End-of-Life Care for Newborn Infants: A Multicenter Real-Life Prospective Study.

Introduction: Most neonatal deaths in industrialized countries follow a process of redirection of care. The objectives of this study were to describe how neonates die in a middle-income country, whether there was redirection of care, and the reason for this decision.

Methods: This was a prospective, multicenter, cross-sectional study.

Prevalence and risk factors associated with the need for surgical intervention due to necrotizing enterocolitis in very low birth weight infants.

Introduction: Necrotizing enterocolitis (NEC) is one of the most common gastrointestinal emergencies affecting very low birth weight (VLBW) infants with an incidence of 6-15 %. Early recognition is crucial. Mortality is high and variable (30-50 %).

Prevalence of osteopenia of prematurity before and after implementing an early strategy with the use of calcium and phosphate.

Introduction. With the use of aggressive parenteral nutrition in very low birth weight infants, alterations in calcium and phosphate metabolism were detected. In 2016, a prevention strategy was implemented through calcium phosphate monitoring and early supplementation.

The Alarm Fatigue Challenge in the Neonatal Intensive Care Unit: A "before" and "after" Study.

Objective: Alarm fatigue (AF) happens when professionals are exposed to many alarms and they become desensitized to them. It is related to proliferation of devices, not standardized alarm limits, and high prevalence of "nonactionable alarms," i.e.

Withdrawing Assisted Nutrition in Neonates: A Survey on Attitudes and Insights in Argentina.

Objective: This study aimed to assess beliefs and attitudes of Argentinean neonatologists and neonatal nurses regarding end-of-life care of newborn infants, including withdrawal of clinically assisted nutrition and hydration (CANH).

Study Design: A five-domain survey was sent to 465 neonatal health care workers, which included demographic data, general ethical concepts, participation in end-of-life decisions, beliefs about end-of-life care practices, and presentation of four clinical scenarios. Standard statistical tests were used, and a multivariable analysis was done to evaluate variables independently associated with rejecting the withdrawal of CANH.

Early high amino-acid intake is associated with hypophosphatemia in preterm infants.

Objective: To estimate the incidence of hypophosphatemia in preterm infants according to parenteral nutrition received and to evaluate associated risk factors.

Design: A prospective multicenter cohort study included 111 patients ≤ 1250 g (7 NICUs of the NEOCOSUR Network). Two groups were compared according to the amino-acid supply in the first 48 h: aggressive parenteral group ≥ 3 g/kg/day and standard parenteral group: <2.

COVID-19 preparedness-a survey among neonatal care providers in low- and middle-income countries.

Objective: To evaluate COVID-19 pandemic preparedness, available resources, and guidelines for neonatal care delivery among neonatal health care providers in low- and middle-income countries (LMICs) across all continents.

Study Design: Cross-sectional, web-based survey administered between May and June, 2020.

Results: Of 189 invited participants in 69 LMICs, we received 145 (77%) responses from 58 (84%) countries.

Preparedness strategies in neonatology units during the COVID-19 pandemic: A survey conducted at maternity centers in Argentina.

Introduction: The objective of this study was to analyze available resources, guidelines in use, and preparedness to care for newborn infants at maternity centers in Argentina during the COVID-19 pandemic.

Method: Cross-sectional study based on a survey administered to medical and nursing staff. In May 2020, Argentine facilities with more than 500 annual births were contacted; 58 % of these were from the public sector.

Risk factors associated with mortality in newborn infants with congenital diaphragmatic hernia.

Introduction: Morbidity and mortality are high in congenital diaphragmatic hernia. Some tools help to predict survival, both prenatally (observed/expected lung-to-head ratio [OELHR], presence of the liver in the chest) and postnatally (Congenital Diaphragmatic Hernia Study Group [CDHSG] score). Our objective was to identify the risk factors associated with mortality and estimate the risk-adjusted mortality in the prenatal period in the subgroup of patients with isolated left-sided hernia.

Randomized Controlled Trial of Nonsynchronized Nasal Intermittent Positive Pressure Ventilation versus Nasal CPAP after Extubation of VLBW Infants.

Background And Objectives: Nasal continuous positive airway pressure (NCPAP) is a useful method of respiratory support after extubation. However, some infants fail despite CPAP use and require reintubation. Some evidence suggests that synchronized nasal intermittent positive pressure ventilation (NIPPV) may decrease extubation failure in preterm infants.

Impact of the volume of blood collected by phlebotomy on transfusion requirements in preterm infants with birth weight of less than 1500 g. A quasi-experimental study.

Introduction: Anemia is a complication in very low birth weight (VLBW) infants, and lab tests are a predominant risk factor. At least one red blood cell transfusion is given in more than 50 % of cases. Transfusions are associated with a higher risk for infections, intracranial hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia.

Heated Humidifier versus Heat-and-Moisture Exchanger During Positive Pressure Ventilation With a T-Piece Resuscitator in Rabbits.

Background: There are many proven benefits of the use of conditioned gases in mechanically ventilated patients. In spite of this, its use in the delivery room is limited, perhaps because of known difficulties with heated humidifiers (HH); moreover, there is no evidence regarding the use of heat-and-moisture exchangers (HME) in a delivery room setting. We sought to asess the airway's absolute humidity level using three diferents strategies: HH, HME and unconditioned gases.

The rising incidence and impact of non-medically indicated pre-labour cesarean section in Latin America.

In the poorest populations of the world the difficulties of performing a surgical procedure lead to extremely low cesarean section rates associated with very high perinatal mortality. Meanwhile the proportion of births by cesarean section has been increasing for several decades in many areas of the world, reaching alarmingly high rates especially in Latin America. This review aims to describe this secular trend.

Hypercalcemia and hypophosphatemia among preterm infants receiving aggressive parenteral nutrition.

Introduction: Aggressive parenteral nutrition is the standard of care among very-low-birth weight preterm infants. However, in recent studies, its impact on short-term outcomes, has been evaluated. The objective was to compare the prevalence of hypercalcemia and hypophosphatemia among preterm infants receiving aggressive or standard parenteral nutrition.

Surfactant Administration through Laryngeal Mask Airway: A Randomized Controlled Study in Rabbits.

Background: Minimally invasive techniques for surfactant administration for infants with respiratory distress syndrome (RDS) of moderate severity have been proposed. The laryngeal mask airway (LMA) helps in securing the airway without the need of laryngoscopy, but still requires the use of positive pressure ventilation (PPV) to flush surfactant into the lungs.

Objective: This article compares the effectiveness of two techniques for LMA surfactant administration, instillation into the LMA lumen followed by PPV versus direct laryngeal instillation through a preinserted feeding tube inside the LMA during spontaneous respirations.

Bronchopulmonary dysplasia: incidence and risk factors.

Introduction: Bronchopulmonary dysplasia is the most common chronic pulmonary sequela among very low birth weight infants. The objective of this study was to estimate its incidence in our Neonatal Unit over the past 5 years and analyze associated risk factors.

Population And Methods: An observational and analytical study was conducted in a retrospective cohort, using data obtained from a prospective database of infants born at Hospital Italiano de Buenos Aires with a birth weight of less than 1500 grams between January 2010 and December 2014.

Open lung strategy in a lamb model of respiratory distress syndrome.

We tested the hypothesis that an open lung strategy with recruitment maneuvers will improve oxygenation and decrease lung injury in comparison with a permissive hypercapnia strategy in preterm lambs. Preterm lambs born by operative delivery at 131 ± 1 days of gestational age (term = 150 days) were randomized to an open lung group (OLG, n = 5) or a permissive hypercapnia group (PHG, n = 4). In the OLG, ramp recruitment maneuvers were performed by increasing and then decreasing peak inspiratory pressure and positive end-expiratory pressure (adjusting for expiratory tidal volume [V(T)] 6 to 8 mL/kg).