Establishing functional residual capacity at birth: the effect of sustained inflation and positive end-expiratory pressure in a preterm rabbit model.

The effect of a 20 s sustained inflation (SI) and positive end-expiratory pressure (PEEP) on functional residual capacity (FRC) formation at birth were investigated. Preterm rabbit pups (28 d) were randomized at birth into four groups (n = 6 for each): 1) SI, PEEP 5 cm H2O, 2) no SI, PEEP 5 cm H2O, 3) no SI + no PEEP, 4) SI + no PEEP. FRC and tidal volume (Vt) were measured by plethysmography and uniformity of lung aeration by phase contrast x-ray imaging.

Ventilation and spontaneous breathing at birth of infants with congenital diaphragmatic hernia.

Objective: To describe the interaction of spontaneous breaths, manual ventilation, and tidal volumes (V(T)) during stabilization of infants with congenital diaphragmatic hernia (CDH) in the delivery room.

Study Design: We studied infants with CDH receiving respiratory support at birth. Airway pressure, flow, and volume were measured, and each breath or inflation was analyzed.

No short-term benefits of antenatal corticosteroid treatment in severely preterm growth restricted fetuses: a case-control study.

Background: Antenatal corticosteroid administration to premature, growth restricted fetuses may not be beneficial and even have adverse effects on neonatal outcome.

Aims: To determine if preterm growth restricted fetuses benefit from antenatal corticosteroids.

Study Design: Retrospective cohort study.

Early nasal continuous positive airway pressure and low threshold for intubation in very preterm infants.

Aim: To determine if selective intubation, use of early nasal continuous positive airway pressure (NCPAP) at birth with a low threshold for early surfactant treatment, reduces the need for intubation in very preterm infants in the first days after birth.

Methods: Two cohorts of very preterm infants < or = 32 weeks, born at the Leiden University Medical Center in the Netherlands, were compared retrospectively before (1996-1997) and after (2003-2004) introducing selective intubation and use of early NCPAP. A FiO(2)> or = 0.

Spontaneous breathing patterns of very preterm infants treated with continuous positive airway pressure at birth.

There are no data describing how very preterm infants breathe spontaneously immediately after birth. We studied a convenience sample of spontaneously breathing infants View Article and Find Full Text PDF

A randomized, controlled trial of delivery-room respiratory management in very preterm infants.

Background: Initial ventilation strategy may play an important role in the development of bronchopulmonary dysplasia in very preterm infants. Early nasal continuous positive airway pressure is an accepted approach, but randomized clinical trials are lacking. Our aim was to determine whether early nasal continuous positive airway pressure, preceded by a sustained inflation, is more effective and less injurious in very preterm infants than conventional intervention.

Risk of persistent pulmonary hypertension of the neonate in twin-to-twin transfusion syndrome.

Background: Chronic twin-to-twin transfusion syndrome (TTTS) is a complication of monochorionic twin gestations and is associated with high perinatal mortality and increased neurological, cardiovascular and renal morbidity.

Objective: To report the risk of severe persistent pulmonary hypertension of the newborn (PPHN) in TTTS and discuss the possible association between severe PPHN and TTTS.

Methods: All cases of monochorionic twins with severe PPHN at birth admitted to our nursery between June 2002 and July 2006 were reviewed retrospectively.

Early respiratory management of respiratory distress syndrome in very preterm infants and bronchopulmonary dysplasia: a case-control study.

Background: In the period immediately after birth, preterm infants are highly susceptible to lung injury. Early nasal continuous positive airway pressure (ENCPAP) is an attempt to avoid intubation and may minimize lung injury. In contrast, ENCPAP can fail, and at that time surfactant rescue can be less effective.

Postnatal management of fetal and neonatal alloimmune thrombocytopenia: the role of matched platelet transfusion and IVIG.

We evaluated the effects of platelet transfusions and intravenous immunoglobulin (IVIG) in neonates with fetal and neonatal alloimmune thrombocytopenia (FNAIT) with and without antenatal treatment with IVIG. Records of neonates with FNAIT admitted between January 2000 and November 2005 were reviewed. The patients were divided into group I, treated antenatally with IVIG for known FNAIT, and group II, postnatally diagnosed with FNAIT.

Preoperative cranial ultrasound findings in infants with major congenital heart disease.

Background: Advances in diagnostic testing and surgical techniques have resulted in reduced mortality in neonates with congenital heart disease (CHD) and a major concern for neurological morbidity in the presence of preoperative neurological injury.

Objectives: To determine the incidence and nature of preoperative cerebral ultrasound abnormalities in neonates with major CHD and to examine the relationship between cerebral abnormalities and the type of CHD.

Methods: Retrospective study; inclusion criteria: (1) neonates with major CHD admitted to the NICU over a 3-y period, (2) gestational age >35 wk, (3) documented preoperative cranial ultrasound available; exclusion criteria: (1) small for gestational age, (2) other congenital anomalies and/or chromosomal abnormalities, (3) a 5-min Apgar score <7, (4) congenital infection.