The use of the VC connector increased the delivery of albuterol sulfate and resulted in a PSD profile at the patient interface that is more consistent with the PSD profile of the selected nebulizer when compared with SoC. This VC connector may be a useful, new approach for the delivery of aerosolized medications to neonates requiring positive pressure ventilatory support.
Abstracts bronchoalveolar lavage cytokines (tumor necrosis factor-alpha, interleukin-1 beta, interleukin-6) also were measured. Measurements and Main Results 26 patients had a positive bacterial culture (bronchoalveolar lavage > or = 10 colony-forming units/mL), and made up 79% of pathogens recovered at high concentrations. The concentrations of bronchoalveolar lavage interleukin-1 beta were 200.4 +/-22.4 and 44.8 +/-14.2 pg/mL (mean +/-se) in the newborn with positive and negative bacterial culture, respectively (p<0.001). Bronchoalveolar lavage interleukin-1 beta was significantly higher in the newborn with a high bacterial burden (p<0.001), with mixed bacterial infection (p<0.001), and with ventilator-associated pneumonia (p<0.001), compared with values in patients without these features. Conclusions Since the concentration of bronchoalveolar lavage interleukin-1 beta was correlated with bacterial burden in the alveoli, it may be a marker for progressive and ongoing inflammation in long term mechanical ventilation newborn. Background and Aims Preterm infants are more sensitive to oxidative stress than older humans. Hyperoxic exposure, although essential for survival of neonates, induces excessive production of reactive oxygen metabolites which could be responsible of morbidities in these babies. Aims of this study were to evaluate the incidence of mortality and bronchodysplasia in preterm infants resuscitated at birth with different concentrations of oxygen. Secondary outcome was to evaluate the serum level of oxdative stress markers in the same population of infants. Methods A randomized clinical trial has been performed in NICU of University of Messina, Italy. Results 60 preterm infants (gestational age < 32 weeks) were recruited and randomly divided into three groups (40%, 60% and 100% of fractional inspired oxygen). We didn't find difference in mortality (p 0,877), but bronchodysplasia was represented only in the group of 100% oxygen (p<0.01). These newborns had also a longer time of ventilation (p 0,001) and hospitalization (p 0,007) and a higher incidence of pneumothorax (p<0.01). Serum levels of Interleukin-1β and nitrosylated protein were higher in preterm infants resuscitated with 100% oxygen in comparison with the other two groups of infants, which instead presented a significant reduction of interleukin-10 levels. Conclusions In our study, the exposure of preterm infants to higher oxygen concentrations at birth is correlated with poor respiratory outcome without influencing neonatal mortality. Imbalances between pro-and anti-inflammatory cytokines may therefore be early indicators of developing chronic lung disease.
OXIDATIVE STRESS AND CLINICAL OUTCOME OF PRETERM INFANTS RESUSCITATED WITH DIFFERENT CONCENTRATIONS OF OXYGEN
AbstractsResults Physical exam, cyanosis in the first 12 hours, tachypnea and/or a severe respiratory distress, systolic murmur on the left border of sternum. ECG: diastolic dysfunction of left ventricular (LV). Chest X ray: cardiomegaly (all cases). PaO 2 : low values-all patients. ECHO aspects: enlargement of the right chambers; severe tricuspid regurgitation with the peak velocity 3-4 m/sec; mitral regurgitation (12/41 of cases), left-to-right shunt across foramen ovale and/or ductus arteriosus (30/41 of cases), enlargement of the pulmonary artery and severe pulmonary regurgitation, septal hypertrophy (11/41 of cases); impaired LV relaxation with normal systolic function; congenital heart diseases (7). Repeated ECHO revealed in most of the cases diminished or no right-to left shunt across ductus arteriosus or foramen ovalae correlate with clinical improvement and disappearance of cyanosis. Conclusions Echocardiographic exam, beside clinical exam and history of the disease, is un important element for the diagnosis and follow up of evolution by the specific treatment applied for PPHN in the newborn with cyanosis and this investigation must be performed early after birth.
Abstractsand two-handed hold (THH) for delivering positive pressure ventilation (PPV). Methods 53 participants from 5 professional groups provided PPV with each hold for 1 minute to a mannequin, using a T-piece resus- (23) 13 (14) Midwife n=12 40 (30) 43 (36) 48 (36) Neonatal nurse n=11 35 (28) 38 (34) 40 (33) The mean (SD) leak was 35(27)%, 38(34)% and 39(33)% for the TPTH, SH and THH respectively (p=0.003). The mean (SD) T VE was not significantly different between the three holds (p=0.09). The lowest mean (SD) leak was measured with the THH by registrars 13(14)% and highest by midwives with the THH 48(36)% (p=0.001). Conclusion Each hold can be used to give PPV. The SH does not appear to reduce leak when compared to the other holds.
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