Neonatology最新文献

筛选
英文 中文
Erratum. 勘误。
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-01-30 DOI: 10.1159/000536368
{"title":"Erratum.","authors":"","doi":"10.1159/000536368","DOIUrl":"10.1159/000536368","url":null,"abstract":"","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"407"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Parental Experiences of Neonatal Care: A Nationwide Study on Determinants of Excellence. 父母对新生儿护理的体验:一项关于优秀决定因素的全国性研究。
Neonatology Pub Date : 2024-01-01 Epub Date: 2023-10-16 DOI: 10.1159/000533900
Agnes Linnér, Ylva Thernström Blomqvist, Kristina Jonsson, Siri Lilliesköld, Mikael Norman
{"title":"Parental Experiences of Neonatal Care: A Nationwide Study on Determinants of Excellence.","authors":"Agnes Linnér, Ylva Thernström Blomqvist, Kristina Jonsson, Siri Lilliesköld, Mikael Norman","doi":"10.1159/000533900","DOIUrl":"10.1159/000533900","url":null,"abstract":"<p><strong>Introduction: </strong>Infant- and family-centered developmental care can reduce adverse outcomes in both infants and parents. Parents' experiences of the care and staff treatment remain to be evaluated.</p><p><strong>Methods: </strong>Parents of infants admitted to neonatal units in Sweden from July 2020 to May 2022 responded to a questionnaire with standardized questions about in-hospital care. Exposures were hospital, gestational age, length of hospital stay, unit level, and bed density. The proportions of parents rating aspects of neonatal care as excellent, defined as five on a Likert scale, and the determinants of excellence were described. The results were benchmarked with ratings in adult somatic care.</p><p><strong>Results: </strong>A total of 4,475/13,108 (34%) parents responded. The ratings of excellent care varied by question from 65% to 90%. The largest variation in excellence between neonatal units (range 43-80%) was found for \"participation and involvement.\" The proportion of excellence was significantly lower among parents of extremely preterm infants. Confidence in the staff was lower in parents of extremely preterm infants than in parents of term infants (56% vs. 83%). Longer hospital stays affected the experience of neonatal care adversely, whereas level of care and bed density were overall unrelated to the parental experience. Parents in neonatal care rated the care as excellent to a higher extent than patients cared for in adult medicine.</p><p><strong>Conclusion: </strong>A majority of parents rated neonatal care in Sweden as excellent. The less frequent ratings of excellence among parents of extremely preterm infants indicate that more could be done to optimize parental involvement and support.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"46-55"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41242752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhanced Category-Based Risk Assessment for Neonatal Early-Onset Sepsis: A Prospective Observational Study. 新生儿早期败血症强化分类风险评估:一项前瞻性观察研究。
Neonatology Pub Date : 2024-01-01 Epub Date: 2023-10-31 DOI: 10.1159/000534091
Hoi Ying Sharon Lau, Xuelian Wang, Ho Tsun Michelia Wong, Ka Hei Catherine Lam, Hugh Simon Lam
{"title":"Enhanced Category-Based Risk Assessment for Neonatal Early-Onset Sepsis: A Prospective Observational Study.","authors":"Hoi Ying Sharon Lau, Xuelian Wang, Ho Tsun Michelia Wong, Ka Hei Catherine Lam, Hugh Simon Lam","doi":"10.1159/000534091","DOIUrl":"10.1159/000534091","url":null,"abstract":"<p><strong>Introduction: </strong>Compared with multivariate risk assessment, traditional category-based risk assessment (CRA) approaches for neonatal early-onset sepsis (EOS) screening are usually straightforward to use, do not require electronic devices, but are associated with higher rates of antibiotic use. This study aims to evaluate the performance of a novel enhanced CRA (eCRA) framework on EOS admissions and antibiotic use and to investigate whether a modified version with adjustments in risk factor weighting can allow its performance to match the EOS calculator while remaining easy to implement.</p><p><strong>Method: </strong>This is a prospective, single-center, two-phase observational study. Infants of all gestations delivered in a tertiary hospital in Hong Kong with risk factors or clinical features of EOS were recruited.</p><p><strong>Phase i: </strong>A novel eCRA framework (period 2) was compared with the CDC 2010-based protocol (period 1).</p><p><strong>Phase ii: </strong>A modified eCRA framework was compared theoretically with the EOS calculator. EOS-specific admissions and antibiotic use were measured.</p><p><strong>Results: </strong>Phase I: 1,025 at-risk infants were recruited during period 2 and compared with 757 infants of period 1. Admissions and antibiotic use decreased from 45.8% to 29.4% and 41.1% to 28.2%, respectively. Antibiotics among those at-risk but well-appearing infants decreased from 25.3% to 16.3% (p &lt; 0.001 for all).</p><p><strong>Phase ii: </strong>antibiotic use was similar (7.3 vs. 6.4%, p = 0.42) between the modified eCRA framework and the EOS calculator.</p><p><strong>Conclusions: </strong>An eCRA framework can effectively and safely provide individualized guidance for EOS screening without the need for tools such as the EOS calculator.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"56-64"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71430653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pancreatic Insufficiency, Digestive Enzyme Supplementation, and Postnatal Growth in Preterm Babies. 早产儿胰腺机能不全、消化酶补充剂和产后生长。
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-01-19 DOI: 10.1159/000535964
Allan Jenkinson, Narendra Aladangady, Sven Wellmann, Simon Eaton, Christoph Bührer, Paul Fleming, Charles Roehr
{"title":"Pancreatic Insufficiency, Digestive Enzyme Supplementation, and Postnatal Growth in Preterm Babies.","authors":"Allan Jenkinson, Narendra Aladangady, Sven Wellmann, Simon Eaton, Christoph Bührer, Paul Fleming, Charles Roehr","doi":"10.1159/000535964","DOIUrl":"10.1159/000535964","url":null,"abstract":"<p><strong>Background: </strong>Optimising postnatal growth facilitates better long-term neonatal neurodevelopmental outcomes. Early postnatal growth is often hindered by a variety of factors unique to the extrauterine environment and digestive immaturity both contributing to reduced enteral feed tolerance during the first few days and weeks after birth. Preterm infants display varying levels of pancreatic insufficiency that are related to gestational age and providing digestive enzyme supplementation, may be one way in which to improve postnatal growth in enterally fed preterm babies.</p><p><strong>Summary: </strong>In this review, we explore which exocrine pancreatic enzymes are deficient in preterm babies, the methods by which exocrine pancreatic function is measured, potential avenues by which digestive enzyme replacement might improve postnatal growth failure, and which babies might benefit most from this intervention.</p><p><strong>Key messages: </strong>Pancreatic exocrine function exhibits developmental immaturity in extremely preterm infants and may contribute to postnatal growth failure. Stool elastase is a simple, non-invasive method of assessing pancreatic function in preterm infants. Available evidence does not currently support routine use of digestive enzyme supplementation in preterm infants.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"283-287"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between Antenatal Antibiotic Exposure and Bronchopulmonary Dysplasia: A Systematic Review and Bayesian Model-Averaged Meta-Analysis. 产前抗生素暴露与支气管肺发育不良之间的关系:系统回顾与贝叶斯模型平均荟萃分析》(Association between Antenatal Antibiotic Exposure and Bronchopulmonary Dysplasia: A Systematic Review and Bayesian Model-Averaged Meta-Analysis)。
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-02-02 DOI: 10.1159/000536220
Karen Van Mechelen, Tamara M Hundscheid, Elke van Westering-Kroon, František Bartoš, Eduardo Villamor
{"title":"Association between Antenatal Antibiotic Exposure and Bronchopulmonary Dysplasia: A Systematic Review and Bayesian Model-Averaged Meta-Analysis.","authors":"Karen Van Mechelen, Tamara M Hundscheid, Elke van Westering-Kroon, František Bartoš, Eduardo Villamor","doi":"10.1159/000536220","DOIUrl":"10.1159/000536220","url":null,"abstract":"<p><strong>Introduction: </strong>Antenatal antibiotic exposure has been suggested as a risk factor for bronchopulmonary dysplasia (BPD). We aimed to summarize the evidence from randomized controlled trials (RCTs) and observational studies on this potential association.</p><p><strong>Methods: </strong>PubMed/Medline and Embase databases were searched. BPD was classified as BPD28 (supplemental oxygen during 28 days or at postnatal day 28), BPD36 (supplemental oxygen at 36 weeks postmenstrual age), BPD36 or death, and BPD-associated pulmonary hypertension (BPD-PH). Bayesian model-averaged (BMA) meta-analysis was used to calculate Bayes factors (BFs). The BF10 is the ratio of the probability of the data under the alternative hypothesis (H1) over the probability of the data under the null hypothesis (H0).</p><p><strong>Results: </strong>We included 6 RCTs and 27 observational studies (126,614 infants). Regarding BPD28, BMA showed that the evidence in favor of H0 (lack of association with antenatal antibiotics) was weak for the RCTS (BF10 = 0.506, 6 studies) and moderate for the observational studies (BF10 = 0.286, 10 studies). Regarding BPD36, the evidence in favor of H0 was moderate for the RCTs (BF10 = 0.127, 2 studies) and weak for the observational studies (BF10 = 0.895, 14 studies). Evidence in favor of H0 was also weak for the associations with BPD36 or death (BF10 = 0.429, 2 studies) and BPD-PH (BF10 = 0.384, 2 studies). None of the meta-analyses showed evidence in favor of H1.</p><p><strong>Conclusions: </strong>The currently available evidence suggests a lack of association between antenatal antibiotics and BPD. However, our results should not be interpreted as an argument for widespread use of antibiotics in the setting of preterm delivery.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"378-387"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11152007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139682228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
European Training Requirements in Neonatology 2021: The ESPR, EAP, and UEMS Accredited European Syllabus for Neonatal Training. 2021 年欧洲新生儿学培训要求:ESPR、EAP 和 UEMS 认可的欧洲新生儿培训大纲。
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-03-22 DOI: 10.1159/000536247
Charles Christoph Roehr, Tomasz Szczapa, Tom Stiris, Adamos Hadjipanayis, Berthold Koletzko, Rob Ross-Russell, Petra Hüppi, Sven Wellmann, Maximo Vento
{"title":"European Training Requirements in Neonatology 2021: The ESPR, EAP, and UEMS Accredited European Syllabus for Neonatal Training.","authors":"Charles Christoph Roehr, Tomasz Szczapa, Tom Stiris, Adamos Hadjipanayis, Berthold Koletzko, Rob Ross-Russell, Petra Hüppi, Sven Wellmann, Maximo Vento","doi":"10.1159/000536247","DOIUrl":"10.1159/000536247","url":null,"abstract":"<p><strong>Introduction: </strong>The European Union stipulates transnational recognition of professional qualifications for several sectoral professions, including medical doctors. The Union of European Medical Specialists (UEMS), in its \"Charter on Training of Medical Specialists,\" defines the principles for high-level medical training. These principles are manifested in the framework for European Training Requirements (ETR), ensuring medical training reflects modern medical practice and current scientific findings. In 1998, the European Society for Paediatric Research developed the first ETR for Neonatology. We present the ETR Neonatology in its third iteration (ETR III), ratified by the European Academy of Paediatrics (EAP), and approved by UEMS in 2021.</p><p><strong>Methods: </strong>In generating the ETR III, existing European policy documents on training requirements, including national syllabi and the European Standards of Care for Newborn Health were considered. To ensure the ETR III meets a pan-European standard of expertise in Neonatology, input from representatives from 27 European national paediatric/neonatal societies, and a European parent organisation, was sought.</p><p><strong>Results: </strong>The ETR III summarises the requirements of contemporary training programs in Neonatology and offers a system for accrediting trainers and training centres. We describe the content of the ETR III training syllabus and means of gaining and assessing competency as a medical care provider in Neonatology.</p><p><strong>Conclusion: </strong>Graduates of courses following the ETR III Neonatology will obtain a certificate of satisfactory training completion which should be accepted by all European member states as a baseline qualification to practice as a specialist in neonatal medicine, enabling mutual recognition of status throughout Europe.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"519-526"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Magnetic Resonance Imaging-Based Reference Values for Two-Dimensional Quantitative Brain Metrics in a Cohort of Extremely Preterm Infants. 基于磁共振成像的极早产儿队列二维定量脑指标参考值。
Neonatology Pub Date : 2024-01-01 Epub Date: 2023-10-20 DOI: 10.1159/000534009
Julia Buchmayer, Gregor Kasprian, Raphaela Jernej, Sophie Stummer, Victor Schmidbauer, Vito Giordano, Katrin Klebermass-Schrehof, Angelika Berger, Katharina Goeral
{"title":"Magnetic Resonance Imaging-Based Reference Values for Two-Dimensional Quantitative Brain Metrics in a Cohort of Extremely Preterm Infants.","authors":"Julia Buchmayer, Gregor Kasprian, Raphaela Jernej, Sophie Stummer, Victor Schmidbauer, Vito Giordano, Katrin Klebermass-Schrehof, Angelika Berger, Katharina Goeral","doi":"10.1159/000534009","DOIUrl":"10.1159/000534009","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebral magnetic resonance imaging (cMRI) is an important diagnostic tool in neonatology. In addition to qualitative analysis, quantitative measurements may help identify infants with impaired brain growth. This study aimed to create reference values for brain metrics of various brain areas in neonates without major brain injuries born before 28 weeks of gestation.</p><p><strong>Methods: </strong>This retrospective study analyzes cMRI imaging data of high-risk patients without severe brain pathologies at term-equivalent age, collected over 4 years since November 2017. Nineteen brain areas were measured, reference values created, and compared to published values from fetal and postnatal MRI. Furthermore, correlations between brain metrics and gestational age at birth were evaluated.</p><p><strong>Results: </strong>A total of 174 cMRI examinations were available for analysis. Reference values including cut-offs for impaired brain growth were established for different gestational age groups. There was a significant correlation between gestational age at birth and larger \"tissue\" parameters, as well as smaller \"fluid\" parameters, including intracerebral and extracerebral spaces.</p><p><strong>Discussion: </strong>With quantitative brain metrics infants with impaired brain growth might be detected earlier. Compared to preexisting reference values, these are the first of a contemporary collective of extremely preterm neonates without severe brain injuries. Measurements can be easily performed by radiologists as well as neonatologists without specialized equipment or computational expertise.</p><p><strong>Conclusion: </strong>Two-dimensional cMRI brain measurements at term-equivalent age represent an easy and reliable approach for the evaluation of brain size and growth in infants at high risk for neurodevelopmental impairment.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"97-105"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49695562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Laryngeal Mask Airway in Neonatal Resuscitation: A Survey of the Union of European Neonatal and Perinatal Societies. 新生儿复苏中的喉罩气道:欧洲新生儿和围产期学会联盟调查。
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-06-04 DOI: 10.1159/000538808
Daniele Trevisanuto, Camilla Gizzi, Francesco Cavallin, Artur Beke, Giuseppe Buonocore, Antonia Charitou, Manuela Cucerea, Boris Filipović-Grčić, Nelly Georgieva Jekova, Esin Koç, Joana Saldanha, Dalia Stoniene, Heili Varendi, Giuseppe De Bernardo, John Madar, Marije Hogeveen, Luigi Orfeo, Fabio Mosca, Giulia Vertecchi, Corrado Moretti
{"title":"Laryngeal Mask Airway in Neonatal Resuscitation: A Survey of the Union of European Neonatal and Perinatal Societies.","authors":"Daniele Trevisanuto, Camilla Gizzi, Francesco Cavallin, Artur Beke, Giuseppe Buonocore, Antonia Charitou, Manuela Cucerea, Boris Filipović-Grčić, Nelly Georgieva Jekova, Esin Koç, Joana Saldanha, Dalia Stoniene, Heili Varendi, Giuseppe De Bernardo, John Madar, Marije Hogeveen, Luigi Orfeo, Fabio Mosca, Giulia Vertecchi, Corrado Moretti","doi":"10.1159/000538808","DOIUrl":"10.1159/000538808","url":null,"abstract":"<p><strong>Introduction: </strong>Laryngeal mask airway (LMA) use in neonatal resuscitation is limited despite existing evidence and recommendations. This survey investigated the knowledge and experience of healthcare providers on the use of the LMA and explored barriers and solutions for implementation.</p><p><strong>Methods: </strong>This online, cross-sectional survey on LMA in neonatal resuscitation involved healthcare professionals of the Union of European Neonatal and Perinatal Societies (UENPS).</p><p><strong>Results: </strong>A total of 858 healthcare professionals from 42 countries participated in the survey. Only 6% took part in an LMA-specific course. Some delivery rooms were not equipped with LMA (26.1%). LMA was mainly considered after the failure of a face mask (FM) or endotracheal tube (ET), while the first choice was limited to neonates with upper airway malformations. LMA and FM were considered easier to position but less effective than ET, while LMA was considered less invasive than ET but more invasive than FM. Participants felt less competent and experienced with LMA than FM and ET. The lack of confidence in LMA was perceived as the main barrier to its implementation in neonatal resuscitation. More training, supervision, and device availability in delivery wards were suggested as possible actions to overcome those barriers.</p><p><strong>Conclusion: </strong>Our survey confirms previous findings on limited knowledge, experience, and confidence with LMA, which is usually considered an option after the failure of FM/ET. Our findings highlight the need for increasing the availability of LMA in delivery wards. Moreover, increasing LMA training and having an LMA expert supervisor during clinical practice may improve the implementation of LMA use in neonatal clinical practice.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"780-790"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Air or Oxygen for Infant Resuscitation: A Prospective Cohort Study of Moderate-Late Preterm Infants Requiring Delivery Room Resuscitation. 婴儿复苏用空气还是氧气?需要产房复苏的中晚期早产儿的前瞻性队列研究。
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-06-18 DOI: 10.1159/000539221
James X Sotiropoulos, Sheeba Binoy, Thy A N Pham, Kylie Yates, Catherine L Allgood, Ansar Kunjunju, Mark Tracy, John Smyth, Ju Lee Oei
{"title":"Air or Oxygen for Infant Resuscitation: A Prospective Cohort Study of Moderate-Late Preterm Infants Requiring Delivery Room Resuscitation.","authors":"James X Sotiropoulos, Sheeba Binoy, Thy A N Pham, Kylie Yates, Catherine L Allgood, Ansar Kunjunju, Mark Tracy, John Smyth, Ju Lee Oei","doi":"10.1159/000539221","DOIUrl":"10.1159/000539221","url":null,"abstract":"<p><strong>Introduction: </strong>Due to concerns of oxidative stress and injury, most clinicians currently use lower levels of fractional inspired oxygen (FiO2, 0.21-0.3) to initiate respiratory support for moderate to late preterm (MLPT, 32-36 weeks gestation) infants at birth. Whether this practice achieves recommended oxygen saturation (SpO2) targets is unknown.</p><p><strong>Methods: </strong>We aimed to determine SpO2 trajectories of MLPT infants requiring respiratory support at birth. We conducted a prospective, opportunistic, observational study with consent waiver. Preductal SpO2 readings were obtained during the first 10 min of life from infants between 32 and 36 weeks gestation requiring respiratory support in the delivery room. Primary outcome was reaching a minimum SpO2 80% at 5 min of life. The study was prospectively registered (ACTRN12620001252909).</p><p><strong>Results: </strong>A total of 76 eligible infants were recruited between February 2021 and March 2022 from 5 hospitals in Australia. Most (n = 58, 76%) had respiratory support initiated with FiO2 0.21 (range 0.21-1.0) using CPAP (92%). Median SpO2 at 5 min was 81% (interquartile range [IQR] 67-90) and 93% (IQR 86-96) at 10 min. At 5 min, 18/43 (42%) infants had SpO2 below 80% and only 8/43 (19%) reached SpO2 80-85%.</p><p><strong>Conclusions: </strong>Many MLPT infants requiring respiratory support do not achieve recommended SpO2 targets. In very preterm infants, SpO2 <80% at 5 min of life increases risk of death, intraventricular haemorrhage, and neurodevelopmental impairment. The implications on this practice on the health outcomes of MLPT infants are unclear and require further research.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"715-723"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiology and Outcomes of Neonatal Sepsis: Experience from a Tertiary Australian NICU. 新生儿败血症的流行病学和疗效:澳大利亚三级新生儿重症监护室的经验。
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-06-18 DOI: 10.1159/000539174
Cheryl Anne Mackay, Elizabeth A Nathan, Michelle Claire Porter, Damber Shrestha, Rolland Kohan, Tobias Strunk
{"title":"Epidemiology and Outcomes of Neonatal Sepsis: Experience from a Tertiary Australian NICU.","authors":"Cheryl Anne Mackay, Elizabeth A Nathan, Michelle Claire Porter, Damber Shrestha, Rolland Kohan, Tobias Strunk","doi":"10.1159/000539174","DOIUrl":"10.1159/000539174","url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal sepsis is associated with significant mortality and morbidity. Low-middle-income countries are disproportionately affected, but late-onset sepsis (LOS) still occurs in up to 20% of infants <28 weeks in high-income countries. Understanding site-specific data is vital to guide management.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at King Edward Memorial Hospital (KEMH), Perth. Infants admitted between January 2012 and June 2022 were included. Data were extracted from routine electronic databases. Incidence and aetiology of sepsis were determined and the association of sepsis with neonatal outcomes analysed.</p><p><strong>Results: </strong>During the study period, 23,395 newborns were admitted with a median gestation of 37 weeks and birth weight of 2,800 g. There were 370 sepsis episodes in 350 infants; 102 were early-onset sepsis (EOS) (1.6 per 1,000 live births), predominantly Streptococcus agalactiae (35, 34.3%) and Escherichia coli (27, 26.5%); 268 were LOS (0.9 per 1,000 inpatient days), predominantly coagulase-negative staphylococci (CONS) (156, 57.6%) and E. coli (30, 11.1%). The incidence of LOS declined from 2012 to 2022 (p = 0.002). Infants with EOS had increased brain injury (25.7% vs. 4.1%; p = 0.002) and mortality (18.8% vs. 1.6%; p < 0.001). Those with LOS had increased hospital stay (median 95 vs. 15 days; p < 0.001), mortality (15.3% vs. 1.6%; p = 0.018), necrotising enterocolitis (NEC) (7.4% vs. 0.5%; p < 0.001), and chronic lung disease (CLD) (58.1% vs. 5.9%; p = 0.005). Infants <28 weeks with sepsis were at increased risk of neurodevelopmental impairment compared to those without infection (43.2% vs. 30.9%, p = 0.027).</p><p><strong>Conclusions: </strong>While we observed a reduction in LOS incidence, sepsis remains associated with higher mortality, and in survivors with longer hospital stay and increased risk of brain injury, NEC, CLD, and neurodevelopmental impairment.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"703-714"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信