Publications by authors named "Fusch C"

Background: Perinatal depression affects 10-15% of mothers and approximately 5% of fathers. However, only a small number of affected individuals seek treatment. If left unrecognized and untreated, it can have negative long-term consequences for the family's health, leading to subsequent high costs.

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  • Medical devices that contact blood can cause clotting and other complications, which is typically managed using anticoagulants and antiplatelet agents, though these can increase bleeding risks.
  • A new method investigates coating polydimethylsiloxane (PDMS) surfaces with an antithrombin-heparin complex and tissue plasminogen activator to inhibit clotting and dissolve early clots.
  • Different coating processes were tested, and the results showed that a specific sequential application of these agents improved their effectiveness and stability, suggesting potential for better blood compatibility in medical devices.
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  • Preterm infants tolerate intravenous (IV) fat less well than enteral feeding, leading to issues like hypertriglyceridemia, so it's recommended to limit parenteral fat intake to 3.5-4.0 g/kg/d compared to 8 g/kg/d from human milk.
  • The study examined fatty acid profiles in preterm infants using gas chromatography/mass spectrometry, comparing breast milk and lipid emulsions, and looking at differences based on triglyceride levels.
  • Results showed that plasma fatty acid levels differed significantly from breast milk and lipid emulsions, with hypertriglyceridemic infants having higher levels of certain fatty acids, suggesting the need for careful formulation of lipid solutions for these infants.
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  • A survey at a major German-speaking symposium on human milk banks revealed that 96% of participants, primarily nurses and physicians, want more digitalization in their operations.
  • Current digital processes, like donor clinical results and milk labeling, are in place, but there's a gap between potential digital advancements and actual implementation.
  • Key benefits of digitalization include improved efficiency, but challenges like financial constraints, staff shortages, and security concerns (like cyberattacks) are major barriers, yet participants remain hopeful for future developments.
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Body composition assessments using air displacement plethysmography (ADP, PEAPOD) have been introduced into clinical practice at a few neonatal units. To allow accurate body composition assessments in term and preterm infants, a workflow for routine testing is needed. The aim of this study was to analyze the feasibility of weekly routine ADP testing.

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The quality-initiative analysis of weekly duplicate PEAPOD body composition measurements was conducted from clinical practice (January to September 2021) on preterm and term infants without respiratory support. Statistical analysis, including regression analysis, Bland-Altman plots and cv-root-mean-square tests, was performed. A total of 188 duplicate (376 individual) measurements were collected from 119 infants (88 preterm, 31 term).

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Premature neonates with underdeveloped lungs experience respiratory issues and need respiratory support, such as mechanical ventilation or extracorporeal membrane oxygenation (ECMO). The "artificial placenta" (AP) is a noninvasive approach that supports their lungs and reduces respiratory distress, using a pumpless oxygenator connected to the systemic circulation, and can address some of the morbidity issues associated with ECMO. Over the past decade, microfluidic blood oxygenators have garnered significant interest for their ability to mimic physiological conditions and incorporate innovative biomimetic designs.

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Reorganization of neonatal intensive care by introducing clinical microsystems may help to allocate nursing time more appropriately to the needs of patients. However, there is concern that cohorting infants according to acuity may enhance noise levels. This single-center study investigated the impact of reorganization of neonatal intensive care unit by implementing clinical microsystems in a Level III NICU on environmental noise.

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  • Multisystemic Inflammatory Syndrome in children (MIS-C) is a rare autoimmune condition linked to previous SARS-CoV-2 infection, with symptoms similar to Kawasaki disease, prompting the need for more research due to potential long-term health impacts.
  • A study conducted in Nuremberg-Erlangen analyzed clinical data of 10 MIS-C patients over two years, noting demographic details, symptoms, treatment, and outcomes.
  • The findings showed an incidence of 2.14/100,000 children, with common symptoms including fever, rash, and conjunctivitis, and most patients received treatments like intravenous immunoglobulin and steroids, with none exhibiting coronary complications.
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The persistence of a patent ductus arteriosus (PDA) is a common condition in preterm infants with a prevalence inversely proportional to gestational age. PDA is associated with mild-to-severe gastrointestinal complications such as feeding intolerance, gastrointestinal perforation, and necrotizing enterocolitis, which represent a major challenge for the nutritional management in preterm infants. In this context, the Section on Nutrition, Gastroenterology and Metabolism and the Circulation Section of the European Society for Pediatric Research have joined forces to review the current knowledge on nutritional issues related to PDA in preterm infants.

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Background: Donor human milk is the recommended alternative for feeding preterm infants if mother's own milk is unavailable. Human milk banks collect, screen, store and distribute donated human milk according to pre-specified standard operating procedures to premature infants without mothers own milk.

Aim:   Herein we characterize current operating models and the structural organisation of German milk bank institutions.

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Unlabelled: Prolonged periods spent outside the target range of oxygen saturation (SpO) in preterm infants, along with frequent desaturation events, predispose them to retinopathy of prematurity (ROP) and long-term neurodevelopmental impairment. The primary aim of this study was to increase the mean time spent within the target SpO range (WTR) by 10% and to reduce the frequency of desaturation events by 5 events per patient day, respectively, within 18 months of implementing a care bundle.

Methods: This study was completed in a 46-bed neonatal intensive care unit (NICU), involving 246 staff members and led by a quality improvement team.

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Catheterization of the umbilical vessels has proven to be an effective and relatively rapid method for gaining central vascular access in neonates. However, it can be technically difficult, the procedure may last 30 min or longer, and it can be associated with complications in some patients. We suggest using a coronary guidewire during catheterization of umbilical vessels to support the placement of umbilical catheters and significantly reduce a risk for complications.

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Objectives: To review the current literature and develop consensus conclusions and recommendations on nutrient intakes and nutritional practice in preterm infants with birthweight <1800 g.

Methods: The European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee of Nutrition (CoN) led a process that included CoN members and invited experts. Invited experts with specific expertise were chosen to represent as broad a geographical spread as possible.

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Aim: Bayley Scales of Infant and Toddler Development (Bayley-III) determines scaled scores and converts these into composite scores. It was shown that applying the German and the U.S.

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  • Neonatal nutritional supplements are used to improve growth in premature or small-for-gestational-age infants, but their long-term effects on cognitive and metabolic health are unclear.
  • Analysis of various trials showed that while these supplements did not significantly impact cognitive impairment or metabolic risk after 3 years, they reduced motor impairment in toddlers and had better outcomes for girls.
  • Additionally, while supplementation lowered triglyceride levels, it didn't change other metabolic factors, suggesting potential benefits in early motor skills without major risks to cognitive or long-term metabolic health.
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Introduction: Parenteral nutrition, usually indicated for preterm infants with a birthweight<1500 g and sick newborns, enables the supply with critical nutrients. As a high degree of therapy safety is required, a European guideline provides recommendations for safe therapy procedures. The present project aimed to evaluate the implementation of the European guideline in German perinatal centers and to identify possible barriers that impede its implementation.

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  • Neonatal nutritional supplements can boost early growth in infants who are small for their gestational age, but their impact on long-term growth remains uncertain.
  • A review of various studies found that while these supplements improved infant length and bone mineral content, they did not significantly affect childhood BMI.
  • Additionally, the benefits in height growth appeared to be present in male toddlers but were not observed in females, indicating that results may vary by sex.
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Native breast milk composition displays significant inter- and intra-individual variation which persists after standard fortification with fixed doses and challenges target fortification. This study aims to analyze the macronutrient composition of different commercially available fortifiers and the effect of different fortification strategies on nutritional intake of preterm infants. In 103 preterm infants, native breast milk samples were collected from 24-h feeding batches ( = 3,338) and fat, protein and carbohydrate contents were analyzed.

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Background: The relationship between ABO non-identical transfusion and the outcomes of necrotizing enterocolitis (NEC), and all-cause mortality in very-low birth weight (VLBW) neonates receiving red blood cell transfusion is unknown.

Study Design And Methods: A retrospective multicenter cohort study was conducted in VLBW neonates in neonatal intensive care units between 2004 and 2016. VLBW (≤1500 grams) neonates were followed until discharge or in-hospital death.

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Despite optimized nutrition, preterm-born infants grow slowly and tend to over-accrete body fat. We hypothesize that the premature dissociation of the maternal-placental-fetal unit disrupts the maintenance of physiological endocrine function in the fetus, which has severe consequences for postnatal development. This review highlights the endocrine interactions of the maternal-placental-fetal unit and the early perinatal period in both preterm and term infants.

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Background: Human milk is recommended for very preterm infants, but its variable macronutrient content may contribute to undernutrition during a critical period in development. We hypothesize that individually targeted human milk fortification is more effective in meeting macronutrient requirements than the current standard of care.

Methods: We designed a single-center randomized, controlled trial enrolling 130 infants born < 31 completed weeks' gestation.

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