Preterm Infants off Positive Pressure Respiratory Support Have a Higher Incidence of Occult Cerebral Hypoxia.

Objective: To use cerebral near-infrared spectroscopy (NIRS) to quantify occult cerebral hypoxia across respiratory support modes in preterm infants.

Study Design: In this prospective, longitudinal, observational study, infants ≤32 weeks gestation underwent serial pulse oximetry (oxygen saturation [SpO]) and cerebral NIRS monitoring (4-6 hours per session) following a standardized recording schedule (daily for 2 weeks, every other day for 2 weeks, then weekly until 35 weeks corrected gestational age). Four calculations were made: median cerebral saturation, median cerebral hypoxia burden (proportion of NIRS samples below the hypoxia threshold [<67%]), median systemic saturation, and median systemic hypoxia burden (proportion of SpO samples below the desaturation threshold [<85%]).

Infantile-onset Pompe disease complicated by sickle cell anemia: Case report and management considerations.

Infantile-onset Pompe disease (IOPD) is a rare, severe disorder of lysosomal storage of glycogen that leads to progressive cardiac and skeletal myopathy. IOPD is a fatal disease in childhood unless treated with enzyme replacement therapy (ERT) from an early age. Sickle cell anemia (SCA) is a relatively common hemoglobinopathy caused by a specific variant in the hemoglobin beta-chain.

Racial discrepancy in pulse oximeter accuracy in preterm infants.

Objective: Pulse oximetry is commonly used in Neonatology, however recent adult data suggest racial disparity in accuracy, with overestimation of oxygen saturation for Black patients.

Study Design: Black and White infants <32 weeks gestation underwent simultaneous arterial blood gas and pulse oximetry measurement. Error by race was examined using mean bias, A, Bland-Altman, and linear/non-linear analysis.

The hidden consequence of intraventricular hemorrhage: persistent cerebral desaturation after IVH in preterm infants.

Background: Previous studies describe a short-term decrease in cerebral oxygen saturation (StO2) after intraventricular hemorrhage (IVH) in premature infants; little is known about long-term implications.

Methods: Infants born <30 weeks gestational age (GA) were included. Clinical characteristics, hemoglobin measurements, the highest grade of IVH, and white matter injury (WMI) were noted.

Racial disparities in calculated risk for bronchopulmonary dysplasia: a dataset.

Bronchopulmonary dysplasia (BPD) is a severe pulmonary complication of prematurity and is associated with significant morbidity or death. Early use of systemic corticosteroids may alter the trajectory of the disease and improve outcomes. A BPD Outcomes estimator, developed by the NICHD using a large population dataset, can be used to calculate individual risk.

Progressive anemia of prematurity is associated with a critical increase in cerebral oxygen extraction.

Background: Elevated cerebral fractional tissue oxygen extraction (cFTOE) is an adaptation to anemia of prematurity (AOP). cFTOE ≥0.4 is associated with brain injury in infants ≤30 weeks.

Blood pressure extremes and severe IVH in preterm infants.

Background: The optimal upper and lower limits of blood pressure in preterm infants are not known. Exceeding these thresholds may contribute to intraventricular hemorrhage (IVH).

Methods: Preterm infants born ≤30 weeks GA were identified.

Cerebellar hemorrhage: a 10-year evaluation of risk factors.

While cerebellar hemorrhage (CH) has been linked with adverse neurodevelopmental outcome in preterm infants, it remains under-recognized and the underlying mechanisms are not fully understood. To determine risk factors for CH in premature infants. A retrospective cohort study included all inborn infants ≤ 30 weeks EGA admitted to the NICU from 2007 to 2016.

A Web-Based Calculator for the Prediction of Severe Neurodevelopmental Impairment in Preterm Infants Using Clinical and Imaging Characteristics.

Although the most common forms of brain injury in preterm infants have been associated with adverse neurodevelopmental outcomes, existing MRI scoring systems lack specificity, do not incorporate clinical factors, and are technically challenging to perform. The objective of this study was to develop a web-based, clinically-focused prediction system which differentiates severe neurodevelopmental outcomes from normal-moderate outcomes at two years. Infants were retrospectively identified as those who were born ≤30 weeks gestation and who had MRI imaging at term-equivalent age and neurodevelopmental testing at 18⁻24 months.

Anemia of prematurity and cerebral near-infrared spectroscopy: should transfusion thresholds in preterm infants be revised?

Objective: To determine the impact of progressive anemia of prematurity on cerebral regional saturation (C-rSO) in preterm infants and identify the hemoglobin threshold below which a critical decrease (>2SD below the mean) in C-rSO occurs.

Study Design: In a cohort of infants born ≤30 weeks EGA, weekly C-rSO data were prospectively collected from the second week of life through 36 weeks post-menstrual age (PMA). Clinically obtained hemoglobin values were noted at the time of recording.

Evaluation of interobserver agreement of apgar scoring in preterm infants.

Background And Objectives: Apgar scoring is accepted by medical professionals both as a measure of the infant's clinical status and the infant's response to resuscitation. Recent studies, however, have suggested significant variability when used for scoring preterm infants. We hypothesized that agreement in Apgar scoring would improve with increasing gestational age and at low levels of respiratory support.