Transcatheter closure in preterm infants with patent ductus arteriosus: feasibility, results, hemodynamic monitoring and future prospectives.

Ductal patency of preterm infants is potentially associated with long term morbidities related to either pulmonary overflow or systemic steal. When an interventional closure is needed, it can be achieved with either surgical ligation or a catheter-based approach.Transcatheter PDA closure is among the safest of interventional cardiac procedures and it is the first choice for ductal closure in adults, children, and infants weighing more than 6 kg.

Use of Cardio-Pulmonary Ultrasound in the Neonatal Intensive Care Unit.

Cardiopulmonary ultrasound (CPUS), the combination of lung ultrasound (LUS) and targeted neonatal echocardiography (TnECHO)AA, may offer a more appropriate approach to the challenging neonatal cardiovascular and respiratory disorders. This paper reviews the possible use of CPUS in the neonatal intensive care unit (NICU).

The importance of lung recruitability: A novel ultrasound pattern to guide lung recruitment in neonates.

Background: Lung Ultrasound (LUS)-guided Lung Recruitment Maneuver (LRM) has been shown to possibly reduce ventilator-induced lung injury in preterm infants. However, to avoid potential hemodynamic and pulmonary side effects, the indication to perform the maneuver needs to be supported by early signs of lung recruitability. Recently, a new LUS pattern (S-pattern), obtained during the reopening of collapsed parenchyma, has been described.

Lung UltraSound Targeted Recruitment (LUSTR): A Novel Protocol to Optimize Open Lung Ventilation in Critically Ill Neonates.

This study investigated the effectiveness of an original Lung UltraSound Targeted Recruitment (LUSTR) protocol to improve the success of lung recruitment maneuvers (LRMs), which are performed as a rescue approach in critically ill neonates. All the LUSTR maneuvers, performed on infants with an oxygen saturation/fraction of inspired oxygen (S/F) ratio below 200, were included in this case-control study (LUSTR-group). The LUSTR-group was matched by the initial S/F ratio and underlying respiratory disease with a control group of lung recruitments performed following the standard oxygenation-guided procedure (Ox-group).

Safety and efficacy of aortic coarctation stenting in children and adolescents.

Percutaneous aortic coarctation treatment with primary stent implantation is the first choice in adult patients. However, current guidelines do not suggest a lower weight limit to perform this procedure safely. The aim of this study was to retrospectively analyze the safety and the mid-term outcome of aortic coarctation stenting in pediatric age at different patients' weights.

Case Report of a Massive Life-threatening Neonatal Thrombosis Treated With a Targeted, Goal-oriented Scheme of Urokinase.

Background: Thrombotic events are severe, often under-diagnosed, complications occurring in newborn infants during their hospital stay. Currently, there is no consensus regarding the optimal treatment scheme for thrombolysis in neonates.

Observations: We present the case of a newborn suffering from a life-threatening thrombosis.

Lung ultrasound guided pulmonary recruitment during mechanical ventilation in neonates: A case series.

Background: Recently, the first report of lung ultrasound (LUS) guided recruitment during open lung ventilation in neonates has been published. LUS guided recruitment can change the approach to open lung ventilation, which is currently performed without any measure of lung function/lung expansion in the neonatal population.

Methods: We included all the newborn infants that underwent a LUS-guided recruitment maneuver during mechanical ventilation as a rescue attempt for an extremely severe respiratory condition with oxygen saturation/fraction of inspired oxygen (SpO2/FIO2) ratio below 130 or the inability to wean off mechanical ventilation.

The effect of clamped and unclamped umbilical cord samples on blood gas analysis.

Purpose: Delayed cord clamping for at least 60 s is recommended to improve neonatal outcomes. The aim of this study is to evaluate whether there are differences in cord BGA between samples collected after double clamping the cord or without clamping the cord, when blood collection occurs within 60 s from birth in both groups.

Methods: A cross-sectional study was carried out, collecting data from 6884 high-risk women who were divided into two groups based on the method of cord sampling (clamped vs unclamped).

Lung recruitment before surfactant administration in extremely preterm neonates with respiratory distress syndrome (IN-REC-SUR-E): a randomised, unblinded, controlled trial.

Background: The importance of lung recruitment before surfactant administration has been shown in animal studies. Well designed trials in preterm infants are absent. We aimed to examine whether the application of a recruitment manoeuvre just before surfactant administration, followed by rapid extubation (intubate-recruit-surfactant-extubate [IN-REC-SUR-E]), decreased the need for mechanical ventilation during the first 72 h of life compared with no recruitment manoeuvre (ie, intubate-surfactant-extubate [IN-SUR-E]).

Efficacy of a new technique - INtubate-RECruit-SURfactant-Extubate - "IN-REC-SUR-E" - in preterm neonates with respiratory distress syndrome: study protocol for a randomized controlled trial.

Background: Although beneficial in clinical practice, the INtubate-SURfactant-Extubate (IN-SUR-E) method is not successful in all preterm neonates with respiratory distress syndrome, with a reported failure rate ranging from 19 to 69 %. One of the possible mechanisms responsible for the unsuccessful IN-SUR-E method, requiring subsequent re-intubation and mechanical ventilation, is the inability of the preterm lung to achieve and maintain an "optimal" functional residual capacity. The importance of lung recruitment before surfactant administration has been demonstrated in animal studies showing that recruitment leads to a more homogeneous surfactant distribution within the lungs.

Bronchopulmonary Dysplasia and Chronic Lung Disease: Stem Cell Therapy.

Bronchopulmonary dysplasia (BPD), a major complication of premature birth, still lacks safe and effective treatment. Mesenchymal stem cells (MSCs) have been proven to ameliorate critical aspects of the BPD pathogenesis. MSCs seem to exert therapeutic effects through the paracrine secretion of anti-inflammatory, antioxidant, antiapoptotic, trophic, and proangiogenic factors.

Weaning from invasive respiratory support in newborn: is there just one strategy?

Despite a even more frequent use to non-invasive respiratory support, mechanical ventilation is stilloften necessary for supporting premature infants with lung disease. Protracted mechanical ventilation is associatedwith increased morbidity and mortality and thus the earliest weaning from invasive respiratory supportis desirable. Weaning protocols may be helpful in achieving more rapid reduction in support.

Circulation of different rhinovirus groups among children with lower respiratory tract infection in Kiremba, Burundi.

The purpose of this investigation was to collect information regarding rhinovirus (RV) circulation in children with lower respiratory tract infections (LRTIs) in Burundi, Central Africa. We enrolled all of the children aged between 1 month and 14 years who were admitted to the hospital of Kiremba, North Burundi, with fever and signs and symptoms of LRTI (i.e.

Patent ductus arteriosus: wait and see?

"Patent ductus arteriosus is one of most common problems that physicians caring for preterm infants have to face. Although medical and surgical treatment of PDA has been extensively investigated, results from the randomized controlled trials and metanalysis are still inconclusive and many authors therefore suggest a less aggressive attitude toward PDA. In the present review evidence for and against routine treatment of PDA are analyzed.

[The surgical and endovascular treatment of the hepatic artery aneurysms: personal experience].

Objective: The aim of this single-institution retrospective study is to report the results of surgical and endovascular treatment of hepatic artery aneurysms.

Materials And Methods: Twenty patients with an extraparenchimal hepatic artery aneurysm made part of the study In the first period, between February 1980 and December 1996, 12 patients were admitted and treated surgically. In the second period, January 1997 until December 2005, 8 patients were admitted.