Midline Head Position for Preterm Infants in the First 72 h: A Pilot Randomised Control Trial.

Aim: Midline head positioning for preterm infants in the first 72 h of life may prevent intraventricular haemorrhage (IVH). The feasibility of conducting a RCT was explored, namely (1) acceptability of the recruitment and consenting process, (2) practicality of recruitment within 4 h after birth, (3) protocol compliance, and (4) staff satisfaction with the intervention.

Methods: An open-label, single centre, balanced 1:1 allocation, parallel-group pilot RCT was adopted.

Pulmonary hemorrhage in preterm infants born <29 weeks' gestation: a population cohort study.

Objective: To evaluate the incidence, clinical characteristics and outcomes of pulmonary hemorrhage (PH) in preterm infants who were born <29 weeks' gestation in relation to their small for gestational age (SGA) status.

Study Design: This retrospective cohort study included preterm infants born <29 weeks' gestation and admitted to one of eight tertiary perinatal hospitals in New South Wales and The Australian Capital Territory, Australia from 1 January 2007 to 31 December 2019. Data for analysis was obtained from the Neonatal Intensive Care Units' (NICUs) database.

Targeted Cerebral Oxygenation Using Dedicated Treatment Versus Usual Care in Extremely Preterm Infants: Protocol for a Multicentre International Phase II Randomised Controlled Trial.

Background: Near infrared spectroscopy (NIRS) allows continuous monitoring of cerebral oxygenation and therefore has the potential to be neuroprotective. Recurrent episodes of cerebral hypo-and/or hyperoxia may result in brain injury. The Safe-BoosC-II study reported stable cerebral oxygenation in extremely preterm infants by combining a dedicated treatment guideline with NIRS monitoring using several devices and adult sensors.

Implementation of Parenteral Nutrition Formulations with Increased Calcium and Phosphate Concentrations and Its Impact on Metabolic Bone Disease in Preterm Infants: A Retrospective Single-Centre Study.

Metabolic Bone Disease of Prematurity (MBDP) is common in extremely preterm infants (≤28 weeks gestation). Parenteral nutrition (PN) with higher calcium (Ca) and phosphorus (P) concentration started soon after birth may improve bone health in preterm infants. We compared the effect of two standard PN formulations on the incidence of MBDP and explored the predictive ability of biochemical markers for diagnosing MBDP.

Parental views on prospective consent: Experience from a pilot randomised trial recruiting extremely preterm infants during the perinatal period.

Aim: To explore parental perceptions of the consenting process and understanding of the study in a pilot randomised controlled trial wherein extremely premature infants (<29 weeks' gestation) were recruited either antenatally or by 4 h of life.

Methods: We prospectively surveyed parents who had consented, declined consent or were eligible infants in the Positioning Preterm Infants for Neuroprotection study, a low-risk intervention study in the first 72 h of life. Structured interview questions explored the process and acceptability of the consenting approach by the parents and their knowledge of the study.

Centhaquine Increases Stroke Volume and Cardiac Output in Patients with Hypovolemic Shock.

Centhaquine is a resuscitative agent that acts on α2B adrenergic receptors. Its effect on cardiac output in hypovolemic shock patients has not been reported. This pilot study was conducted in 12 hypovolemic shock patients treated with centhaquine who participated in an open-label phase IV study (NCT05956418).

Temperature probe placement in very preterm infants during delivery room stabilization: an open-label randomized trial.

Background: Variation in practice exists for temperature probe positioning during stabilization of very preterm infants (<32 weeks gestation). We explored the influence of temperature probe sites on thermoregulation.

Methods: An open-label, stratified, balanced, parallel, randomized trial was conducted.

Addressing the challenges of AI-based telemedicine: Best practices and lessons learned.

Telemedicine is the use of technology to provide healthcare services and information remotely, without requiring physical proximity between patients and healthcare providers. The coronavirus disease 2019 (COVID-19) pandemic has accelerated the rapid growth of telemedicine worldwide. Integrating artificial intelligence (AI) into telemedicine has the potential to enhance and expand its capabilities in addressing various healthcare needs, such as patient monitoring, healthcare information technology (IT), intelligent diagnosis, and assistance.

Enhancing Medical Diagnosis with AI: A Focus on Respiratory Disease Detection.

Background: Artificial intelligence (AI) is revolutionizing medical diagnosis and healthcare, providing constant support to medical practitioners. Intelligent systems alleviate workload pressure while optimizing practitioner performance. AI and deep learning have also improved medical imaging and audio analysis.

Obturator hernia: An uncommon cause of intestinal obstruction: A case report.

Introduction And Importance: An obturator hernia is a rare cause of bowel obstruction. Due to its narrow passage in the obturator canal, these are more susceptible to becoming incarcerated and subsequently strangulated. Due to its challenging detection, obturator hernia is often diagnosed late.

Role of a radiopaque agent and surveillance radiographs for peripherally inserted central catheters in newborn infants.

Background: Controversy exists regarding the use of a radiopaque agent to identify peripherally inserted central catheter (PICC) tip positions in newborn infants and of serial radiography to monitor PICC tip migration.

Objective: To investigate the roles of (1) the injection of a radiopaque agent to identify PICC tip position and (2) the performance of weekly radiography to monitor PICC migration.

Materials And Methods: This retrospective single-centre cohort study included newborn infants who received a PICC between 1 January 2016 and 31 December 2020.

Systemic postnatal corticosteroid use for the prevention of bronchopulmonary dysplasia and its relationship to early neurodevelopment in extremely preterm infants.

Background: Systemic postnatal corticosteroid use in extremely preterm infants poses a risk of adverse neurodevelopmental outcomes. This study explores their use beyond seven days of age with early neurodevelopmental assessments during the fidgety period (9-20 weeks postterm age).

Methods: This retrospective single-center cohort study included inborn extremely preterm infants from 1 January 2014 to 31 December 2018.

One-person versus two-person mask ventilation in preterm infants at birth: a pilot randomised controlled trial.

Background: Mask leak and airway obstruction are common with mask ventilation in newborn infants, leading to suboptimal ventilation. We aimed to perform a pilot study measuring respiratory mechanics during one-person and two-person mask ventilation in preterm infants at birth.

Methods: Infants less than 30 weeks' gestation were eligible for the study.

Thyroid function in infants born to women with hypothyroidism: An observational study at an Australian tertiary perinatal centre.

Objective: Concerns have been raised regarding thyroid dysfunction in infants born to women with hypothyroidism including those with autoimmune hypothyroidism. This concern has led to the practice of thyroid function testing in the early neonatal period. We evaluated the practice of performing a routine thyroid function test around 2 weeks of age in all healthy full-term infants (≥37 weeks gestation) born to women with hypothyroidism to identify thyroid dysfunction.

Quantitative end-tidal carbon dioxide at initiation of resuscitation may help guide the ventilation of infants born at less than 30 weeks gestation.

Aim: Estimation of end-tidal carbon dioxide (EtCO ) with capnography can guide mask ventilation in infants born at less than 30 weeks of gestation. Chemical-sensitive colorimetric devices to detect CO are widely used at resuscitation. We aimed to quantify EtCO in the first breaths following initiation of mask ventilation at birth and correlated need for endotracheal intubation.

Positive end expiratory pressure and respiratory system resistance between self-inflating bag and T-piece resuscitator in a cadaveric piglet lung model.

Introduction: In neonatal resuscitation, T-piece resuscitator (TPR) are used widely, but the evidence is limited for their use in infants born at term gestation. The aim of this study was to compare the delivered positive end expiratory pressure (PEEP) and respiratory system resistance (rs) using TPR and self-inflating bag (SIB) in a cadaveric piglet model.

Methods: Cadaveric newborn piglets were tracheotomised, intubated (cuffed tube) and leak tested.

Reducing antibiotic use in asymptomatic term infants exposed to maternal chorioamnionitis: Predictive role of sepsis risk calculator.

Aim: The sepsis risk calculator (SRC) has been shown to reduce empirical antibiotic usage in neonates at risk of early-onset sepsis without increasing adverse clinical outcomes. However, its use for categorising and improving identification of at-risk neonates exposed to chorioamnionitis in the local population has not been reported. This study compares the management guided by the SRC to our unit's clinical practice of administering empirical antibiotics to all term neonates (born ≥37 weeks gestation), symptomatic and asymptomatic, who were exposed to chorioamnionitis, and evaluates the performance of the SRC in managing asymptomatic term neonates exposed to chorioamnionitis.

Improvement in thermoregulation outcomes following the implementation of a thermoregulation bundle for preterm infants.

Aim: Hypothermia is associated with increased morbidity and mortality in preterm infants. A local audit revealed 60% preterm infants ≤32 weeks gestation and/or very low birth weight (VLBW) infants (<1500 g) had an abnormal body temperature at admission. This study compares thermoregulatory outcomes before and after the implementation of a thermoregulation bundle in the birthing environment.

Asymptomatic full-term infants born to women with chorioamnionitis may not need routine antibiotics.

Aim: While infants with early-onset sepsis require antibiotics, there is little evidence to support their routine use in asymptomatic infants exposed to maternal chorioamnionitis. We aimed to ascertain the incidence of culture-proven sepsis in full-term infants exposed to chorioamnionitis and to determine whether asymptomatic infants need routine antibiotic treatment.

Methods: This study was retrospective.

Skincare practices in extremely premature infants: A survey of tertiary neonatal intensive care units from Australia and New Zealand.

Aim: To investigate skincare practices in the first 2 weeks of life in extremely premature infants across tertiary neonatal intensive care units (NICUs).

Methods: A web-based secure survey invite was emailed to the medical directors of tertiary NICUs. The survey included questions on various aspects of skincare practices in the first 2 weeks of life in extremely premature infants (born before 28 weeks gestation).

Laryngeal mask airway use during neonatal resuscitation: a survey of practice across newborn intensive care units and neonatal retrieval services in Australian New Zealand Neonatal Network.

This is an Australia New Zealand Neonatal Network (ANZNN) wide survey to identify current practice and guide future practice improvement for the use of laryngeal mask airway (LMA) during neonatal resuscitation. An online questionnaire containing 13 questions was sent out to all tertiary neonatal centres (n = 29 units) and neonatal transport units (n = 4) within ANZNN. The non-tertiary (level-II) centres were not included.

Can Ambu self-inflating bag and Neopuff infant resuscitator provide adequate and safe manual inflations for infants up to 10 kg weight?

Background: Manual resuscitation devices for infants and newborns must be able to provide adequate ventilation in a safe and consistent manner across a wide range of patient sizes (0.5-10 kg) and differing clinical states. There are little comparative data assessing biomechanical performance of common infant manual resuscitation devices across the manufacturers' recommended operating weight ranges.