Outcomes at 7 Years of Age of Former Very Preterm Neonates with Repeated Surfactant Treatment for Prolonged Respiratory Distress in the Neonatal Period.

This study aimed at evaluating the 7-year outcomes of 118 very preterm newborns (VPNs, gestational age = 26 ± 1.4 w) involved in a randomized controlled trial. They presented neonatal respiratory distress (RDS), requiring ventilation for 14 ± 2 days post-natal age (PNA).

[Supporting the suffering of caregivers in neonatal palliative care].

Accompanying newborns in palliative care remains difficult for professionals. Representations, fears and real difficulties are all factors that put them to the test. Supervision in conjunction with a pediatric palliative care resource team could be an effective way to prevent burnout and improve the quality of care.

Mobility may impact attention abilities in healthy term or prematurely born children at 7-years of age: protocol for an intervention controlled trial.

Background: Seven years of age is a milestone for learning basic knowledge that is strongly related to attention abilities such as Alerting, Orienting, and Inhibition function, allowing for appropriate adaptation to primary school. These attention abilities are also influenced by gestational age at birth in a complex manner, indicating an area of weakness in prematurely born children. Furthermore, recent studies suggest that allowing children to have freedom of movement during learning may improve their attention level and school performance.

Expiratory Flow - Vital Capacity: Airway - Lung Dysanapsis in 7 Year Olds Born Very Preterm?

An index normalizing airway dimension for lung size derived from spirometry was found inversely correlated to lung size in school children born very preterm, indicating larger alveolar volumes draining into comparatively smaller airways. In contrast in children born full term the index was independent of lung size.

Review shows that using surfactant a number of times or as a vehicle for budesonide may reduce the risk of bronchopulmonary dysplasia.

Aim: Bronchopulmonary dysplasia (BPD) remains the most common respiratory morbidity in immature infants. This review describes the diagnosis of BPD has evolved and summarises the therapeutic approaches that have made it possible to limit the incidence of BPD.

Method: We reviewed the literature from the first definition of BPD by Northway in 1967 to the surfactant treatment policies that are currently in use, drawing on more than 50 papers up to 2017.

[Cancer diagnosis disclosure and supportive care seen from the patient side. A cross sectional multicentre survey].

Unlabelled: The objective of this study was to describe patients' experience during cancer disclosure and initial carers' support phase, in three healthcare facilities in Haute-Savoie District, France.

Methodology: We conducted a multicentric, cross-sectional telephone survey. Patients registered on the multidisciplinary cancer consultation platform lists were randomised.

Doxapram Dosing for Apnea of Prematurity Based on Postmenstrual Age and Gender: A Randomized Controlled Trial.

Introduction: Doxapram is used as a third-line treatment for apnea unresponsive to caffeine and continuous positive airway pressure (CPAP) in preterm infants.

Objectives: The objectives of this study were to compare the effects of dosing adjusted for gender and postmenstrual age (PMA) (GrA) versus infants' weight alone (GrW) on doxapram plasma levels, clinical efficacy, and side effects.

Methods: This was a randomized, double-blind study, including premature infants for whom optimized caffeine and CPAP therapy for apnea of prematurity had failed.

Growth and neurodevelopment outcome in symmetric versus asymmetric small for gestational age term infants.

Objective: Few studies compared growth and neurodevelopment outcome between asymmetric (aSYM) and symmetric (SYM) small for gestational age (SGA) term infants. We aimed at evaluating their respective outcome at 9 months postnatal age.

Study Design: A cohort study including infants born in 2010 to 2011 with a birth weight <5th centile and a head circumference (HC) below (SYM) or above (aSYM) the 5th centile.

Late Surfactant Administration in Very Preterm Neonates With Prolonged Respiratory Distress and Pulmonary Outcome at 1 Year of Age: A Randomized Clinical Trial.

Importance: Although immature neonate survival has improved, there is an increased risk of developing bronchopulmonary dysplasia, leading to significant respiratory morbidity. Measures to reduce bronchopulmonary dysplasia are not always effective or have important adverse effects.

Objective: To evaluate the effect of late surfactant administration in infants with prolonged respiratory distress on ventilation duration, respiratory outcome at 36 weeks' postmenstrual age, and at 1 year postnatal age.

Exercise-induced bronchoconstriction in school-age children born extremely preterm.

Background: School children born preterm often show airway hyperresponsiveness to methacholine or histamine. Less attention has been paid to their airway response to exercise, an important point because of the role of exercise in the child's daily life. The aim of this study was to describe the characteristics of, and potential determinants to, the airway response to exercise in children born extremely preterm.

[Neonatal therapeutic hypothermia: amplitude-integrated electroencephalography to confirm the indication].

Moderate hypothermia therapy (HT) after perinatal asphyxia of the newborn has clearly demonstrated its efficacy in reducing both mortality and long-term neurosensory sequelae. HT has now been introduced in many developed countries as a standard of care for term infants meeting the entry criteria for therapeutic cooling. However, this new therapy is only effective in case of an acute perinatal hypoxic-ischemic event.

[Gender-dependent differences in glutathione (GSH) metabolism in very preterm infants].

Background: Gender differences in mortality and morbidity are often reported in very preterm infants. In studies aiming to understand the underlying mechanisms, better protection against oxidative stress in baby girls has been suggested.

Objectives: Shortly after birth, we compared glutathione (GSH) metabolism in female and male preterm infants and its relationship with prenatal and postnatal parameters.

Methaemoglobinaemia risk factors with inhaled nitric oxide therapy in newborn infants.

Background: Inhaled nitric oxide (iNO), commonly used for hypoxic neonates, may react with haemoglobin to form methaemoglobin (MetHb). MetHb monitoring during iNO therapy has been questioned since low doses of iNO are used.

Aim: To evaluate the incidence of and identify risk factors associated with elevated MetHb in neonates treated with iNO.

[Infants of drug-addicted mothers: pitfalls of replacement therapy].

Maternal drug addiction can cause problems for the fetus and the newborn, and hamper long-term development. The prevalence of drug addiction during pregnancy varies from 1 % to more than 10 % depending on the country and the maternity unit. Management of these mothers can be further complicated by medical, social and psychological problems.

[Neonatal Bartter syndrome's special features in very premature newborns].

Neonatal Bartter syndrome is a rare condition, usually revealed by alkalosis and hypokalemia. Clinical and biological signs of neonatal Bartter syndrome are quite different from those encountered when this disease is diagnosed in older children. Diagnosis of neonatal Bartter syndrome is even more difficult in very preterm infants.

CPAP and the preterm infant: lessons from the COIN trial and other studies.

Bronchopulmonary dysplasia is associated with ventilation. Nasal continuous positive airway pressure (nCPAP) allows earlier weaning in ventilated infants. Starting nCPAP from shortly after birth to prevent ventilation has been questioned because it prevents an early use of surfactant.

[Secondary right-sided diaphragmatic hernia following neonatal group B Streptococcal septicaemia in a preterm infant].

We report on a case of a secondary right-sided diaphragmatic hernia following group B streptococcal (GBS) septicaemia in a very low birth weight infant born at 30 weeks. After initial improvement, the diagnosis of a secondary right-sided diaphragmatic hernia was suspected with the persistent radiological pulmonary right-sided image on the chest x-ray and the clinical degradation. The diagnosis was confirmed by ultrasonography on day 43.

The safety and efficacy of nitric oxide therapy in premature infants.

Objectives: To assess the safety-efficacy balance of low-dose inhaled nitric oxide (iNO) in hypoxemic premature infants because no sustained beneficial effect has been demonstrated clearly and there are concerns about side effects.

Study Design: Eight hundred and sixty infants <32 weeks were randomized at birth to receive 5 ppm iNO or placebo when they presented with hypoxemic respiratory failure (HRF) defined by a requirement for mechanical ventilation, fraction of inspired oxygen (FIO 2 ) >40%, and arterio-alveolar ratio in oxygen (aAO 2 ) <0.22.

Early inhaled nitric oxide improves oxidative balance in very preterm infants.

Inhaled nitric oxide (iNO) improves oxygenation in premature infants, but concern has been raised about its potential oxidative toxicity. We designed this study to assess the oxidative balance in premature infants who were exposed to low dose iNO and the relationship with their clinical outcome on day 28 of life. A total of 274 infants who were <32 wk gestation were randomized at birth to receive 5 ppm of iNO if they presented with hypoxemic respiratory failure.

[Sudden death of neonates in the delivery room].

Healthy newborn death in the delivery room is uncommon. Unlike for sudden infant death syndrome well described in infants between 2 and 6 months of age, few publications have studied this event. We report two cases of asymptomatic term newborns who died unexpectedly in the delivery room.

[Management of severe neonatal Rh disease following in utero exchange transfusion: towards a new strategy].

Important changes in the prevention, diagnosis, and in utero treatment, of Rhesus allo-immunization in the past 30 years, have led to new neonatal clinical presentations. Based upon the analysis of 14 successive pregnancies with severe hemolytic disease, requiring in utero exchange-transfusion, it appears that the current management is no longer adapted to the new resulting clinical postnatal presentations. In the acute phase, intensive phototherapy associated with regular blood cell transfusion as required, appears to be a better policy than traditional postnatal systematic exchange transfusions.

[Massive fetomaternal transfusion after induction of labor by oxytocin].

Unlabelled: Severe fetomaternal transfusions are seldom, but may lead to neonatal morbidity or death.

Case Report: We report a case of lethal fetomaternal transfusion in which a failure to induce labour, at term, can be suspected.

Comments: We emphasize the need of a close monitoring of the fetal well-being in cases of failed induced labour at term.

[Limits of antenatal management: technical and ethical aspects].

The lower limit for elective delivery depends on technical and ethical issues. Elective delivery is usually accepted after 26 weeks gestation with a 60% survival rate and a 30% handicap rate. Decision making requires close coordination between obstetricians and pediatricians.