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  • 1
    Language: English
    In: Pediatrics, November 2015, Vol.136(5), pp.876-84
    Description: Neonatal abstinence syndrome (NAS) is usually treated with opiate derivatives and supported with nonpharmacological treatment. This prospective, randomized, controlled, blinded, single-center study was carried out between March 2009 and November 2014. Newborn infants diagnosed with NAS after maternal opioid substitution therapy were eligible for inclusion. Infants were randomly allocated to the acupuncture group (combining laser acupuncture and pharmacological therapy of morphine and phenobarbital) or control group (pharmacological therapy alone). Laser acupuncture was performed with a LABpen MED 10 (675 nm/10 mW) at 5 ear and 4 body acupuncture points, bilaterally, and sessions were repeated every day. The primary outcome measure was duration of oral morphine therapy for NAS. Secondary outcomes included highest single Finnegan score, time to highest single Finnegan score, maximum amount of oral morphine solution (in milliliters per kilogram and milligrams per kilogram), time to maximum amount of oral morphine solution, and length of hospital stay. Twenty-eight newborns (14 in each group) were eligible for analysis. Duration of oral morphine therapy was significantly reduced in the acupuncture group compared with the control group (28 vs 39 days, respectively, P = .019). In addition, we observed a significantly reduced length of hospital stay in the acupuncture group compared with the control group (35 days [interquartile range 25 to 47] vs 50 days [36 to 66], P = .048). Adjunctive laser acupuncture significantly reduced the duration of morphine therapy in newborns with NAS.
    Subject(s): Lasers ; Acupuncture Therapy -- Methods ; Neonatal Abstinence Syndrome -- Therapy
    ISSN: 0031-4005
    E-ISSN: 1098-4275
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  • 2
    In: Acta Paediatrica, January 2018, Vol.107(1), pp.174-174
    Description: Byline: Berndt Urlesberger, Gerhard Pichler ***** No abstract is available for this article. *****
    Subject(s): Premature Infants – Analysis ; Infrared Spectroscopy – Analysis;
    ISSN: 0803-5253
    E-ISSN: 1651-2227
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  • 3
    Language: English
    In: The Journal of pediatrics, June 2016, Vol.173, pp.266-266
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jpeds.2016.01.067 Byline: Bernhard Schwaberger, Gerhard Pichler, Berndt Urlesberger Author Affiliation: Research Unit for Cerebral Development and Oximetry Research, Medical University of Graz, Graz, Austria Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
    Subject(s): Cerebral Autoregulation ; Transition Period ; Cerebral Blood Volume ; Regional Cerebral Oxygenation (Rcso2) ; Oxygen Delivery ; Cerebral Autoregulation ; Transition Period ; Cerebral Blood Volume ; Regional Cerebral Oxygenation (Rcso2) ; Oxygen Delivery ; Medicine
    ISSN: 0022-3476
    E-ISSN: 1097-6833
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  • 4
    Language: English
    In: European Journal of Pediatrics, 2018, Vol.177(7), pp.1045-1052
    Description: We evaluated the causes for neonatal thrombocytopenia (NT), the duration of NT, and the indications of platelet transfusions (PT) by means of a retrospective cohort study over a 23-year period. Neonates with NT were identified via ICD-10 code D69.6. Of 371 neonates (1.8/1000 live births) with NT, the majority (312; 84.1%) had early onset thrombocytopenia, and 282 (76%) were preterm born. The most frequent causes for NT were early and late onset sepsis and asphyxia. The mean duration of thrombocytopenia was 10.2 days and was negatively correlated (KK = − 0.35) with the number of PT. PT were given to 78 (21%) neonates, 38 (49%) of whom had very severe NT. The duration of NT was positively related to the severity of NT and the number of subsequent PT. A mortality rate of 10.8% was significantly associated with bleeding signs ( p  〈 0.05) and correlated with increasing number of PT ( p  〈 0.05) but not with the severity of NT ( p  = 0.4). In the case of relevant hemorrhage, PT did not influence the mortality rate ( p  = 0.09). All deaths followed neonatal sepsis. Conclusions : Prematurity and diagnoses including early and late onset sepsis and asphyxia were the most common causes of NT. Mortality was not associated with the severity of NT but increased with the number of PT. What is Known: • The causes for neonatal thrombocytopenia (NT) are well known. • The effects of platelet transfusions (PT) and its indications are still a matter of debate and recommendations differ widely. What is New: • The duration of NT is positively related to the severity of NT and the number of subsequent PT. • The mortality rate is not associated with the severity of NT but increases with increasing numbers of PT and in the case of relevant intraventricular hemorrhage (≥ grade II), PT does not influence the mortality rate.
    Subject(s): Neonatal thrombocytopenia ; Platelet transfusion ; Mortality ; Bleeding
    ISSN: 0340-6199
    E-ISSN: 1432-1076
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  • 5
    Language: English
    In: Archives of Disease in Childhood - Fetal and Neonatal Edition, 11 September 2015, Vol.100(5), p.F422
    Description: To investigate the occurrence of peri/intraventricular haemorrhage (P/IVH) in preterm infants and its potential association with cerebral regional oxygen saturation (crSO) during the immediate transition.
    Subject(s): Neonatology ; Brain Injury ; Preterm ; Regional Cerebral Oxygenation
    ISSN: 1359-2998
    ISSN: 13592998
    E-ISSN: 1468-2052
    E-ISSN: 14682052
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  • 6
    In: Acta paediatrica (Oslo, Norway : 1992), 1 January 2015, Vol.104(1), pp.32-37
    Description: AimThis prospective observational studyinvestigated if N-terminal pro-brain natriuretic peptide(NT-proBNP), a cardiac biomarker,correlatedwithcerebral tissue oxygen saturation (crSO2) in preterm infants on their first day of life.Methods Using near infrared spectroscopy (NIRS), crSO2was measured on the right forehead of preterm infants for 24 hours. We alsorecordedarterial oxygen saturation (SpO2) and calculated fractional tissue oxygen extraction (cFTOE) values. At the end of the NIRS measurement,blood was taken to analyse NT-proBNP. Mean values forthe 24-hour period were calculated for crSO2, cFTOE, SpO2 and these values were correlated to NT-proBNP.An echocardiography was performed in all infants during the measurement period.ResultsWe analysed35preterm neonates (33±2 weeks, 1965±523g). NIRS measurements started at 3±1 hours and blood samples were taken at 24±5 hours postnatal. Echocardiography showed an open ductus arteriosus in all infants.Mean NT-proBNP was 4978±3566pg/mL, crSO2 was 76±8% and cFTOEwas 0.20±0.08. NT-proBNP correlated negatively with crSO2 (r=-0.75; p=〈0.001) and positively with cFTOE (r=0.731; p=〈0.001).Conclusion These results emphasise that crSO2 is influenced by cardiac function, in addition to oxygen consumption, arterial oxygen saturation and vascular resistance,and this can be measured by NT-proBNP.This article is protected by copyright. All rights reserved.
    Subject(s): Cardiac Biomarker ; Cardiac Output ; Cerebral Tissue Oxygen Saturation ; N-Terminal Probrain Natriuretic Peptide ; Preterm Neonates
    ISSN: 16512227
    E-ISSN: 16512227
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  • 7
    Language: English
    In: The Journal of pediatrics, August 2013, Vol.163(2), pp.394-399
    Description: To evaluate peripheral regional oxygen saturation (rpSO2) and cerebral regional oxygen saturation (rcSO2) during the immediate postnatal transition in late preterm infants with and without the need for respiratory support. This was a prospective observational study using near-infrared spectroscopy to evaluate changes in rpSO2 and rcSO2. These variables were measured during the first 15 minutes of life after elective cesarean delivery. Peripheral oxygen saturation (SpO2) and heart rate were measured continuously by pulse oximetry, and cerebral fractional tissue oxygen extraction (cFTOE) was calculated. Two groups were compared based on their need for respiratory support: a respiratory support group and a normal transition group. Positive-pressure ventilation was delivered with a T-piece resuscitator, and oxygen was adjusted based on SpO2 values. A Florian respiratory function monitor was used to record the ventilation variables. There were...
    Subject(s): Cbf ; Cftoe ; Fio2 ; Hr ; NIRS ; Peep ; Rcso2 ; Rpso2 ; Rso2 ; Spo2 ; Medicine
    ISSN: 0022-3476
    E-ISSN: 1097-6833
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  • 8
    Language: English
    In: The Journal of pediatrics, December 2013, Vol.163(6), pp.1558-1563
    Description: To define reference ranges for regional cerebral tissue oxygen saturation (crSO2) and regional cerebral fractional tissue oxygen extraction (cFTOE) during the first 15 minutes after birth in neonates requiring no medical support. The crSO2 was measured using near infrared spectroscopy (Invos 5100 cerebral/somatic oximeter monitor; Somanetics Corp, Troy, Michigan) during the first 15 minutes after birth for term and preterm neonates. The near infrared spectroscopy sensor was placed on the left forehead. Peripheral oxygen saturation and heart rate were continuously measured by pulse oximetry, and cFTOE was calculated. Neonates were excluded if they required any medical support. A total of 381 neonates were included: 82 term neonates after vaginal delivery, 272 term neonates after cesarean delivery, and 27 preterm neonates after cesarean delivery. In all neonates, median (10th-90th percentiles) crSO2 was 41% (23-64) at 2 minutes, 68% (45-85)...
    Subject(s): Bw ; Cbf ; CD ; Cdpreterm ; Cdterm ; Cftoe ; Crso2 ; Ga ; Hr ; Lms ; NIRS ; Rso2 ; Spo2 ; VD ; Vdterm ; Medicine
    ISSN: 0022-3476
    E-ISSN: 1097-6833
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  • 9
    In: Acta Paediatrica, June 2018, Vol.107(6), pp.952-957
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/apa.14239/abstract Byline: Nariae Baik-Schneditz, Berndt Urlesberger, Bernhard Schwaberger, Lukas Mileder, Georg Schmolzer, Alexander Avian, Gerhard Pichler Keywords: Neonatal resuscitation; Neonatal transition; Preterm infants; Tactile stimulation; Term infants Abstract Aim This study analysed tactile stimulation during neonatal transition and resuscitation in preterm and term neonates born by Caesarean delivery. It examined the frequency, location and body region, duration and possible effects of stimulation on heart rate and arterial oxygen saturation (SpO.sub.2). Methods Two independent investigators analysed video recordings of tactile stimulation on term and preterm neonates during neonatal transition from January 2012 to December 2014. They were recorded during a prospective observational study and randomised controlled trial at a tertiary centre, the Medical University of Graz, Austria. SpO.sub.2 and heart rate were continuously recorded. Data on the frequency, body region and duration of stimulation were collected. To investigate the possible effects of stimulation, SpO.sub.2 and heart rate were compared before and after stimulation. Results Term infants received tactile stimulation more than once, and it tended to start later, last longer and be applied in more locations than in preterm infants. Only preterm infants showed a significant increase in SpO.sub.2 after stimulation and heart rates did not show any significant changes in either group. Conclusion Tactile stimulation was applied in different ways to preterm and term infants during neonatal transition and SpO.sub.2 showed a significant increase in preterm infants.
    Subject(s): Neonatal Resuscitation ; Neonatal Transition ; Preterm Infants ; Tactile Stimulation ; Term Infants
    ISSN: 0803-5253
    E-ISSN: 1651-2227
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  • 10
    In: Acta Paediatrica, January 2015, Vol.104(1), pp.32-37
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/apa.12828/abstract Byline: Corinna Binder-Heschl, Berndt Urlesberger, Martin Koestenberger, Bernhard Schwaberger,Georg M. Schmolzer, Gerhard Pichler Keywords: Cardiac biomarker; Cardiac output; Cerebral tissue oxygen saturation; N-terminal probrain natriuretic peptide; Preterm neonates Abstract Aim This prospective observational study investigated if N-terminal probrain natriuretic peptide (NT-proBNP), a cardiac biomarker, correlated with cerebral tissue oxygen saturation (crSO2) in preterm infants on their first day of life. Methods Using near infrared spectroscopy (NIRS), crSO.sub.2 was measured on the right forehead of preterm infants for 24 h. We also recorded arterial oxygen saturation (SpO.sub.2) and calculated fractional tissue oxygen extraction (cFTOE) values. At the end of the NIRS measurement, blood was taken to analyse NT-proBNP. Mean values for the 24-h period were calculated for crSO.sub.2, cFTOE, SpO.sub.2 and these values were correlated to NT-proBNP. An echocardiography was performed in all infants during the measurement period. Results We analysed 35 preterm neonates (33 [+ or -] 2 weeks, 1965 [+ or -] 523 g). NIRS measurements started at 3 [+ or -] 1 h and blood samples were taken at 24 [+ or -] 5 h postnatal. Echocardiography showed an open ductus arteriosus in all infants. Mean NT-proBNP was 4978 [+ or -] 3566 pg/mL, crSO.sub.2 was 76 [+ or -] 8%, and cFTOE was 0.20 [+ or -] 0.08. NT-proBNP correlated negatively with crSO.sub.2 (r = -0.75; p [less than or equal to] 0.001) and positively with cFTOE (r = 0.731; p [less than or equal to] 0.001). Conclusion These results emphasise that crSO2 is influenced by cardiac function, in addition to oxygen consumption, arterial oxygen saturation and vascular resistance, and this can be measured by NT-proBNP.
    Subject(s): Cardiac Biomarker ; Cardiac Output ; Cerebral Tissue Oxygen Saturation ; N‐Terminal Probrain Natriuretic Peptide ; Preterm Neonates
    ISSN: 0803-5253
    E-ISSN: 1651-2227
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