Neonatal Updates #39

Storme L, Aubry E, Rakza T, Houeijeh A, Debarge V, Tourneux P, Deruelle P, Pennaforte T: Pathophysiology of persistent pulmonary hypertension of the newborn: Impact of the perinatal environment. Archives of Cardiovascular Diseases 2013, 106(3):169-177.  An excellent review article by someone who has been instrumental in this field for many years, Laurent Storme, and one of our fellows, Thomas Pennaforte.

McMorrow A, Smirk C, Davis PG, Fox LM: Outcomes of preterm infants receiving positive pressure support at term corrected gestation. Journal of Paediatrics and Child Health 2013. I know Peter Davis as a regular guy… so how come he never sleeps, or if he does he must be revising articles in his sleep. This article shows that to still be on positive pressure support when you reach term isn’t a good outcome, but if you are extubated and on non-invasive support it isn’t all that bad unless you need a lot of oxygen, babies needing more than 50%, and especially more than 70% oxygen, or those who are still intubated, don’t do well. Being on CPAP with less oxygen, the majority of babies eventually survived to go home.

Fung ME, Thebaud B: Stem cell-based therapy for neonatal lung disease-it’s in the juice. Pediatr Res 2013. interesting review of the current state of stem cell therapy for lung repair in the preterm. Notes the surprising fact that the cells aren’t important! The media in which the cells are grown looks like it is just as effective. Whod’ve thought.

Pineda RG, Neil J, Dierker D, Smyser CD, Wallendorf M, Kidokoro H, Reynolds LC, Walker S, Rogers C, Mathur AM et al: Alterations in Brain Structure and Neurodevelopmental Outcome in Preterm Infants Hospitalized in Different Neonatal Intensive Care Unit Environments. The Journal of pediatrics 2013. This may just be observational data, but obvious bias I cannot see (as Yoder might put it) babies in single rooms had a number of apparently poorer outcomes, EEG maturation, language development, even after adjustment for risk factors, than similar babies in a more traditional NICU. There are certainly advantages to a single room approach, we need to make sure there aren’t also adverse effects.

About Keith Barrington

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