensive care settings in the developed world, therapeutic hypothermia is established as a therapy for term infants with moderate to severe neonatal encephalopathy due to perinatal asphyxia. Several preclinical, pilot and clinical trials conducted in such settings over the last decade have demonstrated that this therapy is safe and effective. The greatest burden of birth asphyxia falls, however, in low- and middle-income countries; it is still unclear whether therapeutic hypothermia is safe and effective in this context. ⋯ It is argued that there are strong scientific and ethical reasons supporting the conduct of rigorous, randomised controlled trials of therapeutic hypothermia in middle-income settings. There also needs to be substantial and sustainable improvements in all facets of antenatal care and in the basic level of newborn resuscitation in low income countries. This will reduce the burden of disease and allow health workers to determine rapidly which infants are most eligible for potential neuroprotection.
-
Arch. Dis. Child. Fetal Neonatal Ed. · Nov 2010
ReviewMannose-binding lectin and infection risk in newborns: a systematic review.
The authors systematically reviewed the literature on mannose-binding lectin (MBL) and infections in newborns to determine whether infection risk is increased in MBL-deficient newborns. All original reports on MBL and infections in newborns were retrieved from Embase, Medline and CENTRAL from 1966 to December 2009. Information extracted from each article included study design, definitions of MBL deficiency and neonatal infection, follow-up period and risk factor analysis. ⋯ Newborns with low MBL levels appear to have culture-confirmed sepsis more frequently than MBL-sufficient newborns. However, the influence of confounding factors was analysed insufficiently. Variant MBL2 genotypes appear to have less influence.
-
Arch. Dis. Child. Fetal Neonatal Ed. · Nov 2010
Randomized Controlled TrialSweeten, soother and swaddle for retinopathy of prematurity screening: a randomised placebo controlled trial.
To assess the efficacy of oral sucrose combined with swaddling and non-nutritive suck (NNS) as a method for reducing pain associated with retinopathy of prematurity (ROP) screening. ⋯ ROP screening is a necessary but recognised painful procedure. Sucrose combined with NNS and swaddling reduced the behavioural and physiological pain responses. However, pain scores remained consistently high and appropriate pain relief for ROP screening remains a challenge.
-
Arch. Dis. Child. Fetal Neonatal Ed. · Nov 2010
Assessment of tidal volume and gas leak during mask ventilation of preterm infants in the delivery room.
The aim was to compare resuscitators' estimates of tidal volume (V(T)) and face mask leak with measured values during positive pressure ventilation (PPV) of newborn infants in the delivery room. ⋯ During face mask ventilation in the delivery room, V(T) and face mask leak were large and variable. The resuscitators were unable to accurately assess their face mask leak or delivered V(T).