The Effectiveness of Chest Physiotherapy in the Neonatal Intensive Care Unit

Introduction: The aim of the study is to determine the effects of applications and characteristics of patients followed with chest physiotherapy (CP) programs in the neonatal intensive care unit (NICU)

Role of epigenetic regulatory mechanisms in neonatal hypoxic-ischemic brain injury.

Hypoxic-ischemic brain injury is an important cause of neonatal mortality and subsequent serious neurological sequel. in neonatal brain the severity of hypoxic injury varies most probably due to the effects of multiple protective or deleterious factors. But the mechanisms under this difference are still not full understood. In recent years, some evidence has been found supporting the involvement of epigenetic mechanisms in many neurodegenerative diseases and stroke. We hypothesised that epigenetic mechanisms have been also involved in neonatal hypoxic-ischemic brain injury possibly by suppression of ischemia-induced cerebral inflammation and changing the expression of proapoptotic-antiapoptotic genes. (C) 2009 Elsevier Ltd. All rights reserved

Increased sleep tendency in jaundiced infants: role of endogenous CO.

Carbon monoxide formed from the breakdown of heme to bilirubin is produced at a rate equal to the rate of bilirubin synthesis. During long-term clinical experiences we have observed that jaundiced newborns tend to steep more than the unjaundiced ones. There is no clear evidence about the role of endogenous CO in steep physiology, but increased CO production in jaundiced newborns probably plays rote in increased steep state due to the regulatory effects on steep circadian rhythm and REM-steep, via cholinergic system activation. (C) 2008 Elsevier Ltd. ALL rights reserved

Pulmonary hemorrhage after rhDNase treatment in a preterm infant with chronic lung disease

Pulmonary secretions and mucus plugging are common problems in Neonatal Intensive Care Unit (NICU) patients, especially in those with chronic lung disease. Standard methods are not always helpful in resolving these secretions. Because the viscoelastic features of pulmonary secretions are largely due to deoxyribonucleic acid (DNA) content of mucus, a new mucolytic agent used in cystic fibrosis (CF), rhDNase, is proposed for rescue use in premature neonates. We report a premature infant with chronic lung disease, who had pulmonary obstruction secondary to mucus plugging. Lung hemorrhage developed during rhDNase therapy, which was used after standard methods were depleted

Genetic basis of apnoea of prematurity and caffeine treatment response: role of adenosine receptor polymorphisms: genetic basis of apnoea of prematurity.

Aim: Caffeine treatment reduces the frequency of apnoea of prematurity (AOP) and eliminates the need for mechanical ventilation by acting as a nonspecific inhibitor of adenosine A1 and adenosine 2A receptors. Patients with AOP have demonstrated variant responses to caffeine therapy. We proposed to investigate the role of A1 and 2A polymorphisms in the development of AOP and individual differences in caffeine response. Secondly, we aimed to determine whether these polymorphisms have any effect on bronchopulmonary dysplasia (BPD) development. Methods: Cord blood samples were collected from infants born with gestational ages between 24 and 34 weeks. Two groups were defined: patients without apnoea (n = 60) and patients with apnoea (n = 55). Patients with apnoea were divided into two subgroups: a caffeine-responsive group (n = 30) and an unresponsive group (n = 25). Six single-nucleotide polymorphisms were chosen for genotyping. Results: Patients with apnoea over 28 weeks of gestational age who responded to the caffeine treatment were found to carry the rs16851030 C/C genotype rather than the C/T or T/T genotype. Logistic regression analysis showed a significant correlation between rs35320474-C/T and T/T genotypes and apnoea and BPD development. Conclusion: Our results indicate a role for adenosine receptor gene polymorphisms in susceptibility to AOP and BPD and in interindividual variability to caffeine response

Randomized, controlled trial of early intravenous nutrition for prevention of neonatal jaundice in term and near-term neonates

Background: This study was undertaken to investigate the effects of early parenteral nutrition on prevention of neonatal jaundice in term and near-term neonates who could not be enterally fed

Is gastric aspiration needed for newborn management in delivery room?

Aim: Gastric aspiration is still applied in many centres during delivery room management of the newborn without any supporting evidence. We aimed to determine whether gastric aspiration affects vital signs, oxygenation, nutrition and short-term prognosis of the newborn

Impact of volume guarantee on synchronized ventilation in preterm infants: a randomized controlled trial.

The aim of this randomized controlled trial was to assess whether the addition of volume guarantee (VG) to triggered ventilation decreases the duration of ventilation in very low birth weight (VLBW) infants with respiratory distress syndrome (RDS)

Breast Milk Jaundice Correlates With High Levels of Epidermal Growth Factor

Maternal milk plays an important role in breast milk jaundice (BMJ) development and is the major source of epidermal growth factor (EGF) for neonates. The aim of this study was to investigate whether there is a relationship between EGF levels in the infant serum and in the milk of nursing mothers and BMJ. Two groups were defined: study group (n = 30), newborns who were followed up for BMJ without any identifiable pathologic cause; control group, healthy newborns whose serum total bilirubin levels were <10 mg/dL. Milk and infant plasma samples were collected between the third and the fourth postpartum week. EGF concentrations in all of the samples were determined by using ELISA. The infants with BMJ had higher concentrations of EGF in the serum and in the breast milk compared with that of the infants without BMJ. The milk concentrations of EGF were significantly correlated with neonatal bilirubin and blood EGF concentrations. The degree of BMJ was associated with the increased levels of milk borne EGF. Although the exact mechanisms of the hyperbilirubinemic action of. EGF are not completely known. the inhibition of gastric motility, increased absorption, and activation of bilirubin transport have been suggested as possible mechanisms. (Pediatr Res 66: 218-221, 2009

Resolution of chyloperitoneum in a preterm with octreotide, diet and cessation of dialysis

The diagnosis of chyloperitoneum (CP) is based on the presence of high levels of triglycerides (TGs) in the dialysate. It is a rare complication of peritoneal dialysis (PD) and even rarer in neonates. We report here the case of CP in a 1700-g male baby delivered at the 30th gestational week due to posterior urethral valve and associated oligohydramnios. On postnatal day 2, the serum creatinine (Scr) was 1.6 mg/dL, and he was anuric. PD was instituted via a Tenckhoff catheter. At the end of the second week, after the initiation of enteral feeding, the ultrafiltrate became cloudy, with a leukocyte count of 900/mm(3). A treatment regimen consisting of intraperitoneal vancomycin and ceftazidime was then started. Five days later, the fluid became milky, with a TG level of 251 mg/dL. The patient was then placed on a diet based on medium-chain triglycerides and octreotide (1 mu g/kg/h; increasing up to 2 mu g/kg/h over 15 days). Although the TG and leukocyte levels decreased, the milky appearance persisted. PD was stopped for 2 days when the Scr decreased to 1.7 mg/dL. When it was resumed, the fluid was totally clear, with a TG level of 7 mg/dL. The infant was discharged with a nightly intermittent peritoneal dialysis program and has had no recurrence. In summary, we report a preterm infant who developed CP during PD and recovered following treatment that included diet modification, octreotide, and temporary discontinuation of the PD