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Dtsch Arztebl Int 2019 Mar;116(11):177-183

Department of General Pediatrics & Neonatology, Center for Pediatrics and Youth Medicine, Justus Liebig University of Giessen; Division of Neonatology, Children's Hospital of Eastern Ontario, Ottawa, Canada; Department of Neonatology, Charité-Universitätsmedizin Berlin, Berlin; Member of the German Lung Research Center (DZL), Giessen.

Background: Invasive mechanical ventilation (IMV) has been replaced by early continuous positive airway pressure (CPAP) in the treatment of respiratory distress syndrome (RDS) in preterm infants aiming to reduce the rate of bronchopulmonary dysplasia (BPD). Subsequently, modern non-invasive ventilation strategies (NIV) were introduced into clinical practice with limited evidence of effects on pulmonary and neurodevelopmental outcomes.

Methods: We performed a selective literature search in PubMed including randomized controlled trials (RCT) (n ≥ 200) and meta-analyses published in the field of NIV in neonatology and follow-up studies focusing on long term pulmonary and neurodevelopmental outcomes. Read More

Mil Med Res 2019 Apr 24;6(1):11. Epub 2019 Apr 24.

Division of Critical Care Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, 2200 Children's Way, Nashville, TN, 37232, USA.

With improvements in personnel and vehicular body armor, robust casualty evacuation capabilities, and damage control resuscitation strategies, more combat casualties are surviving to reach higher levels of care throughout the casualty evacuation system. As such, medical centers are becoming more accustomed to managing the deleterious late consequences of combat trauma related to the dysregulation of the immune system. In this review, we aim to highlight these late consequences and identify areas for future research and therapeutic strategies. Read More

Crit Care 2019 Apr 17;23(1):128. Epub 2019 Apr 17.

Division of Pediatric Critical Care Medicine, Department of Pediatrics and Communicable Diseases, University of Michigan, 1500 East Medical Center Dr, F6790/5243, Ann Arbor, MI, 48109, USA.

Background: The association of plasma interleukin-8 (IL-8), or IL-8 genetic variants, with pediatric acute respiratory distress syndrome (PARDS) in children with acute respiratory failure at risk for PARDS has not been examined. The purpose of this study was to examine the association of early and sequential measurement of plasma IL-8 and/or its genetic variants with development of PARDS and other clinical outcomes in mechanically ventilated children with acute respiratory failure.

Methods: This was a prospective cohort study of children 2 weeks to 17 years of age with acute airways and/or parenchymal lung disease done in 22 pediatric intensive care units participating in the multi-center clinical trial, Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE). Read More

Transfusion 2019 Apr 16. Epub 2019 Apr 16.

Department of Pathology, University British Columbia, Vancouver, British Columbia, Canada.

Background: Transfusion-related acute lung injury (TRALI) is a serious complication of blood transfusion and is among the leading causes of transfusion-related morbidity and mortality in most developed countries. In the past decade, the pathophysiology of this potentially life-threatening syndrome has been increasingly elucidated, large cohort studies have identified associated patient conditions and transfusion risk factors, and preventive strategies have been successfully implemented. These new insights provide a rationale for updating the 2004 consensus definition of TRALI. Read More

Adv Biomed Res 2019 21;8:12. Epub 2019 Feb 21.

Department of Epidemiology and Biostatistics, Health School, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Different morbidity conditions are globally reported from different nations for premature infants. The aim of this study was to identify the relative frequency of some of the most important complications of prematurity in a population of about 1000 of very low birth weight (VLBW; i.e. Read More

Respir Res 2019 Apr 16;20(1):75. Epub 2019 Apr 16.

Division of Pediatrics and Neonatal Critical Care, Medical Center "A.Béclère", South Paris University Hospitals, AP-HP, Paris, France.

Background: It is not known if the endogenous surfactant pool available early in life is associated with the RDS clinical course in preterm neonates treated with CPAP. We aim to clarify the clinical factors affecting surfactant pool in preterm neonates and study its association with CPAP failure.

Methods: Prospective, pragmatic, blind, cohort study. Read More

Am J Perinatol 2019 Apr 16. Epub 2019 Apr 16.

Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.

Objective:  To estimate sex-specific differences in late preterm outcomes and evaluate whether betamethasone modifies this association.

Study Design:  We conducted a secondary analysis of a multicenter trial of women at risk for late preterm birth randomized to receive betamethasone or placebo. We included women who delivered at 34 to 37 weeks and excluded major fetal anomalies. Read More

Neonatology 2019 Apr 11;115(4):411-422. Epub 2019 Apr 11.

Neonatal-Perinatal Medicine, Department of Pediatrics, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA.

Traditionally, surfactant has been administered to preterm infants with respiratory distress syndrome via an endotracheal tube and in conjunction with mechanical ventilation. However, negative consequences of mechanical ventilation such as pneumothorax and bronchopulmonary dysplasia are well known. In order to provide the benefits of surfactant administration without the negative effects of mechanical ventilation, several methods of less invasive surfactant administration have been developed. Read More

Neonatology 2019 Apr 11;115(4):432-451. Epub 2019 Apr 11.

Department of Child Health, Queen's University Belfast and Royal Maternity Hospital, Belfast, United Kingdom.

As management of respiratory distress syndrome (RDS) advances, clinicians must continually revise their current practice. We report the fourth update of "European Guidelines for the Management of RDS" by a European panel of experienced neonatologists and an expert perinatal obstetrician based on available literature up to the end of 2018. Optimising outcome for babies with RDS includes prediction of risk of preterm delivery, need for appropriate maternal transfer to a perinatal centre and timely use of antenatal steroids. Read More

Paediatr Int Child Health 2019 Apr 8:1-9. Epub 2019 Apr 8.

e Department of Paediatrics , Federal Medical Centre , Jabi , Nigeria.

Background: The bubble continuous positive airway pressure (bCPAP) technique is widely applied in neonatal respiratory support. Commercial bCPAP brands are expensive in Nigeria and this has driven Nigerian paediatricians to use potentially risky improvised devices (IbCPAP).

Aim: This study aimed to design, produce and trial an appropriate low-cost bCPAP machine which is functionally effective and safe. Read More

Chest 2019 Apr;155(4):740-748

Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China; Chongqing Key Laboratory of Pediatrics, Chongqing, China; Department of Pediatrics, Daping Hospital of the Army Medical University, Chongqing, China. Electronic address:

Background: Nasal high-frequency oscillatory ventilation (NHFOV) has been described as supplying the combined advantages of nasal CPAP (NCPAP) and HFOV. However, its effect on preterm infants needs to be further elucidated. Our objective was to assess whether NHFOV could reduce intubation and Pco levels as compared with NCPAP during the postextubation phase in preterm infants. Read More

Eur J Pharmacol 2019 Apr 3;854:79-91. Epub 2019 Apr 3.

Department of Critical Care Medicine and Orthopedics, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou City, 310009, China. Electronic address:

Acute lung injury (ALI) and acute respiratory distress syndrome are life-threatening conditions that still have no definite pharmacotherapy. Hence, we investigate the potential effectiveness and underlying mechanism of CT-133, a newly developed selective antagonist of prostaglandin D2 receptor 2 (DP2) or of chemoattractant receptor homologous molecule expressed on Th2 cells (CRTH2), against lipopolysaccharide (LPS)-induced ALI. CT-133 (10 or 30 mg/kg) or dexamethasone (1 mg/kg, positive control) were intragastrically administered 1 h before and 12 h after intratracheal LPS instillation, and primary neutrophils and macrophages and RAW264. Read More

PLoS One 2019 3;14(4):e0202456. Epub 2019 Apr 3.

Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.

Many lung diseases, such as the acute respiratory distress syndrome (ARDS), display significant regional heterogeneity with patches of severely injured tissue adjacent to apparently healthy tissue. Current mouse models that aim to mimic ARDS generally produce diffuse injuries that cannot reproducibly generate ARDS's regional heterogeneity. This deficiency prevents the evaluation of how well therapeutic agents reach the most injured regions and precludes many regenerative medicine studies since it is not possible to know which apparently healing regions suffered severe injury initially. Read More

J Neonatal Perinatal Med 2019 Mar 29. Epub 2019 Mar 29.

University of Nebraska, Lincoln, Nebraska, USA.

Aim: To evaluate the association between the use of nasal continuous positive airway pressure (nCPAP) or nasal intermittent positive pressure ventilation (NIPPV) with the development of bronchopulmonary dysplasia (BPD).

Methods: This is a single center retrospective cohort analysis of infants born at ≤1000 grams and ≤28 weeks gestation with respiratory distress treated with nCPAP or NIPPV. Groups were compared using Student's t test or chi-square, and associations estimated by logistic regression. Read More

Pediatr Radiol 2019 Mar 30. Epub 2019 Mar 30.

Department of Radiology, Children's Hospital Colorado, 13123 E. 16th Ave., Box 125, Aurora, CO, 80045, USA.

Background: The expression of the NKX2-1 gene and its encoded protein, thyroid transcription factor 1 (TTF-1), plays a role in pulmonary surfactant homeostasis and lung development. NKX2-1 mutations have been associated with neonatal respiratory distress, hypotonia, choreoathetosis and congenital hypothyroidism. These clinical findings have been coined brain-lung-thyroid syndrome, although not all three organs are always involved. Read More

Oman Med J 2019 Mar;34(2):99-104

Department of Pediatrics and Neonatology, Tabriz University of Medical Sciences, Tabriz, Iran.

Objectives: There is a tendency to use noninvasive ventilation (NIV) as a substitute for mechanical ventilation in preterm infants who need respiratory support. Two important modes of NIV include nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV). We sought to compare the efficacy of NCPAP and NIPPV as early respiratory support in preterm infants with respiratory distress syndrome in reducing the need for intubation, surfactant administration, and mechanical ventilation. Read More

Biomicrofluidics 2018 Jul 3;12(4):044101. Epub 2018 Jul 3.

Department of Pediatrics, McMaster University, Hamilton, Ontario L8S 4L7, Canada.

Preterm neonates suffering from respiratory distress syndrome require assistive support in the form of mechanical ventilation or extracorporeal membrane oxygenation, which may lead to long-term complications or even death. Here, we describe a high performance artificial placenta type microfluidic oxygenator, termed as a double-sided single oxygenator unit (dsSOU), which combines microwire stainless-steel mesh reinforced gas permeable membranes on both sides of a microchannel network, thereby significantly reducing the diffusional resistance to oxygen uptake as compared to the previous single-sided oxygenator designs. The new oxygenator is designed to be operated in a pumpless manner, perfused solely due to the arterio-venous pressure difference in a neonate and oxygenate blood through exposure directly to ambient atmosphere without any air or oxygen pumping. Read More

J Pediatric Infect Dis Soc 2019 Mar 13. Epub 2019 Mar 13.

Department of Medicine, Swiss Tropical and Public Health Institute and Faculty of Medicine, University of Basel, Switzerland.

Background: Scrub typhus, caused by Orientia tsutsugamushi, is a major cause of acute febrile illness in children in the rural tropics.

Methods: We recruited 60 febrile pediatric patients with a positive scrub typhus rapid diagnostic test result and 40 healthy controls from Chiang Rai Province in northern Thailand. Diagnosis was confirmed by the detection of (1) O. Read More

Am J Physiol Lung Cell Mol Physiol 2019 Mar 6. Epub 2019 Mar 6.

Pediatrics and Communicable Disease, University of Michigan, United States.

Protein phosphatase 2A (PP2A), a ubiquitously expressed ser/thr phosphatase is an important regulator of cytokine signaling and cell function. We previously showed that myeloid-specific deletion of PP2A (LysMcrePP2A-/-) increased mortality in a murine peritoneal sepsis model. In the current study, we assessed the role of myeloid PP2A in regulation of lung injury induced by lipopolysaccharide (LPS) or bleomycin delivered intratracheally. Read More

Niger J Clin Pract 2019 Mar;22(3):298-304

Department of Radiology, Bayero University Kano, Aminu Kano Teaching Hospital, Kano, Nigeria.

Background: Intraventricular hemorrhage (IVH) is a severe complication among preterm neonates which can result in hydrocephalus, cerebral palsy, behavioural disorders, learning disabilities, or death. It is important to identify the factors associated with IVH in order to prevent these neurological consequences and reduce the resultant burden of neurological disease. Aim: To determine the factors associated with IVH among preterm neonates. Read More

J Leukoc Biol 2019 Mar 5. Epub 2019 Mar 5.

Department of Pediatrics, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.

It has become increasingly apparent that the biomechanical properties of neutrophils impact on their trafficking through the circulation and in particularly through the pulmonary capillary bed. The retention of polarized or shape-changed neutrophils in the lungs was recently proposed to contribute to acute respiratory distress syndrome pathogenesis. Accordingly, this study tested the hypothesis that neutrophil priming is coupled to morpho-rheological (MORE) changes capable of altering cell function. Read More

World J Pediatr 2019 Mar 4. Epub 2019 Mar 4.

Department of Pediatrics, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mahatma Gandhi Road, Mysuru, Karnataka 570 004, India.

Background: There is a paucity of studies conducted in India on neonatal outcomes of preterm birth and low birth weight. Hence, we aimed to assess the impact of preterm birth and low birth weight on medical conditions, medication use and mortality among neonates.

Methods: A prospective observational cohort study was conducted at the neonatal intensive care unit (NICU) over a period of 9 months. Read More

Pediatr Crit Care Med 2019 Mar;20(3):303-305

Division of Pediatric Critical Care Medicine, Rainbow Babies & Children's Hospital, Cleveland, OH Department of Pediatrics, UFRGS School of Medicine, Department of Pediatric Emergency Medicine and Critical Care, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.

Expert Rev Respir Med 2019 Feb 28:1-3. Epub 2019 Feb 28.

a David Geffen School of Medicine , University of California Los Angeles , Los Angeles , CA , USA.

Sci Rep 2019 Feb 27;9(1):2874. Epub 2019 Feb 27.

Emory University School of Medicine, Department of Pediatrics, Atlanta, GA, USA.

Neutrophils are recruited to the airways of patients with acute respiratory distress syndrome (ARDS) where they acquire an activated pro-survival phenotype with an enhanced respiratory burst thought to contribute to ARDS pathophysiology. Our in vitro model enables blood neutrophil transepithelial migration into cell-free tracheal aspirate fluid from patients to recapitulate the primary airway neutrophil phenotype observed in vivo. Neutrophils transmigrated through our model toward airway fluid from children with lower respiratory viral infections coinfected with bacteria had elevated levels of neutrophil activation markers but paradoxically exhibited an inability to kill bacteria and a defective respiratory burst compared with children without bacterial coinfection. Read More

Expert Rev Respir Med 2019 Apr;13(4):327-336

b Division of Pediatric Critical Care Medicine, Department of Pediatrics , Duke Children's Hospital , Durham , NC , USA.

Introduction: The use of mechanical ventilation is an invaluable tool in caring for critically ill patients. Enhancing our capabilities in mechanical ventilation has been instrumental in the ability to support clinical conditions and diseases which were once associated with high mortality. Areas covered: Within this manuscript, we will look to discuss emerging approaches to improving the care of pediatric patients who require mechanical ventilation. Read More

Int J Spine Surg 2019 Jan 22;13(1):68-78. Epub 2019 Feb 22.

Division of Spinal Surgery, Departments of Orthopaedic and Neurological Surgery, Hospital for Joint Diseases at NYU Langone Medical Center, NYU School of Medicine, New York, New York.

Background: The study aimed to characterize trends in incidence, etiology, fracture types, surgical procedures, complications, and concurrent injuries associated with traumatic pediatric cervical fracture using a nationwide database.

Methods: The Kids' Inpatient Database (KID) was queried. Trauma cases from 2003 to 2012 were identified, and cervical fracture patients were isolated. Read More

J Perinat Med 2019 Feb 21. Epub 2019 Feb 21.

Division of Neonatology, Department of Pediatrics, Cairo University Children's Hospital, Cairo, Egypt.

Background The pathogenesis of bronchopulmonary dysplasia (BPD) includes arrest of alveolar septation and enhanced fibrosis. We hypothesized that mesenchymal stromal cells (MSC) and transforming growth factor-β1 (TGF-β1) in tracheal aspirates of mechanically ventilated premature infants differ in BPD and non-BPD infants. Methods Tracheal aspirates were collected during the first week of life. Read More

BMJ Open 2019 Jan 17;9(1):e024687. Epub 2019 Jan 17.

Department of Health Sciences, University of Yamanashi, Chuo City, Japan.

Objective: To calculate the incidence of hospitalisation due to acute respiratory failure, pneumonia, acute respiratory distress syndrome (ARDS), febrile seizures and encephalitis/encephalopathy among influenza-positive patients in Japan, where point-of-care tests are routinely used to diagnose influenza.

Design: A cross-sectional study using routinely collected data.

Setting: Japanese clinics and hospitals between 2012 and 2016. Read More

Pediatr Res 2019 Feb 19. Epub 2019 Feb 19.

Medical Sciences Division, University Department of Paediatrics, University of Oxford, Oxford, UK.

JCI Insight 2019 Mar 21;4(6). Epub 2019 Mar 21.

Thomas E. Starzl Transplantation Institute.

Acute respiratory distress syndrome is an often fatal disease that develops after acute lung injury and trauma. How released tissue damage signals, or alarmins, orchestrate early inflammatory events is poorly understood. Herein we reveal that IL-33, an alarmin sequestered in the lung epithelium, is required to limit inflammation after injury due to an unappreciated capacity to mediate Foxp3+ Treg control of local cytokines and myeloid populations. Read More

Pediatr Res 2019 Apr 15;85(5):693-696. Epub 2019 Feb 15.

Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA.

Background: Preeclampsia (PE) is a pregnancy complication characterized by an anti-angiogenic environment. This can affect fetal pulmonary vascular and alveolar development but data of the impact of PE on respiratory outcome in extremely premature infants are inconclusive. The objective of this study was to determine if PE is associated with an increased risk for severe respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) in extremely premature infants. Read More

Front Pediatr 2019 29;7. Epub 2019 Jan 29.

Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States.

To determine if increasing positive end expiratory pressure (PEEP) leads to a change in cardiac index in children with Pediatric Acute Respiratory Distress Syndrome ranging from mild to severe. Prospective interventional study. Multidisciplinary Pediatric Intensive Care Unit in a University teaching hospital. Read More

Korean J Pediatr 2019 Feb 8. Epub 2019 Feb 8.

Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine, Busan , Korea.

After the first successful trial of surfactant replacement therapy for preterm infants with respiratory distress syndrome (RDS) by Fujiwara in 1980, several animal-derived natural surfactants and synthetic surfactants have been developed. Synthetic surfactants were made to overcome limitations of natural surfactants such as expensiveness, immune reactions, and infections due to animal proteins contained in natural surfactants. However, first-generation synthetic surfactants that are protein-free have failed to prove superiority over natural surfactants because they do not have surfactant protein (SP). Read More

J Clin Med 2019 Feb 10;8(2). Epub 2019 Feb 10.

School of Medicine, College of Medicine, Fu Jen Catholic University, Xinzhuang Dist., New Taipei City 24205, Taiwan (R.O.C).

Since the clinical benefit of lung recruitment maneuvers (LRMs) is still conflicting, we performed this prospective, randomized, controlled study to investigate whether LRMs should be used in the routine management of acute respiratory distress syndrome (ARDS). This trial was conducted in four intensive care units (ICUs) to compare application of a modified stepwise LRMs with solely lung-protective ventilation in patients with moderate to severe ARDS within 72 h from the onset. The primary outcome was 28-day mortality, and the secondary outcomes were ventilator-free days and ICU-free days. Read More

Respir Res 2019 Feb 6;20(1):28. Epub 2019 Feb 6.

Division of Pediatrics and Neonatal Critical Care, Medical Center "A. Béclère", South Paris University Hospitals, Assistance Publique-Hôpitaux de Paris (APHP) , Paris, France.

Background: Bovine surfactants are known to be clinically equivalent but it is unclear if porcine or bovine surfactants at their licensed dose should be preferred to treat respiratory distress syndrome in preterm neonates.

Methods: We performed a comprehensive review of biochemical and pharmacological features of surfactants to understand the biological plausibility of any clinical effect. We then performed a pragmatic meta-analysis comparing internationally marketed porcine and bovine surfactants for mortality and respiratory outcomes. Read More

Circ J 2019 Feb 7;83(3):654-661. Epub 2019 Feb 7.

Cardiovascular Research Institute, Yokohama City University.

Background: Antenatal betamethasone (BMZ) is a standard therapy for reducing respiratory distress syndrome in preterm infants. Recently, some reports have indicated that BMZ promotes ductus arteriosus (DA) closure. DA closure requires morphological remodeling; that is, intimal thickening (IT) formation; however, the role of BMZ in IT formation has not yet been reported. Read More

Front Pediatr 2018 22;6:436. Epub 2019 Jan 22.

Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.

High frequency oscillatory ventilation (HFOV) is considered a lung protective ventilation mode in preterm infants only if lung volume is optimized. However, whilst a "high lung volume strategy" is advocated for HFOV in preterm infants this strategy is not precisely defined. It is not known to what extent lung recruitment should be pursued to provide lung protection. Read More

Pediatr Crit Care Med 2019 Feb;20(2):204-205

Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA Department of Pediatrics and Public Health Sciences, Penn State University College of Medicine, Hershey, PA.

Clin Infect Dis 2019 Feb 2. Epub 2019 Feb 2.

The Joint Center for Infection and Immunity: a. Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou, China; b. Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China.

We identified, for the first time, the presence of small circular single stranded Gemykibivirus (GkV) genome from the respiratory tract of an elderly woman with severe acute respiratory distress syndrome using metagenomics analysis. Our results suggest that further studies on whether GkVs infect humans and cause respiratory disease are needed. Read More

Am J Perinatol 2019 Jan 31. Epub 2019 Jan 31.

Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.

To date, few studies have investigated whether perinatal factors affect coagulation parameters at birth in preterm and term neonates. We retrospectively investigated coagulation factors on day 1 in 609 consecutive neonates admitted to our neonatal intensive care unit between January 2010 and December 2017. We measured coagulation factors on day 1 using peripheral blood samples. Read More

Case Rep Pediatr 2018 30;2018:4549060. Epub 2018 Dec 30.

Department of Pathology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

Complications due to spontaneous septostomy of the dividing membrane in monochorionic diamniotic pregnancies are rarely described. Herein, we report the case of a preterm female neonate from a monochorionic diamniotic twin pregnancy delivered by caesarean section at 32 weeks of gestation. She was born with a broad band of a transparent membrane-like material firmly attached to her lower abdomen. Read More

Pediatr Crit Care Med 2019 Apr;20(4):323-331

Division of Critical Care, Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA.

Objectives: As acute kidney injury and elevated cumulative fluid balance commonly co-occur in pediatric acute respiratory distress syndrome, we aimed to identify risk factors for their development and evaluate their independent relationships with mortality. We hypothesized that acute kidney injury and elevated cumulative fluid balance would be associated with markers of inflammation and that children with elevated cumulative fluid balance and concomitant acute kidney injury would have worse outcomes than other children.

Design: Prospective observational study using the pediatric Risk, Injury, Failure, Loss, End-Stage acute kidney injury classification. Read More

Am J Perinatol 2019 Jan 21. Epub 2019 Jan 21.

Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Objective:  This article identifies the prevalence and associated factors of hypophosphatemia (HP) in very low birth weight (VLBW) infants in the first week of life.

Study Design:  Prospective exploratory cohort study of 106 consecutive VLBW infants admitted to neonatal intensive care at Foothills Hospital, Calgary, Canada. HP was defined as at least one measurement of serum phosphate < 1. Read More

Pediatr Pulmonol 2019 Apr 20;54(4):405-414. Epub 2019 Jan 20.

Division of Neonatology, Maimonides Infants and Children's Hospital, Brooklyn, New York.

Background: The management practices of Respiratory Distress Syndrome (RDS) in the newborn have changed over time. We examine the trends in the epidemiology, resource utilization, and outcomes (mortality and bronchopulmonary dysplasia [BPD]) of RDS in preterm neonates ≤34 weeks gestational age (GA) in the United States.

Methods: In this retrospective serial cross-sectional study, we used ICD-9 codes to classify preterm infants GA ≤34 weeks between 2003 and 2014 from the National Inpatient Sample as having RDS or not. Read More

Ann Intensive Care 2019 Jan 18;9(1). Epub 2019 Jan 18.

Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Huispost CA 80, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.

Background: High-frequency oscillatory ventilation (HFOV) is a common but unproven management strategy in paediatric critical care. Oscillator settings have been traditionally guided by patient age and/or weight rather than by lung mechanics, thereby potentially negating any beneficial effects. We have adopted an open-lung HFOV strategy based on a corner frequency approach using an initial incremental-decremental mean airway pressure titration manoeuvre, a high frequency (8-15 Hz), and high power to initially target a proximal pressure amplitude (∆P) of 70-90 cm HO, irrespective of age or weight. Read More

J Hum Genet 2019 Apr 18;64(4):297-304. Epub 2019 Jan 18.

United Diagnostic and Research Center for Clinical Genetics, School of Public Health of Xiamen University & Xiamen Maternal and Child Health Hospital, Xiamen, Fujian, 361003, China.

COQ4 mutations have recently been shown to cause a broad spectrum of mitochondrial disorders in association with CoQ10 deficiency. Herein, we report the clinical phenotype, in silico and biochemical analyses, and intervention for a novel c.370 G > A (p. Read More

Cureus 2018 Oct 25;10(10):e3495. Epub 2018 Oct 25.

Neonatology and Pediatrics, International Modern Hospital, Dubai, ARE.

Minimally invasive surfactant therapy (MIST) in neonates without intubation has in recent times become an accepted standard in the neonatal intensive care units (NICU) especially in Europe. We have adapted this novel technique in our clinical practice in the neonatal intensive care units in Dubai since 2018. Herein we report the successful outcome of implementation of this technique in three of our neonates of gestation/weight, 28/1. Read More

J Obstet Gynaecol Can 2019 Jan 12. Epub 2019 Jan 12.

Department of Obstetrics and Gynaecology. Division of Maternal Fetal Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON. Electronic address:

Objective: This study sought to determine the incidence and severity of respiratory morbidity among late preterm and term babies born by elective Caesarean section (CS) in London, Ontario.

Methods: A retrospective chart review was conducted of all elective CSs performed at or beyond 36+0 weeks gestation from June 2010 to June 2014 at London Health Sciences Centre and St. Joseph's Health Care (Canadian Task Force Classification II-2). Read More

Pediatr Crit Care Med 2019 Mar;20(3):e145-e153

Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA.

Objectives: The impact of tidal volume on outcomes in mechanically ventilated children with pediatric acute respiratory distress syndrome remains unclear. To date, observational investigations have failed to calculate tidal volume based on standardized corrections of weight. We investigated the impact of tidal volume on mortality and probability of extubation in pediatric acute respiratory distress syndrome using ideal body weight-adjusted tidal volume. Read More