Evaluation of a simple intervention to reduce exchange transfusion rates among inborn and outborn neonates in Myanmar, comparing pre- and post-intervention rates.

Background: In Myanmar, approximately half of all neonatal hospital admissions are for hyperbilirubinaemia, and tertiary facilities report high rates of Exchange Transfusion (ET). The aim of this study was to evaluate the effectiveness of the pilot program in reducing ET, separately of inborn and outborn neonates.

Methods: The study was conducted in the Neonatal Care Units of four national tertiary hospitals: two exclusively treating inborn neonates, and two solely for outborn neonates.

Delivery room management of extremely low birth weight infants in Italy: comparison between academic and non-academic birth centres.

Objective: International Guidelines provide a standardised approach to newborn resuscitation in the DR and, in their most recent versions, recommendations dedicated to management of ELBWI were progressively increased. It is expected that introduction in clinical practice and dissemination of the most recent evidence should be more consistent in academic than in non-academic hospitals. The aim of the study was to compare adherence to the International Guidelines and consistency of practice in delivery room management of extremely low birth weight infants between academic and non-academic institutions.

Postnatal acute renal failure after fetal exposure to angiotensin receptor blockers.

Maternal hypertensive treatment with angiotensin receptor blockers (ARBs) during the second and third trimester of pregnancy is associated with several fetal and neonatal complications, and potential adverse outcomes. We report a neonate presenting with transient renal acute failure during the first days of life after maternal treatment with ARBs. Women who became pregnant while taking one of these drugs must modify antihypertensive therapy with a different class drug as soon as pregnancy is recognised.

Delivery room management of ELBW infants in Italy.

In this article we evaluated the consistency of practice and the adherence to the International Guidelines in early delivery room management of ELBW infants in Italy. A polyethylene bag/wrap was used by 54 centres (55.1%).

Neonatal resuscitation in Vietnam: a national survey of a middle-income country.

Aim: Interventions that improve neonatal resuscitation are critical if we are to reduce perinatal mortality. We evaluated the consistency of resuscitation practices, and adherence to the international guidelines for neonatal resuscitation, in a large representative sample of hospitals in Vietnam.

Methods: A questionnaire was sent to 187 public central, provincial and district hospitals, representing the three levels of public hospital-based maternity services in Vietnam.

Risk factors for acute bilirubin encephalopathy on admission to two Myanmar national paediatric hospitals.

Background: Jaundice is the commonest neonatal ailment requiring treatment. Untreated, it can lead to acute bilirubin encephalopathy (ABE), chronic bilirubin encephalopathy (CBE) or death. ABE and CBE have been largely eliminated in industrialised countries, but remain a problem of largely undocumented scale in low resource settings.

Delivery room management of extremely low birthweight infants shows marked geographical variations in Italy.

Aim: To evaluate any geographical variations in practice and adherence to international guidelines for early delivery room management of extremely low birthweight (ELBW) infants in the North, Centre and South of Italy.

Methods: A questionnaire was sent to all 107 directors of Italian level III centres between April and August 2012.

Results: There was a 92% (n = 98) response rate.

Oxygen administration for the resuscitation of term and preterm infants.

Oxygen has been widely used in neonatal resuscitation for about 300 years. In October 2010, the International Liaison Committee on Neonatal Resuscitation released new guidelines. Based on experimental studies and randomized clinical trials, the recommendations on evaluation and monitoring of oxygenation status and oxygen supplementation in the delivery room were revised in detail.

Occurrence of pneumothorax during noninvasive positive pressure ventilation through a helmet.

A 79-year-old woman presented with hypoxemic acute respiratory failure secondary to pneumonia and was started on continuous noninvasive positive pressure ventilation (NPPV) by helmet. Patient improved over first two days of NPPV, but worsened suddenly on the third day because of development of a pneumothorax. Pneumothorax may have been caused by barotrauma from desynchronization between patient and ventilator.