Publications by authors named "Almudena Alonso Ojembarrena"

Article Synopsis
  • Lung ultrasound could be a valuable tool in predicting the severity of lung disease and the need for extended ventilatory support in critically ill children.
  • In a study involving 538 children in the ICU, those requiring prolonged mechanical ventilation (over 7 days) had significantly higher lung ultrasound scores at 12 and 48-72 hours post-admission.
  • The lung ultrasound score demonstrated a strong correlation with oxygen levels and was effective in predicting prolonged mechanical ventilation, showing high accuracy in both initial assessment and multivariable analysis.
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Importance: Surfactant administration may be needed in late preterm through full-term neonates, but the pathophysiology of their respiratory failure can be different from that of early preterm neonates. The lung ultrasonography score (LUS) is accurate to guide surfactant replacement in early preterm neonates, but to our knowledge, it has not yet been studied in the late preterm through full-term neonatal population.

Objective: To assess whether LUS is equally accurate to predict surfactant need in late preterm through full-term neonates as in early preterm neonates.

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Article Synopsis
  • An international survey was conducted across 560 neonatal intensive care units (NICUs) in 24 European countries to assess the usage of lung ultrasound (LU), revealing significant variability in adoption rates (20%-98%).
  • Most NICUs (76%) use LU for clinical reasons, primarily to diagnose respiratory issues and manage acute conditions.
  • Key barriers to LU implementation include lack of experience in technical skills and image interpretation, with suggestions for improvement involving specific training courses and a standardized international guideline.
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Article Synopsis
  • * The review highlights both normal lung characteristics and common respiratory issues in neonates, such as TTN and RDS, emphasizing the importance of ultrasound for diagnosis and treatment planning.
  • * Lung ultrasound can also streamline care in non-NICU settings by assessing respiratory distress severity and guiding early interventions like surfactant therapy, making it valuable for all pediatricians.
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Background: We aimed to determine the prevalence and severity of glomerular and tubular renal dysfunction by means of urinalysis in infants and toddlers with congenital cytomegalovirus infection (cCMV) and their association with cCMV disease, viruria and antiviral treatment.

Methods: This cross-sectional study was done using the Spanish Registry of Congenital Cytomegalovirus Infection. First-morning urine samples were collected from January 2016 to December 2018 from patients <5 years old enrolled in Spanish Registry of Congenital Cytomegalovirus Infection.

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Background: The management of respiratory distress syndrome (RDS) in premature newborns is based on different types of non-invasive respiratory support and on surfactant replacement therapy (SRT) to avoid mechanical ventilation as it may eventually result in lung damage. European guidelines currently recommend SRT only when the fraction of inspired oxygen (FiO) exceeds 0.30.

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Introduction: Early targeted surfactant therapy for preterm infants is recommended but the best criteria to personalize treatment are unclear. We validate a previously published multivariate prognostic model based on gestational age (GA), lung ultrasound score (LUS), and oxygen saturation to inspire oxygen fraction ratio (SatO2/FiO2) using an independent data set.

Methods: Pragmatic, observational study in 10 Italian and Spanish NICUs, including preterm babies (250 and 336 weeks divided into 3 GA intervals) with clinical signs of respiratory distress syndrome and stabilized on CPAP.

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Bronchopulmonary dysplasia (BPD) is a multifactorial disease with many associated co-morbidities, responsible for most cases of chronic lung disease in childhood. The use of imaging exams is pivotal for the clinical care of BPD and the identification of candidates for experimental therapies and a closer follow-up. Imaging is also useful to improve communication with the family and objectively evaluate the clinical evolution of the patient's disease.

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Diaphragm ultrasound (DU) has been used in adult and pediatric critical patients in relation to prediction of extubation success or to detect diaphragm dysfunction, but there is a lack of evidence in neonates. Our aim is to study the evolution of diaphragm thickness in preterm infants, as well as related variables. This prospective monocentric observational study included preterm infants born before 32 weeks (PT32).

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Introduction: Congenital pulmonary malformations are a heterogeneous group of embryological alterations at different stages of lung development, the most frequent being the congenital malformation of the airway. Lung ultrasound is a very useful tool in neonatal intensive care units, providing great value for differential diagnosis, as well as therapeutic response or early detection of complications.

Case Report: The case is a newborn of 38weeks' gestation who was followed by prenatal ultrasound control for suspected adenomatous cystic malformation type III in the left lung from week 22.

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Introduction: The lung ultrasound score (LUS) has been suggested to predict moderate-severe bronchopulmonary dysplasia (msBPD) in preterm infants. We aimed to assess LUS evolution after birth in preterm infants and the effect of gestational age.

Methods: This multicentre prospective observational study was performed with newborns born before 33 weeks of gestation.

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Unlabelled: The N-terminal end of B-type natriuretic peptide (NT-proBNP) and lung ultrasound (LUS) score have been proven to be adequate early biomarkers of bronchopulmonary dysplasia (BPD) in preterm infants. Our aim was to study if the predictive capacity of each one is increased by analyzing them together. We included infants born before 32 weeks with NT-proBNP and LUS scores on the first day of life (DOL) and on the 3rd, 7th, and 14th DOL and compared the diagnostic ability for moderate-severe BPD (msBPD) of each biomarker and in combination.

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Objective: Lung ultrasound is a useful tool for diagnosis and follow-up of diseases in critically ill neonates. Its use is increasingly widespread thanks to its advantages over other imaging tests and the rapidly growing body of evidence to support it, and "point-of-care ultrasound" (POCUS) has become a key component in neonatal guidelines. The objective of this special article is to present the foundations and the established diagnostic and therapeutic applications of lung ultrasonography as well as introducing new applications.

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Article Synopsis
  • A nationwide survey was conducted to understand the perceptions and implementation of ultrasound-guided vascular access (USG-VA) among neonatologists in Spain, revealing that 81% see it as essential in clinical practice.
  • Although many recognize its importance, 35.5% have never applied it on real patients, and most perform fewer than 5 procedures annually.
  • The lack of proper training is considered the main barrier to its use, with 87% of neonatologists advocating for formal training in USG-VA for future doctors.
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Unlabelled: Neonatal pneumothorax (NP) is a potentially life-threatening condition. Lung ultrasound (LUS) has shown higher sensitivity and specificity in diagnosis compared to x-rays, but evidence regarding its usefulness in complex NP is lacking. We report four neonates suffering from cardiac or esophageal malformations who developed lateral and/or posterior pneumothoraces, in which LUS helped, making NP diagnosis and management easier and faster.

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Lung ultrasound scores (LUS) might be useful in monitoring neonates with chronic pulmonary insufficiency of prematurity and in predicting bronchopulmonary dysplasia (BPD). Given their ease of use, accuracy, and lack of invasiveness, LUS have been the subject of several recent studies. We sought to clarify whether LUS provide an accurate and early (within the first 2 wk of life) prediction of BPD in preterm infants of gestational age ⩽32 weeks.

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Lung ultrasound (LUS) is now widely used in the diagnosis and monitor of neonatal lung diseases. Nevertheless, in the published literatures, the LUS images may display a significant variation in technical execution, while scanning parameters may influence diagnostic accuracy. The inter- and intra-observer reliabilities of ultrasound exam have been extensively studied in general and in LUS.

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