Seminars in Fetal & Neonatal Medicine最新文献

The value of thromboelastography to neonatology 血栓弹性成像对新生儿科的价值。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2025.101610

Francesca Manzoni , Ludovica Raymo , Vittoria Carolina Bronzoni , Andrea Tomaselli , Stefano Ghirardello , Monica Fumagalli , Giacomo Cavallaro , Genny Raffaeli

{"title":"The value of thromboelastography to neonatology","authors":"Francesca Manzoni , Ludovica Raymo , Vittoria Carolina Bronzoni , Andrea Tomaselli , Stefano Ghirardello , Monica Fumagalli , Giacomo Cavallaro , Genny Raffaeli","doi":"10.1016/j.siny.2025.101610","DOIUrl":"10.1016/j.siny.2025.101610","url":null,"abstract":"<div><div>Hemostatic derangements are common in critically ill and premature neonates. Nevertheless, hemostasis assessment in neonates is still challenging. The hemostatic system undergoes age-related physiological changes during its maturation and exhibits quantitative and qualitative differences between infants and adults. Conventional coagulation tests are mainly responsive to procoagulant factors, regardless of the contribution of cellular elements, anticoagulants and fibrinolytic contributors and, therefore, their role in predicting bleeding in neonatal acquired coagulopathy is somewhat limited. Viscoelastic coagulation tests offer a promising alternative, enabling a bedside and real-time assessment of the entire hemostatic process in short turn-around times with a limited amount of blood. These tests allow a targeted hemostatic monitoring and a tailored management of blood products and anticoagulation. The routine use of VCTs in the NICU remains limited, especially for premature infants, due to the lack of established normative ranges. In this review we will provide an overview of the main evidence related to the clinical application of viscoelastic monitoring in the neonatal setting.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 1","pages":"Article 101610"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532056","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

Health and societal infant mortality burden of neonatal hemolytic disorders 新生儿溶血性疾病的健康和社会婴儿死亡率负担。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2025.101620

Ramesh Vidavalur , Vinod K. Bhutani

{"title":"Health and societal infant mortality burden of neonatal hemolytic disorders","authors":"Ramesh Vidavalur , Vinod K. Bhutani","doi":"10.1016/j.siny.2025.101620","DOIUrl":"10.1016/j.siny.2025.101620","url":null,"abstract":"<div><div>Hemolytic disorders in neonates, once exceedingly common causes of infant mortality, have become increasingly rare and now largely non-fatal. Global advancements in neonatal care and deeper understanding of the mechanisms of neonatal hemolysis have significantly improved survival outcomes, particularly among those in high-income countries. However, regional disparities persist due to non-equitable healthcare access. Their long-lasting health consequences have been attributed to social, demographic factors that are most likely amenable to healthcare governance. In this review, we focus our attention to neonatal hemolytic disorders to i) analyze data resourced from the Global Burden of Disease (GBD) 2021 report; ii) study the trends in infant mortality rates (IMR) as related to hemolytic disorders including its severe complication, extreme hyperbilirubinemia (EHB-IMR); iii) evaluate geospatial disparities among GBD super regions; and iv) examine these trends in relation to the socio-demographic index (SDI) of the countries that comprise the “super-regions”. From 1991 to 2021, global EHB-related IMR has declined significantly, from 73 to 25 per 100,000 live births. By 2021, EHB and kernicterus accounted for only 0.7 % of all under-five deaths. High-income countries have dramatically minimized hemolytic disease fatalities, but matched progress eludes regions like South Asia and sub-Saharan Africa. The inverse relationship between SDI and EHB-IMR highlight these national disparities to manifest as slower decline in IMR. In order to achieve equitable healthcare access for all regions, an improved understanding of the societal risk factors would guide re-engineering solutions that are also empowered by audited resource utilization to evaluate remedial governance policies.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 1","pages":"Article 101620"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568679","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

A practical review of iron deficiency in pregnancy 妊娠期缺铁的实际回顾。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2025.101611

Kimberly A. Moyle

引用次数: 0

Should granulocyte transfusion therapy for septic neutropenic neonates be resurrected? 粒细胞输注治疗感染性中性粒细胞减少新生儿是否应该恢复？

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2025.101616

Shelley M. Lawrence

{"title":"Should granulocyte transfusion therapy for septic neutropenic neonates be resurrected?","authors":"Shelley M. Lawrence","doi":"10.1016/j.siny.2025.101616","DOIUrl":"10.1016/j.siny.2025.101616","url":null,"abstract":"<div><div>Nearly half a century ago, granulocyte transfusions were trialed in critically ill, septic, neutropenic neonates and showed improved survival when used concurrently with antimicrobials. Benefits were particularly noteworthy for Gram-negative and fungal infections. The introduction of granulocyte colony-stimulating factor into clinical medicine in 1991 and inherent problems associated with granulocyte procurement for transfusion caused granulocyte transfusions to become nearly extinct for this patient population. Simultaneous technological and clinical management advancements have enabled the survival of younger neonates, who are at the highest risk for neutropenia and neonatal sepsis. These infants have well-documented developmental deficiencies in the number and functional capabilities of their neutrophils compared to older patients. A continued surge in antimicrobial resistance and an increasing number of Gram-negative infections have created an urgent need for clinicians to rethink old therapies and consider new ones. This review details the evolution of granulocyte transfusions and whether they should be resurrected in neonatal patients.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 1","pages":"Article 101616"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558544","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

Prenatal diagnosis and treatment of congenital anemias 先天性贫血的产前诊断与治疗。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2025.101613

Yair J. Blumenfeld

引用次数: 0

A practical guide to reducing/eliminating red blood cell transfusions in the neonatal intensive care unit 新生儿重症监护室减少/消除输注红细胞的实用指南。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2024.101545

Robin K. Ohls , Timothy M. Bahr , Thomas G. Peterson , Robert D. Christensen

{"title":"A practical guide to reducing/eliminating red blood cell transfusions in the neonatal intensive care unit","authors":"Robin K. Ohls , Timothy M. Bahr , Thomas G. Peterson , Robert D. Christensen","doi":"10.1016/j.siny.2024.101545","DOIUrl":"10.1016/j.siny.2024.101545","url":null,"abstract":"<div><div>Red blood cell transfusions can be lifesaving for neonates with severe anemia or acute massive hemorrhage. However, it is imperative to understand that red cell transfusions convey unique and significant risks for neonates. The extremely rare risks of transmitting a viral, bacterial, or other microbial infection, or causing circulatory overload are well known and are part of blood transfusion informed consent. Less well known, and not always part of the consent process, are more common risks of transfusing the smallest and most immature NICU patients; specifically, multiple transfusions may worsen inflammatory conditions (particularly pulmonary inflammation), and in certain subsets are associated with retinopathy of prematurity and neurodevelopmental delay. Instituting non-pharmacological transfusion-avoidance techniques reduces transfusion rates. Pharmacological transfusion-avoidance, specifically erythropoietic stimulating agents, further reduces the risk of needing a transfusion. The protocols described herein constitute an efficient and cost-effective transfusion-avoidance program. Using these protocols, many NICU patients can remain transfusion-free.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 1","pages":"Article 101545"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548565","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

Revised World Health Organization (WHO) classification of G6PD gene variants: Relevance to neonatal hyperbilirubinemia 修订的世界卫生组织（WHO） G6PD基因变异分类：与新生儿高胆红素血症的相关性。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2025.101619

Jon F. Watchko , Vinod K. Bhutani

引用次数: 0

Recent advances in NICU platelet transfusions 新生儿重症监护病房血小板输注的最新进展。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2025.101609

Patricia Davenport, Martha Sola-Visner

引用次数: 0

Neonatal/perinatal diagnosis of hemolysis using ETCOc 使用 ETCOc 诊断新生儿/围产期溶血。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2024.101547

Robert D. Christensen , Timothy M. Bahr , Robin K. Ohls , Kenneth J. Moise Jr.

{"title":"Neonatal/perinatal diagnosis of hemolysis using ETCOc","authors":"Robert D. Christensen , Timothy M. Bahr , Robin K. Ohls , Kenneth J. Moise Jr.","doi":"10.1016/j.siny.2024.101547","DOIUrl":"10.1016/j.siny.2024.101547","url":null,"abstract":"<div><div>Hemolysis is a pathological shortening of the red blood cell lifespan. When hemolysis occurs in a neonate, hazardous hyperbilirubinemia and severe anemia could result. Hemolysis can be diagnosed, and its severity quantified, by the non-invasive measurement of carbon monoxide (CO) in exhaled breath. The point-of-care measurement is called “End-tidal CO corrected for ambient CO” (ETCOc). Herein we explain how ETCOc measurements can be used to diagnose and manage various perinatal/neonatal hemolytic disorders. We provide information regarding five clinical situations; 1) facilitating a precise diagnosis among <em>neonates</em> presenting with anemia or jaundice of unknown etiology, 2) monitoring <em>fetal</em> hemolysis with serial measurements of mothers during pregnancy, 3) measuring the <em>duration</em> of hemolysis in neonates with hemolytic disease, 4) measuring neonates who require <em>phototherapy,</em> to determine whether they have hemolytic <em>vs.</em> non-hemolytic jaundice, and 5) measuring <em>all neonates</em> in the birth hospital as part of a jaundice-detection and management program.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 1","pages":"Article 101547"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511654","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

Iron supplementation for infants in the NICU: What preparation, how much, and how long is optimal? 新生儿重症监护室的婴儿补铁：什么制剂，多少，多长时间是最佳的？

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2025.101612

Sandra Juul , Kendell German

引用次数: 0