Archives of Disease in Childhood - Fetal and Neonatal Edition This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

SurE for surfactant: response to letter
We would like to thank Nobile et al for their interest in our network meta-analysis comparing the efficacy of methods for surfactant administration.1 The authors raised concerns by giving emphasis on the combination of various study designs. However, our network meta-analysis implemented a parametric design-adjusted meta-analysis in order to incorporate both randomised and non-randomised evidence in the analysis, as suggested by Efthimiou et al.2 Following this approach, various weights were placed on observational studies, enabling the evaluation of their effects on the overall outcome. Combining randomised and non-random...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Bellos, I., Pandita, A. Tags: PostScript Source Type: research

Critical appraisal of the evidence underpinning the efficacy of less invasive surfactant administration
We read with great interest the network meta-analysis by Bellos and colleagues1 aimed at comparing less invasive surfactant administration (LISA, via thin catheters, laryngeal mask, nebulisation, pharyngeal instillation), intubation and surfactant administration followed by immediate extubation (InSurE) and no surfactant administration among preterm infants born <37 weeks of gestation. Primary outcomes were mortality, mechanical ventilation (MV) and bronchopulmonary dysplasia (BPD). Secondary outcomes were necrotising enterocolitis, intraventricular haemorrhage, pneumothorax, periventricular leukomalacia, patent ductus ...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Nobile, S., Bottoni, A., Giordano, L., Paladini, A., Vento, G. Tags: PostScript Source Type: research

Survey of the use of videolaryngoscopy in neonatal units in the UK
Intubation is a core skill for paediatric trainees. Videolaryngoscopy is increasingly used in neonatal units and is recommended as part of the recent British Association of Perinatal Medicine difficult airway guidance.1 Videolaryngoscopy is widely used in adult airway management. We performed a telephone-based interview of all neonatal units across the UK to ascertain the ownership and use of a videolaryngoscope (VL) within the unit. We inquired about the level of unit, whether the unit had access to a VL and the brand used. We asked if VL was used in various clinical situations. We also asked the units their perceived bar...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Thomas, H., Lugg, R., James, B., Geeroms, C., Risbridger, A., Bell, R., Bartle, D. G. Tags: PostScript Source Type: research

Outcomes of establishing a neonatal peripheral vascular access team
Intravenous vascular access (VA) is essential in neonatal intensive care units (NICUs). Short peripheral intravenous catheters (PIVCs) are the most frequently used short-term device.1 Many unmodifiable and potentially modifiable factors affect the incidence of complications, contributing to the success or failure of therapy.2 Numerous interventions such as evidence-based care bundles, innovations in device design and manufacturer are targeted at reducing the incidence and severity of complications.3 Internationally, specialist multiprofessional teams for central venous access are widely established4 but evidence about the ...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: van Rens, M., Hugill, K., Gaffari, M. A. K., Francia, A. V., Ramkumar, T., Garcia, K. L. P., van Loon, F. H. J. Tags: PostScript Source Type: research

Impact of the new NICE guidance 2021 on management of early onset neonatal sepsis
In April 2021, the National Institute for Health and Care Excellence (NICE) published new guidelines for neonatal infection,1 replacing the 2012 guidance. In order to reduce antibiotic usage in healthy infants, NICE modified risk factors and allowed use of Kaiser Permanente Sepsis Risk Calculator (KP-SRC)2 as an alternative with prospective audit. KP-SRC provides recommendations for antibiotics, culture with observation or observation only. Previous studies,3 including from our group,4 demonstrated significant reductions (up to 84%) in antibiotic usage on virtual application of KP-SRC compared with NICE 2012. No studies ex...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Macaskill, L., Slee, S., van Hasselt, T. J., Naseem, M., Ewer, A. K., Surana, P., Paediatric Research Across the Midlands (PRAM) Network Tags: PostScript Source Type: research

Would the fetus drawn by Leonardo da Vinci have delivered by the breech?
Discovery consists of seeing what everybody has seen and thinking what nobody has thought. Albert Szent-Györgyi (1893–1986), Nobel Laureate in Physiology A respected mentor’s ‘voice from the past’ taught me a lesson probably familiar to many of us, that when we ensure that what we publish is accurate, we enable others in the future to add to our findings in the light of new knowledge. I doubt Leonardo da Vinci was taught this premise, but it does in fact apply; even almost 500 years on, there are things we can add by observing the detail contained in his extraordinary anatomical drawings. Mo...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Macnab, A. Tags: Viewpoint Source Type: research

Implications of the HELIX trial for treating infants with hypoxic-ischaemic encephalopathy in low-to-middle-income countries
Perinatal hypoxia-ischaemia (HI) is the single most common trigger of perinatal brain injury, and contributes to over 2 million deaths worldwide each year, of which about 96% were from low/middle-income countries (LMICs).1 2 In high-income countries (HICs), there is compelling evidence that therapeutic hypothermia for infants with HI encephalopathy (HIE) reduces grey and white matter lesions3 4 and improves survival without disability.5–7 In view of the differing populations, risks and medical systems, it cannot be assumed that even such a simple and low-cost treatment would be suitable for LMICs.8 Supporting this co...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Davidson, J. O., Battin, M. R., Gunn, A. J. Tags: Viewpoint Source Type: research

Implementing two-stage consent pathway in neonatal trials
Perinatal trials sometimes require rapid recruitment processes to facilitate inclusion of participants when interventions are time-critical. A two-stage consent pathway has been used in some trials and is supported by national guidance. This pathway includes seeking oral assent for participation during the time-critical period followed by informed written consent later. This approach is being used in the fluids exclusively enteral from day one (FEED1) trial where participants need to be randomised within 3 hours of birth. There is some apprehension about approaching parents for participation via the oral assent pathway. Th...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Mitchell, E., Oddie, S. J., Dorling, J., Gale, C., Johnson, M. J., McGuire, W., Ojha, S. Tags: Open access Short reports Source Type: research

Umbilical cord thrombosis and chorioamnionitis in neonatal arterial ischaemic stroke
A baby boy was delivered at term by emergency caesarean section because of abnormal fetal heart rate patterns during spontaneous labour. The umbilical cord arterial blood obtained at delivery had a pH of 6.97 and a lactate concentration of 12.1 mmol/L. The Apgar scores were 3 and 7, respectively, at 1 and 5 min. The proximal umbilical cord had a thrombotic aspect at delivery (figure 1). A thrombus was also identified in the ductus venosus at 1 hour of life. The boy presented left hemicorporeal seizures at 21 hours of life, which revealed a neonatal arterial ischaemic stroke (NAIS; figure 2). Placental histology revealed ac...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Dridi, M., Chabrier, S., Raia-Barjat, T., Giraud, A. Tags: Open access Images in neonatal medicine Source Type: research

Remote ischaemic conditioning in necrotising enterocolitis: a phase I feasibility and safety study
Conclusions This study is pivotal for designing a future randomised controlled trial to assess the efficacy of RIC in preterm infants with NEC. Trial registration number NCT03860701. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Zozaya, C., Ganji, N., Li, B., Janssen Lok, M., Lee, C., Koike, Y., Gauda, E., Offringa, M., Eaton, S., Shah, P. S., Pierro, A. Tags: Open access Original research Source Type: research

A randomised trial comparing weaning from CPAP alone with weaning using heated humidified high flow nasal cannula in very preterm infants: the CHiPS study
Conclusion For infants ready to wean from nCPAP, the CHiPS study found that nHF was non-inferior to discontinuing nCPAP at 5 cm water. Trial registration number Australia and New Zealand Clinical Trials Registry (ACTRN12615000077561). (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Clements, J., Christensen, P. M., Meyer, M. Tags: Open access Original research Source Type: research

Aetiology and outcomes of prolonged neonatal jaundice in tertiary centres: data from the China Neonatal Genome Project
Conclusion Known aetiologies were identified in approximately 80% of neonates in our cohort, and their overall outcomes were favourable. Genetic aetiology should be considered a priority in neonates with PCHB or the persistence of jaundice after 4 weeks of age. Moreover, genetic data can modify the clinical diagnosis and guide disease management, potentially improving outcomes. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Xiao, T., Wang, J., Wang, H., Mei, H., Dong, X., Lu, Y., Cheng, G., Wang, L., Hu, L., Lu, W., Ni, Q., Li, G., Zhang, P., Qian, Y., Li, X., Peng, X., Wang, Y., Shen, C., Chen, G., Dou, Y.-l., Cao, Y., Chen, L., Kang, W., Li, L., Pan, X., Wei, Q., Zhuang, D Tags: Original research Source Type: research

Lung ultrasound of the dependent lung detects real-time changes in lung volume in the preterm lamb
Conclusion LUS was able to detect large changes in total and regional lung volume in real time and correctly identified opening and closing pressures but lacked the precision to detect small changes in lung volume. Further work is needed to improve precision prior to translation to clinical practice. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Sett, A., Kenna, K. R., Sutton, R. J., Perkins, E. J., Sourial, M., Chapman, J. D., Donath, S. M., Sasi, A., Rogerson, S. R., Manley, B. J., Davis, P. G., Pereira-Fantini, P. M., Tingay, D. G. Tags: Open access Original research Source Type: research

Feasibility of and experience using a portable MRI scanner in the neonatal intensive care unit
Conclusion This single-centre series demonstrated portable MRI examinations can be performed safely with standard patient support equipment present in the NICU. These findings demonstrate that portable MRI could be used in the future to guide care in the NICU setting. Trial registration number NCT04629469. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Sien, M. E., Robinson, A. L., Hu, H. H., Nitkin, C. R., Hall, A. S., Files, M. G., Artz, N. S., Pitts, J. T., Chan, S. S. Tags: Open access Original research Source Type: research

Acceleration during neonatal transport and its impact on mechanical ventilation
Conclusions Infants are exposed to significant acceleration and vibration during emergency transport. While these forces do not interfere with overall maintenance of ventilator parameters, they make the pressure-volume loops more irregular. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 15, 2022 Category: Perinatology & Neonatology Authors: Lantos, L., Szell, A., Chong, D., Somogyvari, Z., Belteki, G. Tags: Original research Source Type: research