Respiratory Outcomes in Preterm Infants

Respiratory Outcomes in Preterm Infants
Author: Anna Maria Hibbs
Publisher: Humana Press
Total Pages: 238
Release: 2017-01-20
Genre: Medical
ISBN: 331948835X
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This book presents pulmonary outcomes of prematurity, from their emergence in infancy through to their consequences in adulthood. With an increasing number of preterm births and more infants surviving, there is now a larger population of adults with lung disease originating in infancy requiring specialized care. Looking at the whole group of preterm infants, not just those with bronchopulmonary dysplasia, this text covers a wide spectrum of pulmonary outcomes, including: pulmonary hypertension, wheezing, and alterations in sleep. The chapter authors focus on critically appraising what is and is not known about each outcome and suggest key questions that still need to be answered. Respiratory Outcomes in Preterm Infants: Sequelae from Infancy through Adulthood is an ideal reference for the multidisciplinary group that cares for these preterm infants and the adults they become, including: neonatologists, pediatric pulmonologists, pediatricians, adult pulmonologists, primary care physicians, nurses, and fellows.

Preterm Birth

Preterm Birth
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 791
Release: 2007-05-23
Genre: Medical
ISBN: 030910159X
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The increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers.

Inhaled Nitric Oxide in Preterm Infants

Inhaled Nitric Oxide in Preterm Infants
Author: U. S. Department of Health and Human Services
Publisher: Createspace Independent Pub
Total Pages: 310
Release: 2013-05-09
Genre: Medical
ISBN: 9781484934616
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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?

Manual of Neonatal Respiratory Care

Manual of Neonatal Respiratory Care
Author: Steven M. Donn
Publisher: Springer Nature
Total Pages: 894
Release: 2022-05-09
Genre: Medical
ISBN: 3030939979
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Respiratory care is the largest overall component of neonatal intensive care, and the fifth edition of the Manual of Neonatal Respiratory Care is the leading bedside guide for all aspects of respiratory care in the neonatal intensive care unit. Its easy-to-read outline format is simple yet comprehensive and covers all aspects of lung disease in the newborn infant, including embryology, principles of mechanical ventilation, procedures and techniques, monitoring, devices, adjunctive therapies, management of respiratory illness, complications, outcomes, and related issues. The latest edition includes fully revised and updated information, coverage on new equipment and devices, and an expanded authorship to enhance its international appeal. The new edition also features two new co-editors, Dr. Mark Mammel and Dr. Anton Van Kaam, internationally recognized experts in the field who bring a fresh perspective to the manual. Divided into sixteen sections, the book begins with a section on lung development and maldevelopment, specifically covering the development of the respiratory system, malformations, deformations, disorders of the neonatal airway, and developmental lung anomalies. The second section reviews the principles of mechanical ventilation, with coverage on such topics as spontaneous breathing, oxygen therapy, oxygen toxicity, pulmonary mechanics, and ventilator parameters. The third section of the manual outlines procedures and techniques, including neonatal resuscitation, laryngoscopy and endotracheal intubation, and tracheostomy. The following section dives into the monitoring of the ventilated patient, specifically focusing on continuous monitoring techniques, clinical controversies in pulse oximetry, and echocardiography. The next section spotlights noninvasive ventilatory techniques, such as nasal interfaces, humidified high-flow nasal cannula therapy, and sustained inflation. The sixth section of the manual focuses on ventilatory modes and modalities, with coverage on intermittent mandatory ventilation, pressure support ventilation, and pressure control ventilation. The following section segues into high-frequency ventilation, reviewing general concepts, high-frequency jet ventilation, and high-frequency oscillatory ventilation. The eighth section centers around commonly used neonatal ventilators, such as the DRAEGER VN500 ventilator, the AVEA ventilator, and the Twinstream ventilator. The ninth section reviews adjunctive therapies, including hemodynamic support, nutritional support, the use of sedation and analgesia, inhaled nitric oxide therapy, and ECMO. The tenth section shifts gears to spotlight the management of common neonatal respiratory diseases, with chapters on mechanisms of respiratory failure, tissue hypoxia, respiratory distress syndrome, persistent pulmonary hypertension, and pulmonary hypoplasia/agensis among others. Section eleven reviews the etiology, pathogenesis, and management of bronchopulmonary dysplasia, as well as the long-term outcome of newborns with this chronic lung disease. The next section presents complications associated with mechanical ventilation, such as thoracic air leaks, neonatal pulmonary hemorrhage, and neurologic complications. The following two sections spotlights ethical, legal and other considerations, among them nursing care of the ventilated infant, long-term ventilator dependency, home ventilation, withdrawal of ventilatory support, and medical liability and risk management. The fifteenth section focuses on research and literature, with coverage on interpreting medical literature, data collection and assessment of respiratory outcomes, and contemporary classics in neonatal respiratory care. The final section presents ventilatory case studies. The text also features over 300 high-yield radiographic images, figures, tables, and algorithms.

WHO Child Growth Standards

WHO Child Growth Standards
Author: World Health Organization
Publisher: World Health Organization
Total Pages: 238
Release: 2007
Genre: Medical
ISBN: 9241547189
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A comprehensive review of the uses and interpretation of anthropometric references undertaken by WHO in the early 1990s concluded that new growth curves were needed to replace the existing international reference. To develop new standards, a multi-country study was carried out to collect primary growth data and related information from 8440 healthy breastfed infants and young children from diverse ethnic backgrounds and cultural settings (Brazil, Ghana, India, Norway, Oman, and the USA). The first set of growth standards (length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age) was published in April 2006. This report presents the second set of growth standards (head circumference-for-age, arm circumference-for-age, triceps skinfold-for-age, and subscapular skinfold-for-age). The standards depict normal early childhood growth under optimal environmental conditions and can be used to assess children everywhere, regardless of ethnicity socioeconomic status and type of feeding. This report will be useful to pediatricians and other healthcare providers, nutritionists, policy makers, researchers, national institutes of health, schools of medicine, and professional associations. Companion volume: WHO Child Growth Standards: Length/Height-for-age Weight-for-age Weight-for-length Weight-for-height and Body Mass Index-for age. Methods and Development

Goldsmith’s Assisted Ventilation of the Neonate

Goldsmith’s Assisted Ventilation of the Neonate
Author: Martin Keszler
Publisher: Elsevier Health Sciences
Total Pages: 769
Release: 2021-12-24
Genre: Medical
ISBN: 032376178X
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A must-have reference for the entire NICU, Goldsmith’s Assisted Ventilation of the Neonate, 7th Edition, is the only fully comprehensive, evidence-based guide to all aspects of this fast-changing field. Easy to use and multidisciplinary in scope, this trusted reference provides authoritative guidance on contemporary management of neonatal respiratory diseases, with an emphasis on evidence-based pharmacologic and technologic advances that improve outcomes and quality of life in newborns. It’s an outstanding resource for neonatologists and NICU professionals to acquire new knowledge and techniques in this critical area of neonatal care. Covers all aspects of both basic and advanced respiratory management of neonates: general principles and concepts; assessment, diagnosis and monitoring methods; therapeutic respiratory interventions; adjunctive interventions; and special situations and outcomes. Provides updated content on rapidly changing technology and guidelines for assisted ventilation, with up-to-date descriptions of bedside methodologies and the rationale for providing all types of ventilator care in infants. Contains new chapters on respiratory gas conditioning, diagnosis and management of PPHN, care of the infant with CDH, gaps in knowledge, and future directions. Includes significant updates on cardiovascular assessment and management, as well as complications of respiratory support. Provides extensive, full-color visual support with photographs, drawings, charts and diagrams, and radiographic images throughout. Features more than 30 appendices that help you quickly find normal values, assessment charts, ICU flow charts, procedure steps and other useful, printable forms.