Protecting brains and saving futures guidelines: A prospective, multicenter, and observational study on the use of telemedicine for neonatal neurocritical care in Brazil.

Background: Management of high-risk newborns should involve the use of standardized protocols and training, continuous and specialized brain monitoring with electroencephalography (EEG), amplitude integrated EEG, Near Infrared Spectroscopy, and neuroimaging. Brazil is a large country with disparities in health care assessment and some neonatal intensive care units (NICUs) are not well structured with trained personnel able to provide adequate neurocritical care. To reduce this existing gap, an advanced telemedicine model of neurocritical care called Protecting Brains and Saving Futures (PBSF) Guidelines was developed and implemented in a group of Brazilian NICUs.

Vagal Neuromodulation in Chronic Heart Failure With Reduced Ejection Fraction: A Systematic Review and Meta-Analysis.

The aim of this study was to evaluate the effects of invasive vagal nerve stimulation (VNS) in patients with chronic heart failure (HF) and reduced ejection fraction (HFrEF). Heart failure is characterized by autonomic nervous system imbalance and electrical events that can lead to sudden death. The effects of parasympathetic (vagal) stimulation in patients with HF are not well-established.

Predictors of extubation readiness in preterm infants: a systematic review and meta-analysis.

Context: A variety of extubation readiness tests have already been incorporated into clinical practice in preterm infants.

Objective: To identify predictor tests of successful extubation and determine their accuracy compared with clinical judgement alone.

Methods: MEDLINE, Embase, PubMed, Cochrane Library and Web of Science were searched between 1984 and June 2016.

The use of mechanical ventilation protocols in Canadian neonatal intensive care units.

Objectives: To identify the proportion of Canadian neonatal intensive care units with existing mechanical ventilation protocols and to determine the characteristics and respiratory care practices of units that have adopted such protocols.

Methods: A structured survey including 36 questions about mechanical ventilation protocols and respiratory care practices was mailed to the medical directors of all tertiary care neonatal units in Canada and circulated between December 2012 and March 2013.

Results: Twenty-four of 32 units responded to the survey (75%).

Heart rate variability and extubation readiness in extremely preterm infants.

Background: Mechanical ventilation (MV) is associated with changes in autonomic nervous system activity in preterm infants, which can be assessed by measurements of heart rate variability (HRV). Decreased HRV has been described in adults undergoing disconnection from MV; such information is not available in preterm infants.

Objective: To compare differences in HRV between infants successfully extubated and those who failed, and to evaluate the accuracy of HRV as a predictor of extubation readiness.

Cooling in the real world: therapeutic hypothermia in hypoxic-ischemic encephalopathy.

Background And Aim: The benefits of therapeutic hypothermia have not been assessed from the perspective of the neurology clinic. We aimed to report the impact of the implementation of a local regional therapeutic hypothermia program on the neurodevelopmental outcomes of surviving hypoxic-ischemic encephalopathy (HIE) infants who were followed in the neonatal neurology clinic.

Methods: Retrospective analysis of term infants referred to the neonatal neurology clinic after having been diagnosed with HIE and meeting eligibility criteria for therapeutic hypothermia between March 1999 and June 2010.

Liver fluid collection in neonates and its association with the use of a specific umbilical vein catheter: Report of five cases.

In newborns, the presence of liver fluid collection is a rare event. The reported cases are isolated or described over long periods. Within four months, five neonates were diagnosed with liver fluid collection from safety occurrence reports.

Fluctuations in relative humidity provided to extremely low-birthweight infants (R1).

Background: In extremely low-birthweight infants, the addition of relative humidity (RH) improves thermal stability, fluid and electrolyte balance. However, during routine care this microenvironment is frequently disturbed. The objective of this study was to determine the frequency, magnitude and direction of fluctuations in RH provided to extremely low-birthweight infants.

Implementation of a respiratory therapist-driven protocol for neonatal ventilation: impact on the premature population.

Objective: The purpose of this work was to evaluate the impact of the implementation of a ventilation protocol driven by registered respiratory therapists on respiratory outcomes of premature infants with birth weight < or =1250 g.

Methods: A ventilation protocol driven by a registered respiratory therapist was developed by a multidisciplinary group and implemented in our unit in July 2004. A retrospective review of 301 inborn infants with birth weight < or =1250 g who were mechanically ventilated was performed.