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  • 1
    Language: English
    In: Acta Paediatrica, 2018-01, Vol.107 (1), p.174-174
    Description: Byline: Berndt Urlesberger, Gerhard Pichler
    Subject(s): Analysis ; Cerebrovascular Circulation ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infants (Premature) ; Infrared spectroscopy ; Intensive Care, Neonatal ; Spectroscopy, Near-Infrared
    ISSN: 0803-5253
    E-ISSN: 1651-2227
    Source: Alma/SFX Local Collection
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  • 2
    Language: English
    In: European journal of pediatrics, 2018-04-28, Vol.177 (7), p.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): Bleeding ; Blood platelets ; Infants (Newborn) ; Medicine ; Medicine & Public Health ; Mortality ; Neonatal thrombocytopenia ; Original ; Original Article ; Pediatrics ; Platelet transfusion ; Thrombocytopenia ; Transfusion
    ISSN: 0340-6199
    E-ISSN: 1432-1076
    Source: Academic Search Ultimate
    Source: Alma/SFX Local Collection
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  • 3
    Language: English
    In: Neonatology (Basel, Switzerland), 2016-06, Vol.110 (1), p.66-74
    Description: In 2010, the congenital diaphragmatic hernia (CDH) EURO Consortium published a standardized neonatal treatment protocol. Five years later, the number of participating centers has been raised from 13 to 22. In this article the relevant literature is updated, and consensus has been reached between the members of the CDH EURO Consortium. Key updated recommendations are: (1) planned delivery after a gestational age of 39 weeks in a high-volume tertiary center; (2) neuromuscular blocking agents to be avoided during initial treatment in the delivery room; (3) adapt treatment to reach a preductal saturation of between 80 and 95% and postductal saturation 〉70%; (4) target PaCO2 to be between 50 and 70 mm Hg; (5) conventional mechanical ventilation to be the optimal initial ventilation strategy, and (6) intravenous sildenafil to be considered in CDH patients with severe pulmonary hypertension. This article represents the current opinion of all consortium members in Europe for the optimal neonatal treatment of CDH.
    Subject(s): Care and treatment ; Clinical Protocols - standards ; Congenital diaphragmatic hernia ; Consensus ; Consensus Statement ; Diaphragm ; Europe ; Expert Testimony ; Genetic disorders ; Hernia ; Hernias, Diaphragmatic, Congenital - complications ; Hernias, Diaphragmatic, Congenital - therapy ; Humans ; Hypertension, Pulmonary - therapy ; Infant ; Infant, Newborn ; Infants (Newborn) ; Medical protocols ; Medicin och hälsovetenskap ; Methods ; Monitoring, Physiologic ; Pediatric research ; Postnatal care ; Postnatal Care - standards ; Practice guidelines (Medicine) ; Practice Guidelines as Topic ; Respiration, Artificial ; Sildenafil Citrate - therapeutic use ; Standardized treatment ; Standards
    ISSN: 1661-7800
    ISSN: 1661-7819
    E-ISSN: 1661-7819
    Source: Alma/SFX Local Collection
    Source: SWEPUB Freely available online
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  • 4
    Language: English
    In: The Journal of pediatrics, 2013, Vol.163 (6), p.1558-1563
    Description: Objective 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. Study design 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. Results 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) at 5 minutes, 79% (65-90) at 10 minutes, and 77% (63-89) at 15 minutes of age. In all neonates, median (10th-90th percentiles) cFTOE was 33% (11-70) at 2 minutes, 21% (6-45) at 5 minutes, 15% (5-31) at 10 minutes, and 18% (7-34) at 15 minutes of age. Conclusion We report reference ranges of crSO2 and cFTOE in neonates requiring no medical support during transition immediately after birth. The use of cerebral oxygenation monitoring and use of these reference ranges in neonates during transition may help to guide oxygen delivery and avoid cerebral hypo-oxygenation and hyperoxygenation.
    Subject(s): Abridged Index Medicus ; Brain - metabolism ; Humans ; Infant, Newborn ; Infants (Newborn) ; Medical informatics ; Monitoring, Physiologic - methods ; Oxygen - analysis ; Oxygen - metabolism ; Pediatrics ; Prospective Studies ; Reference Values ; Spectroscopy, Near-Infrared ; Time Factors
    ISSN: 0022-3476
    E-ISSN: 1097-6833
    Source: Backfile Package - All of Back Files EBS [ALLOFBCKF]
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  • 5
    Language: English
    In: PloS one, 2015, Vol.10 (9), p.e0138964-e0138964
    Description: Sustained lung inflations (SLI) during neonatal resuscitation may promote alveolar recruitment in preterm infants. While most of the studies focus on respiratory outcome, the impact of SLI on the brain hasn't been investigated yet. Do SLI affect cerebral blood volume (CBV) in preterm infants? Preterm infants of gestation 28 weeks 0 days to 33 weeks 6 days with requirement for respiratory support (RS) were included in this randomized controlled pilot trial. Within the first 15 minutes after birth near-infrared spectroscopy (NIRS) measurements using 'NIRO-200-NX' (Hamamatsu, Japan) were performed to evaluate changes in CBV and cerebral tissue oxygenation. Two groups were compared based on RS: In SLI group RS was given by applying 1-3 SLI (30 cmH2O for 15 s) continued by respiratory standard care. Control group received respiratory standard care only. 40 infants (20 in each group) with mean gestational age of 32 weeks one day (±2 days) and birth weight of 1707 (±470) g were included. In the control group ΔCBV was significantly decreasing, whereas in SLI group ΔCBV showed similar values during the whole period of 15 minutes. Comparing both groups within the first 15 minutes ΔCBV showed a tendency toward different overall courses (p = 0.051). This is the first study demonstrating an impact of SLI on CBV. Further studies are warranted including reconfirmation of the present findings in infants with lower gestational age. Future investigations on SLI should not only focus on respiratory outcome but also on the consequences on the developing brain. German Clinical Trials Register DRKS00005161 https://drks-neu.uniklinik-freiburg.de/drks_web/setLocale_EN.do.
    Subject(s): Alveoli ; Archives & records ; Birth weight ; Blood ; Blood Volume ; Brain ; Brain - blood supply ; Brain - metabolism ; Brain research ; Cerebral blood flow ; Clinical trials ; Gestation ; Gestational age ; Health aspects ; Humans ; I.R. radiation ; Infant, Newborn ; Infant, Premature ; Infants ; Infants (Premature) ; Inflation (Finance) ; Infrared spectra ; Infrared spectroscopy ; Japan ; Life assessment ; Lung - physiopathology ; Lungs ; Medical research ; Near infrared radiation ; Neonates ; Newborn babies ; Oxygen - metabolism ; Oxygen Inhalation Therapy - methods ; Oxygenation ; Pediatrics ; Physiology ; Pilot Projects ; Randomization ; Research ; Respiration ; Respiration, Artificial - methods ; Respiratory Distress Syndrome, Newborn - physiopathology ; Respiratory Distress Syndrome, Newborn - therapy ; Resuscitation ; Studies ; Usage ; Ventilators
    ISSN: 1932-6203
    E-ISSN: 1932-6203
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 6
    Language: English
    In: PloS one, 2021-11-15, Vol.16 (11), p.e0259648
    Description: Background Parents’ meaningful activities (occupations) and occupational balance are relevant to neonatal care. Valid and reliable self-reported measurement instruments are needed to assess parents’ occupational balance and to evaluate occupational balance interventions in neonatal care. The aims of this study were to develop a self-reported questionnaire on occupational balance in informal caregivers (OBI-Care) and to examine its measurement properties including construct validity and internal consistency. Methods and findings A mixed method multicenter study design was employed. Items of the OBI-Care were created with parents of preterm infants based on qualitative research methods. Measurement properties were analyzed with quantitative data of parents of preterm infants. Construct validity was assessed by determining dimensionality, overall and item fit to a Rasch model, differential item functioning and threshold ordering. Internal consistency was examined by determining inter-item and item-total correlations, Cronbach’s alpha and Rasch’s person separation index. Fourteen parents participated in item creation. Measurement properties were explored in data of 304 parents. Twenty-two items, summarized in three subscales were compiled to the OBI-Care. Items showed an overall fit and except one item, an item fit to the Rasch model. There was no evidence of differential item functioning and all items displayed ordered thresholds. Each subscale had good values of person separation indices and Cronbach’s alpha. Conclusions The OBI-Care demonstrates construct validity and internal consistency and is thus a suitable measurement instrument to assess occupational balance of parents of preterm infants in neonatal care. OBI-Care is generic and can be applied in various health care settings.
    Subject(s): Analysis ; Care and treatment ; Caregivers ; Family ; Health aspects ; Infants ; Infants (Premature) ; Occupations ; Parental influences ; Psychological aspects ; Research ; Social aspects ; Surveys ; Work-life balance
    ISSN: 1932-6203
    E-ISSN: 1932-6203
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 7
    Language: English
    In: Acta Paediatrica, 2021-02, Vol.110 (2), p.458-464
    Description: Aim Necrotising enterocolitis (NEC) is still a disease with high morbidity and mortality. The aim of the study was to analyse retrospectively whether the introduction of a multi‐modal three‐component enteral medication regimen resulted in a change in morbidity and mortality in neonates with NEC. Methods When diagnosis of NEC was established, the following multi‐modal three‐component enteral medication regimen was administered enterally (via nasogastric tube): an antibiotic, an antifungal agent and a probiotic. The primary outcome parameters were intestinal perforation, surgical interventions and mortality during the observational periods. Results In the study period, 2212 patients were admitted to the NICU, out of which 200 (9%) developed NEC. Significantly fewer infants died in the Intervention Group (13 of 104 infants, 13%) compared to the Control Group (38 of 96 infants, 40%) (P = .0001). No infant in the Intervention Group (0%) presented with an intestinal perforation, as compared to 15 infants (16%) within the Control Group (P = .0001). In the Control Group, 21 infants (22%) needed surgical intervention, whereas 0 (0%) infants needed this in the Intervention Group. Conclusion The introduction of an enteral multi‐modal three‐component medication regimen resulted in a significant reduction of mortality and of need for surgical intervention in infants suffering from NEC.
    Subject(s): Enteral Nutrition ; enteral therapeutic approach ; Enterocolitis ; Enterocolitis, Necrotizing - epidemiology ; Homeopathy ; Humans ; Infant ; Infant, Newborn ; Infant, Premature, Diseases ; Infants ; Materia medica and therapeutics ; Medical research ; Medicine, Experimental ; Morbidity ; Mortality ; necrotising enterocolitis ; Patient outcomes ; preterm infants ; Regular ; Regular & Brief Reports ; Retrospective Studies ; term infants ; Therapeutics
    ISSN: 0803-5253
    E-ISSN: 1651-2227
    Source: Alma/SFX Local Collection
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  • 8
    Language: English
    In: Archives of disease in childhood. Fetal and neonatal edition, 2015-09, Vol.100 (5), p.F422-F427
    Description: ObjectivesTo investigate the occurrence of peri/intraventricular haemorrhage (P/IVH) in preterm infants and its potential association with cerebral regional oxygen saturation (crSO2) during the immediate transition.MethodsIn this two-centre prospective observational cohort study, crSO2 was measured with near-infrared spectroscopy in preterm infants (〈32 weeks of gestational age) during the immediate neonatal transition (15 min). In addition, arterial oxygen saturation (SpO2) and heart rate (HR) were monitored with pulse oximetry. Cranial ultrasound scans were performed on day 4, day 7 and day 14 after birth and before discharge. Neonates with IVH of any grade (IVH group) were matched to the neonates without IVH (Non-IVH group) on gestational age (±1 week) and birth weight (±100 g). The duration and magnitude of deviation from the 10th centile in crSO2 during immediate transition was analysed and expressed in %minutes.ResultsIVH was found in 12 of the included neonates, who were matched to 12 neonates without IVH. There was no difference in SpO2 and HR between these two groups. The duration and magnitude of centiles-deviation of crSO2 was significantly pronounced in the IVH group compared with the Non-IVH group (1870%min vs 456%min).ConclusionsThe neonates of the IVH group showed significantly lower crSO2 values during the immediate transition, although there was no difference concerning SpO2 and HR. The additional monitoring of crSO2 during the immediate transition could reveal neonates with higher risk of developing an IVH later in the course.
    Subject(s): Abridged Index Medicus ; Birth weight ; Blood pressure ; Brain ; Brain - metabolism ; Care and treatment ; Cerebral Hemorrhage - metabolism ; Cerebrovascular Circulation ; Health aspects ; Heart Rate ; Hemorrhage ; Humans ; Hypoxia ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases - metabolism ; Infants (Premature) ; Intensive care ; Ischemia ; Monitoring, Physiologic - methods ; Oximetry ; Oxygen ; Oxygen - blood ; Oxygen Consumption ; Oxygen therapy ; Premature birth ; Prospective Studies ; Risk factors ; Spectroscopy, Near-Infrared ; Spectrum analysis ; Traumatic brain injury ; Ultrasonic imaging ; Usage ; Ventilation
    ISSN: 1359-2998
    E-ISSN: 1468-2052
    Source: Alma/SFX Local Collection
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  • 9
    Language: English
    In: Frontiers in pediatrics, 2021-08-13, Vol.9, p.710465-710465
    Description: Fetal hemoglobin (HbF) is a principal oxygen carrier in the blood of preterm and term neonates. Compared to adult hemoglobin, it has a significantly higher affinity for oxygen and its oxyhemoglobin dissociation curve (ODC) is left-shifted accordingly. Tissue oxygenation measured with near-infrared spectroscopy (NIRS) during neonatal intensive care is directly affected by hemoglobin concentration. We performed a systematic qualitative review regarding the impact of HbF on tissue oxygenation monitoring by NIRS. The PubMed/Medline, EMBASE, Cochrane library and CINAHL databases were searched from inception to May 2021 for studies relating to HbF and NIRS in preterm and term neonates in the first days and weeks after birth. Out of 1,429 eligible records, four observational studies were included. Three studies found no effect of HbF on cerebral tissue oxygenation. One peripheral NIRS study found a positive correlation between HbF and peripheral fractional oxygen extraction (FOE). Currently available limited data suggest that FHbF could affect peripheral muscle FOE, but seems not to affect cerebral oxygenation in preterm neonates. More studies are needed to draw a final conclusion on this matter, especially concerning the oxygenation changes driven by adult RBC transfusions.
    Subject(s): cerebral tissue oxygenation ; fetal hemoglobin ; fractional oxygen extraction ; near infrared spectroscopy ; newborn
    ISSN: 2296-2360
    E-ISSN: 2296-2360
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 10
    Language: English
    In: Current neurology and neuroscience reports, 2017-04-08, Vol.17 (5), p.1-15
    Description: Purpose of Review Substantial research exists focusing on the various aspects and domains of early human development. However, there is a clear blind spot in early postnatal development when dealing with neurodevelopmental disorders, especially those that manifest themselves clinically only in late infancy or even in childhood. Recent Findings This early developmental period may represent an important timeframe to study these disorders but has historically received far less research attention. We believe that only a comprehensive interdisciplinary approach will enable us to detect and delineate specific parameters for specific neurodevelopmental disorders at a very early age to improve early detection/diagnosis, enable prospective studies and eventually facilitate randomised trials of early intervention. Summary In this article, we propose a dynamic framework for characterising neurofunctional biomarkers associated with specific disorders in the development of infants and children. We have named this automated detection ‘Fingerprint Model’, suggesting one possible approach to accurately and early identify neurodevelopmental disorders.
    Subject(s): Biomarkers ; Computer vision ; Diagnosis ; Early Diagnosis ; Early human development ; Humans ; Intelligent vocalisation analysis ; Medicin och hälsovetenskap ; Medicine ; Medicine & Public Health ; Multidimensional assessment ; Neurodevelopmental disorders ; Neurodevelopmental Disorders - diagnosis ; Neurology ; Neurosciences ; Pediatric Neurology (WE Kaufmann ; Pediatric Neurology (WE Kaufmann, Section Editor) ; Section Editor ; Topical Collection on Pediatric Neurology
    ISSN: 1528-4042
    ISSN: 1534-6293
    E-ISSN: 1534-6293
    Source: Alma/SFX Local Collection
    Source: SWEPUB Freely available online
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