Vasopressin as adjunctive therapy in pulmonary hypertension associated with refractory systemic hypotension in term newborns.

Objective: The use of vasopressin as an adjunctive therapy in pulmonary hypertension associated with refractory systemic hypotension has increased. The objective of our study is to describe its effects on term infants.

Study Design: Retrospective observational study.

Risk-stratified Results among Congenital Diaphragmatic Hernia Patients in Two Large Extracorporeal Membrane Oxygenation Centers in South America.

Introduction: Mortality related to CDH is high, but with great variability among centers. There are few studies on patients with this condition born in South America which show poor outcomes. The goal of this study is to present the outcome of CDH in several high-volume quaternary centers in South America, ascertain the factors associated with lower mortality in our population, and compare our outcomes to those of the CDH Study Group (CDHSG).

Congenital diaphragmatic hernia: phosphodiesterase-5 and Arginase inhibitors prevent pulmonary vascular hypoplasia in rat lungs.

Background: Severe pulmonary hypoplasia related to congenital diaphragmatic hernia (CDH) continues to be a potentially fatal condition despite advanced postnatal management strategies.

Objective: To evaluate the effect of the antenatal sildenafil and 2(S)-amino-6-boronohexanoic acid (ABH-Arginase inhibitor) on lung volume, pulmonary vascular development, and nitric oxide (NO) synthesis in a Nitrofen-induced CDH rat model.

Methods: Nitrofen-induced CDH rat model was used.

Early, Postnatal Pulmonary Hypertension Severity Predicts Inpatient Outcomes in Congenital Diaphragmatic Hernia.

Introduction: Pulmonary hypertension (PH) is the major pathophysiologic consequence of congenital diaphragmatic hernia (CDH). We aimed to evaluate the association between early CDH-associated PH (CDH-PH) and inpatient outcomes.

Methods: The CDH Study Group registry was queried for infants born 2015-2019 with echocardiograms before 48h of life.

Early use of combined exogenous surfactant and inhaled nitric oxide reduces treatment failure in persistent pulmonary hypertension of the newborn: a randomized controlled trial.

Objective: To evaluate whether combined surfactant with inhaled nitric oxide (iNO) use will prevent newborns with hypoxemic respiratory failure (HRF) from developing an Oxygenation Index (OI) > 40.

Methods: 100 term newborns with acute HRF (OI ≥ 20) were randomized to: Surfactant+iNO: received iNO plus up to two doses of surfactant or iNO-Controls: received iNO+placebo. Main outcome was the development of severe HRF (OI > 40) despite iNO use.

Ventricular Dysfunction Is a Critical Determinant of Mortality in Congenital Diaphragmatic Hernia.

Congenital diaphragmatic hernia (CDH) is an anomaly with a high morbidity and mortality. Cardiac dysfunction may be an important and underrecognized contributor to CDH pathophysiology and determinant of disease severity. Our aim was to investigate the association between early, postnatal ventricular dysfunction and outcome among infants with CDH.

Hypopharyngeal oxygen concentration and pressures delivered by low flow nasal cannula in preterm infants: Relationship with flow, gas mixture, and infant's weight.

Background: Low flow nasal cannula (LFNC) are frequently used in preterm infants. However, the delivered inspired oxygen concentration and airway pressures are not well established.

Objective: To determine the fraction of inspired oxygen (FiO ) and hypopharyngeal pressures generated by LFNC at different gas flows, gas mixture concentrations and infant's weight.

Prenatally versus postnatally diagnosed congenital diaphragmatic hernia - Side, stage, and outcome.

Aim: To compare outcomes between prenatally and postnatally diagnosed CDH in a large multicenter database of prospectively collected data and evaluate factors associated with poorer outcome for prenatally diagnosed CDH.

Material And Methods: We used information from the multicenter, multinational CDH Study Group database on patients born between 2007 and 2015. We compared differences between prenatally and postnatally diagnosed CDH with respect to survival, side, size, ECMO needs, associated major cardiac malformations and liver position.

Early versus late surgical correction in congenital diaphragmatic hernia.

Introduction: The timing of surgical repair in patients with congenital diaphragmatic hernia has been a controversial topic over the years, and there is still no agreement as to whether immediate repair or late surgery with preoperative stabilization is preferable.

Methods: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach.

Right versus left congenital diaphragmatic hernia - What's the difference?

Background: Right-sided congenital diaphragmatic hernias (CDH) and bigger defect sizes have been associated with poorer outcomes.

Aim: The aim of this study was to evaluate right- and left-sided CDH in terms of size, survival, associated anomalies, and morbidity.

Material And Methods: We used information from a multicenter, multinational database including patients with CDH born between 2007 and 2015.

[Strategies to reduce infections and antibiotic use and its effects in a neonatal care unit].

Introduction: Late onset sepsis (LOS) remains an important cause of morbidity and mortality in neonatal intensive care units (NICU). The empirical use of vancomycin and other broad spectrum antibiotics is very frequent and is associated with the emergence of resistant agents, infection by gram-negative bacilli (GNB), fungal infections and increased morbidity and mortality.

Objective: To evaluate the impact of 5 intervention protocols designed to reduce infections and promote the rational use of antibiotics (AB) in a single NICU.

Congenital Diaphragmatic Hernia Defect Size and Infant Morbidity at Discharge.

Background And Objective: Survival for infants with congenital diaphragmatic hernia (CDH) has gradually improved, yet substantial burden of disease remains. Although larger CDH defect sizes increase mortality, the association between defect size and morbidity has not been reported. Our objective was to evaluate the association of defect size with pulmonary, neurologic, and gastrointestinal morbidity at the time of hospital discharge.

Single vs. double phototherapy in the treatment of full-term newborns with nonhemolytic hyperbilirubinemia.

Objective: To compare the effectiveness of single (1 panel) vs. double (2 panels) phototherapy in reducing nonhemolytic hyperbilirubinemia in term newborns.

Methods: Term newborns with hyperbilirubinemia were prospectively randomized to receive double or single phototherapy.

Urine microscopy as screen for urinary tract infections in a pediatric emergency unit in Chile.

Objective: To evaluate the accuracy of urine microscopy as a predictor of urinary tract infections (UTIs), taking the urine culture as a criterion standard in a pediatric emergency unit.

Methods: Retrospective study in which all medical charts were analyzed for children younger than 15 years who underwent urine culture and sediment tests. Urine microscopy test was considered positive for leukocyturia when there were more than 10 leukocytes per microliter, and bacteriuria test was considered positive when any presence of bacteria was detected at x40 magnification.