Seminars in Fetal & Neonatal Medicine最新文献

Herpes simplex virus - state of the art of prevention and treatment. 单纯疱疹病毒——预防和治疗的最新进展。

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-09-29 DOI: 10.1016/j.siny.2025.101664

Kia Hee Schultz Dungu, Emma Louise Malchau Carlsen, Olav Bjørn Petersen, Nadja Hawwa Vissing, Ulrikka Nygaard

引用次数: 0

Central line-associated blood stream infections in newborns: From vulnerability to prevention. 新生儿中央静脉相关血流感染：从易感性到预防。

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-09-25 DOI: 10.1016/j.siny.2025.101665

Varvara Dimopoulou, Kirsten Glaser, Eric Giannoni

{"title":"Central line-associated blood stream infections in newborns: From vulnerability to prevention.","authors":"Varvara Dimopoulou, Kirsten Glaser, Eric Giannoni","doi":"10.1016/j.siny.2025.101665","DOIUrl":"https://doi.org/10.1016/j.siny.2025.101665","url":null,"abstract":"Newborns, especially preterm infants, are vulnerable to invasive infections due to their developing immune system and frequent need for central venous catheters. Central line-associated bloodstream infections (CLABSI) are among the most common invasive infections in this population and represent the leading cause of neonatal bloodstream infection in many settings. Neonatal CLABSI is associated with substantial mortality, long-term morbidity, and increased healthcare costs. Most importantly, CLABSI is preventable. Bundles centered on rigorous hand hygiene combined with standardized practices for catheter insertion, maintenance and removal have proven effective in reducing infection rates in neonates. Benchmarking and quality improvement initiatives enable neonatal intensive care units (NICUs) to track progress and share best practices. While no novel prevention strategies with robust evidence have emerged, sustained declines in CLABSI rates in many NICUs and networks over the past decades highlight the importance of a comprehensive multidisciplinary approach to implement and maintain best practices.","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101665"},"PeriodicalIF":2.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Probiotic supplementation - does it prevent or cause neonatal sepsis? 益生菌补充-它是预防还是导致新生儿败血症？

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-09-25 DOI: 10.1016/j.siny.2025.101668

Nicholas D Embleton, Chris H P van den Akker, Belal N Alshaikh

{"title":"Probiotic supplementation - does it prevent or cause neonatal sepsis?","authors":"Nicholas D Embleton, Chris H P van den Akker, Belal N Alshaikh","doi":"10.1016/j.siny.2025.101668","DOIUrl":"https://doi.org/10.1016/j.siny.2025.101668","url":null,"abstract":"Probiotic supplementation in preterm infants is one of the most extensively studied interventions in neonatal medicine, with over 50 randomised controlled trials. This paper examines the relationship between probiotic supplementation and late onset sepsis (LOS), considering mechanistic pathways, clinical evidence, and safety profile. Multiple systematic reviews and meta-analyses consistently show that probiotics reduce necrotising enterocolitis (NEC) incidence and all-cause mortality in preterm infants, establishing them as one of the most beneficial interventions in neonatology. Current evidence suggests modest effects on LOS, with Cochrane systematic reviews reporting relative risk 0.89 (95 % CI 0.82-0.97) but with low certainty. Mechanisms supporting LOS reduction include competitive pathogen exclusion, enhanced epithelial barrier function, improved immune responses, and reduced time to full enteral feeding with decreased intravenous access requirements. The safety profile of probiotics is reassuring, with serious adverse events being exceptionally rare. Probiotic-induced sepsis probably occurs in less than 0.5 % of treated infants, representing a very low risk that must be weighed against the likely substantial benefits for NEC and mortality reduction. Product contamination and other quality issues exist but appear manageable with appropriate quality control. Given the robust evidence for NEC and mortality reduction, probiotics represent a valuable intervention for preterm infants but may have limited, if any impact on sepsis. While their specific role in LOS prevention and impacts on the resistome requires further investigation, the overall benefit-risk profile strongly favors their use. Future research will further refine understanding of optimal strain selection and implementation strategies for maximizing clinical benefits while maintaining safety.","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101668"},"PeriodicalIF":2.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Respiratory syncytial virus. What's new in prevention? 呼吸道合胞病毒。预防方面有什么新进展？

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-09-25 DOI: 10.1016/j.siny.2025.101667

Nestor E Vain, Paolo Manzoni, Kee Thai Yeo

引用次数: 0

Advancements and potential in the prevention of congenital CMV infection. 预防先天性巨细胞病毒感染的进展和潜力。

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-09-25 DOI: 10.1016/j.siny.2025.101662

Yarlini Vipulanandan, Suresh Boppana, Karen B Fowler, David W Kimberlin

引用次数: 0

The role of parents to prevent infections in the neonatal intensive care unit. 父母在新生儿重症监护病房预防感染中的作用。

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-09-25 DOI: 10.1016/j.siny.2025.101669

Isabelle Ommert, Caroline-Aleksi Mägi, Siri Lilliesköld, Ylva Thernström Blomqvist, Anna Axelin, Agnes Linnér

引用次数: 0

Antibiotic stewardship in the neonatal intensive care unit and prevention of antimicrobial resistance. 新生儿重症监护病房的抗生素管理和抗菌素耐药性的预防。

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-09-25 DOI: 10.1016/j.siny.2025.101666

Ashraf Kharrat, Najla Tabbara, Prakesh S Shah

引用次数: 0

"Gentle" cardio-respiratory management in congenital diaphragmatic hernia: Time for a precision-medicine approach? 先天性膈疝的“温和”心肺管理：是时候采用精准医学方法了？

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-09-19 DOI: 10.1016/j.siny.2025.101660

Anna Foth, David Tingay, Florian Kipfmueller

{"title":"\"Gentle\" cardio-respiratory management in congenital diaphragmatic hernia: Time for a precision-medicine approach?","authors":"Anna Foth, David Tingay, Florian Kipfmueller","doi":"10.1016/j.siny.2025.101660","DOIUrl":"https://doi.org/10.1016/j.siny.2025.101660","url":null,"abstract":"Congenital diaphragmatic hernia (CDH) remains one of the most challenging conditions to manage in neonatal intensive care, with outcomes determined by the complex interplay between pulmonary hypoplasia, pulmonary vascular remodeling, and ventricular dysfunction. Traditional treatment strategies, including high-frequency ventilation, inhaled nitric oxide, and vasopressor use, fail to account for the dynamic heterogeneity of CDH physiology and may contribute to persistently high mortality. Emerging evidence delineates three principal hemodynamic phenotypes: (1) preserved biventricular function with mild/no pulmonary hypertension (PH), (2) pre-capillary PH with or without right ventricular dysfunction, and (3) post-capillary PH with primary left ventricular (LV) dysfunction. Each phenotype demands distinct ventilatory and pharmacologic strategies, ranging from cautious respiratory support to targeted pulmonary vasodilators, inodilators, or LV-directed therapies. Ventilation in CDH is further complicated by profound lung inhomogeneity, the \"baby lung\" phenomenon, and susceptibility to ventilator-induced lung injury. Advances in lung-protective strategies, including low driving pressure, permissive hypercapnia, synchrony-enhancing modes, and real-time functional monitoring with echocardiography, lung ultrasound, electrical impedance tomography, and use of circulating biomarkers enable tailored interventions. A precision medicine approach, grounded in multimodal monitoring and gentle cardiopulmonary support, holds promise to optimize hemodynamic balance, reduce iatrogenic injury, and improve survival and long-term outcomes in infants with CDH.","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101660"},"PeriodicalIF":2.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Introduction to seminars in fetal and neonatal medicine, Congenital Diaphragmatic Hernia issue. 胎儿和新生儿医学研讨会介绍，先天性膈疝问题。

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-09-13 DOI: 10.1016/j.siny.2025.101661

Neil Patel

引用次数: 0

Optimizing ECLS strategies in the management of congenital diaphragmatic hernia: Recent advances and best practices. 优化ECLS治疗先天性膈疝的策略：最新进展和最佳实践。

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-09-02 DOI: 10.1016/j.siny.2025.101659

Kylie I Holden, Devin Saljuud, Kevin Johnson, Matthew T Harting

引用次数: 0