Risk assessment of survival and morbidity of infants born at <24 completed weeks of gestation.

Background: Infants born at the threshold of viability have a high risk of mortality and morbidity. The British Association of Perinatal Medicine (BAPM) provided updated guidance in 2019 advising a risk-based approach to balancing decisions about active versus redirected care at birth.

Aims: To determine survival and morbidity of infants born between 22 and 24 completed weeks of gestation.

Diaphragmatic ultrasound and patent ductus arteriosus in the newborn: A retrospective case series.

Background: Patent ductus arteriosus (PDA) and diaphragmatic dysfunction are frequently seen in newborn infants but their relationship remains unknown. We aimed to use point of care ultrasound to compare diaphragmatic kinetics in infants with a PDA compared to in those without a PDA.

Methods: M-mode ultrasonography was used to measure the mean inspiratory velocity ( ) in newborn infants with and without a haemodynamically significant PDA admitted in the Neonatal Unit at King's College Hospital during a three month period.

Respiratory function monitoring during early resuscitation and prediction of outcomes in prematurely born infants.

Objectives: Over the last decade, there has been increased use of end-tidal carbon dioxide (ETCO) and oxygen saturation (SpO) monitoring during resuscitation of prematurely born infants in the delivery suite. Our objectives were to test the hypotheses that low end-tidal carbon dioxide (ETCO) levels, low oxygen saturations (SpO) and high expiratory tidal volumes (VT) during the early stages of resuscitation would be associated with adverse outcomes in preterm infants.

Methods: Respiratory recordings made in the first 10 min of resuscitation in the delivery suite of 60 infants, median GA 27 (interquartile range 25-29) weeks were analysed.

Prediction of survival in infants with congenital diaphragmatic hernia and the response to inhaled nitric oxide.

Unlabelled: The use of inhaled nitric oxide (iNO) in treating pulmonary hypertension in infants with congenital diaphragmatic hernia (CDH) is controversial. Our aims were to identify factors associated with survival in CDH infants and whether this was influenced by the response to iNO. Results of CDH infants treated in a tertiary surgical and medical perinatal centre in a ten year period (2011-2021) were reviewed.

Diaphragmatic electromyography during a spontaneous breathing trial to predict extubation failure in preterm infants.

Background: Premature attempts at extubation and prolonged episodes of ventilatory support in preterm infants have adverse outcomes. The aim of this study was to determine whether measuring the electrical activity of the diaphragm during a spontaneous breathing trial (SBT) could predict extubation failure in preterm infants.

Methods: When infants were ready for extubation, the electrical activity of the diaphragm was measured by transcutaneous electromyography (EMG) before and during a SBT when the infants were on endotracheal continuous positive airway pressure.

Acute kidney injury in infants with congenital diaphragmatic hernia.

Objectives: To assess the incidence of acute kidney injury (AKI) in infants with congenital diaphragmatic hernia (CDH), including those who had fetoscopic endoluminal tracheal occlusion (FETO), and the effect of AKI on mortality and length of stay.

Study Design: Ten-year retrospective review of infants admitted with CDH to a tertiary perinatal centre.

Result: Ninety-four infants with median gestational age of 38 weeks were included.

Outcomes following less-invasive-surfactant-administration in the delivery-room.

Background: Less invasive surfactant administration (LISA) on the neonatal unit reduces the need for mechanical ventilation and bronchopulmonary dysplasia (BPD).

Aims: To assess the immediate and longer-term efficacy of LISA to prematurely born infants in the delivery-room.

Study Design: A case control study with inborn historical controls matched for gestational age, birthweight and gender to each LISA infant.

Pulmonary hypertension in infants with bronchopulmonary dysplasia: risk factors, mortality and duration of hospitalisation.

Objectives: Pulmonary hypertension (PH) is a complication of bronchopulmonary dysplasia (BPD) and associated with increased mortality and morbidity. Our aim was to identify, in infants with BPD, the effect of PH on health-care utilisation and health related cost of care.

Methods: An electronic data recording system was used to identify infants ≤32 weeks of gestation who developed BPD.