Early Exclusively Non-Invasive Inhaled Nitric Oxide In Spontaneously Breathing Preterm And Term Neonates With Arterial Pulmonary Hypertension PDF Download
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Author: Corinna Mirjam Gebauer Publisher: ISBN: Category : Languages : en Pages :
Book Description
Background and aims: Inhaled nitric oxide (iNO) is an approved therapy for neonates with mechanical ventilation for hypoxic respiratory failure (HRF). Little is known about the early non-invasive iNO treatment of persistent pulmonary hypertension (PPH) via nasal cannula or mask. We studied this practice in spontaneously breathing term and preterm infants, hypothesizing that it would be associated with reduced oxygen requirements.Methods: In our electronic medical records (2011 to 2017) we identified 123 inborn neonates receiving iNO. Whereof 46 singletons with PPH were exclusively spontaneously breathing on respiratory support via nasal continuous positive airway pressure (CPAP) receiving non-invasive iNO treatment starting within their first 12 hours of life. In all infants HRF (persistent supplemental oxygen >30%) was accompanied by echocardiographically proven PPH. Results: 46 neonates receiving non-invasive iNO were studied with a median birth weight of 2629g (740g u2013 4680g) and a median gestational age of 35 weeks (24+6 weeks u2013 41+6 weeks) including 10 preterm infants u2264 30 weeks. Median duration of non-invasive iNO application was 24 hours (1,5 hours u2013 168 hours) with a mean starting dose of 20 ppm. Fractional oxygen requirements dropped with initiation of non-invasive iNO from median 60% to 25% (p
Author: Corinna Mirjam Gebauer Publisher: ISBN: Category : Languages : en Pages :
Book Description
Background and aims: Inhaled nitric oxide (iNO) is an approved therapy for neonates with mechanical ventilation for hypoxic respiratory failure (HRF). Little is known about the early non-invasive iNO treatment of persistent pulmonary hypertension (PPH) via nasal cannula or mask. We studied this practice in spontaneously breathing term and preterm infants, hypothesizing that it would be associated with reduced oxygen requirements.Methods: In our electronic medical records (2011 to 2017) we identified 123 inborn neonates receiving iNO. Whereof 46 singletons with PPH were exclusively spontaneously breathing on respiratory support via nasal continuous positive airway pressure (CPAP) receiving non-invasive iNO treatment starting within their first 12 hours of life. In all infants HRF (persistent supplemental oxygen >30%) was accompanied by echocardiographically proven PPH. Results: 46 neonates receiving non-invasive iNO were studied with a median birth weight of 2629g (740g u2013 4680g) and a median gestational age of 35 weeks (24+6 weeks u2013 41+6 weeks) including 10 preterm infants u2264 30 weeks. Median duration of non-invasive iNO application was 24 hours (1,5 hours u2013 168 hours) with a mean starting dose of 20 ppm. Fractional oxygen requirements dropped with initiation of non-invasive iNO from median 60% to 25% (p
Author: U. S. Department of Health and Human Services Publisher: Createspace Independent Pub ISBN: 9781484934616 Category : Medical Languages : en Pages : 310
Book Description
Neonatal lung disease is the most common complication of preterm delivery, and results in significant morbidity and mortality. Preterm infants suffer from both acute and chronic respiratory failure as a result of anatomic and biochemical disruption of lung function, lung inflammation and oxidative stress, nutritional deficiencies, and arrest of tracheobronchial and pulmonary vascular growth. Treatment for acute respiratory failure often contributes to evolving bronchopulmonary dysplasia (BPD) and chronic respiratory failure, due to barotrauma and oxygen toxicity from prolonged respiratory support, deficient nutrition, as well as immaturity of lung growth, vascular development and immunologic defenses. Pulmonary hypertension may occur in association with acute and/or chronic respiratory failure. Multiple etiologies make finding an effective treatment for respiratory failure in preterm infants challenging. Disorders related to prematurity and respiratory distress are among the leading causes of infant mortality in the U.S. Treatment options for respiratory failure in preterm infants include a variety of modalities. Prenatal steroids, antibiotics, exogenous surfactant replacement, tidal volume ventilation, conventional ventilation, continuous positive airway pressure, high flow oxygen administration, and high frequency ventilation are all used as therapeutic modalities. Treatment of preterm infants with inhaled nitric oxide (iNO) as a rescue therapy for refractory hypoxemic respiratory failure is an extension of the relative success of the treatment of term and near term infants with iNO. Inhaled NO has demonstrated efficacy in improving oxygenation and reducing the need for extracorporeal membrane oxygenation (ECMO) in late preterm infants born after 34 weeks gestation and full term infants with respiratory failure, with no evidence of long term benefits. Despite the approved use of iNO in full term and late preterm infants, the developmentally distinct mechanisms of respiratory failure and differing cardiovascular, pulmonary, and pharmacokinetic characteristics of more immature infants require systematic study of the short and long term outcomes for preterm infants treated with iNO to prevent or treat respiratory failure. The Cochrane review acknowledged very limited data on long term outcomes of preterm infants treated with iNO. If iNO is beneficial, the number need to treat would be very large. Papers published or presented from 2007 to present report conflicting results as to whether, in preterm infants, iNO has beneficial, adverse, or no effects on long term neurodevelopmental and pulmonary outcomes. Despite the ongoing controversy, iNO continues to be used for hypoxemic respiratory failure in preterm infants less than 34 weeks gestation even with potential harm to the developing lungs and brain. There is an urgent need to weigh the current evidence as to whether iNO is a safe and effective treatment in preterm infants. We sought to identify and synthesize evidence addressing the following questions: 1. Does inhaled nitric oxide (iNO) therapy increase survival and/or reduce the occurrence or severity of bronchopulmonary dysplasia (BPD) among premature infants who receive respiratory support? 2. Are there short term risks of iNO therapy among premature infants who receive respiratory support? 3. Are there effects of iNO therapy on long term pulmonary and/or neurodevelopmental outcomes among premature infants who receive respiratory support? 4. Does the effect of iNO therapy on BPD and/or death or neurodevelopmental impairment vary across subpopulations of premature infants? 5. Does the effect of iNO therapy on BPD and/or death or neurodevelopmental impairment vary by timing of initiation, mode of delivery, dose and duration, or concurrent therapies?
Author: Judy L. Aschner Publisher: Elsevier Health Sciences ISBN: 1455747408 Category : Medical Languages : en Pages : 342
Book Description
Top authors were selected to write clinical review articles devoted to Advances in Respiratory Care of the Newborn. Articles are devoted to: Effects of chorioamnionitis on lung function and growth; Delivery room respiratory management of the term and preterm infant; CPAP or INSURE for initial respiratory support; Which CPAP is best?; Non-invasive respiratory support; Volume limited and volume targeted ventilation; Weaning from mechanical ventilation; Predictors of bronchopulmonary dysplasia; Brain Injury in Chronically Ventilated Preterm Neonates: Collateral Damage Related to Ventilation Strategy; The Pulmonary Circulation in Respiratory Failure; Novel methods for assessment of right heart structure and function in pulmonary hypertension; Control of oxygenation; Non-invasive monitoring by photoplethysmography; Cell-based strategies to reconstitute lung function in infants with severe bronchopulmonary dysplasia; Permissive Hypercapnea; Prevention of BPD with Nitric Oxide; and Aero-digestive pulmonary disorders in the neonate.
Author: Peter C. Rimensberger Publisher: Springer ISBN: 3642012191 Category : Medical Languages : en Pages : 1584
Book Description
Written by outstanding authorities from all over the world, this comprehensive new textbook on pediatric and neonatal ventilation puts the focus on the effective delivery of respiratory support to children, infants and newborns. In the early chapters, developmental issues concerning the respiratory system are considered, physiological and mechanical principles are introduced and airway management and conventional and alternative ventilation techniques are discussed. Thereafter, the rational use of mechanical ventilation in various pediatric and neonatal pathologies is explained, with the emphasis on a practical step-by-step approach. Respiratory monitoring and safety issues in ventilated patients are considered in detail, and many other topics of interest to the bedside clinician are covered, including the ethics of withdrawal of respiratory support and educational issues. Throughout, the text is complemented by numerous illustrations and key information is clearly summarized in tables and lists.
Author: Eduardo da Cruz Publisher: Springer ISBN: 9781447146186 Category : Medical Languages : en Pages : 3572
Book Description
Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care provides a consistent and comprehensive approach to multiple congenital and acquired cardiac pathologies pre, peri and postoperatively, with the use of algorhythms, guidelines and current research issues. Included with the e-reference are interactive videos with the most common interventions, online access to practical learning activities, and to the comprehensive Aristotle score and database. This reference work satisfies the need for a universal and practical review of management of critically ill children and adults with congenital heart disease, based upon taskforce decisions and the cumulative experience of the world leaders in the field.
Author: Charles Vacanti Publisher: Cambridge University Press ISBN: 1139498401 Category : Medical Languages : en Pages : 1191
Book Description
The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.
Author: Giuseppe Buonocore Publisher: Springer ISBN: 9783319294872 Category : Medical Languages : en Pages : 0
Book Description
This landmark book, a reference work now in its second edition, provides healthcare practitioners in neonatology with an up-to-date, comprehensive source of readily accessible practical advice that will assist in the expert management of patients and their diverse illnesses. Leading experts in their fields discuss the underlying causes and mechanisms and all aspects of the treatment of the full range of neonatal diseases and abnormalities, citing the evidence base whenever appropriate. In addition, detailed information is provided on epidemiology and fetal medicine; therapeutic issues such as the organization of care, transport services, and home care after discharge; legal issues; nutrition; and the consequences of medication use during pregnancy, maternal drug abuse and smoking, and maternal diabetes. The inclusion of summaries, tables, and carefully selected guidelines and recommendations will supply practitioners with quick references and instant solutions during daily practice. The book will be a superb resource for all involved in the care of newborn babies, including neonatologists, pediatricians, pediatric surgeons, anesthesiologists, midwives, and nursing staff. It is published within the SpringerReference program, which delivers access to living editions constantly updated through a dynamic peer-review publishing process.
Author: Istvan Seri Publisher: Elsevier Health Sciences ISBN: 0323568432 Category : Medical Languages : en Pages : 635
Book Description
Dr. Richard Polin's Neonatology Questions and Controversies series highlights the most challenging aspects of neonatal care, offering trustworthy guidance on up-to-date diagnostic and treatment options in the field. In each volume, renowned experts address the clinical problems of greatest concern to today's practitioners, helping you handle difficult practice issues and provide optimal, evidence-based care to every patient. - Stay fully up to date in this fast-changing field with Hemodynamics and Cardiology, 3rd Edition. - A new editorial team and a completely redesigned volume with state-of-the-art chapters on neonatal hemodynamics. - New chapters on the role of delayed cord clamping/cord milking, the relationship between neonatal transition and brain injury, the hemodynamics of the asphyxiated neonate, the hemodynamic impact of therapeutic hypothermia, and practical physiology-based approaches to the diagnosis and treatment of neonatal hypotension, PPHN and PDA. - A new section discusses comprehensive real-time monitoring of neonatal hemodynamics, and its role in the establishment of precision medicine in neonatology and the prediction of neonatal sepsis using mathematical modelling of heart rate variability. - Expanded sections review the clinical application of the tools available for bedside monitoring of systemic and organ blood flow and oxygen delivery and the approaches to the pathophysiology-based treatment of neonatal shock and outcomes. - Consistent chapter organization to help you find information quickly and easily. - The most authoritative advice available from world-class neonatologists who share their knowledge of new trends and developments in neonatal care. Purchase each volume individually, or get the entire 7-volume set!Gastroenterology and NutritionHematology, Immunology and GeneticsHemodynamics and CardiologyInfectious Disease and Pharmacology New Volume!Nephrology and Fluid/Electrolyte PhysiologyNeurologyThe Newborn Lung
Author: Corinna Mirjam Gebauer
Author: Corinna Mirjam Gebauer
Author: U. S. Department of Health and Human Services
Author: 
Author: Judy L. Aschner
Author: Peter C. Rimensberger
Author: Donald L. Shapiro
Author: Eduardo da Cruz
Author: Charles Vacanti
Author: Giuseppe Buonocore
Author: Istvan Seri