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Mashup Score: 1Evaluation of infants born to a parent with gene-positive long QT syndrome: a retrospective single-centre review - 6 day(s) ago
Objective To describe early management of infants born to a parent with gene-positive long QT syndrome (LQTS) referred for specialist review. Review the diagnostic utility of the early neonatal and first clinic ECG. Design Retrospective cohort study, including a review of the first neonatal and first clinic ECG. Setting Quaternary paediatric-only referral hospital with specialised unit for the management of paediatric inherited cardiovascular diseases. Patients Infants born 2015–2022 referred in the setting of parental LQTS who subsequently underwent predictive genetic testing for a parental LQTS-causative genetic variant. Main outcome measures Age (at first early neonatal ECG, referral, first clinic attendance), genetic testing data, clinical course, exposure to QT-prolonging medications, neonatal hypoxia-ischaemia and cardiac events (cardiac arrest or death) in the infant’s first year. The first neonatal and first clinic ECGs were evaluated for QTc and T-wave morphology, by two obser
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Mashup Score: 9Volume of umbilical cord blood collection in the era of delayed cord clamping: a multicentre, prospective, feasibility study - 1 month(s) ago
Objectives To determine the percentage of adequate umbilical cord blood (UCB) collections defined as ≥70 mL of UCB after delayed cord clamping for 3 min was applied. Second, to correlate the UCB volume to gestational age at birth, birth weight and sex. Design We conducted a multicentre, prospective, feasibility study in near-term infants delivered through caesarean section between November 2023 and December 2024. UCB was collected ex-utero, immediately after the placenta was removed from the womb. Results A total of 195 UCB collections were attempted. In 11 cases (5.6%), the attempt failed due to rupture of the umbilical cord or damaged placenta by removal of the placenta from the uterus. The median volume of the remaining 184 UCB collections was 72 mL (IQR 56–86 mL). In only 54% (100/184), the UCB volume reached the target volume of ≥70 mL. We found that UCB volume was positively associated with birth weight (R2=0.0813, F(1181)=16.02, p value <0.001) but not with gestational age at bi
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Mashup Score: 5
In 1972, Eastern Air Lines flight 401 tragically crashed in the Florida Everglades, resulting in the loss of 101 lives. The Federal Aviation Administration investigation found that pilots became preoccupied with a burnt-out landing gear indicator light. This resulted in autopilot disconnection being unnoticed by the flight crew as they were attempting to correct the unsafe landing gear position indication.1 This is just one example of how profoundly distraction and a loss of situational awareness can impact aviation. These issues, often referred to as human factors, result in performance shortcomings, with human error being the cause of up to 70%–80% of (largely preventable) aviation accidents.2 Distraction is recognised as one of the top 12 human factors contributing to adverse events. Often referred to as ‘the dirty dozen’ (table 1), these errors frequently precede accidents and incidents, forming the core focus of human …
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Mashup Score: 2
Objective To evaluate the effect of low-dose postnatal dexamethasone therapy for bronchopulmonary dysplasia (BPD) prevention/treatment on MRI-derived regional brain volumes at term-equivalent age (TEA) and neurodevelopmental outcomes in a regional cohort of preterm infants. Study design We prospectively recruited 392 preterm infants (≤32 weeks gestational age (GA)), who underwent structural MRI (3T Philips Ingenia) at TEA. We automatically segmented T2-weighted MRI scans using the Developing Human Connectome Project pipeline to derive a priori selected, two primary outcomes of interest: volumes of the cerebellum and subcortical grey matter. We estimated propensity scores for subjects with a logistic regression model and used weighted linear regression to determine the independent effects of dexamethasone on primary and two secondary outcomes: cortical surface area at TEA and motor scores at 2 years corrected age. Results Of 392 infants, 41 were treated with low cumulative dose dexameth
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Mashup Score: 2Automated tactile stimulation in response to cardiorespiratory events in preterm infants: a feasibility study - 1 month(s) ago
Objective Assess the feasibility and safety of a purpose-built automated tactile stimulation device (ATSD) responding to cardiorespiratory events in preterm infants. Design Randomised cross-over study. Setting Level-III neonatal intensive care unit in the Netherlands. Patients Infants born between 24 and 30 weeks gestational age, receiving non-invasive respiratory support and experiencing apnoea, bradycardia and/or hypoxia for>10 s. Interventions Infants underwent two study periods of 24 hours. In the control period, the ATSD was attached but inactive. In the intervention period, ATSD was activated and used in addition to standard care, providing direct vibratory stimulation in response to clinical alarms. Main outcome measure Feasibility of using ATSD, expressed by the number of infants completing the study, the ability to provide stimulation on the skin and the perceived feasibility by the nurses. Results 16 infants were included, of which 14 (88%) completed both study periods. Two i
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Mashup Score: 0Relationship between applied face mask force and mask leak during simulated neonatal ventilation: a randomised simulation study - 1 month(s) ago
Objective Assess the relationship between applied face mask force and leak during simulated ventilation using different ventilating devices and mask holds. Design Randomised cross-over simulation study. Setting Quiet, non-clinical room in children’s hospital. Participants Twenty-four experienced neonatal healthcare providers. Interventions Ventilate a manikin for 2 min per trial, each with three trial conditions: self-inflating bag (SIB) with one-hand hold, T-piece with one-hand hold, T-piece with two-hand hold. Main outcome measures Applied force (newtons (N)) measured under the head and at four locations on the manikin’s face (nasal bridge, mentum, left and right zygomatic arches), force asymmetry applied to the mask rim, and mask leak. Results Under-head force was greatest using the SIB with one-hand hold (mean (SD) 20.53 (5.87) N) and least using the T-piece with one-hand hold (mean (SD) 17.58 (6.11) N). While mask leak was reduced with increasing force, leak-free ventilation was a
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Mashup Score: 0
Endotracheal intubation, the insertion of an endotracheal tube (ETT) through the vocal cords into the trachea, is an essential and potentially life-saving procedure in neonates. Most commonly, endotracheal intubation is required soon after birth in infants who are apneic, require extensive resuscitation, have high supplemental oxygen requirements or are performed for the administration of exogenous surfactant to preterm infants with respiratory distress syndrome. When undertaking neonatal endotracheal intubation, clinicians must identify and maintain visualisation of the glottis so the endotracheal tube can be correctly positioned in the trachea (intubation success), ideally with the first attempt at laryngoscopy. Clinicians also aim to maintain the clinical stability of the infant during the procedure (intubation safety). Neonates are at particular risk of clinical instability during intubation, as they have a lower respiratory reserve than older children and often have underlying lun
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Mashup Score: 9Video versus direct laryngoscopy for urgent tracheal intubation in neonates: a systematic review and meta-analysis - 1 month(s) ago
Introduction Intubation is most often performed electively by anaesthetists in controlled conditions in operating theatres. In neonates, however, it is most often performed by neonatologists or paediatricians in urgent circumstances in the neonatal intensive care unit (NICU) or delivery room (DR). Neonatal intubation is a difficult skill to learn and maintain, and success rates are suboptimal both in the NICU and DR. Video laryngoscopy (VL) has the potential to increase intubation success and safety as it may offer a better view of the airway, which can be shared by the intubator and other clinicians. Objectives To compare the efficacy and safety of using VL to direct laryngoscopy (DL) for intubation of neonates in the NICU and DR. Search methods We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase and CINAHL up to August 2024 without language restrictions. Selection criteria Randomised controlled trials (RCTs), quasi‐RCTs, cluster‐RCTs or cross‐over trials t
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Mashup Score: 1Treatment of Hypotension of Prematurity: a randomised trial - 1 month(s) ago
Objective To evaluate whether a perfusion-based approach (permissive hypotension, PH) for idiopathic low mean arterial blood pressure (MABP) during the first 72 hours after birth in preterm infants without overt sepsis affects neurodevelopmental outcome (NDO) at 24 months of age. Design Randomised controlled trial. Outcome assessors were blinded. Setting Single centre. Patients Infants <30 weeks gestational age (GA) with MABP in mm Hg
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Mashup Score: 20Treatment of Hypotension of Prematurity: a randomised trial - 2 month(s) ago
Objective To evaluate whether a perfusion-based approach (permissive hypotension, PH) for idiopathic low mean arterial blood pressure (MABP) during the first 72 hours after birth in preterm infants without overt sepsis affects neurodevelopmental outcome (NDO) at 24 months of age. Design Randomised controlled trial. Outcome assessors were blinded. Setting Single centre. Patients Infants <30 weeks gestational age (GA) with MABP in mm Hg
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Evaluation of infants born to a parent with gene-positive long QT syndrome Incorporation of T-wave morphology increase diagnostic accuracy than QTc alone Retrospective single-centre review https://t.co/agmf41Nzip