Influence of catheter thickness on respiratory physiology during less invasive surfactant administration in extremely preterm infants.

Introduction: Delivering surfactant via thin catheters (minimal-invasive surfactant therapy (MIST); less invasive surfactant administration (LISA)) has become a common procedure. However, the effect of tracheal obstruction caused by catheters of different sizes on tracheal resistance in extremely low gestational age newborns (ELGANs) is unknown.

Methods: To investigate the effect of catheters size 3.

Less Invasive Surfactant Administration in Preterm Infants in Tertiary Neonatal Intensive Care Units in Germany: A Survey.

Introduction: The European guideline for treatment of respiratory distress syndrome recommends less invasive surfactant administration (LISA) as the preferred method of surfactant administration in spontaneously breathing preterm infants. However, there is limited evidence on practical aspects such as sedation and catheter types, leading to considerable variability between centers.

Methods: An anonymous online survey ( View Article and Find Full Text PDF

Randomised crossover study on pulse oximeter readings from different sensors in very preterm infants.

Objective: In extremely preterm infants, different target ranges for pulse oximeter saturation (SpO) may affect mortality and morbidity. Thus, the impact of technical changes potentially affecting measurements should be assessed. We studied SpO readings from different sensors for systematic deviations.

Parental perspectives about information and deferred versus two-stage consent in studies of neonatal asphyxia.

Objective: The ALBINO Trial (NCT03162653) investigates effects of very early postnatal allopurinol on neurocognitive outcome following perinatal asphyxia where prenatal informed consent (IC) is impossible. Ethically and legally, waiver of consent and/or deferred consent (DC) is acceptable in such an emergency. Short oral/two-step consent (SOC, brief information and oral consent followed by IC) has recently been investigated.

Quantifying workload using nonlinear dynamical measures of biomechanical parameters during cycling on a roller trainer.

The aim of the present study was to determine the effectiveness of nonlinear parameters in distinguishing individual workload in cycling by using bike-integrated sensor data. The investigation focused on two nonlinear parameters: The ML1, which analyzes the geometric median in phase space, and the maximum Lyapunov exponent as nonlinear measure of local system stability. We investigated two hypothesis: 1.

Comparison of statistical models for characterizing continuous differences between two biomechanical measurement systems.

Most biomechanical processes are continuous in nature. Measurement systems record this continuous behavior as curve data, which is often treated inappropriately in validation studies. The current paper compares different statistical models for analyzing the agreement of curves from two measurement systems.

Effects of an active hand exoskeleton on forearm muscle activity in industrial assembly grips.

Background: The Bioservo Ironhand® is a commercially available active hand exoskeleton for reducing grip-induced stress.

Objectives: The study aimed at quantifying the effect of the Ironhand® exoskeleton on the myoelectric muscle activity of forearm flexor and extensor muscles in three relevant assembly grip tasks: 2-Finger-grip (2Finger), 5-Finger-grip (5Finger) and Full grip (FullGrip).

Methods: Twenty-two subjects were tested in three different exoskeleton conditions for each grip task (overall 3×3×10 = 90 repetitions in randomized order): Exoskeleton off (Off), Exoskeleton on, "locking tendency" 0% (On_LT0), and Exoskeleton on, "locking tendency" 85% (On_LT85).

Pharmacokinetic/Pharmacodynamic Modelling of Allopurinol, its Active Metabolite Oxypurinol, and Biomarkers Hypoxanthine, Xanthine and Uric Acid in Hypoxic-Ischemic Encephalopathy Neonates.

Background: Allopurinol, an xanthine oxidase (XO) inhibitor, is a promising intervention that may provide neuroprotection for neonates with hypoxic-ischemic encephalopathy (HIE). Currently, a double-blind, placebo-controlled study (ALBINO, NCT03162653) is investigating the neuroprotective effect of allopurinol in HIE neonates.

Objective: The aim of the current study was to establish the pharmacokinetics (PK) of allopurinol and oxypurinol, and the pharmacodynamics (PD) of both compounds on hypoxanthine, xanthine, and uric acid in HIE neonates.

Comparison of nostril sizes of newborn infants with outer diameter of endotracheal tubes.

Background: Recommendations for endotracheal tube (ETT) size usually refer to the inner diameter (ID). Outer diameters (OD), however, vary greatly between manufacturers, which in some brands might cause difficulties in passing the ETT through the nostrils if choosing the nasal route for intubation. Even though the nostrils are dilatable by an ETT, it might be difficult to pass an ETT through the posterior naris (narrowest point of the nasal passage), if the OD is bigger than the nostrils.

Icy road ahead-rapid adjustments of gaze-gait interactions during perturbed naturalistic walking.

Most humans can walk effortlessly across uniform terrain even when they do not pay much attention to it. However, most natural terrain is far from uniform, and we need visual information to maintain stable gait. Recent advances in mobile eye-tracking technology have made it possible to study, in natural environments, how terrain affects gaze and thus the sampling of visual information.

Differential metabolism of choline supplements in adult volunteers.

Background: Adequate intake of choline is essential for growth and homeostasis, but its supply does often not meet requirements. Choline deficiency decreases phosphatidylcholine (PC) and betaine synthesis, resulting in organ pathology, especially of liver, lung, and brain. This is of particular clinical importance in preterm infants and cystic fibrosis patients.

Catheter insertion depths in less-invasive surfactant administration.

Introduction: Less-invasive surfactant administration (LISA) under continuous positive airway pressure is increasingly used for the treatment of neonatal respiratory distress. Different procedures are described, but data on the optimal catheter insertion depth are sparse.

Objective: To generate data for recommending an optimal catheter insertion depth in LISA.

Glomerular Filtration Rate in Asphyxiated Neonates Under Therapeutic Whole-Body Hypothermia, Quantified by Mannitol Clearance.

Background: Therapeutic hypothermia (TH) is an established intervention to improve the outcome of neonates with moderate-to-severe hypoxic-ischemic encephalopathy resulting from perinatal asphyxia. Despite this beneficial effect, TH may further affect drug elimination pathways such as the glomerular filtration rate.

Objectives: The objective of this study was to quantify the effect of TH in addition to asphyxia on mannitol clearance as a surrogate for the glomerular filtration rate.

Clinical evaluation of an application aid for less-invasive surfactant administration (LISA).

Background: Less-invasive surfactant administration (LISA) is increasingly used. We investigated the feasibility of a new LISA-device (Neofact®) in neonates.

Design: Prospective observational pilot study with open-label LISA in two tertiary neonatal intensive care units.

Nasal insertion depths for neonatal intubation.

Aim: Data on the depth of nasal intubation in neonates are rare, although this is the preferred route in some countries. Therefore, recommendations on optimal nasal intubation depths based on gestational age (GA) and weight are desirable.

Methods: We determined the distances between the middle of thoracic vertebrae 2 (T2) and the tip of the endotracheal tube in 116 X-rays from nasally intubated neonates.

Microbiological analyses of nasally guided catheters after less invasive surfactant administration - a pilot study.

Background: Respiratory distress syndrome (RDS) is a frequent complication of premature birth. Treating RDS by continuous positive airway pressure and less invasive surfactant administration (LISA) may reduce bronchopulmonary dysplasia. Surfactant, however, can be inactivated by bacterial infection.

Effects of closed-loop automatic control of the inspiratory fraction of oxygen (FiO-C) on outcome of extremely preterm infants - study protocol of a randomized controlled parallel group multicenter trial for safety and efficacy.

Background: Most extremely low gestational age neonates (ELGANS, postmenstrual age at birth (PMA) < 28 completed weeks) require supplemental oxygen and experience frequent intermittent hypoxemic and hyperoxemic episodes. Hypoxemic episodes and exposure to inadequately high concentrations of oxygen are associated with an increased risk of retinopathy of prematurity (ROP), chronic lung disease of prematurity (BPD), necrotizing enterocolitis (NEC), neurodevelopmental impairment (NDI), and death beyond 36 weeks PMA. Closed-loop automated control of the inspiratory fraction of oxygen (FiO-C) reduces time outside the hemoglobin oxygen saturation (SpO) target range, number and duration of hypo- and hyperoxemic episodes and caregivers' workload.

Effect of allopurinol in addition to hypothermia treatment in neonates for hypoxic-ischemic brain injury on neurocognitive outcome (ALBINO): study protocol of a blinded randomized placebo-controlled parallel group multicenter trial for superiority (phase III).

Background: Perinatal asphyxia and resulting hypoxic-ischemic encephalopathy is a major cause of death and long-term disability in term born neonates. Up to 20,000 infants each year are affected by HIE in Europe and even more in regions with lower level of perinatal care. The only established therapy to improve outcome in these infants is therapeutic hypothermia.

Phase space methods for non-linear analysis of pedalling forces in cycling.

Introduction: From the perspective of dynamic systems theory, stability and variability of biological signals are both understood as a functional adaptation to variable environmental conditions. In the present study, we examined whether this theoretical perspective is applicable to the pedalling movement in cycling. Non-linear measures were applied to analyse pedalling forces with varying levels of subjective load.

Reproducibility of Blood Lactate Concentration Rate under Isokinetic Force Loads.

(1) Background: Maximum isokinetic force loads show strongly increased post-load lactate concentrations and an increase in the maximum blood lactate concentration rate ( V ˙ La), depending on load duration. The reproducibility of V ˙ La must be known to be able to better assess training-related adjustments of anaerobic performance using isokinetic force tests. (2) Methods: 32 subjects were assigned to two groups and completed two unilateral isokinetic force tests (210° s, Range of Motion 90°) within seven days.

Validation of an inertial measurement unit for the quantification of rearfoot kinematics during running.

Background: The popular protocol used to study running motion suffers from problems that lead to a limited ability to generalize the obtained results. Inertial measurement units (IMU) appear to be promising in increasing ecological validity of the collected data. However, quantifying running kinematics utilizing IMU signals is complex and potentially affected by several well-established and less well-known errors.

The effect of intracortical bone pin application on kinetics and tibiocalcaneal kinematics of walking gait.

Bone anchored markers using intracortical bone pins are one of the few available methods for analyzing skeletal motion during human gait in-vivo without errors induced by soft tissue artifacts. However, bone anchored markers require local anesthesia and may alter the motor control and motor output during gait. The purpose of this study was to examine the effect of local anesthesia and the use of bone anchored markers on typical gait analysis variables.