Post-Resuscitation Care for Neonates Receiving Positive Pressure Ventilation at Birth

Akinloye, O; O’Connell, Colleen; Allen, Alexander C.; El-Naggar, Walid

doi:10.1542/peds.2014-0554

Cited by 14 publications

(7 citation statements)

References 17 publications

(13 reference statements)

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“…Furthermore, we examined the direct effects of abruption, which furthers understanding of the associated risk beyond the mediators of preterm delivery and SGA. The association between abruption and delivery-room resuscitation, NICU admission, and longer LOS in the NICU is in accord with extant research; however, the few previous reports are based on samples with fewer than 250 cases and primarily from single sites (9,19,(33)(34)(35). A major strength of our study was the ability to report the incidence of rare outcomes in a large, multisite US cohort.…”

Section: Strengths and Limitations Of This Studysupporting

confidence: 65%

“…It is also the largest study to examine the association between abruption and respiratory distress syndrome, as well as the need for medical intervention. Previous reports of the association between abruption and need for medical intervention are limited by small sample sizes or focused on specific high-risk subpopulations, such as neonates requiring positive pressure ventilation at birth (34) or pregnancies complicated specifically by chronic abruption-oligohydramnios sequence (35). Furthermore, in contrast to the majority of existing studies of abruption, which have controlled for gestational age and birth weight in the analyses, we also estimated risk of poor outcomes conditioned on preterm birth and SGA.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

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Neonatal Outcomes Associated With Placental Abruption

Downes

Shenassa

Grantz

2017

American Journal of Epidemiology

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Placental abruption (early separation of the placenta) is associated with preterm birth and perinatal mortality, but associations with other neonatal morbidities remain understudied. We examined the association between abruption and newborn outcomes. We analyzed 223,341 singleton deliveries from the Consortium on Safe Labor study, a retrospective, multisite, observational study (2002-2008) of electronic medical records in the United States. Adjusted relative risks, incidence rate ratios, and 99% confidence intervals were estimated. Direct effects attributable to abruption were examined by conditioning on intermediates (preterm birth and small for gestational age) with sensitivity analyses. Incidence of abruption was 1.6% (n = 3,619). Abruption was associated with an elevated risk of newborn resuscitation (relative risk (RR) = 1.5, 99% confidence interval (CI): 1.5, 1.6), apnea (RR = 5.8, 99% CI: 5.1, 6.5), asphyxia (RR = 8.5, 99% CI: 5.7, 11.3), respiratory distress syndrome (RR = 6.5, 99% CI: 5.9, 7.1), neonatal intensive care unit admission (RR = 3.4, 99% CI: 3.2, 3.6), longer intensive care length of stay (incidence rate ratio = 2.0, 99% CI: 1.9, 2.2), stillbirth (RR = 6.3, 99% CI: 4.7, 7.9), and neonatal mortality (RR = 7.6, 99% CI: 5.2, 10.1). In sensitivity analyses, there was a direct effect of abruption associated with increased neonatal risks. These findings expand our knowledge of the association between abruption and perinatal and neonatal outcomes.

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Section: Strengths and Limitations Of This Studysupporting

confidence: 65%

Section: Comparison With Other Studiesmentioning

confidence: 99%

Neonatal Outcomes Associated With Placental Abruption

Downes

Shenassa

Grantz

2017

American Journal of Epidemiology

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“…The newborn babies who required extensive resuscitation should have ongoing post resuscitation assessment for next 24-48 hours after birth. Even those babies who respond well to initial simple resuscitation support may sometimes need further intervention in next few hours 20. In our study, only 66% had the perception of importance of reassessment of the baby after initial NR.…”

Section: Discussioncontrasting

confidence: 60%

Knowledge of clinicians/pediatricians about neonatal resuscitation in a tertiary care hospital

Muneer¹,

Bari

Haider³

et al. 2019

Pak J Med Sci

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Objective: To analyze the knowledge of the doctors dealing with pediatric patients about neonatal resuscitation. Methods: This was a cross sectional study conducted at The Lahore General Hospital over one year. Total 137 doctors related to pediatrics with different job descriptions were enrolled and requested to fill a questionnaire proforma regarding their knowledge about basic equipment required and about neonatal resuscitation steps. Data was entered and analyzed using SPSS 20. Results: Out of 137 participants, majority (71%) had >2 years of experience in pediatrics and 52.5% had higher postgraduate qualification. Neonatal resuscitation workshop was attended by 57% doctors. In resuscitation of newborns at the time of delivery, resuscitating doctors were assisted by nurse in 50%, by junior doctor in 35%, paramedic staff 11% and it was done by single doctor in 4% cases. Oxygen (central or O2 cylinder) and warmer facilities were available in 90% and 82% of health facilities respectively. Majority (86%) of participants were of view that every neonate must be attended at birth. Not a single doctor followed all the standard steps of neonatal resuscitation although 90% had knowledge about resuscitation equipment and common resuscitation drugs. Conclusion: Pediatric health care professionals had knowledge about neonatal resuscitation but there are gaps in the practical application. There is a strong need of frequent neonatal resuscitation workshops for improving neonatal outcomes. doi: https://doi.org/10.12669/pjms.35.3.987 How to cite this:Muneer A, Bari A, Haider A, Ali AS. Knowledge of clinicians/pediatricians about neonatal resuscitation in a tertiary care hospital. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.987 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…Advances in neonatal intensive care and mechanical ventilation of newborns have increased infants’ survival during recent years and was subject of many recent investigations ( Donn et al, 2003 ; Wu et al, 2015 ; Armanian et al, 2014 ; Salvo et al, 2015 ; Chu et al, 2015 ; Akinloye et al, 2014 ; Schmölzer et al, 2014 ). New ventilation methods and techniques that have newly become available have made the mechanical ventilation in neonates a masterpiece in the twenty-first century ( Keszler, 2006 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Two Levels of Pressure Support Ventilation on Success of Extubation in Preterm Neonates: A Randomized Clinical Trial

Farhadi¹,

Lotfi²,

Alipour³

et al. 2015

GJHS

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Background:Pressure Support Ventilation (PSV) is one of the modes of mechanical ventilation that can be used alone as a weaning strategy in neonates. However, studies on the appropriate pressure level for this mode in neonates are limited.Objectives:Because the use of adequate pressure support in this mode, keeping the appropriate neonate’s tidal volume, and preventing the respiratory complications, this study was aimed to compare extubation failure in the two levels of pressure support ventilation of 10 and 14 cmH2O when removing the neonates from the ventilator.Materials & Methods:In this randomized clinical trial 50 premature infants of 27-37 weeks with respiratory distress syndrome (RDS) were under mechanical ventilation for at least 48 hours, were randomly assigned to two groups. One group was extubated in PSV mode with pressure of 14 cmH2O and the other with 10 cmH2O. Extubation failure rate and complications such as pneumothorax, death and respiratory parameters were compared in the two groups.Results:Twenty five neonates in each group were assessed. Weaning time, extubation failure rate, and mean airway pressure was lesser in PSV of 10 cmH20 group than Level of 14 cmH2O and those differences were statistically significant (P<0.05). Difference between work of breathing, ventilation time, pneumothorax and mortality rate between two groups were not statistically significant (P>0.05).Conclusion:The results of our study show that extubation of the neonates using 10 CmH2O in PSV mode increases the success rate of extubation. Although when Volume- assured PSV can be used, it is more logical to use it for guaranteeing tidal volume, but using the appropriate level of pressure support when the PSV mode is used alone is inevitable and further studies are necessary to demonstrate the level of pressure in this mode.

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Post-Resuscitation Care for Neonates Receiving Positive Pressure Ventilation at Birth

Cited by 14 publications

References 17 publications

Neonatal Outcomes Associated With Placental Abruption

Neonatal Outcomes Associated With Placental Abruption

Knowledge of clinicians/pediatricians about neonatal resuscitation in a tertiary care hospital

Comparison of Two Levels of Pressure Support Ventilation on Success of Extubation in Preterm Neonates: A Randomized Clinical Trial

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