The Evolving Respiratory Management of Neonates
It is hard to deny the extraordinary influence respiratory ailments and their management have had on the entire discipline of neonatology. The quest to save premature babies and reduce the limit of viability has relied squarely on advances in respiratory management. As we approach the biologic limits at which extrauterine existence appears unlikely, a new quest has begun: achieving handicap-free survival with minimal lung injury. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Authors: Lucky Jain Tags: Foreword Source Type: research
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(Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Source Type: research
Advances in Respiratory Management
CLINICS IN PERINATOLOGY (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Authors: Manuel S ánchez-Luna Source Type: research
Copyright
ELSEVIER (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Source Type: research
Contributors
LUCKY JAIN, MD, MBA (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Source Type: research
Contents
Lucky Jain (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Source Type: research
Forthcoming Issues
Current Controversies in Neonatology (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Source Type: research
Coronavirus Disease 2019 Infection in Newborns
Maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can present with or without symptoms at the time of birth. Symptomatic mothers are more likely be associated with preterm births. Population studies demonstrate a consistent association of SARS-CoV-2 infection and a reduction in preterm birth rate. Newborns with positive SARS-CoV-2 test results appear to have minimal burden of illness that is directly associated with a viral infection. Neonatal mortality directly related to SARS-CoV-2 is extremely rare. Maternal vaccination in pregnant women leads to maternal antibody production, and this can o...
Source: Clinics in Perinatology - November 8, 2021 Category: Perinatology & Neonatology Authors: Jeffrey M. Perlman, Christine Salvatore Source Type: research
COVID-19 Infection in Newborns
Maternal SARS-CoV-2 infection can present with or without symptoms at the time of birth. Symptomatic mothers are likely be associated with preterm births. However population studies, demonstrate a consistent association of SARS-CoV-2 infection and a reduction in preterm birth rate. Newborns with positive SARS-CoV-2 test results appeared to have minimal burden of illness that is directly associated with a viral infection. The reported incidence of positive neonatal SARS-CoV-2 PCR test ranges from 0.56 to 6.9%. Neonatal mortality directly related to SARSCoV-2 is extremely rare. Maternal vaccination in pregnant women leads to...
Source: Clinics in Perinatology - November 8, 2021 Category: Perinatology & Neonatology Authors: Jeffrey M. Perlman, Christine Salvatore Source Type: research
Nasal Continuous Positive Airway Pressure and High-Flow Nasal Cannula Today
This study reviews the mechanisms of action and physiologic effects of nasal continuous positive airway pressure (nCPAP) and high-flow nasal cannula (HFNC) in preterm infants with respiratory distress syndrome, discusses the main characteristics of available devices and patients ’ interfaces, reports on risk of failure and possible adverse effects, and summarizes clinical evidence regarding effectiveness for preventing mechanical ventilation as primary respiratory support or after extubation in the neonatal intensive care unit. nCPAP is preferred to HFNC as primary mode o f noninvasive respiratory support in preterm infa...
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Carlo Dani Source Type: research
Nasal Intermittent Positive Pressure Ventilation for Neonatal Respiratory Distress Syndrome
Nasal or noninvaisve intermittent positive pressure ventilation (NIPPV) refers to well-established noninvasive respiratory support strategies combining a continuous distending pressure with intermittent pressure increases. Uncertainty remains regarding the benefits provided by the various devices and techniques used to generate NIPPV. Our included meta-analyses of trials comparing NIPPV with continuous positive airway pressure (CPAP) in preterm infants demonstrate that both primary and postextubation NIPPV are superior to CPAP to prevent respiratory failure leading to additional ventilatory support. This short-term benefit...
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Christoph M. R üegger, Louise S. Owen, Peter G. Davis Source Type: research
Synchronized Nasal Intermittent Positive Pressure Ventilation
Avoiding MV is a critical goal in neonatal respiratory care. Different modes of noninvasive respiratory support beyond nasal CPAP, such as nasal intermittent positive pressure ventilation (NIPPV) and synchronized NIPPV (SNIPPV), may further reduce intubation rates. SNIPPV offers consistent benefits over nonsynchronized techniques such as a more efficient positive pressure transmission to the lung, an effective increase in transpulmonary pressure during ventilation, and a better stabilization of the chest wall during inspiration. This review discusses mechanisms of action, benefits and limitations of synchronized noninvasiv...
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Corrado Moretti, Camilla Gizzi Source Type: research
Nasal High-Frequency Ventilation
Noninvasive high-frequency oscillatory (NHFOV) and percussive (NHFPV) ventilation represent 2 nonconventional techniques that may be useful in selected neonatal patients. We offer here a comprehensive review of physiology, mechanics, and biology for both techniques. As NHFOV is the technique with the wider experience, we also provided a meta-analysis of available clinical trials, suggested ventilatory parameters boundaries, and proposed a physiology-based clinical protocol to use NHFOV. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Daniele De Luca, Roberta Centorrino Source Type: research
Neurally Adjusted Ventilatory Assist in Newborns
This article provides an updated review of the physiology and the scientific literature pertaining to the use of NAVA in children (neonatal and pediatric age groups). Both the invasive NAVA and NIV-NAVA publications since 2016 are summarized, as well as the use of Edi monitoring. Overall, the use of NAVA and Edi monitoring is feasible and safe. Compared with conventional ventilation, NAVA improves patient-ventilator interaction, provides lower peak inspiratory pressure, and lowers oxygen requirements. Evidence from several studies suggests improved comfort, less sedation req uirements, less apnea, and some trends toward re...
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Jennifer Beck, Christer Sinderby Source Type: research
New Modes of Respiratory Support for the Premature Infant: Automated Control of Inspired Oxygen Concentration
Most extremely premature infants have respiratory instability that can manifest as frequent episodes of intermittent hypoxemia. Although caregivers target clinically recommended ranges of arterial oxygen saturation (oxygen saturation as measured by pulse oximetry [Spo2]), consistent maintenance of these ranges is not always achieved. Excessive administration of supplemental oxygen combined with limited staff resources increases exposure to extreme Spo2 levels. In this population, exposure to hyperoxemia and prolonged episodes of intermittent hypoxemia have been associated with damage to the eye and lung and impaired neurod...
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Nelson Claure, Eduardo Bancalari Source Type: research
