Neonatal Updates #31

Yoder BA, Stoddard RA, Li M, King J, Dirnberger DR, Abbasi S: Heated, Humidified High-Flow Nasal Cannula Versus Nasal CPAP for Respiratory Support in Neonates. Pediatrics 2013. A multi-center RCT among just over 400 infants who were at least 1 kg and at least 28 weeks gestation. Infants who would otherwise receive CPAP were randomized to either CPAP (at 5 or 6 cm H2O) or high flow cannulae at between 3 and 5 liters per minute depending on their body weight. Babies were eligible either in the first 24 hours or after extubation. The outcomes were very similar in the two groups, with some minor evidence of benefit with CPAP (fewer days of positive pressure in total).

Azzopardi D, Robertson NJ, Kapetanakis A, Griffiths J, Rennie JM, Mathieson SR, Edwards AD: Anticonvulsant effect of xenon on neonatal asphyxial seizures. Archives of Disease in Childhood – Fetal and Neonatal Edition 2013. Of 14 infants receiving xenon gas in addition to cooling, 5 had seizure. The seizures stopped during xenon therapy, started again when xenon was withdrawn, and stopped again when xenon was restarted.

Bohnhorst B: Usefulness of abdominal ultrasound in diagnosing necrotising enterocolitis. Archives of Disease in Childhood – Fetal and Neonatal Edition 2013. A good quality review, appropriately cautious about the place of ultrasound. I have certainly had radiologists tell me that a baby had penumatosis on an abdominal ultrasound performed for other reasons entirely, I do think that portal venous gas is probably a reliable sign of NEC, and ultrasound is probably much more sensitive than x-ray for this finding.

Bremer DL, Rogers DL, Good WV, Tung B, Hardy RJ, Fellows R: Glaucoma in the Early Treatment for Retinopathy of Prematurity (ETROP) study. Journal of American Association for Pediatric Ophthalmology and Strabismus 2012, 16(5):449-452. It is not common, but I was unaware that babies with high risk prethreshold RoP are at risk of glaucoma, about 2% before 6 years of age, regardless of whether they had early laser treatment or not.

About Keith Barrington

I am a neonatologist and clinical researcher at Sainte Justine University Health Center in Montréal
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