Online First
September 23, 2021
September 22, 2021
- Original researchImplementation of an adapted Sepsis Risk Calculator algorithm to reduce antibiotic usage in the management of early onset neonatal sepsis: a multicentre initiative in Wales, UK
Antibiotic use in the newborn may have long lasting impact. Neonatal sepsis is relatively rare but one which causes concern, investigation and treatment. This paper describes the implementation of an sepsis risk calculator to reduce antibiotic use in a safe and sustainable way.
September 21, 2021
- Original researchOutcomes in relation to early parenteral nutrition use in preterm neonates born between 30 and 33 weeks’ gestation: a propensity score matched observational study
This is large study of over 16,000 infants born between 30 and 32+6 weeks gestation. It compares those who received parenteral nutrition compared to those who did not and explores the risk and benefit of this intervention.
September 20, 2021
- Original researchSafety and efficacy of low-dose diazoxide in small-for-gestational-age infants with hyperinsulinaemic hypoglycaemia
SGA infants are at risk of hyperinsulinaemic hypoglycaemia and neuronal injury. We report that low dose diazoxide (3-5 mg/kg/day) effectively treats hyperinsulinaemic hypoglycaemia in these SGA infants. Its safety profile was excellent, but adverse events were still observed.
September 11, 2021
- Original researchMortality and significant neurosensory impairment in preterm infants: an international comparison
The composite outcome of mortality and significant neurodisability in extremely low birth weight infants is compared across 3 different international cohorts (Canada, Australia/New Zealand, France). The composite outcome was higher in the French cohort, driven by a higher mortality.
- Original researchSARS-CoV-2 RNA and antibody detection in breast milk from a prospective multicentre study in Spain
ARS-CoV-2 antibodies but not RNA are found in breast milk from COVID-19 infected mothers.
September 07, 2021
September 06, 2021
- Original researchImpact of personal protective equipment on neonatal resuscitation procedures: a randomised, cross-over, simulation study
Unique study of neonatal resuscitation in PPE using a simulation model which identified small but potentially important differences in timings of key resus events. Also shows the inevitable discomfort and inconvenience of PPE in this scenario.
August 30, 2021
- Original researchNeonates with mild hypoxic–ischaemic encephalopathy receiving supportive care versus therapeutic hypothermia in California
This manuscript reports trends in the use of therapeutic hypothermia for babies with mild HIE in the NICUs in the CPQCC catchment, and assesses odds ratios for maternal and infant factors associated with the use of TH. There was an increase in the use of TH for mild HIE increased over time as a form of therapeutic creep.
- Original researchComparison of intraosseous and intravenous epinephrine administration during resuscitation of asphyxiated newborn lambs
When intravenous access is not easily attainable, recommendations are to use intra-osseus as an alternative route for adrenaline administration in neonatal resuscitation. In an non-randomized trial in a lamb model, these two delivery routes were equivalent in terms of success in resuscitation and serum adrenaline levels.
August 25, 2021
- ReviewManipulating the neonatal gut microbiome: current understanding and future perspectives
This review summarises current understanding regarding how modern birth influence neonatal gut microbiome development together with potential methods of microbiome engineering that might encourage the development of a microbiome that promote long term health.
- Original researchNecrotising enterocolitis, late-onset sepsis and mortality after routine probiotic introduction in the UK
In this single-centre retrospective review of more than 1000 infants born before 32 week's gestation. The routine introduction of multi-strain probiotics was not associated with changes in the risk of mortality or necrotising enterocolitis.
August 23, 2021
- Original researchIdentification of treatment-warranted retinopathy of prematurity by neonatal nurse specialist
This study demonstrates that screening for retinopathy of prematurity treatment can be performed by a specialist nurse practitioner obtaining and interpreting digital retinal images, with excellent agreement with treating ophthalmologists.
August 19, 2021
- Original researchIndividualised decision making: interpretation of risk for extremely preterm infants—a survey of UK neonatal professionals
Topical and important insight into the current state of play in the UK regarding active management at the limit of viability.
- Original researchObservational cohort study of changing trends in non-invasive ventilation in very preterm infants and associations with clinical outcomes
This analysis of the National Neonatal Research Database from 2010-17 shows that the use of high-flow nasal cannula quadrupled, particularly as initial respiratory support, but was associated with adverse outcomes including BPD.
- Short reportTiming of neonatal stoma closure: a survey of health professional perspectives and current practice
This survey reports the perspectives of 166 respondents from 27 UK neonatal surgical centres regarding timing of neonatal stoma closure
- Original researchVideo-based reflection on neonatal interventions during COVID-19 using eye-tracking glasses: an observational study
Single centre evaluation of the use of eye-tracking glasses during neonatal procedures as an additional tool for outside teaching and video-based reflection. The feasibility and potential benefit during a pandemic is reported.
- Original researchCharacteristics of neonatal herpes simplex virus infections in Germany: results of a 2-year prospective nationwide surveillance study
This two-year prospective nationwide surveillance study of neonatal HSV infections finds few cases in Germany. Most children had few symptoms and good outcomes, but five infants had significant sequelae. Orofacial HSV infection was present in one or more family members for 20/23 babies where data was available, but it is not clear if this was the mode of transmission.
August 04, 2021
August 03, 2021
- Original researchMonitoring of carbon dioxide in ventilated neonates: a prospective observational study
This study comparing the precision and accuracy of end-tidal and transcutaneous pCO2 with arterial measurements found that end-tidal CO2, measured through a double-lumen ET tube in ventilated neonates, was superior to tcpCO2.
August 02, 2021
- Original researchComparison of three intraosseous access devices for resuscitation of term neonates: a randomised simulation study
Three different devices for intra-osseous access during were evaluated in a bone model intended to simulate insertion in term newborns. A total of 92 paediatricians were involved. Success rates were markedly different between devices.
July 30, 2021
- Original researchOutcomes of very preterm infants with neonatal hyperglycaemia: a systematic review and meta-analysis
In a systematic review and meta-analysis, hyperglycemia in very preterm infants is associated with higher odds of mortality, IVH, and ROP.
- Original researchAssessment of optimal chest compression depth during neonatal cardiopulmonary resuscitation: a randomised controlled animal trial
In an asphyxiated piglet model, time to return of spontaneous circulation was similar for chest compressions 25%, 33%, and 40% anterior-posterior depth, while Increasing compression depth improved hemodynamic and respiratory parameters.
July 29, 2021
July 28, 2021
- Original researchTemporal trends in respiratory care and bronchopulmonary dysplasia in very preterm infants over a 10-year period in Spain
National survey of changes in respiratory outcomes of VLBW infants over 2 periods, showing that outcome did not improve despite an increase in the use of non-invasive ventilation.
- Original researchOesophageal atresia: sonographic signs may prenatally predict surgical complexity
This manuscript characterizes prenatal ultrasound findings of babies with esophageal atresia with the presence or absence of a distal fistula. The authors found several ultrasound parameters were correlated with more complex repair and absence of a distal fistula
- Original researchDirect swallowing training and oral sensorimotor stimulation in preterm infants: a randomised controlled trial
This single centre, masked RCT enrolling 186 infants <32 weeks gestation found that direct swallowing training combined with oral sensorimotor stimulation significantly shortened the time to independent oral feeding compared with no intervention.
July 19, 2021
- Original researchTemporal trends of in utero and early postnatal transfer of extremely preterm infants between 2011 and 2016: a UK population study
Between 2011 and 2016, the rate of intra-uterine transfer of extremely preterm infants within the UK decreased, with an associated increase in early postnatal transfer. This also includes early postnatal transfer between level 3 NICUs.
July 14, 2021
- Original researchHead circumference, total cerebral volume and neurodevelopment in preterm neonates
This paper looks at the relationship between head growth during neonatal unit stay and neurodevelopmental outcomes in a prospective cohort.
July 13, 2021
- Original researchGrowth in extremely preterm children born in England in 1995 and 2006: the EPICure studies
This paper describes the growth to age 11 of a sample of the EPICure 2 2006 preterm birth cohort, compared to healthy same age controls and to the 1995 EPICure cohort. Since 1995, childhood growth in weight, height and BMI have improved for births <26 weeks of gestation, but there was no improvement in head growth.
- Original researchTitres and neutralising capacity of SARS-CoV-2-specific antibodies in human milk: a systematic review
Systematic review on the titers and neutralising capacity of SARS-CoV-2-specific antibodies in human milk demonstrates that these antibodies can neutralise the virus in vitro. Furthermore, high pressure, but not Holder pasteurisation deactivates the specific IgAs.
July 07, 2021
- Original researchComparison of volume guarantee and volume-controlled ventilation both using closed loop inspired oxygen in preterm infants: a randomised crossover study (CLIO-VG study)
Cross-over study addressing whether improved time within oxygen saturation target can be primarily improved by volume-controlled ventilation or automatic control of the FiO2, with the results clearly showing that the latter is more important for reaching this goal
- Short reportAntenatal magnesium sulfate to prevent cerebral palsy
Embedding a quality improvement program on prenatal magnesium administration is feasible to reduce the impact of cerebral palsy.
June 29, 2021
- 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.
- Images in neonatal medicineUmbilical cord thrombosis and chorioamnionitis in neonatal arterial ischaemic stroke
June 28, 2021
- Original researchLife-threatening bronchopulmonary dysplasia: a British Paediatric Surveillance Unit Study
The authors describe a prospective cohort of 153 babies with "life threatening BPD" defined as requiring positive pressure at 38 weeks corrected gestational age. Data were collected from the British Paediatric Surveillance Unit from June 2017 to July 2018. Findings include a high likelihood of serious morbidity and mortality, and large practice variation in therapies.
June 25, 2021
June 23, 2021
- Original researchExtubation generates lung volume inhomogeneity in preterm infants
Observational study using Electrical Impedance Tomography to confirm that lung volume is lost during transition from IPPV to CPAP.
- Original researchParent-reported health status of preterm survivors in a Canadian cohort
Among infants <29 weeks' gestation in the Canadian Neonatal Follow Up Network with parent-reported health status impact at 36 months, most reported none or mild concerns, and only ~ 1 in 4 reported moderate or severe concerns. Concerns were associated with a range of factors.
June 18, 2021
- Original researchFamily integrated care: very preterm neurodevelopmental outcomes at 18 months
In a subset of infants who participated in a cluster RCT of Family Integrated Care (FICare), FICare was not associated with a significant reduction in Bayley-III Cognitive or Language composite scores <85 at 18-21 months, but there was evidence of better motor development.