Neurodevelopmental outcome at 5.5 years in Dutch preterm infants born at 24-26 weeks' gestational age: the EPI-DAF study.

Objective: After lowering the Dutch threshold for active treatment from 25 to 24 completed weeks' gestation, survival to discharge increased by 10% in extremely preterm live born infants. Now that this guideline has been implemented, an accurate description of neurodevelopmental outcome at school age is needed.

Design: Population-based cohort study.

Doxapram versus placebo in preterm newborns: a study protocol for an international double blinded multicentre randomized controlled trial (DOXA-trial).

Background: Apnoea of prematurity (AOP) is one of the most common diagnoses among preterm infants. AOP often leads to hypoxemia and bradycardia which are associated with an increased risk of death or disability. In addition to caffeine therapy and non-invasive respiratory support, doxapram might be used to reduce hypoxemic episodes and the need for invasive mechanical ventilation in preterm infants, thereby possibly improving their long-term outcome.

Propofol in neonates causes a dose-dependent profound and protracted decrease in blood pressure.

Aim: To analyse the effects of different propofol starting doses as premedication for endotracheal intubation on blood pressure in neonates.

Methods: Neonates who received propofol starting doses of 1.0 mg/kg (n = 30), 1.

Propofol for endotracheal intubation in neonates: a dose-finding trial.

Objective: To find propofol doses providing effective sedation without side effects in neonates of different gestational ages (GA) and postnatal ages (PNA).

Design And Setting: Prospective multicentere dose-finding study in 3 neonatal intensive care units.

Patients: Neonates with a PNA <28 days requiring non-emergency endotracheal intubation.

Preterm neonates benefit from low prophylactic platelet transfusion threshold despite varying risk of bleeding or death.

The Platelets for Neonatal Thrombocytopenia (PlaNeT-2) trial reported an unexpected overall benefit of a prophylactic platelet transfusion threshold of 25 × 109/L compared with 50 × 109/L for major bleeding and/or mortality in preterm neonates (7% absolute-risk reduction). However, some neonates in the trial may have experienced little benefit or even harm from the 25 × 109/L threshold. We wanted to assess this heterogeneity of treatment effect in the PlaNet-2 trial, to investigate whether all preterm neonates benefit from the low threshold.

Quality assessment and response to less invasive surfactant administration (LISA) without sedation.

Background: Although sedative premedication for endotracheal intubation is considered standard of care, less invasive surfactant administration (LISA) is often performed without sedative premedication. The aim of this study was to assess success rates, technical quality and vital parameters in LISA without sedative premedication.

Methods: Prospective observational study in 86 neonates <32 weeks' gestation.

Evaluation of an Intubation Readiness Score to Assess Neonatal Sedation before Intubation.

Background: Premedication for neonatal intubation facilitates the procedure and reduces stress and physiological disturbances. However, no validated scoring system to assess the effect of premedication prior to intubation is available.

Objective: To evaluate the usefulness of an Intubation Readiness Score (IRS) to assess the effect of premedication prior to intubation in newborn infants.

Assessment of sedation level prior to neonatal intubation: A systematic review.

Background: Adequate premedication before neonatal endotracheal intubation reduces pain, stress, and adverse physiological responses, diminishes duration and number of attempts at intubation, and prevents traumatic airway injury. Therefore, intubation should not be started until an adequate level of sedation is reached. It is not clear how this should be measured in the clinical situation.

Insufficient Sedation and Severe Side Effects after Fast Administration of Remifentanil during INSURE in Preterm Newborns.

Background: Neonatal intubation is stressful and should be performed with premedication. In the case of an INSURE (intubation/surfactant/extubation) procedure a short duration of action of the premedication used is needed to facilitate fast extubation. Given its pharmacological profile, remifentanil seems a suitable candidate.

Sedation of newborn infants for the INSURE procedure, are we sure?

Background: Neonatal intubation is a stressful procedure that requires premedication to improve intubation conditions and reduce stress and adverse physiological responses. Premedication used during the INSURE (INtubation, SURfactant therapy, Extubation) procedure should have a very short duration of action with restoration of spontaneous breathing within a few minutes.

Aims: To determine the best sedative for intubation during the INSURE procedure by systematic review of the literature.

Double-blind placebo-controlled food challenges in children with alleged cow's milk allergy: prevention of unnecessary elimination diets and determination of eliciting doses.

Background: Children with cow's milk allergy (CMA) need a cow's milk protein (CMP) free diet to prevent allergic reactions. For this, reliable allergy-information on the label of food products is essential to avoid products containing the allergen. On the other hand, both overzealous labeling and misdiagnosis that result in unnecessary elimination diets, can lead to potentially hazardous health situations.

Long-term subcutaneous protein C replacement in neonatal severe protein C deficiency.

We describe here the case of a boy who presented 2 days after birth with purpura fulminans on his feet and scalp. Laboratory investigations revealed signs of disseminated intravascular coagulation. An underlying coagulation disorder was suspected, and therapy with recombinant tissue plasminogen activator, fresh-frozen plasma, and unfractionated heparin was started.

Improvement of heart function after balloon dilation of congenital valvar aortic stenosis: a pilot study with ultrasound tissue Doppler and strain rate imaging.

The aim was to investigate the effects of balloon dilation of congenital valvar aortic (Ao) stenosis on heart function with conventional and with new echocardiographic techniques. Nine patients, preballoon and 1 to 4 d postballoon dilation of Ao-valve, were included in the study. Assessment of heart function was made by using conventional echo/Doppler, tissue Doppler imaging (TDI) and strain rate imaging (SRI).