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Neonatal Perfusion Assessment

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1. Non-invasive continuous cardiac output and cerebral perfusion monitoring in term infants with neonatal encephalopathy: Assessment of feasibility and reliability. (PubMed)

Non-invasive continuous cardiac output and cerebral perfusion monitoring in term infants with neonatal encephalopathy: Assessment of feasibility and reliability. BackgroundNoninvasive hemodynamic monitoring of infants with neonatal encephalopathy (NE) undergoing therapeutic hypothermia (TH) would be a potentially useful clinical tool. We aimed to assess the feasibility and reliability of noninvasive cardiac output monitoring (NICOM) and near-infrared spectroscopy (NIRS (...) % (limits of agreement 3-51%). NICOM illustrated lower CO during TH, which increased during rewarming. SctO2 increased over the first 30 h of TH and stayed high for the remainder of the study. There was a rise in SVR over the first 30 h of TH and a decrease during rewarming (all P<0.05).ConclusionsNoninvasive hemodynamic assessment of infants with NE is feasible and illustrates potentially important changes. Larger studies are needed to assess the clinical applicability of those methods in this cohort.

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2017 Pediatric Research

2. Exhaled CO2 Parameters as a Tool to Assess Ventilation-Perfusion Mismatching during Neonatal Resuscitation in a Swine Model of Neonatal Asphyxia (PubMed)

Exhaled CO2 Parameters as a Tool to Assess Ventilation-Perfusion Mismatching during Neonatal Resuscitation in a Swine Model of Neonatal Asphyxia End-tidal CO2 (ETCO2), partial pressure of exhaled CO2 (PECO2), and volume of expired CO2 (VCO2) can be continuously monitored non-invasively to reflect pulmonary ventilation and perfusion status. Although ETCO2 ≥14 mmHg has been shown to be associated with return of an adequate heart rate in neonatal resuscitation and quantifying the PECO2 has (...) the potential to serve as an indicator of resuscitation quality, there is little information regarding capnometric measurement of PECO2 and ETCO2 in detecting return of spontaneous circulation (ROSC) and survivability in asphyxiated neonates receiving cardiopulmonary resuscitation (CPR).Seventeen newborn piglets were anesthetized, intubated, instrumented, and exposed to 45-minute normocapnic hypoxia followed by apnea to induce asphyxia. Protocolized resuscitation was initiated when heart rate decreased

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2016 PloS one

3. Neonatal Perfusion Assessment

Neonatal Perfusion Assessment Neonatal Perfusion Assessment Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Neonatal Perfusion (...) Assessment Neonatal Perfusion Assessment Aka: Neonatal Perfusion Assessment II. Protocol: Evaluate Central Color Pink or only (acrocyanosis) Observe and monitor Use Blow-By Oxygen until pink Re-evaluate status periodically III. References Kattwinkel (2000) , AAP-AHA Kattwinkel (2010) , AAP-AHA Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Neonatal Perfusion Assessment." Click on the image (or right click) to open the source website

2018 FP Notebook

4. Neonatal Myocardial Perfusion in Right Ventricle Dependent Coronary Circulation: Clinical Surrogates and Role of Troponin-I in Postoperative Management Following Systemic-to-Pulmonary Shunt Physiology. (PubMed)

the interstage period towards conversion to the superior cavopulmonary shunt physiology. Current literature is scarce regarding this specific patient population. Cardiac troponin-I is widely used as a marker of coronary ischemia in adults, but its use for routine monitoring of neonatal myocardial tissue injury due to supply/demand perfusion mismatch is, yet to be determined. We sought to evaluate the clinical correlation of cTnl perioperative use in a PA/IVS RVDCC case and assess its interplay (...) Neonatal Myocardial Perfusion in Right Ventricle Dependent Coronary Circulation: Clinical Surrogates and Role of Troponin-I in Postoperative Management Following Systemic-to-Pulmonary Shunt Physiology. Right ventricle dependent coronary circulation (RVDCC) in pulmonary atresia with intact ventricular septum (PA/IVS) is associated with significant mortality risk in the immediate post-operative period following the initial stage of surgical palliation. Prognosis remains guarded during

2018 Pediatric Cardiology

5. Arterioportal shunting, splanchnic capillary perfusion, and the effects of colloids during capnoperitoneum in neonatal and adolescent pigs. (PubMed)

of splanchnic organs in the young including effects of colloid application.Male piglets (n = 25) were divided into four groups: (1) neonatal controls, (2) neonates with crystalloid restitution, (3) neonates with colloidal restitution, and (4) adolescents with crystalloid restitution. Animals were ventilated and subjected to a 3-h, 10 mmHg CO2 pneumoperitoneum followed by 2 h resuscitation. Hepatic, splanchnic, and arteriovenous shunt perfusion was assessed via central and portal venous catheters. Capillary (...) Arterioportal shunting, splanchnic capillary perfusion, and the effects of colloids during capnoperitoneum in neonatal and adolescent pigs. Clinical and experimental data indicate that neonates are sensitive to the CO2 pneumoperitoneum. An impaired splanchnic perfusion during laparoscopy in adults has been reported. We recently confirmed that intravenous colloids improve macrocirculatory function in neonates. We aimed to determine the impact of CO2 pneumoperitoneum on the perfusion

2017 Surgical endoscopy

6. Quantification of Cerebral Perfusion by Contrast-enhanced Ultrasound During Neonatal Heart Surgery

Quantification of Cerebral Perfusion by Contrast-enhanced Ultrasound During Neonatal Heart Surgery Quantification of Cerebral Perfusion by Contrast-enhanced Ultrasound During Neonatal Heart Surgery - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove (...) one or more studies before adding more. Quantification of Cerebral Perfusion by Contrast-enhanced Ultrasound During Neonatal Heart Surgery (TCEUS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03215628 Recruitment

2017 Clinical Trials

7. Contrast Enhanced Ultrasound Evaluation of Brain Perfusion in Neonatal Post-Hemorrhagic Hydrocephalus

Last Update Posted : January 25, 2018 Sponsor: Johns Hopkins University Information provided by (Responsible Party): Johns Hopkins University Study Details Study Description Go to Brief Summary: The aim of the proposed project is therefore to utilize the CEUS technique to assess cerebral perfusion changes before and after ventricular shunting in neonatal cases of PHH. The expectation of the proposed project is to validate statistically significant cerebral perfusion differences before and after (...) Contrast Enhanced Ultrasound Evaluation of Brain Perfusion in Neonatal Post-Hemorrhagic Hydrocephalus Contrast Enhanced Ultrasound Evaluation of Brain Perfusion in Neonatal Post-Hemorrhagic Hydrocephalus - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please

2017 Clinical Trials

8. Specialist neonatal respiratory care for babies born preterm

be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Specialist neonatal respiratory care for babies born preterm (NG124) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 (...) compared with babies who do not receive dexamethasone. Although there was evidence demonstrating this lack of difference, there is uncertainty about the risk of neurodevelopmental delay and neurosensory impairment because the studies reported neurodevelopmental assessments at different timepoints. Specialist neonatal respiratory care for babies born preterm (NG124) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 11

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

9. ACR–ASNR–SPR Practice Parameter for the Performance of Intracranial Magnetic Resonance Perfusion Imaging

of Radiology (ACR), the American Society of Neuroradiology (ASNR), and the Society for Pediatric Radiology (SPR). Magnetic resonance perfusion imaging is a proven and useful tool for the evaluation, assessment of severity, and follow-up of diseases of the central nervous system. It can be performed with contrast administration using dynamic susceptibility contrast (DSC) or dynamic contrast enhancement (DCE) techniques or without contrast administration using arterial spin-labeling (ASL) techniques. II (...) protocol may vary depending on the manufacturer and field strength. For imaging neoplasms, an initial GBCA dose of approximately 0.05 mmol/kg may be injected prior to the DSC injection in order to correct for anticipated leakage effects. Alternatively, intravascular blood pool agents may be considered to evaluate perfusion, although these agents limit evaluation of blood-brain barrier leakage. To assess the hemodynamic significance of an arterial stenosis or occlusion, pharmacologic challenge testing

2019 American Society of Neuroradiology

10. Does Routine Assessment of Gastric Residuals in Preterm Neonates Influence Time Taken to Reach Full Enteral Feeding?

Does Routine Assessment of Gastric Residuals in Preterm Neonates Influence Time Taken to Reach Full Enteral Feeding? Does Routine Assessment of Gastric Residuals in Preterm Neonates Influence Time Taken to Reach Full Enteral Feeding? - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number (...) of saved studies (100). Please remove one or more studies before adding more. Does Routine Assessment of Gastric Residuals in Preterm Neonates Influence Time Taken to Reach Full Enteral Feeding? (GRASS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details

2017 Clinical Trials

11. Management of Stroke in Neonates and Children

Management of Stroke in Neonates and Children Management of Stroke in Neonates and Children: A Scientific Statement From the American Heart Association/American Stroke Association | Stroke Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 February 2019 February 2019 January 2019 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access article , MD, MS, FAHA, Co (...) scientific statement on pediatric stroke was published 10 years ago. Although stroke has long been recognized as an adult health problem causing substantial morbidity and mortality, it is also an important cause of acquired brain injury in young patients, occurring most commonly in the neonate and throughout childhood. This scientific statement represents a synthesis of data and a consensus of the leading experts in childhood cardiovascular disease and stroke. Methods— Members of the writing group were

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2019 American Heart Association

12. Perfusion index assessment during transition period of newborns: an observational study. (PubMed)

Perfusion index assessment during transition period of newborns: an observational study. Perfusion index (PI) is becoming a part of clinical practice in neonatology to monitor peripheral perfusion noninvasively. Hemodynamic and respiratory changes occur in newborns during the transition period after birth in which peripheral perfusion may be affected. Tachypnea is a frequent symptom during this period. While some tachypneic newborns get well in less than 6 h and diagnosed as "delayed transition (...) ", others get admitted to intensive care unit which transient tachypnea of newborn (TTN) being the most common diagnosis among them. We aimed to compare PI of neonates with TTN and delayed transition with controls, and assess its value on discrimination of delayed transition and TTN.Neonates with gestational age between 37 and 40 weeks who were born with elective caesarian section were included. Eligible neonates were monitored with Masimo Set Radical7 pulse-oximeter (Masimo Corp., Irvine, CA, USA

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2016 BMC Pediatrics

13. Heterogeneous increases of regional cerebral blood flow during preterm brain development: Preliminary assessment with pseudo-continuous arterial spin labeled perfusion MRI (PubMed)

Heterogeneous increases of regional cerebral blood flow during preterm brain development: Preliminary assessment with pseudo-continuous arterial spin labeled perfusion MRI The human brain develops rapidly during 32-45 postmenstrual weeks (PMW), a critical stage characterized by dramatic increases of metabolic demand. The increasing metabolic demand can be inferred through measurements of regional cerebral blood flow (CBF), which might be coupled to regional metabolism in preterm brains (...) . Arterial spin labeled (ASL) perfusion MRI is one of the few viable approaches for imaging regional CBF of preterm brains, but must be optimized for the extremely slow blood velocity unique in preterm brains. In this study, we explored the spatiotemporal CBF distribution in newborns scanned at the age of 32-45PMW using a pseudo-continuous ASL (pCASL) protocol adapted to slow blood flow in neonates. A total of 89 neonates were recruited. PCASL MRI was acquired from 34 normal newborns and phase contrast

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2016 NeuroImage

14. Standards for Neonatal Resuscitation

Appendix 1: Neonatal Resuscitation Supplies and Equipment Quick Check for Radiant Warmer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Appendix 2: Neonatal Resuscitation Supplies and Equipment . . . . . . . . . . . 21 Appendix 3: Individual Integrated Skills Station Assessment tool . . . . . . . . . 23 Appendix 4: Neonatal Resuscitation Algorithm . . . . . . . . . . . . . . . . . . . . . . 25 Appendix 5: Safe Skin to Skin Positioning (...) Columbia (BC). ? ? Facilities that offer planned perinatal services must ensure their personnel are capable of neonatal resuscitation, post-resuscitation assessment and stabilization. 2 ? ? All facilities must have an algorithm / plan outlining the provision of neonatal resuscitation. In some facilities, the response team may include health care personnel from outside the usual perinatal team (e.g., emergency room, anesthesia, medicine, surgery, respiratory). The roles and responsibilities of each

2017 British Columbia Perinatal Health Program

15. Resuscitation - neonatal

hypothermia Temperature between 35.5 °C and 35.9 °C Moderate hypothermia Temperature between 32.0 °C and 35.4°C Queensland Clinical Guideline: Neonatal resuscitation Refer to online version, destroy printed copies after use Page 5 of 38 Table of Contents 1 Introduction 7 1.1 Clinical standards 7 1.2 Clinicians 8 2 Risk factors for neonatal resuscitation 9 3 Preparation: staff, equipment, medications and environment 10 3.1 Communication and information sharing 11 4 Assessment and management of baby 12 4.1 (...) Endotracheal tube intubation 37 Acknowledgements 38 Queensland Clinical Guideline: Neonatal resuscitation Refer to online version, destroy printed copies after use Page 6 of 38 List of Tables Table 1 Clinical standards 7 Table 2 Clinicians 8 Table 3 Risk factors 9 Table 4 Preparation 10 Table 5 Communication and information sharing 11 Table 6 Assessment and initial management at birth 12 Table 7 Subsequent assessment and management 13 Table 8 Oxygen saturation monitoring 14 Table 9 Care of baby 15 Table 10

2018 Queensland Health

16. Neonatal stabilisation for retrieval

· Specific condition management–consider: o OGT/NGT on free drainage o Polyethylene bag/sheet Review obstetric history that may impact on neonatal management Assess all babies at birth · Effective respirations · Tone · Heart rate Prevent hypothermia · Overhead radiant warmer/ incubator · Dry, warm wraps, hat, booties · Polyethylene bag/sheet o 30% Work of breathing · Tachypnoea · Chest recession (sternal, intercostal, lower costal) · Nasal flaring · Audible expiratory grunt O 2 saturations · Target: o (...) continuously · Normal respiratory rate: 30–60 breaths per minute 27,28 · Assess work of breathing—nasal flaring, subcostal/intercostal/sternal recession, grunting, tracheal tug · Refer to Table 8. Respiratory support Oxygen saturation · Monitor continuously and record pre-ductal measurement from right hand or wrist · In the absence of good quality evidence, Queensland Neonatal Services Advisory Group (QNSAG) endorse the following consensus recommendation for oxygen saturation targets after 10 minutes

2018 Clinical Practice Guidelines Portal

17. Inflammatory and vascular placental lesions are associated with neonatal amplitude integrated EEG recording in early premature neonates. (PubMed)

associated with depressed neonatal cerebral activity during the first 3 days of life (P = 0.007).Depressed neonatal aEEG patterns are associated with placental lesions consistent with maternal under perfusion, and amniotic fluid infection of fetal type, but not with fetal thrombo-oclusive vascular disease of inflammatory type. Our findings highlight the association between the intrauterine mechanisms leading to preterm parturition and subsequent depressed neonatal cerebral function early after birth (...) Inflammatory and vascular placental lesions are associated with neonatal amplitude integrated EEG recording in early premature neonates. Placental histologic examination can assist in revealing the mechanism leading to preterm birth. Accumulating evidence suggests an association between intrauterine pathological processes, morbidity and mortality of premature infants, and their long term outcome. Neonatal brain activity is increasingly monitored in neonatal intensive care units by amplitude

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2017 PLoS ONE

18. Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock

of the stage of hemodynamic abnormality at the time of presentation ( ). In both neonates and children, shock should be further evaluated and resuscitation treatment guided by hemodynamic variables including perfusion pressure (MAP – CVP) and CO. Invasive blood pressure monitoring provides more accurate reflection of vasomotor state. Shock has historically been divided into warm and cold based on clinical examination, inferring vasodilation or vasoconstriction based on warm and cold phenotypes (...) mitochondrial dysfunction, a high CO state, or overly aggressive resuscitation ( ). In this narrow AVDO 2 shock state, practitioners should incorporate in their serial patient assessments other markers of adequate tissue oxygen delivery and utilization and organ perfusion such as serum lactate and urine output. In isolation, any one of the above clinical or hemodynamic parameters may underestimate or overestimate the true severity of illness, leading to either false reassurance and underresuscitation

2017 Society of Critical Care Medicine

19. Neonatal seizures

) 3131 6777. For permissions beyond the scope of this licence, contact: Intellectual Property Officer, Queensland Health, GPO Box 48, Brisbane Qld 4001, email ip_officer@health.qld.gov.au, phone (07) 3234 1479. Queensland Clinical Guideline: Neonatal seizures Refer to online version, destroy printed copies after use Page 3 of 32 Flow Chart: Assessment and management Baby with suspected seizure activity Observe and monitor: • Seizure activity • Temperature, heart rate, respiratory rate & effort, BP, O (...) : Neonatal seizures Refer to online version, destroy printed copies after use Page 5 of 32 Abbreviations AED Antiepileptic drugs aEEG Amplitude integrated electro-encephalogram BGL Blood glucose level BP Blood pressure cEEG Continuous electro-encephalogram CMV Cytomegalovirus CNS Central nervous system CSF Cerebro-spinal fluid EEG Electroencephalogram GMA General movements assessment HIE Hypoxic-ischaemic encephalopathy HSV Herpes simplex virus IM Intramuscular IV Intravenous IVH Intraventricular

2017 Queensland Health

20. Does Pentaerytrithyltetranitrate reduce fetal growth restriction in pregnancies complicated by uterine mal-perfusion? Study protocol of the PETN-study: a randomized controlled multicenter-trial. (PubMed)

(birth weight < 3rd centile) and perinatal death. Placental abruption, birth weight below the 3rd, 5th and 10th centile, development of FGR requiring delivery before 34 weeks` gestation, neonatal intensive care unit admission, and spontaneous preterm delivery < 34 weeks` and 37 weeks` gestation will be assessed as secondary endpoints. Patient enrolment was started in August 2017. Results are expected in 2020.During the past decade therapeutic agents with possible perfusion optimizing potential have (...) Does Pentaerytrithyltetranitrate reduce fetal growth restriction in pregnancies complicated by uterine mal-perfusion? Study protocol of the PETN-study: a randomized controlled multicenter-trial. Affecting approximately 10% of pregnancies, fetal growth restriction (FGR), is the most important cause of perinatal mortality and morbidity. Impaired placental function and consequent mal-perfusion of the placenta is the leading cause of FGR. Although, screening for placental insufficiency based

2019 BMC Pregnancy and Childbirth

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