Respiratory support strategies in neonatal transport in the UK and Ireland.

Unlabelled: Infants requiring interhospital transfer for a higher level of care in the neonatal period are at increased risk of adverse outcomes. Optimising respiratory management is an important priority. The aim of this survey was to investigate current respiratory support strategies in neonatal transport and identify opportunities for the optimisation of clinical care and future research.

Closed-loop automated oxygen control in late preterm and term, ventilated infants: A randomised controlled trial.

Aim: To compare the time spent above the target oxygen saturation range (SpO > 96%) and the duration of supplemental oxygen between ventilated infants receiving closed-loop automated oxygen control (CLAC) or manual oxygen control in late preterm and term ventilated infants.

Methods: Infants were randomised to receive CLAC or manual oxygen control from recruitment and within 24 h of mechanical ventilation until successful extubation.

Results: Forty infants with a median (IQR) gestational age of 37.

Racial Differences in Respiratory Morbidity in Late Preterm Infants: A Retrospective Cohort Study.

. The role of race in late preterm respiratory morbidity has not been adequately described. We aimed to determine whether neonatal respiratory morbidity differs between Black and White late preterm infants.

Chorioamnionitis and respiratory outcomes in prematurely born children: a systematic review and meta analysis.

Introduction: To conduct a systematic review and meta-analysis of the association between chorioamnionitis and respiratory outcomes of prematurely born children.

Content: Pubmed, Medline and Embase were searched for relevant studies. Studies were included if they assessed prematurely born children, who had been exposed to chorioamnionitis and had either lung function testing or assessment of wheeze or asthma following NICU discharge.

Chest radiographic thoracic areas and respiratory outcomes in infants with anterior abdominal wall defects.

Objectives: Infants with anterior abdominal wall defects (AWD) can suffer from pulmonary complications. Our aims were to determine if the chest radiographic thoracic areas (CRTAs) on day one differed between infants with exomphalos or gastroschisis, whether this related to differing severity of outcomes and if they were lower than those of controls indicating abnormal antenatal lung growth.

Methods: A review of infants with exomphalos or gastroschisis born between January 2004 and January 2023 was conducted.

Pancreatic Insufficiency, Digestive Enzyme Supplementation, and Postnatal Growth in Preterm Babies.

Background: 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.

Study protocol for a randomised cross-over trial of Neurally adjusted ventilatory Assist for Neonates with Congenital diaphragmatic hernias: the NAN-C study.

Background: Neurally adjusted ventilatory assist (NAVA) is a mode of mechanical ventilation that delivers oxygen pressures in proportion to electrical signals of the diaphragm. The proportional assistance can be adjusted by the clinician to reduce the patient's work of breathing. Several case series of infants with congenital diaphragmatic hernias (CDH) have shown that NAVA may reduce oxygenation index and mean airway pressures.

Artificial intelligence in the NICU to predict extubation success in prematurely born infants.

Objectives: Mechanical ventilation in prematurely born infants, particularly if prolonged, can cause long term complications including bronchopulmonary dysplasia. Timely extubation then is essential, yet predicting its success remains challenging. Artificial intelligence (AI) may provide a potential solution.

Postnatal corticosteroid usage in United Kingdom and Ireland neonatal units.

Aim: To perform a survey on postnatal corticosteroids usage in neonatal units in the United Kingdom and Ireland.

Methods: An 18-item structured questionnaire was created asking for the level of neonatal care and corticosteroid prescribing practices. A consultant neonatologist or senor specialty training registrar/advanced neonatal nurse practitioner was contacted in every neonatal unit in the UK and Ireland between September and December 2022.

Carboxyhaemoglobin levels in infants with hypoxic ischaemic encephalopathy.

Objectives: Hypoxic ischaemic encephalopathy (HIE) is associated with oxidative stress. A potential marker of oxidative damage is carboxyhaemoglobin (COHb) which is the product of the reaction between carbon monoxide and haemoglobin and is routinely assessed on blood gas analysis. Our objective was to test the hypothesis that higher COHb levels would be associated with worse outcomes in infants treated for HIE.

Systematic review of the long-term effects of postnatal corticosteroids.

Background: Dexamethasone administration can reduce bronchopulmonary dysplasia, our objective was to identify long term adverse effects.

Content: A systematic review was performed to determine the childhood and adolescent cardiopulmonary and cognitive effects of dexamethasone systemically administered to preterm infants during neonatal intensive care. Relevant studies were identified by searching two electronic health databases and the grey literature.

Does closed-loop automated oxygen control reduce the duration of supplementary oxygen treatment and the amount of time spent in hyperoxia? A randomised controlled trial in ventilated infants born at or near term.

Background: Ventilated infants frequently require supplemental oxygen, but its use should be monitored carefully due to associated complications. The achievement of oxygen saturation (SpO) targets can be challenging as neonates experience frequent fluctuations of their oxygen levels that further increase the risk of complications. Closed-loop automated oxygen control systems (CLAC) improve achievement of oxygen saturation targets, reduce hyperoxaemic episodes and facilitate weaning of the inspired oxygen concentration in ventilated infants born at or near term.

Ventilatory response to added dead space in infants exposed to second-hand smoke in pregnancy.

Maternal cigarette smoking in pregnancy can adversely affect infant respiratory control. In utero nicotine exposure has been shown to blunt the infant ventilatory response to hypercapnia, which could increase the risk of sudden infant death syndrome. The potential impact of maternal second-hand smoke exposure, however, has not yet been determined.

Closed-loop oxygen system in late preterm/term, ventilated infants with different severities of respiratory disease.

Aim: To evaluate closed-loop automated oxygen control (CLAC) in ventilated infants >33 weeks of gestation with different respiratory disease severities.

Methods: Infants were studied on two consecutive days for 6 h each day. They were randomised to receive standard care or standard care with CLAC (Oxygenie) first.

Randomised study of heart rate measurement in preterm newborns with ECG plus pulse oximetry versus oximetry alone.

Aim: To determine whether the IntelliVue monitor (ECG plus Masimo pulse oximeter (PO)) displays heart rate (HR) at birth more quickly than Nellcor PO (PO alone) among infants of 29-35 weeks' gestational age.

Methods: Unmasked parallel group randomised (1:1) study.

Results: We planned to enrol 100 infants; however, the study was terminated due to the COVID-19 pandemic when 39 infants had been enrolled (17 randomised to IntelliVue, 22 to Nellcor).

Beaulieu-Boycott-Innes syndrome: an intellectual disability syndrome with characteristic facies.

We report a female child from an Irish Traveller family presenting with severe intellectual disability, dysmorphic features, renal anomalies, dental caries and cyclical vomiting. Current health issues include global developmental delay, mild concentric left ventricular hypertrophy, dental malocclusion and caries and a single duplex left kidney. The proband and her mother also have multiple epiphyseal dysplasia.