Imposed work of breathing of 16 neonatal CPAP-devices using different mechanisms of CPAP generation.

Background And Objectives: Failure of continuous positive airway pressure (CPAP) in preterm infants may result from respiratory exhaustion, potentially also evoked by the CPAP device's imposed work of breathing (iWOB). This study investigated in-vitro the iWOB of 16 CPAP-devices in four simulated neonatal scenarios with focus on the impact of different mechanisms of CPAP-generation.

Methods: A neonatal lung model and 3D-printed nasopharyngeal dummies (representing a 1000 g preterm and a 3000 g term infant, settings: preterm/term: V 4.

Case Report: Post-surgical Guillain-Barré syndrome as a rare differential diagnosis of flaccid paralysis of the lower extremities in an infant after cardiac surgery.

Introduction: Guillain-Barré syndrome (GBS) is an important cause of flaccid paralysis in children and is mainly associated with antecedent infections. Surgery as an additional trigger for GBS is a well-documented phenomenon in adults, but is significantly less reported in pediatric patients. This case report describes an infant with post-surgical GBS following cardiac surgery, highlighting the diagnostic challenges and differential diagnoses of post-surgical GBS in the pediatric intensive care setting.

The Utility of Lung Ultrasound Scoring in Predicting Post-Extubation Respiratory Support After Congenital Heart Surgery.

Objectives: Lung ultrasound (LU) is effective in diagnosing the accumulation of extravascular lung water and assessing real-time fluid status in infants following congenital cardiac surgery with cardiopulmonary bypass. This study evaluated whether LU can be used as a prognostic marker for changes in noninvasive respiratory support after extubation.

Methods: Infants with congenital heart disease (CHD) <1 year of age requiring mechanical ventilation for more than 24 hours postoperatively were included.

Lung ultrasound to predict the duration of respiratory support in newborn infants with respiratory distress.

Aim: Lung ultrasound (LU) and clinical parameters evaluated during the first postnatal hour potentially predict the length of CPAP therapy in newborns with respiratory distress.

Methods: In a single-centre, prospective observational pilot study, 130 newborns ≥36 weeks gestational age were assessed using standardised LU at 30 and 60 min postnatally. Various clinical parameters were evaluated influencing CPAP duration (<1 vs.

Interventions for Promoting Meconium Passage in Very Preterm Infants-A Survey of Current Practice at Tertiary Neonatal Centers in Germany.

Meconium passage is often delayed in preterm infants. Faster meconium passage appears to shorten the time to full enteral feeds, while severely delayed meconium passage may indicate meconium obstruction. Neonatologists often intervene to promote meconium passage, assuming that benefits outweigh potential risks such as necrotizing enterocolitis (NEC).

Impact of early antibiotic exposure on the risk of colonization with potential pathogens in very preterm infants: a retrospective cohort analysis.

Background: Sepsis is one of the most important complications in preterm infants. For this reason, most preterm infants receive antibiotics during their first postnatal week. Since 2013, a weekly colonization screening has been installed in German neonatal intensive care units (NICUs), including multi-drug resistant organisms (MDRO) and pathogens with increased epidemic potential.

Lipid enemas for meconium evacuation in preterm infants - a retrospective cohort study.

Background: Enemas are used in preterm infants to promote meconium evacuation, but frequent high-volume enemas might contribute to focal intestinal perforation (FIP). To replace a regime consisting of frequent enemas of varying volume and composition, we implemented a once-daily, low-volume lipid enema (LE) regimen. We investigated its impact on meconium evacuation, enteral nutrition, and gastrointestinal complications in preterm infants.

Differential metabolism of choline supplements in adult volunteers.

Background: Adequate intake of choline is essential for growth and homeostasis, but its supply does often not meet requirements. Choline deficiency decreases phosphatidylcholine (PC) and betaine synthesis, resulting in organ pathology, especially of liver, lung, and brain. This is of particular clinical importance in preterm infants and cystic fibrosis patients.

Evaluating the Effect of a Neonatal Care Bundle for the Prevention of Intraventricular Hemorrhage in Preterm Infants.

Germinal matrix intraventricular hemorrhage (IVH) remains a severe and common complication in preterm infants. A neonatal care bundle (NCB) was implemented as an in-house guideline at a tertiary neonatal intensive care unit to reduce the incidence of IVH in preterm infants. The NCB was applied either to preterm infants <1250 g birth weight or <30 weeks gestational age or both, and standardized patient positioning, nursing care, and medical procedures within the first week of life.

Randomized Longitudinal Study Comparing Three Nasal Respiratory Support Modes to Prevent Intermittent Hypoxia in Very Preterm Infants.

Nasal continuous positive airway pressure (NCPAP) devices using variable (vf-) and continuous (cf-) flow or synchronized nasal intermittent positive pressure ventilation (s-NIPPV) are used to prevent or treat intermittent hypoxia (IH) in preterm infants. Results concerning which is most effective vary. We aimed to investigate the effect of s-NIPPV and vf-NCPAP compared to cf-NCPAP on the rate of IH episodes.

Sudden infant death syndrome (SIDS) and polymorphisms in Monoamine oxidase A gene (MAOA): a revisit.

Literature describes multiple possible links between genetic variations in the neuroadrenergic system and the occurrence of sudden infant death syndrome. The X-chromosomal Monoamine oxidase A (MAOA) is one of the genes with regulatory activity in the noradrenergic and serotonergic neuronal systems and a polymorphism of the promoter which affects the activity of this gene has been proclaimed to contribute significantly to the prevalence of sudden infant death syndrome (SIDS) in three studies from 2009, 2012 and 2013. However, these studies described different significant correlations regarding gender or age of children.