Journal of neonatal-perinatal medicine
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J Neonatal Perinatal Med · Jan 2014
Review Comparative Study Observational StudyMonitoring regional tissue oxygen extraction in neonates <1250 g helps identify transfusion thresholds independent of hematocrit.
We sought to characterize the effects of "booster" packed red blood cell transfusions on multisite regional oxygen saturation in very low birth weight neonates during the first postnatal week and to examine the utility of fractional tissue oxygen extraction as an estimate of tissue oxygenation adequacy. ⋯ "Booster" transfusions improved indices of regional tissue oxygenation while no departures were observed in conventional cardiovascular assessments. We speculate that NIRS-derived oxygenation parameters can provide an objective, graded, and continuous estimate of oxygen delivery-consumption balance not evident using standard monitoring techniques.
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J Neonatal Perinatal Med · Jan 2014
Multicenter Study Clinical TrialAssociation between tracheal pepsin, a reliable marker of gastric aspiration, and head of bed elevation among ventilated neonates.
To determine the frequency of tracheal pepsin in ventilated neonates and whether the angle of head elevation was associated with tracheal pepsin. ⋯ Pepsin, a marker for gastric secretion aspiration, was detected in 53% of ventilated low birth weight neonates; early elevation of the head of the bed was associated with a lower rate of tracheal pepsin.
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J Neonatal Perinatal Med · Jan 2014
Review Case ReportsUmbilical venous catheter-induced hepatic hematoma in neonates.
Umbilical vessel catheterization is common practice for infants in the neonatal intensive care unit (NICU). Umbilical venous catheters (UVC) although very useful as a means of obtaining vascular access, do not come without risks. ⋯ We believe liver hematomas may be a more common complication of malpositioned UVCs than previously believed. An appreciation of the complications of malpositioned UVCs should alert clinicians to screen for potential complications and to ensure ideal line placement.
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J Neonatal Perinatal Med · Jan 2014
Case ReportsUnplanned ultrasound-guided puncture of a tracheal balloon in a premature infant with congenital diaphragmatic hernia.
Temporary tracheal balloons have been shown to improve lung growth in fetuses with severe congenital diaphragmatic hernia. Fetoscopic Endoluminal Tracheal Occlusion (FETO) is performed at 26-28 weeks gestation, and then is removed in utero at 34 weeks gestation at highly specialized centers. ⋯ We have successfully performed an ultrasound-guided approach to puncture and remove the tracheal balloon in a premature infant in an emergency setting at birth. After that she was treated for congenital diaphragmatic hernia at our Newborn Intensive Care Unit.
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J Neonatal Perinatal Med · Jan 2014
Association of packed red blood cell transfusion and necrotizing enterocolitis in very low birth weight infants.
To investigate the association of PRBC transfusion and the development of NEC in VLBW preterm infants at a tertiary care neonatal unit. ⋯ We observed a lower association of PRBC transfusion and severe NEC in VLBW infants. Prospective, randomized well powered studies are needed to confirm our findings.