Seminars in Fetal & Neonatal Medicine最新文献_第2页

Platelet transfusion and bleeding risk 血小板输注和出血风险。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2025.101608

Valeria Cortesi , Enrico Lopriore , Susanna Fustolo-Gunnink

{"title":"Platelet transfusion and bleeding risk","authors":"Valeria Cortesi , Enrico Lopriore , Susanna Fustolo-Gunnink","doi":"10.1016/j.siny.2025.101608","DOIUrl":"10.1016/j.siny.2025.101608","url":null,"abstract":"<div><div>In neonatal patients, bleeding is a multifactorial event in which several factors may play a pathogenic role. Among these, thrombocytopenia is often considered a risk factor for bleeding, although a causal relationship has never been demonstrated. In fact, major bleeding mainly occurs in non-thrombocytopenic newborns and thrombocytopenic newborns rarely experience major bleeding. Therefore, parameters other than platelet count might better assess the hemostatic function and define bleeding risk. Historically, neonatologists aimed to reduce the risk of bleeding by administering platelet transfusions. However, recent studies demonstrated that transfusing newborns at higher threshold is associated with an increased risk of death, bleeding, bronchopulmonary dysplasia and neurodevelopmental impairment. The mechanism behind this association is not known and various hypotheses have been proposed, including the non-hemostatic effects of adult-derived platelets transfused into neonates. Alternatively, the rapid volume expansion caused by a platelet transfusion might cause hemodynamic instability and cardiocirculatory overload. Guidelines about platelet transfusions should now include this recent evidence and adopt more stringent thresholds. Future research should focus on finding alternative or improved transfusion products more suitable for newborns.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 1","pages":"Article 101608"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634803","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

Term umbilical cord blood, fully tested and processed, as the source of red blood cell transfusions for extremely-low-gestational age neonates 将经过全面检测和处理的末期脐带血作为极低胎龄新生儿输注红细胞的来源。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2024.101546

Timothy M. Bahr , Thomas R. Christensen , Sarah J. Ilstrup , Robin K. Ohls , Robert D. Christensen

{"title":"Term umbilical cord blood, fully tested and processed, as the source of red blood cell transfusions for extremely-low-gestational age neonates","authors":"Timothy M. Bahr , Thomas R. Christensen , Sarah J. Ilstrup , Robin K. Ohls , Robert D. Christensen","doi":"10.1016/j.siny.2024.101546","DOIUrl":"10.1016/j.siny.2024.101546","url":null,"abstract":"<div><div>ELGANs (Extremely-Low-Gestational-Age Neonates; those born before 28 weeks gestation) are at risk for developing significant morbidities including retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and cognitive impairment. The pathogenesis of each of these morbidities is complex, but a growing literature suggests that repeated transfusions of adult donor red blood cells (RBC) conveys a propensity to develop these disorders. The biological rationale for the propensities might vary with each morbidity. For instance, hemoglobin A in adult red cells increases oxygen delivery to the developing retina, potentiating ROP, while a proinflammatory nature of adult donor RBC might potentiate BPD. It is possible that fetal RBC harvested from otherwise discarded umbilical cord blood after healthy term births would be a more physiologically appropriate transfusion product for anemic ELGANs. Such a product might result in a lower incidence or severity of the common morbidities. Herein we review our progress, and that of others, toward testing that theory.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 1","pages":"Article 101546"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548567","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

Foreword: Recent advances in neonatal hematology and transfusion medicine 前言：新生儿血液学和输血医学的最新进展。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2025.101607

Bertil Glader

引用次数: 0

Severe anemia predisposes very premature infants to transfusion-associated necrotizing enterocolitis 严重贫血易使早产儿患输血相关性坏死性小肠结肠炎。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-03-01 DOI: 10.1016/j.siny.2025.101615

Akhil Maheshwari

引用次数: 0

Optimal respiratory support for extremely low birth weight infants – do we have the answers? 极低出生体重儿的最佳呼吸支持--我们有答案吗？

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.siny.2024.101563

Alexander J. Rickart , Theodore Dassios , Anne Greenough

引用次数: 0

Neonatal delirium 新生儿谵妄

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.siny.2024.101567

Olivia Ruth , Nasuh Malas

引用次数: 0

Surfactant therapy - The conundrum of which infant should be given, when, which drug in what dose via which route of administration? 表面活性物质疗法--应该在什么时间、什么剂量、通过什么给药途径给哪个婴儿用药的难题？

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.siny.2024.101568

Shivashankar Diggikar , Radu Galis , Karthik Nagesh , Aakash Pandita , Maria Livia Ognean , Mario Rüdiger , Jan Mazela , Boris W. Kramer

{"title":"Surfactant therapy - The conundrum of which infant should be given, when, which drug in what dose via which route of administration?","authors":"Shivashankar Diggikar , Radu Galis , Karthik Nagesh , Aakash Pandita , Maria Livia Ognean , Mario Rüdiger , Jan Mazela , Boris W. Kramer","doi":"10.1016/j.siny.2024.101568","DOIUrl":"10.1016/j.siny.2024.101568","url":null,"abstract":"<div><div>Surfactant therapy in preterm and term born infants has been a huge success story. In the meantime, we have very detailed answers to the five essential questions of each medical therapy: which infant should be treated, when, with which drug, in/at what dose, and via which route of administration. The answers to these questions depend on the gestational age of the infant. We have focused on preterm infants <28 weeks of gestation as they are the most vulnerable and may have the maximum benefit of appropriate treatment. Therefore, we performed a sub-group analysis for data available from the published trials in infants less than 28 weeks who received less/minimal invasive surfactant administration/therapy [LISA/MIST] versus intubation-surfactant-extubation (INSURE). The need for mechanical ventilation (MV) was significantly reduced by 28 % (RR:0.72, 95%CI:0.64–0.80, n = 548 infants) after LISA/MIST. The incidence of bronchopulmonary dysplasia (BPD) was significantly decreased by 30 % (RR:0.70, 95%CI:0.66–0.75, n = 6528 infants) after LISA/MIST. No difference in mortality was noted between the two groups. In the current review, we discuss the applicability of guidelines to individual patient groups like the infants <28 weeks and emphasize the individual assessment of published data by the treating physician.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"29 6","pages":"Article 101568"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631269","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

High-frequency jet ventilation in ELBW infants: A review and update ELBW 婴儿的高频喷射通气：回顾与更新。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.siny.2024.101566

Evan D. Richards , Robert M. DiBlasi

引用次数: 0

Assessment of Global Burden due to neonatal encephalopathy: An economic evaluation 新生儿脑病造成的全球负担评估：经济评估。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.siny.2024.101560

Ramesh Vidavalur , Kiran More , Vinod K. Bhutani

{"title":"Assessment of Global Burden due to neonatal encephalopathy: An economic evaluation","authors":"Ramesh Vidavalur , Kiran More , Vinod K. Bhutani","doi":"10.1016/j.siny.2024.101560","DOIUrl":"10.1016/j.siny.2024.101560","url":null,"abstract":"<div><div>Neonatal encephalopathy (NE) is a significant cause of neonatal mortality in low- and middle-income (LAMI) countries, with far-reaching impacts on families and national human capital. Quantifying the disease burden in monetary terms is crucial for resource allocation and public health prioritization, yet data on the economic impact of NE-related neonatal mortality and prevention is limited. This study estimates the country-specific disease burden and economic impacts of NE for the ten countries with the highest death tolls in 2019. Using data from the Global Burden of Disease (GBD) Collaborative Network, we analyzed NE-specific mortality trends and calculated years of life lost (YLLs) based on life expectancy, with and without age weighting and discounting. Economic losses were evaluated using the value per statistical life (VSL) and value per statistical life year (VSLY) methodologies, with sensitivity analyses incorporating variable discount rates. In 2019, the ten countries with the highest NE burden was estimated at 138,763 neonatal deaths. YLLs ranged from 4.5 million with discounting to 9.8 million without. While nine of these countries reduced overall neonatal mortality from 2010 to 2019, six saw rising NE-specific mortality. Economic losses were estimated at $80 billion using the VSL method and between $72 billion and $163 billion using VSLY. Despite overall progress in reducing neonatal mortality, targeted funded strategies are needed to address <span>NE</span> in LAMI countries. Burden of NE could be reduced with improved strategic access to quality antenatal care and effective peripartum practices through efficient and enhanced resource allocation.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"29 6","pages":"Article 101560"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631209","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

Management of patent ductus arteriosus – Evidence to practice 动脉导管未闭的管理--从证据到实践。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2024-12-01 DOI: 10.1016/j.siny.2024.101565

Samir Gupta , Steven M. Donn

引用次数: 0