The effects of telepresence with real-time video and audio communication on parent-infant interaction and staff experience in neonatal intensive care unit.

Objective: We implemented an online visitation system named "telepresence" in the neonatal intensive care unit (NICU) for family members at home to communicate with their babies in real-time using video and audio. This study evaluated the impact of this system on families and medical staff.

Methods: Nineteen families of babies admitted to the NICU between 2022 and 2023 and 65 medical staff participated.

Feasibility of Three-Dimensional Echocardiographic Analysis in Newborns by Novice Observers.

Three-dimensional echocardiography (3DE) provides better interobserver agreement than conventional methods. However, more evidence of whether there is good agreement between novice and experienced observers, especially in pediatric 3DE analysis, is required. We conducted 3DE analysis training in novice observers and investigated the agreement when analyzing 3DE images between novice and experienced observers.

Indocyanine green lymphography in the congenital chylothorax and chylous ascites.

Background: The prognosis of congenital chylothorax and ascites ranges from spontaneous resolution to death, but no established examination exists to predict the prognosis. We aimed to develop a clinically useful method to evaluate lymphatic abnormalities using indocyanine green (ICG) lymphography in infants with congenital chylothorax and ascites.

Methods: We retrospectively evaluated infants with congenital chylothorax and chylous ascites who underwent ICG lymphography in our hospital between 2012 and 2022.

Biventricular function in preterm infants with patent ductus arteriosus ligation: A three-dimensional echocardiographic study.

Background: The detailed hemodynamics after patent ductus arteriosus (PDA) ligation in preterm infants remain unknown. We aimed to clarify the effect of surgical ligation on left ventricular (LV) and right ventricular (RV) volume and function.

Methods: Echocardiography was performed in 41 preterm infants (median gestational age: 25 weeks) before and after PDA ligation.

Respiratory function testing for guiding ventilator mode conversion in congenital diaphragmatic hernia.

Introduction: For patients with a congenital diaphragmatic hernia, conventional mechanical ventilation (CMV) and high-frequency oscillatory ventilation (HFOV) are used in initial ventilatory management. HFOV has recently been recommended as a rescue therapy; however, we use HFOV for initial ventilation management, with a preoperative challenge test for CMV conversion and respiratory function testing at the time of CMV conversion. We aimed to compare patient characteristics between CMV conversion- and HFOV-preferred treatment groups.

Death of children with Down syndrome by gestational age and cause.

Background: We often encounter preterm infants with Down syndrome (DS) who die in the neonatal intensive care unit (NICU). In this study, we examined survival until NICU discharge and assessed the developmental prognosis of preterm infants with DS.

Methods: We retrospectively reviewed 416 infants with DS hospitalized during the past 27 years at our NICU.

Common Blood Test Indices for Predicting Transient Abnormal Myelopoiesis-Related Mortality in Infants with Down Syndrome.

Transient abnormal myelopoiesis (TAM) can cause early death in children with Down syndrome, and liver failure is the most common cause of death. The aim of this single-center retrospective study was to identify a quantitative index for predicting TAM-related mortality at the time of diagnosis. Of the 462 children with Down syndrome admitted to our hospital from 1992 to 2021, we studied 12 infants with TAM-related death and 31 survivors who were diagnosed with TAM.

Reopening of ductus arteriosus in idiopathic premature constriction or closure of ductus arteriosus: A case series.

Background: There is no consensus on managing pregnancy when the fetus is diagnosed with idiopathic premature constriction or closure of the ductus arteriosus (PCDA). Knowing whether the ductus reopens is valuable information for managing idiopathic PCDA. We conducted a case-series study to investigate the natural perinatal course of idiopathic PCDA and examined factors associated with ductal reopening.

Right to left ventricular volume ratio is associated with mortality in congenital diaphragmatic hernia.

Background: Congenital diaphragmatic hernia (CDH) is associated with high neonatal mortality. We performed this study to test the hypothesis that left ventricular (LV) and right ventricular (RV) volumes assessed by three-dimensional echocardiography may be associated with mortality in CDH.

Methods: This study was a single-center retrospective cohort study involving 35 infants with CDH.

Changes in regional oxygen saturation of the kidney and brain of infants during hospitalization.

Background: In pre-term infants, the postnatal changes in the regional oxygen saturation (rSO) of the brain and kidney are unclear.

Methods: We performed a prospective observational study. We measured the cerebral/renal rSO ratio and recorded the associated clinical features of infants born at 23 to 41 weeks of gestation weekly from the early postnatal period to discharge.

Cytomegalovirus-related sepsis-like syndrome in very premature infants in Japan.

Background: Very premature infants are at high risk of developing a symptomatic postnatal cytomegalovirus (CMV) disease, such as CMV-related sepsis-like syndrome (CMV-SLS). To address the limited data regarding its clinical features, a nationwide survey of CMV-SLS was conducted.

Methods: A questionnaire regarding CMV status and the clinical outcomes of CMV-SLS was sent to centers with reported cases of CMV-SLS.

Acute effect of hydrocortisone for respiratory deterioration in preterm infants: Oxygenation, ventilation, vital signs, and electrolytes.

Background: Preterm infants with severe bronchopulmonary dysplasia require rescue therapy with glucocorticoids, and hydrocortisone is increasingly replacing dexamethasone. The standard for rescue therapy is unclear.

Aim: To quantify the short-term effects of respiratory rescue hydrocortisone of 4 mg/kg/day for 3 days.

Clinical features of very-low-birthweight infants with congenital heart disease.

Background: Few studies have investigated the developmental prognosis of very-low-birthweight (VLBW) infants with congenital heart diseases (CHDs). This study aimed to determine the mortality and morbidity, including the developmental prognosis, of VLBW infants with CHD.

Methods: This single-center, retrospective cohort study included VLBW infants admitted to the neonatal intensive care unit from January 2006 to December 2011.

Clinical Presentation of Preterm Infants with Ventricular Septal Defect.

Ventricular septal defects (VSDs) are the most common congenital heart diseases; however, case reports of preterm infants with VSD are limited. The aim of this study is to share our experience with preterm infants with VSD and to record their short-term outcomes. Between January 2000 and December 2017, 32 preterm infants with VSD were admitted to our neonatal intensive care unit at gestational age < 32 weeks.

Acute respiratory effect of transpyloric feeding for respiratory exacerbation in preterm infants.

Objectives: Gastroesophageal reflux may exacerbate chronic lung disease in preterm infants. We evaluated the short-term effects of transpyloric feeding on respiratory status in preterm infants during mechanical ventilation.

Methods: We retrospectively collected data from the hospital information management system.

Using airway resistance measurement to determine when to switch ventilator modes in congenital diaphragmatic hernia: a case report.

Background: Congenital diaphragmatic hernia is a deficiency of the fetal diaphragm resulting in herniation of the abdominal viscera into the thoracic cavity. The best method of respiratory management of congenital diaphragmatic hernia is unclear, but high frequency oscillatory ventilation is often used as the initial ventilator mode for severe congenital diaphragmatic hernia. When it becomes impossible to maintain the pre-ductal saturations, the timing of successful switching of the ventilation mode from high frequency oscillatory ventilation to conventional mechanical ventilation remains unclear.

Ultrasound-Guided Umbilical Venous Catheter Insertion With Alignment of the Umbilical Vein and Ductus Venosus.

Previous studies have highlighted the importance of confirming the position of an umbilical venous catheter (UVC) tip by an ultrasound (US) examination. However, methods for preventing insertion into the portal circulation under US guidance have not yet been established. We report 15 cases in which a UVC was successfully passed through the ductus venosus by compressing the upper abdomen near the portal sinus of the liver to align the umbilical vein and ductus venosus under US guidance.

Reliability of real-time continuous glucose monitoring in infants.

Background: Neonatal hypoglycemia is a common and treatable risk factor for neurological impairment. Real-time continuous glucose monitoring (RT-CGM) can show glucose concentration in real time. Using an RT-CGM alarm, physicians can be alerted and intervene in hypoglycemia.

Blood potassium and urine aldosterone after doxapram therapy for preterm infants.

Objective: We often encounter infants who developed hypokalaemia following low-dose doxapram for apnea of prematurity (AOP).

Aims: To determine changes in blood potassium (K+) levels after doxapram administration.

Study Design: We studied infants born before 30 weeks gestation.

Association between cord blood cystatin C levels and early mortality of neonates with congenital abnormalities of the kidney and urinary tract: a single-center, retrospective cohort study.

Background: Some fetuses with congenital abnormalities of the kidney and urinary tract (CAKUT) have severe renal dysfunction during the prenatal period that can result in oligohydramnios, pulmonary hypoplasia, and death following birth. We hypothesized that cord blood cystatin C (CysC) levels are elevated in neonates who have life-threatening pulmonary hypoplasia and oligohydramnios due to severe renal dysfunction. In this study we compared cord blood CysC levels between a non-survivor group with CAKUT and a survivor group.

Temporal Relationship between Serum Levels of Interleukin-6 and C-Reactive Protein in Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy.

 C-reactive protein (CRP) is a useful marker of neonatal infection. Recent studies have shown that neonatal therapeutic hypothermia delays an elevation of CRP in infants with hypoxic-ischemic encephalopathy (HIE). This study investigated the time difference of peak levels of serum CRP and other inflammatory responses during therapeutic hypothermia.

Genotype-phenotype relationship in Japanese patients with congenital central hypoventilation syndrome.

Examine the genotype-phenotype relationship in Japanese congenital central hypoventilation syndrome (CCHS) patients and estimate the incidence of CCHS in Japan. Subjects were 92 Japanese patients with PHOX2B mutations; 19 cases carried 25 polyalanine repeat expansion mutations (PARMs); 67 cases carried 26 or more PARMs; and 6 had non-PARMs (NPARMs). We collected clinical data in all patients and estimated the development or intelligent quotients only in the patients carrying 25 PARM.

Increased Incidence of Late-Onset Circulatory Collapse after Changing Clinical Practice: A Retrospective Investigation of Causative Factors.

Objective: Acute primary profound circulatory failure responsive to glucocorticoid therapy after the first week of age in preterm infants is termed late-onset circulatory collapse (LCC). This study was performed to identify factors that notably increased the incidence of LCC after various management practices were changed.

Study Design: We retrospectively studied the clinical characteristics of infants (<29 weeks' gestation) before (n=26) and after (n=35) implementing the following practice changes: stress reduction, conservative replacement of thyroid hormone, positive antenatal glucocorticoid administration, sedation with fentanyl (<7 days after birth), and hydrocortisone therapy for hypotension.