June 11, 2021
- Original researchHypotension in Preterm Infants (HIP) randomised trial
This multicentre double blind randomised trial of restricting the use of dopamine for treatment of hypotensive extremely preterm infants was stopped after recruitment of 8% of the planned sample size. No difference in rates of survival free of severe brain injury was found.
June 10, 2021
- Original researchRespiratory support after delayed cord clamping: a prospective cohort study of at-risk births at ≥35+0 weeks gestation
This manuscript reports risk factors for the need for respiratory support in a prospective cohort of babies delivered at > 35 weeks who had DCC in pediatrician attended births. A heart rate < 165 90 - 120 sec after birth was associated with the need for respiratory support.
- Original researchComparison of two devices for automated oxygen control in preterm infants: a randomised crossover trial
In this crossover study comparing two commercially available devices for automated adjustment of inspired oxygen there were significant differences between devices in the proportion of time infants spent in their intended target SpO2 range and in their exposure to high and low SpO2.
- Original researchTrial of aerosolised surfactant for preterm infants with respiratory distress syndrome
This is a report of a pilot trial of a new device to aerosolize surfactant delivery to preterm infants with respiratory distress requiring CPAP using comparison to historical controls. No safety issues were identified, and there was a trend toward improvement in treated infants.
- Original researchPrediction of outcome from MRI and general movements assessment after hypoxic-ischaemic encephalopathy in low-income and middle-income countries: data from a randomised controlled trial
In a secondary analyses of a RCT of hypothermia for HIE in India, neonatal MRI and general movements assessment (GMA) were evaluated in prediction of adverse 2-year neurodevelopmental outcomes. GMA may be a feasible low-cost alternative or complementary approach to MRI in low-resource settings.
- Original researchNeurodevelopmental outcome of patients with congenital gastrointestinal malformations: a systematic review and meta-analysis
This systemic review and meta-analysis examines neurodevelopmental outcomes of infants with a wide variety of congenital gastrointestinal malformations. The authors report that these lesions are associated with poorer outcomes, and recommend routine follow-up.
June 09, 2021
- Original researchAqueous chlorhexidine 1% versus 2% for neonatal skin antisepsis: a randomised non-inferiority trial
This controlled trial tested different strengths of aqueous chlorhexidine for neonatal skin antisepsis prior to intravenous cannulation in a neonatal intensive care unit in India, finding that 1% chlorhexidine was effective, but not clearly equivalent to 2% which pending further research remains the recommended concentration for this purpose.
- Original researchEffect of breathing on venous return during delayed cord clamping: an observational study
Real-time echocardiographic monitoring of blood flow in the ductus venosus and hepatic vein was undertaken during perinatal transition with intact umbilical cord of term born infants. Antegrade flow increased during inspiration, preferentially directing blood flow from the ductus venosus into the right atrium.
June 03, 2021
May 27, 2021
- Original researchOutcomes of neonatal hypoxic-ischaemic encephalopathy in centres with and without active therapeutic hypothermia: a nationwide propensity score-matched analysis
UK study using national data investigate the effect of birth in or outside a recognised cooling centre on short term outcomes of babies >36 weeks with moderate to severe HIE. Birth in a cooling centre, is associated with improved survival to discharge without seizures, fewer seizures, and similar mortality.
- Images in neonatal medicineCongenital cutaneous candidiasis in one infant among a twin sibling pair
- Original researchNeurodevelopmental outcome following hypoxic ischaemic encephalopathy and therapeutic hypothermia is related to right ventricular performance at 24-hour postnatal age
This manuscript details measures of right ventricular dysfunction as a predictor of adverse neurodevelopmental outcome in babies with HIE. One measure of RV dysfunction (tricuspid annulus plane systolic excursion) was independently associated with adverse outcomes.
May 26, 2021
- Original researchStrict glycaemic control in very low birthweight infants using a continuous glucose monitoring system: a randomised controlled trial
This is a randomized controlled trial investigating whether using a continuous glucose monitoring system improves glycaemic control in very low birth weight infants.
May 21, 2021
- Original researchNeuronal exosome proteins: novel biomarkers for predicting neonatal response to therapeutic hypothermia
In an observational cohort study, exosome based central nervous system biomarkers from peripheral blood in newborns less than 12 hours old undergoing hypothermia for hypoxic-ischemic encephalopathy differentiated those with favorable and unfavorable MRI injury scores at 5-7 days.
May 20, 2021
- Original researchSystematic review of high-flow nasal cannula versus continuous positive airway pressure for primary support in preterm infants
Systematic review on studies comparing high-flow nasal cannula with N-CPAP support for preterm infants, reporting a higher risk of treatment failure for the former, but because the authors found no difference in intubation rates and a lower rate of nasal trauma, they conclude that HFNC may still be preferable.
May 14, 2021
- Original researchEarly lung ultrasound affords little to the prediction of bronchopulmonary dysplasia
These investigators report a prospective analysis of preterm babies < 28 weeks gestation in whom lung ultrasounds were performed on a scheduled basis. They found that u/s was predictive in univariate analysis of the development of BPD, but added little to the predictive value when gestational age was included in the model.
- Original researchNeonatal arterial stroke location is associated with outcome at 2 years: a voxel-based lesion-symptom mapping study
In a prospective observational multicenter study of neonatal stroke, lesion location identified by MRI is associated with language, motor, and cognitive outcomes at two years of age.
- Short reportNasal expression of SARS-CoV-2 entry receptors in newborns
Low nasal expression of SARS-CoV-2 entry receptors in newborns in both preterm and term cases may contribute to the low attack rates and mild disease in newborns.
May 10, 2021
- Original researchPredictive Intelligent Control of Oxygenation (PRICO) in preterm infants on high flow nasal cannula support: a randomised cross-over study
Randomised cross-over study of an oxygen controller during high-flow nasal cannula support. The controller reduced time spent in hypoxia considerably, yet not that in hyperoxia.
- ReviewNeuroscience meets nurture: challenges of prematurity and the critical role of family-centred and developmental care as a key part of the neuroprotection care bundle
This review examines the developmental milestones of fetal brain and how preterm birth can disrupt this trajectory. It then outlines effective non-medical, family-centred and developmental care strategies which have the potential to improve neurodevelopmental outcomes.
- Images in neonatal medicineCongenital self-healing reticulohistiocytosis in a neonate
May 07, 2021
- Original researchAutomated control of oxygen titration in preterm infants on non-invasive respiratory support
An automated oxygen controller increased the proportion of time that oxygen dependent preterm infants on non-invasive respiratory support spent in their target SpO2 range and reduced their exposure to extremes of SpO2.
- Short reportProspective comparison of thermometers used in very preterm infants
When used in predictive mode an electronic thermometer performed poorly for detecting hypothermia on admission to the neonatal unit.
- Original researchInterface leakage during neonatal CPAP treatment: a randomised, cross-over trial
Crossover study comparing interface leaks occurring with masks vs. prongs in 50 preterm infants and showing significantly lower leak with prongs. With either device, leak could be reduced by simple maneuvers, e.g., adjusting the angle, straps, bonnet or shape of the interface.
May 06, 2021
- Original researchIntrapartum group B Streptococcal prophylaxis and childhood weight gain
Retrospective study of a large cohort of term babies followed up for 5 years. Just under a fifth (17%) of these babies were exposed to antibiotics given to the mother for GBS prophylaxis and these had elevated weight gain in the first 5 yrs. The authors suggest alteration of microbiome as a possible mechanism.
May 05, 2021
- Images in neonatal medicineFunctional 2:1 AV block in a preterm
- Original researchAdministration of parenteral nutrition during therapeutic hypothermia: a population level observational study using routinely collected data held in the National Neonatal Research Database
Large retrospective cohort study on infants with HIE treated with hypothermia, showing that parenteral nutrition during therapeutic hypothermia was associated with higher late-onset infection, but lower mortality.
- Short reportAssociation of Total Sarnat Score with brain injury and neurodevelopmental outcomes after neonatal encephalopathy
In infants who received therapeutic hypothermia for neonatal encephalopathy, Total Sarnat Score >12 within 6 hours of birth indicated high risk of adverse neurodevelopment while <4 indicated intact survival
April 30, 2021
April 29, 2021
- Original researchViability and thresholds for treatment of extremely preterm infants: survey of UK neonatal professionals
Important and timely survey of UK clinicians' opinions regarding resuscitation at the limit of viability.
April 27, 2021
April 22, 2021
- Original researchUsefulness of video recordings for validating neonatal encephalopathy exams: a population-based cohort study
This manuscript assesses the use of video recordings in a prospective cohort of babies with HIE compared to the neurological assessments by the on site attending physician. There were some discrepancies, especially in babies with mild HIE, but the data support the use of telemedicine to assess HIE severity.
April 21, 2021
- ReviewSafe emergency neonatal airway management: current challenges and potential approaches
This review describes the challenges encountered with neonatal intubation, particularly in relation to training and achieving competency. It discusses strategies to optimise intubation success and examines the airway adjuncts currently available to manage the neonatal airway.
April 20, 2021
- Original researchComparison of the efficacy and safety of cuffed versus uncuffed endotracheal tubes for infants in the intensive care setting: a pilot, unblinded RCT
This single centre RCT enrolling 76 infants ≥35 weeks gestation and ≥3kg found that cuffed endotracheal tubes did not improve the percentage of time the ETT leak was within the optimal target range. Improvements were noted in some secondary outcomes. Further studies are required to provide assurance of safety in this population.
April 19, 2021
- Original researchCan EEG accurately predict 2-year neurodevelopmental outcome for preterm infants?
Prospective single centre study of the use of EEG (at 3 gestational ages 72 hours after birth, 32 and 35 weeks corrected) to predict outcome in 57 preterm infants. the study suggest that EEG at 35 weeks is a predictor of outcome at 2years.
April 16, 2021
- Original researchNeonatal hyperglycaemia is associated with worse neurodevelopmental outcomes in extremely preterm infants
Neonatal hyperglycemia itself is associated with lower IQ scores and worse motor outcome at 6.5 years, while insulin was not associated with poorer or better outcome in EXPRESS cohort survivors.
April 13, 2021
- Images in neonatal medicineOral cavity masses in a newborn
- Original researchAssociation of maternal body mass index with intellectual disability risk
In a large Swedish population-based birth cohort (1992-2006), maternal underweight or overweight/obesity in early pregnancy was independently associated with intellectual disability among offspring. High SES may attenuate the risk among children of underweight mothers.
- Images in neonatal medicinePericardial effusion and pulmonary vein stenosis in severe bronchopulmonary dysplasia
March 31, 2021
- Original researchOsteopathic manipulative treatment to improve exclusive breast feeding at 1 month
This single centre RCT of 128 mother/infant dyads experiencing breast feeding difficulties showed that early osteopathic manipulative treatment did not improve exclusive breast-feeding rates at one month.
- Original researchTotal body water in full-term and preterm newborns: systematic review and meta-analysis
This systematic review identified 22 eligible trials and confirmed that the proportion of total body water at birth falls with increasing gestational age, from 90% at 26 weeks’ gestation to 74% at term.
March 11, 2021
- Original researchThermal management with and without servo-controlled system in preterm infants immediately after birth: a multicentre, randomised controlled study
This multicentre double blind RCT of 450 preterm infants evaluated the effectiveness of a thermal servo-controlled system in the delivery room. There was no important difference in rates of normothermia but the servo-controlled system was associated with increased mild hypothermia.
March 09, 2021
- Original researchRandomised trial of epinephrine dose and flush volume in term newborn lambs
In newborn lambs with cardiac arrest, higher doses of adrenaline and larger flush volumes were more effective in achieving return of spontaneous circulation during cardiopulmonary resuscitation.
March 08, 2021
- Original researchTrends in the incidence and management of hypoxic-ischaemic encephalopathy in the therapeutic hypothermia era: a national population study
This paper describes trends in the diagnosis and treatment of hypoxic ischaemic encephalopathy in the UK National Neonatal Research Database for the years 2011-13 and 2014-16. Mortality of moderate/severe HIE decreased and more infants with mild HIE were treated in the later period.