Impact of Changes in Perinatal Care on Neonatal Respiratory Outcome and Survival of Preterm Newborns: An Overview of 15 Years

Flôr-de-Lima, Filipa; Rocha, Gustavo; Guimarães, Hercília

doi:10.1155/2012/643246

Cited by 14 publications

(18 citation statements)

References 38 publications

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“…[1] Despite advances in antepartum, intrapartum, and neonatal care, RDS remains a major cause of mortality and morbidity among premature infants, especially in developing countries. [2] About 27%–31% of very low birth weight infants die because of RDS or its complications.…”

Section: Introductionmentioning

confidence: 99%

Cytokine profiles at birth and the risk of developing severe respiratory distress and chronic lung disease

Hammoud

Barakat²,

Eltomi

et al. 2017

J Res Med Sci

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Background:Neonates with the diagnosis of respiratory distress syndrome (RDS) were studied to investigate possible associations between cytokine levels at birth and developing severe RDS or chronic lung disease (CLD).Materials and Methods:This was a cross-sectional study on serum and bronchoalveolar lavage (BAL) samples collected within hours of birth from infants with moderate and severe RDS. Twenty infants with moderate RDS and 20 infants with severe RDS were studied. RDS was diagnosed on the basis of radiographic findings, respiratory distress, and an increasing oxygen requirement. RDS severity was graded based on the radiological findings and Downe's Score. CLD was diagnosed when infants were still on supplemented O2 by at least 28 days of age. Levels of the cytokines interleukin (IL)-1β, IL-6, IL-8, IL-10, and tumor necrosis factor alpha were measured using enzyme-linked immunosorbent assay. “Statistical analysis was performed using the SPSS for Windows, (SPSS Inc., Chicago, IL, USA).”Results:Levels of the proinflammatory cytokines IL-8 and IL-1β were significantly higher in BAL of infants with severe RDS than those with moderate RDS (P = 0.007 and P = 0.02, respectively). IL-8 levels were also significantly higher in BAL and serum of infants who later progressed to CLD than in those who did not (P = 0.03 for both). The IL-8/IL-10 cytokine ratio was significantly higher in the BAL of severe RDS infants than in moderate RDS (P = 0.01) and in the serum of infants who progressed to CLD than in those who did not (P = 0.03).Conclusion:Levels of IL-8 and the IL-8/IL-10 ratio measured soon after birth were associated with severity of RDS as well as progression to CLD. Early measurement of cytokines levels and ratios may contribute to the prognosis and management of RDS and CLD.

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Section: Introductionmentioning

confidence: 99%

Cytokine profiles at birth and the risk of developing severe respiratory distress and chronic lung disease

Hammoud

Barakat²,

Eltomi

et al. 2017

J Res Med Sci

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“…The use of Naloxone was optional in most studies [18, 19, 21], standard practice in one study [22], and not mentioned in one study [20]. None of these 5 studies provided details on intubation conditions and number of attempts for successful intubation.…”

Section: Resultsmentioning

confidence: 99%

Sedation of Newborn Infants for the INSURE Procedure, Are We Sure?

Kort

Simons

2013

BioMed Research International

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Background. Neonatal intubation is a stressful procedure that requires premedication to improve intubation conditions and reduce stress and adverse physiological responses. Premedication used during the INSURE (INtubation, SURfactant therapy, Extubation) procedure should have a very short duration of action with restoration of spontaneous breathing within a few minutes. Aims. To determine the best sedative for intubation during the INSURE procedure by systematic review of the literature. Methods. We reviewed all relevant studies reporting on premedication, distress, and time to restoration of spontaneous breathing during the INSURE procedure. Results. This review included 12 studies: two relatively small studies explicitly evaluated the effect of premedication (propofol and remifentanil) during the INSURE procedure, both showing good intubation conditions and an average extubation time of about 20 minutes. Ten studies reporting on fentanyl or morphine provided insufficient information about these items. Conclusions. Too little is known in the literature to draw a solid conclusion on which premedication could be best used during the INSURE procedure. Both remifentanil and propofol are suitable candidates but dose-finding studies to detect effective nontoxic doses in newborns with different gestational ages are necessary.

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“…In this center, antenatal steroid regimen is performed with betamethasone since 2003 in pregnancies below 25 weeks of GA, in which preterm birth is a possibility [8].…”

Section: Methodsmentioning

confidence: 99%

“…We divided the newborns into three groups of two weeks of age each according to their GA: G23 +0 -24 +6 , G25 +0 -26 +6 , and G27 +0 -28 +6 . We focused our study on data after 2005 because there were a few major changes in the NICU concerning the management of preterm newborns [8].…”

Section: Methodsmentioning

confidence: 99%

Morbidity and mortality of preterm infants less than 26 weeks of gestational age

Durães¹,

Flôr-de-Lima²,

Rocha³

et al. 2018

Minerva Pediatr

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Background: Preterm birth is certainly a public health problem. Aside from being an important cause of mortality, prematurity increases the risk of serious lifetime disabilities.Objective: To assess the overall survival, causes of death and neonatal morbidities associated with prematurity of newborns less than 29 weeks of gestational age (GA). Results: In this 12-year-period, 160 preterm neonates less than 29 weeks of GA admitted to this NICU met our inclusion criteria. Overall deaths were 60 (37.5%), variating between 25 (92.6%) in the G23 +0 -24 +6 , 23 (46%) in the G25 +0 -26 +6 and 12 (14.5%) in the G27 +0 -28 +6 . The leading causes of death were intraventricular hemorrhage (IVH) and sepsis. Early neonatal mortality was 20.6%. Among survivors, 41% had bronchopulmonary dysplasia (BPD), 69% developed late sepsis, 56% retinopathy of prematurity (ROP), 44% IVH and 10% cystic periventricular leukomalacia (cPVL).Conclusions: Mortality rates in this preterm group were high in spite of all the technological and scientific advances. Pulmonary conditions (respiratory distress syndrome and BPD), sepsis and neurologic outcomes (ROP, IVH and cPVL) were still major causes of morbidity. In line with other series, the limit of viability in this cohort of preterm infants is 25 weeks of GA. Prenatal, perinatal and postnatal care still all have a long road ahead, especially when it comes to these "gray zone" newborns.

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Impact of Changes in Perinatal Care on Neonatal Respiratory Outcome and Survival of Preterm Newborns: An Overview of 15 Years

Cited by 14 publications

References 38 publications

Cytokine profiles at birth and the risk of developing severe respiratory distress and chronic lung disease

Cytokine profiles at birth and the risk of developing severe respiratory distress and chronic lung disease

Sedation of Newborn Infants for the INSURE Procedure, Are We Sure?

Morbidity and mortality of preterm infants less than 26 weeks of gestational age

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