Randomized crossover comparison of proportional assist ventilation and patient-triggered ventilation in extremely low birth weight infants with evolving chronic lung disease.

Abstract:

BACKGROUND:Refinement of ventilatory techniques remains a challenge given the persistence of chronic lung disease of preterm infants. METHODS:To test the hypothesis that proportional assist ventilation (PAV) will allow to lower the ventilator pressure at equivalent fractions of inspiratory oxygen (FiO(2)) and arterial hemoglobin oxygen saturation in ventilator-dependent extremely low birth weight infants in comparison with standard patient-triggered ventilation (PTV). DESIGN:Randomized crossover design. SETTING:Two level-3 university perinatal centers. PATIENTS:22 infants (mean (SD): birth weight, 705 g (215); gestational age, 25.6 weeks (2.0); age at study, 22.9 days (15.6)). INTERVENTIONS:One 4-hour period of PAV was applied on each of 2 consecutive days and compared with epochs of standard PTV. RESULTS:Mean airway pressure was 5.64 (SD, 0.81) cm H(2)O during PAV and 6.59 (SD, 1.26) cm H(2)O during PTV (p < 0.0001), the mean peak inspiratory pressure was 10.3 (SD, 2.48) cm H(2)O and 15.1 (SD, 3.64) cm H(2)O (p < 0.001), respectively. The FiO(2) (0.34 (0.13) vs. 0.34 (0.14)) and pulse oximetry readings were not significantly different. The incidence of arterial oxygen desaturations was not different (3.48 (3.2) vs. 3.34 (3.0) episodes/h) but desaturations lasted longer during PAV (2.60 (2.8) vs. 1.85 (2.2) min of desaturation/h, p = 0.049). PaCO(2) measured transcutaneously in a subgroup of 12 infants was similar. One infant met prespecified PAV failure criteria. No adverse events occurred during the 164 cumulative hours of PAV application. CONCLUSIONS:PAV safely maintains gas exchange at lower mean airway pressures compared with PTV without adverse effects in this population. Backup conventional ventilation breaths must be provided to prevent apnea-related desaturations.

journal_name

Neonatology

journal_title

Neonatology

authors

Schulze A,Rieger-Fackeldey E,Gerhardt T,Claure N,Everett R,Bancalari E

doi

10.1159/000098376

subject

Has Abstract

pub_date

2007-01-01 00:00:00

pages

1-7

issue

1

eissn

1661-7800

issn

1661-7819

pii

000098376

journal_volume

92

pub_type

杂志文章,多中心研究,随机对照试验
  • Antioxidant activity in the newborn brain: a luciferase mouse model.

    abstract:INTRODUCTION:Oxidative stress in the newborn period may cause cell injury and inflammation if the antioxidant capacity is insufficient. To monitor antioxidant and inflammatory activity we examined by in vivo imaging various strains of luciferase reporter mice whose light-emitting properties were regulated by response e...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000107777

    authors: Dohlen G,Odland HH,Carlsen H,Blomhoff R,Thaulow E,Saugstad OD

    更新日期:2008-01-01 00:00:00

  • Variability of influenza AH1N1 infections in a neonatal unit in Spain.

    abstract::We describe three positive influenza AH1N1 cases in a neonatal unit during the influenza pandemic in Spain. One term baby presented with an upper respiratory tract infection, another preterm infant with an apnea episode following nosocomial infection, and thirdly, a term infant of a mother with influenza AH1N1 had sev...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000324232

    authors: Calvo C,Gonzalez-Carrasco E,Quevedo S,García-García ML,Rando A,Ledesma J,Calderon A,Pozo F,Pérez-Breña P,Casas I

    更新日期:2011-01-01 00:00:00

  • Identifying Risk Factors Shared by Bronchopulmonary Dysplasia, Severe Retinopathy, and Cystic Periventricular Leukomalacia in Very Preterm Infants for Targeted Intervention.

    abstract:BACKGROUND:Bronchopulmonary dysplasia (BPD), severe retinopathy of prematurity (sROP), and cystic periventricular leukomalacia (cPVL) are 3 major morbidities with long-term neurodevelopmental impairments in preterm infants. OBJECTIVE:To investigate the strength of associations and identify key risk factors shared by B...

    journal_title:Neonatology

    pub_type: 杂志文章,多中心研究

    doi:10.1159/000487505

    authors: Wang LW,Lin YC,Wang ST,Huang CC,on behalf of the Taiwan Premature Infant Developmental Collaborative Study Group.

    更新日期:2018-01-01 00:00:00

  • Congenital ichthyosis in severe type II Gaucher disease with a homozygous null mutation.

    abstract::This paper describes a neonate with type II Gaucher disease. The phenotype was unusually severe with congenital ichthyosis, hepatosplenomegaly, muscular hypotonia, myoclonus and respiratory failure. Electron microscopy of the skin revealed lamellar body contents in the stratum corneum interstices, appearances consider...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000324116

    authors: Haverkaemper S,Marquardt T,Hausser I,Timme K,Kuehn T,Hertzberg C,Rossi R

    更新日期:2011-01-01 00:00:00

  • Early neonatal special care units and their scientific achievements.

    abstract::Treatment of sick neonates originated in maternity and foundling hospitals in the 19th century. Nosocomial infections and difficult logistics of wet-nursing prevented admission of neonates in most children's hospitals well into the 20th century. In this article, 31 hospitals are described, all located in large cities,...

    journal_title:Neonatology

    pub_type: 历史文章,杂志文章

    doi:10.1159/000336285

    authors: Obladen M

    更新日期:2012-01-01 00:00:00

  • Prospective volumetric analysis of gallbladders in critically ill newborns: the impact of nutrition.

    abstract:BACKGROUND:Neonatal reference values of gallbladder size have been assessed in healthy newborns with enteral feeding regimen. Their applicability to critically ill patients under total parenteral nutrition (TPN) remains to be questioned. OBJECTIVE:Our aim was to evaluate the impact of short-term TPN versus enteral nut...

    journal_title:Neonatology

    pub_type: 临床试验,杂志文章

    doi:10.1159/000102058

    authors: Schmidt B,Roth B,Stützer H,Benz-Bohm G

    更新日期:2007-01-01 00:00:00

  • Phenobarbital, Midazolam Pharmacokinetics, Effectiveness, and Drug-Drug Interaction in Asphyxiated Neonates Undergoing Therapeutic Hypothermia.

    abstract:BACKGROUND:Phenobarbital and midazolam are commonly used drugs in (near-)term neonates treated with therapeutic hypothermia for hypoxic-ischaemic encephalopathy, for sedation, and/or as anti-epileptic drug. Phenobarbital is an inducer of cytochrome P450 (CYP) 3A, while midazolam is a CYP3A substrate. Therefore, co-trea...

    journal_title:Neonatology

    pub_type: 杂志文章,多中心研究

    doi:10.1159/000499330

    authors: Favié LMA,Groenendaal F,van den Broek MPH,Rademaker CMA,de Haan TR,van Straaten HLM,Dijk PH,van Heijst A,Simons SHP,Dijkman KP,Rijken M,Zonnenberg IA,Cools F,Zecic A,van der Lee JH,Nuytemans DHGM,van Bel F,Egberts TCG,

    更新日期:2019-01-01 00:00:00

  • Increased Carbon Monoxide Washout Rates in Newborn Infants.

    abstract:BACKGROUND:Endogenous carbon monoxide (CO) production is primarily due to heme degradation, which also results in the equimolar production of bilirubin. Thus, estimates of total body CO production can serve as indices of total body bilirubin formation. The elimination rate of CO from a person's body (CO washout rate) a...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000503635

    authors: Stevenson DK,Wong RJ,Ostrander CR,Maric I,Vreman HJ,Cohen RS

    更新日期:2020-01-01 00:00:00

  • Ventilator gas flow rates affect inspiratory time and ventilator efficiency index in term lambs.

    abstract:BACKGROUND:Despite increasing survival in the smallest preterm infants, the incidence of chronic lung disease has not decreased. Research into ventilatory strategies has concentrated on minimising barotrauma, volutrauma and atelectotrauma, but little attention has been paid to the role of bias gas flow rates and the po...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000220765

    authors: Bach KP,Kuschel CA,Oliver MH,Bloomfield FH

    更新日期:2009-01-01 00:00:00

  • Cardiac troponin T: a useful early marker for cardiac and respiratory dysfunction in neonates.

    abstract:BACKGROUND:Cardiac troponin T (cTnT) has been proposed as specific biochemical marker for myocardial infarction in adults. Cardiac function in neonates could be influenced by the severity of respiratory distress and its ventilatory management. OBJECTIVES:To establish a normal range of cTnT in healthy neonates, compare...

    journal_title:Neonatology

    pub_type: 临床试验,杂志文章

    doi:10.1159/000100964

    authors: Awada H,Al-Tannir M,Ziade MF,Alameh J,El Rajab M

    更新日期:2007-01-01 00:00:00

  • QuickSF: A New Technique in Surfactant Administration.

    abstract:BACKGROUND:Recent studies indicate an increasing use of less invasive surfactant administration. Different techniques have been shown with distinct risks and benefits. The aim of this study was to develop a new method that simplifies this procedure. OBJECTIVES:An applicator was developed and tested on a manikin to mak...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000450823

    authors: Maiwald CA,Neuberger P,Vochem M,Poets C

    更新日期:2017-01-01 00:00:00

  • Accuracy of Brain Natriuretic Peptide for Diagnosing Pulmonary Hypertension in Severe Bronchopulmonary Dysplasia.

    abstract:BACKGROUND:Premature infants with severe bronchopulmonary dysplasia (sBPD) are at risk of pulmonary hypertension (PH). Serum brain natriuretic peptide (BNP) is used to predict disease severity in adult PH. Its diagnostic utility in sBPD-associated PH is unknown. OBJECTIVE:The aim of this paper was to determine the acc...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000499082

    authors: Avitabile CM,Ansems S,Wang Y,Fraga MV,Kirpalani HM,Zhang H,Mercer-Rosa L,Jensen EA

    更新日期:2019-01-01 00:00:00

  • Necrotizing enterocolitis in small-for-gestational-age neonates: a matched case-control study.

    abstract:BACKGROUND:Small for gestational age (SGA) neonates are at increased risk of mortality and morbidity, including necrotizing enterocolitis (NEC), but detailed information on the incidence and risk factors of NEC in SGA neonates is lacking. OBJECTIVE:This study aims to estimate the incidence of NEC in a large cohort of ...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000356033

    authors: Ree IM,Smits-Wintjens VE,Rijntjes-Jacobs EG,Pelsma IC,Steggerda SJ,Walther FJ,Lopriore E

    更新日期:2014-01-01 00:00:00

  • Body Composition in Very Preterm Infants: Role of Neonatal Characteristics and Nutrition in Achieving Growth Similar to Term Infants.

    abstract:BACKGROUND:The identification of factors involved in the postnatal growth of preterm infants will help achieve growth similar to that of term infants. OBJECTIVES:As per protocol: to compare body composition in very preterm infants at term-corrected age (TCA) with that in term infants, and to explore relationships betw...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000450882

    authors: Tremblay G,Boudreau C,Bélanger S,St-Onge O,Pronovost E,Simonyan D,Marc I

    更新日期:2017-01-01 00:00:00

  • Very Preterm Infants with Technological Dependence at Home: Impact on Resource Use and Family.

    abstract:OBJECTIVE:To examine the impact of medical complexity among very preterm infants on health care resource use, family, and neurodevelopmental outcomes at 18 months' corrected age. METHODS:This observational cohort study of Canadian infants born < 29 weeks' gestational age in 2009-2011 compared infants with and those wi...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000496494

    authors: Nassel D,Chartrand C,Doré-Bergeron MJ,Lefebvre F,Ballantyne M,Van Overmeire B,Luu TM,on behalf of the Canadian Neonatal Network and the Canadian Neonatal Follow-Up Network.

    更新日期:2019-01-01 00:00:00

  • Randomised Controlled Trials for Informing Perinatal Care.

    abstract:BACKGROUND:Randomised controlled trials provide the best evidence for the effects of interventions and are a key tool in the effort to improve the care and outcomes for newborn infants. METHODS:We discuss the role of randomisation for minimising selection bias in clinical trials and describe examples of seminal trials...

    journal_title:Neonatology

    pub_type: 杂志文章,评审

    doi:10.1159/000499881

    authors: Gale C,McGuire W,Juszczak E

    更新日期:2020-01-01 00:00:00

  • The Neuroprotective Effects of Hypothermia on Bilirubin-Induced Neurotoxicity in vitro.

    abstract:BACKGROUND:In high-risk newborns indirect hyperbilirubinemia can lead to acute bilirubin encephalopathy and kernicterus. Despite the current therapeutic modalities, preventing or reversing the neurotoxicity cannot be achieved in all infants. OBJECTIVE:To investigate the neuroprotective effects of hypothermia on biliru...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000487221

    authors: Kuter N,Aysit-Altuncu N,Ozturk G,Ozek E

    更新日期:2018-01-01 00:00:00

  • Diagnostic value of an interleukin-6 bedside test in term and preterm neonates at the time of clinical suspicion of early- and late-onset bacterial infection.

    abstract:BACKGROUND:For quick detection or exclusion of neonatal early-onset bacterial infection (EOBI) or late-onset bacterial infection (LOBI), interleukin (IL)-6 is used. Its clinical use is sometimes limited due to prolonged recall times. Therefore, an IL-6 bedside test was established. OBJECTIVE:To compare the diagnostic ...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000336632

    authors: Batfalsky A,Lohr A,Heussen N,Neunhoeffer F,Orlikowsky TW

    更新日期:2012-01-01 00:00:00

  • Neonatal Umbilical Arterial Catheter Removal Is Accompanied by a Marked Decline in Phlebotomy Blood Loss.

    abstract:BACKGROUND:Umbilical arterial catheters (UACs) are frequently used in critically ill neonates. UAC are convenient, reliable, and allow for caregiver convenience in performing painless arterial blood sampling. We hypothesized that UAC removal in extremely low birth weight (ELBW) neonates will result in significantly les...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000506907

    authors: Carroll PD,Zimmerman MB,Nalbant D,Gingerich EL,An G,Cress GA,Veng-Pedersen P,Widness JA

    更新日期:2020-01-01 00:00:00

  • Comparison of Neonatal Intubation Practice and Outcomes between the Neonatal Intensive Care Unit and Delivery Room.

    abstract:BACKGROUND:Characteristics of neonatal tracheal intubations (TI) may vary between the neonatal intensive care unit (NICU) and delivery room (DR). The impact of the setting on TI outcomes is not well characterized. OBJECTIVE:The aim of this study was to define variation in neonatal TI practice between settings, and ide...

    journal_title:Neonatology

    pub_type: 杂志文章,多中心研究

    doi:10.1159/000502611

    authors: Herrick HM,Glass KM,Johnston LC,Singh N,Shults J,Ades A,Nadkarni V,Nishisaki A,Foglia EE,for the NEAR4NEOS Investigators.

    更新日期:2020-01-01 00:00:00

  • Diagnosis of Hemidiaphragmatic Paresis in a Preterm Infant with Transcutaneous Electromyography: A Case Report.

    abstract::Transcutaneous electromyography of the diaphragm (dEMG) is a noninvasive and easy applicable tool to measure the electrical activity of the diaphragm. dEMG monitoring has recently been introduced in the neonatal intensive care unit as a novel cardiorespiratory monitor providing direct information on diaphragmatic brea...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000381207

    authors: Kraaijenga JV,Hutten GJ,de Jongh FH,van Kaam AH

    更新日期:2015-01-01 00:00:00

  • Predictive value of the parent-completed ASQ for school difficulties in preterm-born children

    abstract:BACKGROUND:Preterm infants are at greater risk of developmental impairment and require close follow-up for early and optimal care. OBJECTIVES:The objective of the present study was to determine from which age the parental Ages and Stages Questionnaire (ASQ) allows detection of school difficulties in preterm children <...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000363216

    authors: Halbwachs M,Muller JB,Nguyen The Tich S,Gascoin G,Chauty-Frondas A,Branger B,Rouger V,Roze JC,Flamant C

    更新日期:2014-01-01 00:00:00

  • Bronchopulmonary Dysplasia: 50 Years after the Original Description.

    abstract::Bronchopulmonary dysplasia (BPD) is one of the few diseases in neonatal medicine that has continued to evolve since its first description about 50 years ago. Over these years, advancements in neonatal medicine such as antenatal steroids and exogenous surfactant therapy have significantly reduced neonatal mortality and...

    journal_title:Neonatology

    pub_type: 杂志文章,评审

    doi:10.1159/000497422

    authors: Bancalari E,Jain D

    更新日期:2019-01-01 00:00:00

  • The Use of Peritoneal Dialysis in Phenobarbitone Toxicity in a Critically Unwell Neonate.

    abstract:BACKGROUND:Phenobarbitone (PB) is the first-line anti-convulsant for neonatal seizures. The use of peritoneal dialysis (PD) to enhance drug elimination in cases of neonatal PB overdose has not been reported. OBJECTIVE:To report a case of neonatal severe PB toxicity and review the elimination of PB by PD. METHODS:Asse...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000481879

    authors: Le Page AK,Stewart AE,Roehr CC,Johnstone LM,Graudins A

    更新日期:2018-01-01 00:00:00

  • Early transient hypoglycemia is associated with increased albumin nitration in the preterm infant.

    abstract:BACKGROUND:The clinical significance of early transient hypoglycemia (ETH), a frequent event in preterm newborns, is a highly controversial issue. In experimental models, hypoglycemia has been reported to cause oxidative stress. Among the reactive species, early generated peroxynitrite is responsible for protein nitrat...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000326936

    authors: Wayenberg JL,Cavedon C,Ghaddhab C,Lefèvre N,Bottari SP

    更新日期:2011-01-01 00:00:00

  • Diagnosis of gastro-oesophageal reflux in preterm infants: sonography vs. pH-monitoring.

    abstract:OBJECTIVES:To compare the ultrasound examination with pH-metry in order to evaluate the diagnostic accuracy of sonography for diagnosis of gastro-oesophageal reflux (GOR) in preterm infants. METHODS:A prospective study was conducted on 31 premature infants <34 weeks with clinically diagnosed GOR. First, they underwent...

    journal_title:Neonatology

    pub_type: 临床试验,杂志文章

    doi:10.1159/000097447

    authors: Pezzati M,Filippi L,Psaraki M,Rossi S,Dani C,Tronchin M,Rubaltelli FF

    更新日期:2007-01-01 00:00:00

  • Does sustained lung inflation at birth improve outcome of preterm infants at risk for respiratory distress syndrome?

    abstract:BACKGROUND:Sustained lung inflation (SLI) applied at birth has been demonstrated to lead to clearance of lung fluid and achievement of a precocious functional residual capacity in animal studies. OBJECTIVES:To verify if the application of SLI in preterm infants at birth may reduce the need for mechanical ventilation a...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000298312

    authors: Lista G,Fontana P,Castoldi F,Cavigioli F,Dani C

    更新日期:2011-01-01 00:00:00

  • A Distinctive Ictal Amplitude-Integrated Electroencephalography Pattern in Newborns with Neonatal Epilepsy Associated with KCNQ2 Mutations.

    abstract:BACKGROUND:Recurrent and prolonged seizures are harmful for the developing brain, emphasizing the importance of early seizure recognition and effective therapy. Amplitude-integrated electroencephalography (aEEG) has become a valuable tool to diagnose epileptic seizures, and, in parallel, genetic etiologies are increasi...

    journal_title:Neonatology

    pub_type: 杂志文章,多中心研究

    doi:10.1159/000478651

    authors: Vilan A,Mendes Ribeiro J,Striano P,Weckhuysen S,Weeke LC,Brilstra E,de Vries LS,Cilio MR

    更新日期:2017-01-01 00:00:00

  • DHA Reduces Oxidative Stress after Perinatal Asphyxia: A Study in Newborn Piglets.

    abstract:BACKGROUND:Perinatal hypoxic-ischemic brain damage is a major cause of acute mortality and chronic neurological morbidity in infants and children. Oxidative stress due to free radical formation and the initiation of abnormal oxidative reactions appears to play a key role. Docosahexanoic acid (DHA), a main component of ...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000454982

    authors: Solberg R,Longini M,Proietti F,Perrone S,Felici C,Porta A,Saugstad OD,Buonocore G

    更新日期:2017-01-01 00:00:00

  • Hypoxic-Ischemic Encephalopathy-Associated Liver Fatty Degeneration and the Effects of Therapeutic Hypothermia in Newborn Piglets.

    abstract:BACKGROUND:Although liver can be injured under the hypoxic-ischemic encephalopathy (HIE) condition, there is currently no histopathological evidence. Therapeutic hypothermia is used to protect the brain; however, the therapeutic potential for concomitant liver injury is unknown. OBJECTIVES:This study aimed to histopat...

    journal_title:Neonatology

    pub_type: 杂志文章

    doi:10.1159/000450721

    authors: Kubo H,Shimono R,Nakamura S,Koyano K,Jinnai W,Yamato S,Yasuda S,Nakamura M,Tanaka A,Fujii T,Kanenishi K,Chiba Y,Miki T,Kusaka T,Ueno M

    更新日期:2017-01-01 00:00:00