For infants born with extremely low birth weight (ELBW), we examined the (1) correlation between results on the Ages and Stages Questionnaire (ASQ) and the Bayley Scales of Infant Development-II (BSID-II) at 18 to 22 months corrected age; (2) degree to which earlier ASQ assessments predict later BSID-II results; (3) ...

This study aimed to determine the prevalence of vertical HIV-1 transmission in the western region of the State of São Paulo, Brazil. The study analyzed the medical records of HIV-1-infected mothers and infant pairs living in the municipalities of São Paulo Regional Health Departments DRS II (Araçatuba) and DRS XI ...

Bidirectional cavopulmonary anastomosis has been performed without cardiopulmonary bypass for some single-ventricle heart defects. Limited data are available for the outcomes of off-pump bidirectional cavopulmonary anastomosis in infants with hypoplastic left heart syndrome. The purpose of this study is to determine the early outcomes for stage II palliation of hypoplastic ...

OBJECTIVE: The insulin-like growth factor-I (IGF-I), insulin-like growth factor binding protein-3 (IGFBP-3) and human growth hormone (h-GH) have been recognized as therapeutic targets for the heart disease therapy. The bioavailability and actions of insulin-like growth factors-II (IGF-II) and matrix metalloproteinase-9 (MMP9) are important for embryonic development and cardiomyocyte differentiation as ...

Percutaneous closure of a tubular patent ductus arteriosus can be challenging in the infant and small child. In this report, we describe the successful closure of tubular patent ductus arteriosus with the Amplatzer Vascular Plug II in two patients, ages 3 months and 13 months.

Postoperative residual ventricular septal defects (VSDs) are often percutaneously closed using septal occluder devices. However, their use is not advisable in small infants, because of poor outcome. We describe the successful device closure of a residual muscular VSD with an Amplatzer Duct Occluder II (ADO II) device in a child ...

Aim. To explore the potential usefulness of the mean, standard deviation (SD), and coefficient of variation (CV = SD/mean) of oximeter oxygen saturations in the clinical care of preterm babies. Methods. This was an exploratory investigation involving 31 preterm babies at 36 weeks postmenstrual age. All babies were healthy, but ...

The discovery of acute rib fractures in deceased infants and young children can be unsettling. Although significant injuries may occur subsequent to resuscitative efforts in adults, it is well documented that such injuries are rare in much younger individuals. In particular, it is considered exceptional for rib fractures to follow ...

We describe psoas abscess with concomitant septic hip arthritis in 2 infants, 3 and 7 months old. The common clinical features were a palpable mass in the inguinal region, irritable hip, and delayed treatment. The diagnosis of septic hip was delayed in one child, and they both had residual hip ...

A 5-week-old preterm infant was scheduled for inguinal hernia repair. Following induction of general anaesthesia, 10 mg.kg(-1) ropivacaine was injected, accidently, into the caudal space. The infant developed cardiac depression with bradycardia (minimum heart rate 50 beats.min(-1) ), elevated T waves and widening of QRS complexes. Resuscitation by means of ...

Neonates born to mothers with preeclampsia are known to be associated with lipid alterations that might increase the risk for cardiovascular disease in adult life. The aim of this study was to investigate the effect of preeclampsia on lipid metabolism, aortic intimamedia thickness (aIMT) and subsequent atherogenic risk in newborn ...

This study was designed to test the hypothesis that 2 training programs would reduce incrementally 7-day neonatal mortality rates for low-risk institutional deliveries. Using a train-the-trainer model, certified research midwives sequentially trained the midwives who performed deliveries in low-risk, first-level, urban, community health clinics in 2 cities in Zambia in ...

In the last few years there has been intense debate in Italy on administration of life-prolonging treatment to premature babies at the edge of viability. In 2006, a group of experts based in Florence drafted recommendations known as Carta di Firenze (CdF) for responsible use of intensive care for premature ...

In an effort to determine the actual conduct of neonatal resuscitation and the errors that may be occurring during this process, we developed a method of video recording neonatal resuscitations as an ongoing quality assurance project. We initiated video recordings of resuscitations using simple video recorders attached to an overhead ...

This article summarizes the historical background for the use of oxygen during newborn resuscitation and describes some of the research and the process of changing the previous practice from a high- to a low-oxygen approach. Findings of a recent Cochrane review suggest that more than 100,000 newborn lives might be ...

Neonatal resuscitation techniques are evolving. More sophisticated methods of monitoring have emerged and current practices have been challenged. It is recognised that most newborns will require only gentle assistance to facilitate the transition from intrauterine life. The routine use of suction and oxygen supplementation is no longer recommended and the ...

Poor condition at birth may impact on IQ, although its effect on other measures of neurodevelopment is unclear. The authors' aim was to determine whether infants receiving resuscitation after birth have reduced scores in measures of attention, memory and language skills or the need for educational support at school even ...

The aim was to compare resuscitators' estimates of tidal volume (V(T)) and face mask leak with measured values during positive pressure ventilation (PPV) of newborn infants in the delivery room. The authors measured inflating pressures and V(T) delivered using a respiratory function monitor, and calculated face mask leak. After 60 ...

During the stress of cardiopulmonary resuscitation (CPR), it is difficult to maintain the right rhythm and correct ratio of insufflations to chest compressions and to exert the compressions at a constant pressure. In this paper, we propose and demonstrate an integrated sensor system-the "Rhythm of Life Aid" (ROLA) to support ...

All emergency departments (EDs) should be adequately equipped and prepared to deal with unexpected neonatal deliveries and resuscitation. A study was undertaken to determine what neonatal resuscitation equipment is available in EDs in the UK and to formulate recommendations for improvement. A prospective telephone survey of all UK EDs was ...

Resuscitation is one of the most frequently performed procedures in the neonatal period. Since the most recent guidelines from the International Liaison Committee on Resuscitation (ILCOR) appeared in 2005, experimental and clinical research has introduced changes regarding the different components of the procedure, with the common denominator being the least ...

BACKGROUND: Although survival rates for infants of less than 26 weeks' gestation have increased, rates for those born at less than 24 weeks do not appear to have changed. While there are good data on overall survival, it is unclear how many infants are offered active resuscitation but do not ...

The authors have conducted video review of neonatal resuscitations since 1999. Over this 10-year period 3 phases of our experience have been recognized. Our early reviews helped us recognize what we were doing in the delivery room, an area that had been ignored in improved intervention. It was noted that ...

Of the 3.7 million neonatal deaths and 3.3 million stillbirths each year, 98% occur in developing countries. An evaluation of community-based interventions designed to reduce the number of these deaths is needed. With the use of a train-the-trainer model, local instructors trained birth attendants from rural communities in six countries ...

The present study was planned to evaluate the safety and efficacy of vinyl bags in prevention of hypothermia during resuscitation at birth in very low birth weight neonates. Sixty neonates of gestational age ≤32 weeks and birth weight ≤ 1500gm were randomised to either study group, or control group. Study ...

OBJECTIVE: To compare the clinical responses of extremely low birth weight (ELBW) infants resuscitated in polyethylene bags with ELBW infants who were resuscitated using traditional temperature control measures. STUDY DESIGN: Retrospective cohort investigation of 70 ELBW infants who were resuscitated using polyethylene bags (study) and 70 ELBW infants (control) resuscitated ...

AIM: This observational study aims to describe: (1) the use of positive pressure ventilation (PPV) for resuscitation in the delivery room among newly born near-term infants; (2) the methods used for PPV resuscitation [e.g., bag-facial mask (BFM), laryngeal mask airway (LMA), endotracheal tube (ETT)]; and (3) the association of each ...

OBJECTIVES: The study aims to evaluate the optimal chest compression site in two-rescuer infant cardiopulmonary resuscitation (CPR). METHODS: Charts and multidirectional computed tomography images of infants who presented to one of four hospitals from March 2004 to March 2009 were reviewed retrospectively. The length of the sternum (S(total)), the length ...

The first breath is the critical moment that initiates life outside the womb. But 10 million or more babies each year need assistance in establishing that first breath. Attempts at assisting the newborn began in ancient times and have undergone significant changes. This article looks at the history of neonatal ...

Each year approximately 10 million babies do not breathe immediately at birth, of which about 6 million require basic neonatal resuscitation. The major burden is in low-income settings, where health system capacity to provide neonatal resuscitation is inadequate. To systematically review the evidence for neonatal resuscitation content, training and competency, ...

Cardiopulmonary resuscitation (CPR) is necessary in about 1-2% of all newly born infants in their first minutes of life. However, CPR may also be needed in newborns beyond the time of birth, particularly in high risk categories of infants admitted in the NICU or in other less specialised units. In ...

Selective resuscitation refers to the practice of providing resuscitative efforts to one or some (but not all) infants born in the setting of multiple gestation. When one fetus is known to have a severe anomaly or severe growth restriction, parents are sometimes offered this option. In the setting of extreme ...

The anticipated delivery of an extremely low gestational age infant raises difficult questions for all involved, including whether to initiate resuscitation after delivery. Each institution caring for women at risk of delivering extremely preterm infants should provide comprehensive and consistent guidelines for antenatal counseling. Parents should be provided the most ...

Neonatal resuscitation is an attempt to facilitate the dynamic transition from fetal to neonatal physiology. This article outlines the current practices in delivery room management of the neonate. Developments in cardiopulmonary resuscitation techniques for term and preterm infants and advances in the areas of cerebral resuscitation and thermoregulation are reviewed. ...

BACKGROUND: Mild cerebral injury might cause subtle defects in cognitive function that are only detectable as the child grows older. Our aim was to determine whether infants receiving resuscitation after birth, but with no symptoms of encephalopathy, have reduced intelligence quotient (IQ) scores in childhood. METHODS: Three groups of infants ...

BACKGROUND: Oxygen exposure during delivery room (DR) resuscitation, even when brief, is potentially toxic. A practice plan (PP) was introduced for very low birth weight (VLBW) infants < or = 1500 g as follows: initial FiO(2) from 0.21 to 1.0 using blenders, oxygen guided by oximetry to maintain saturation between ...

BACKGROUND: The effects of the Born-Alive Infants Protection Act of 2002, which defines the legal status of live-born infants have not been evaluated. OBJECTIVE: To study neonatologists' perceptions and the potential effects of the Born-Alive Infants Protection Act and subsequent Department of Health and Human Services enforcement guidelines on resuscitation ...

PURPOSE OF REVIEW: The International Liaison Committee on Resuscitation (ILCOR) recommends initiating neonatal resuscitation with concentrations of oxygen between 21 and 100%. This wide range of oxygen concentrations recommended for resuscitation highlights the lack of evidence supporting either 21 or 100% O2. The purpose of this review is to analyze ...

Resuscitation in a position other then supine is necessary in certain situations. It has been reported that it can be successfully carried out in the prone position but not in the lateral position. The technical limitations and ventilation-perfusion mismatch in the lateral position make the resuscitation difficult. We present a ...

BACKGROUND: Multidisciplinary study groups have produced documents in an attempt to support decisions regarding whether to resuscitate "at risk" newborns or not. Moreover, there has been an increasingly insistent request for juridical regulation of neonatal resuscitation practices as well as for clarification of the role of parents in decisions regarding ...

AIM: To investigate whether end-tidal CO(2) monitoring is useful for more rapid recognition of tracheal vs. esophageal intubation as compared to standard clinical evaluation in very low birth weight infants during neonatal resuscitation at birth. PATIENTS AND METHODS: Forty infants were prospectively identified. Tracheal tube placement was evaluated either using ...

Both stereoisomer of hydroxyethylamine (HEA) and hydroxyethylsulfide (HES) transition-state isostere inhibitors of BACE-1 were synthesized. The syn-HEA epimer resulted always more active than the anti stereoisomer independently from the P(1) and the P(1)' substituents. On the contrary, the anti epimer of the HES isostere resulted more active than the syn ...

This paper describes the performance of a thoron ((220)Rn) flowthrough source made of a commercially available lantern mantle. This (220)Rn source is easy to construct and operate and has a negligible radon ((222)Rn) gas generated when the air was passed through the source. We studied the (220)Rn concentration generated from ...

BACKGROUND: The influence of delivery room resuscitation practice on neonatal breastfeeding pattern is largely not data driven, and clinical experience is insufficient to indicate the impact of available management methods. AIM: This cohort observational study investigated weather laryngeal mask airway (LMA) rather conventional positive pressure resuscitation devices, face mask (FM), ...

We present the first measurements of radiance spectra of rainbows. The bows on two sunny days (3 and 6 June 2008) were produced by the fountain in the Parque de las Ciencias, Granada, Spain, that consists of a rectangular perimeter of 40 spray nozzles. Optical thickness of the spray from ...

BACKGROUND: In the absence of identified risk factors, 7% of term newly borns require PPV-ETT (positive pressure ventilation and/or endotracheal intubation). Factors increasing need for resuscitation, and therefore for individuals with advanced resuscitation skills, require further evaluation. OBJECTIVE: To evaluate the predictive value of ante- and intra-partum risk factors for ...

There has been considerable controversy surrounding the optimal inspired oxygen concentration for resuscitation of term and preterm infants. We have developed a rat pup model to quantify both physiologic and biochemical parameters associated with normoxic vs. hyperoxic resuscitation. We have confirmed existing human data that hyperoxic resuscitation of rat pups ...

Endotracheal intubation to resuscitate neonates was used by Scheel in 1798. A century before endotracheal anesthesia was developed, inventive obstetricians constructed devices for endotracheal intubation of infants and mastered their insertion, localization, and airtight sealing. Fell's laryngoscope, Magill's intubation forceps and tissue-friendly materials were significant contributions of the 20th century ...

INTRODUCTION: There appears to be a circadian rhythm in the timing of cardiovascular and neurovascular events. The majority of studies have been conducted in western populations. This is the first study to look at the peaks and distribution of out-of-hospital cardiac arrest (OHCA) patients in Singapore. METHODS: The Cardiac Arrest ...

BACKGROUND: Current surgical procedures restoring a dislocated acromioclavicular joint aim to perform an anatomically correct and biomechanically stable reconstruction. However, the coracoidal insertions for the coracoclavicular ligaments have not yet been defined. PURPOSE: The objective was to evaluate dimension and orientation of the coracoclavicular footprints with respect to bony landmarks ...