Latest & greatest articles for infants

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Top results for infants

81. Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants.

Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants. BACKGROUND: In preterm newborns, the ductus arteriosus frequently fails to close and the infants require medical or surgical closure of the patent ductus arteriosus (PDA). A PDA can be treated surgically; or medically with one of two prostaglandin inhibitors, indomethacin or ibuprofen. Case reports suggest that paracetamol may be an alternative for the closure of a PDA. An association between (...) prenatal or postnatal exposure to paracetamol and later development of autism or autism spectrum disorder has been reported. OBJECTIVES: To determine the effectiveness and safety of intravenous or oral paracetamol compared with placebo or no intervention, intravenous indomethacin, intravenous or oral ibuprofen, or with other cyclo-oxygenase inhibitors for treatment of an echocardiographically diagnosed PDA in preterm or low birth weight infants. SEARCH METHODS: We used the standard search strategy

Cochrane2018

82. Infant diets that include egg or peanut products appear to reduce food allergies

Infant diets that include egg or peanut products appear to reduce food allergies NIHR DC | Signal - Infant diets that include egg or peanut products appear to reduce food allergies Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Infant diets that include egg or peanut products appear to reduce food allergies Published on 29 November 2016 Certain allergenic foods introduced to an infant’s diet while weaning appear to reduce the chance of developing food allergies. This high (...) quality review, including studies published this year, suggests that historical recommendations to delay the introduction of peanut and other allergenic foods to infant child’s diet in the first year of life may have been mistaken. The methodological limitations in some studies included in this review, reduce our certainty in the degree of benefit, but as more high quality studies are undertaken the benefits and practicalities of how to introduce these foods are likely to become clearer. The causes

NIHR Dissemination Centre2018

83. Delayed umbilical cord clamping reduces hospital mortality for preterm infants

Delayed umbilical cord clamping reduces hospital mortality for preterm infants NIHR DC | Signal - Delayed umbilical cord clamping reduces hospital mortality for preterm infants Dissemination Centre Discover Portal NIHR DC Discover Delayed umbilical cord clamping reduces hospital mortality for preterm infants Published on 6 February 2018 Delays to clamping the umbilical cord of about a minute can reduce hospital mortality for preterm infants by around 32%. Delayed clamping also reduced (...) the proportion of infants needing a blood transfusion by 10%. This review adds more precise data on survival from new trials including a large Australian trial (over 1,600 babies) to a previous Cochrane 2012 review of trails including 738 infants and provides new more precise data on the survival benefit. These findings are consistent with current guidelines which recommend delayed clamping in preterm infants. Share your views on the research. Why was this study needed? The optimal timing of umbilical cord

NIHR Dissemination Centre2018

84. Infants anaesthetised without placing a tube in the trachea have fewer adverse breathing events

Infants anaesthetised without placing a tube in the trachea have fewer adverse breathing events NIHR DC | Signal - Infants anaesthetised without placing a tube in the trachea have fewer adverse breathing events Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Infants anaesthetised without placing a tube in the trachea have fewer adverse breathing events Published on 11 July 2017 Adverse breathing events are about three times more common when using endotracheal tubes than (...) laryngeal mask airways for infants under 12 months receiving non-urgent surgery. Airway problems are common during anaesthesia in children, accounting for three quarters of critical incidents and a third of cardiac arrests. They are more frequent in younger children, especially infants under 12 months, who have smaller airways and rapidly use up their oxygen reserves. Laryngeal mask airways have been used in adults and older children for over 35 years for minor and intermediate surgery. Many studies

NIHR Dissemination Centre2018

85. Morbidity and Mortality in Small for Gestational Age Infants at 22 to 29 Weeks' Gestation

Morbidity and Mortality in Small for Gestational Age Infants at 22 to 29 Weeks' Gestation 29348195 2018 02 13 1098-4275 141 2 2018 Feb Pediatrics Pediatrics Morbidity and Mortality in Small for Gestational Age Infants at 22 to 29 Weeks' Gestation. e20172533 10.1542/peds.2017-2533 To identify the relative risks of mortality and morbidities for small for gestational age (SGA) infants in comparison with non-SGA infants born at 22 to 29 weeks' gestation. Data were collected (2006-2014) on 156 587 (...) infants from 852 US centers participating in the Vermont Oxford Network. We defined SGA as sex-specific birth weight <10th centile for gestational age (GA) in days. Binomial generalized additive models with a thin plate spline term on GA by SGA were used to calculate the adjusted relative risks and 95% confidence intervals for outcomes by GA. Compared with non-SGA infants, the risk of patent ductus arteriosus decreased for SGA infants in early GA and then increased in later GA. SGA infants were also

EvidenceUpdates2018

87. Dysfunction of NaV1.4, a skeletal muscle voltage-gated sodium channel, in sudden infant death syndrome: a case-control study.

Dysfunction of NaV1.4, a skeletal muscle voltage-gated sodium channel, in sudden infant death syndrome: a case-control study. BACKGROUND: Sudden infant death syndrome (SIDS) is the leading cause of post-neonatal infant death in high-income countries. Central respiratory system dysfunction seems to contribute to these deaths. Excitation that drives contraction of skeletal respiratory muscles is controlled by the sodium channel NaV1.4, which is encoded by the gene SCN4A. Variants in NaV1.4 (...) that directly alter skeletal muscle excitability can cause myotonia, periodic paralysis, congenital myopathy, and myasthenic syndrome. SCN4A variants have also been found in infants with life-threatening apnoea and laryngospasm. We therefore hypothesised that rare, functionally disruptive SCN4A variants might be over-represented in infants who died from SIDS. METHODS: We did a case-control study, including two consecutive cohorts that included 278 SIDS cases of European ancestry and 729 ethnically matched

Lancet2018

88. Association of Placebo, Indomethacin, Ibuprofen, and Acetaminophen With Closure of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-analysis.

Association of Placebo, Indomethacin, Ibuprofen, and Acetaminophen With Closure of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-analysis. Importance: Despite increasing emphasis on conservative management of patent ductus arteriosus (PDA) in preterm infants, different pharmacotherapeutic interventions are used to treat those developing a hemodynamically significant PDA. Objectives: To estimate the relative likelihood of hemodynamically (...) significant PDA closure with common pharmacotherapeutic interventions and to compare adverse event rates. Data Sources and Study Selection: The databases of MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception until August 15, 2015, and updated on December 31, 2017, along with conference proceedings up to December 2017. Randomized clinical trials that enrolled preterm infants with a gestational age younger than 37 weeks treated with intravenous or oral

JAMA2018

89. A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis.

A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis. BACKGROUND: High-flow oxygen therapy through a nasal cannula has been increasingly used in infants with bronchiolitis, despite limited high-quality evidence of its efficacy. The efficacy of high-flow oxygen therapy through a nasal cannula in settings other than intensive care units (ICUs) is unclear. METHODS: In this multicenter, randomized, controlled trial, we assigned infants younger than 12 months of age who had (...) bronchiolitis and a need for supplemental oxygen therapy to receive either high-flow oxygen therapy (high-flow group) or standard oxygen therapy (standard-therapy group). Infants in the standard-therapy group could receive rescue high-flow oxygen therapy if their condition met criteria for treatment failure. The primary outcome was escalation of care due to treatment failure (defined as meeting ≥3 of 4 clinical criteria: persistent tachycardia, tachypnea, hypoxemia, and medical review triggered

NEJM2018

90. The Neonatal Behavioral Assessment Scale (NBAS) and Newborn Behavioral Observations (NBO) system for supporting caregivers and improving outcomes in caregivers and their infants.

The Neonatal Behavioral Assessment Scale (NBAS) and Newborn Behavioral Observations (NBO) system for supporting caregivers and improving outcomes in caregivers and their infants. BACKGROUND: The first three years of a child's life are a key period of physical, physiological, cognitive and social development, and the caregiver-infant relationship in early infancy plays an important role in influencing these aspects of development. Specifically, caregiver attunement facilitates the move from (...) coregulation to self-regulation; a parent's ability to understand their infant's behaviour as communication is a key part of this process. Early, brief interventions such as the Neonatal Behavioral Assessment Scale (NBAS) or Neonatal Behavioral Observation (NBO) system are potential methods of improving outcomes for both infant and caregiver. OBJECTIVES: To assess the effects of the NBAS and NBO system for improving caregiver-infant interaction and related outcomes in caregivers and newborn babies

Cochrane2018

91. Standard (head-down tilt) versus modified (without head-down tilt) postural drainage in infants and young children with cystic fibrosis.

Standard (head-down tilt) versus modified (without head-down tilt) postural drainage in infants and young children with cystic fibrosis. BACKGROUND: Postural drainage is used primarily in infants with cystic fibrosis from diagnosis up to the moment when they are mature enough to actively participate in self-administered treatments. However, there is a risk of gastroesophageal reflux associated with this technique.This is an update of a review published in 2015. OBJECTIVES: To compare (...) the effects of standard postural drainage (15º to 45º head-down tilt) with modified postural drainage (15º to 30º head-up tilt) with regard to gastroesophageal reflux in infants and young children up to six years old with cystic fibrosis in terms of safety and efficacy. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Cystic Fibrosis Trials Register. We also searched the reference lists of relevant articles and reviews. Additional searches were conducted

Cochrane2018

92. Provision of respiratory support compared to no respiratory support before cord clamping for preterm infants.

Provision of respiratory support compared to no respiratory support before cord clamping for preterm infants. BACKGROUND: Placental transfusion (by means of delayed cord clamping (DCC), cord milking, or cord stripping) confers benefits for preterm infants. It is not known if providing respiratory support to preterm infants before cord clamping improves outcomes. OBJECTIVES: To assess the efficacy and safety of respiratory support provided during DCC compared with no respiratory support during (...) placental transfusion (in the form of DCC, milking, or stripping) in preterm infants immediately after delivery. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL, 2017, Issue 5), MEDLINE via PubMed (1966 to 19 June 2017), Embase (1980 to 19 June 2017), and CINAHL (1982 to 19 June 2017). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles

Cochrane2018

93. Antibiotics at the time of removal of central venous catheter to reduce morbidity and mortality in newborn infants.

Antibiotics at the time of removal of central venous catheter to reduce morbidity and mortality in newborn infants. BACKGROUND: Late-onset sepsis is associated with increased rates of mortality and morbidity in newborn infants, in addition to poorer long-term developmental outcomes and increased length of stay and hospital costs. Central line-associated blood stream infection (CLABSI) is the most common cause of late-onset sepsis in hospitalised infants, and prevention of CLABSI is a key (...) objective in neonatal care. Increased frequency of CLABSI around the time of removal of central venous catheters (CVCs) has been reported, and use of antibiotics at the time of removal may reduce the incidence and impact of late-onset sepsis in vulnerable newborn infants. OBJECTIVES: To determine the efficacy and safety of giving antibiotics at the time of removal of a central venous catheter (CVC) for reduction of morbidity and mortality in newborn infants, in particular effects on late-onset sepsis

Cochrane2018

94. Higher versus lower amino acid intake in parenteral nutrition for newborn infants.

Higher versus lower amino acid intake in parenteral nutrition for newborn infants. BACKGROUND: Sick newborn and preterm infants frequently are not able to be fed enterally, necessitating parenteral fluid and nutrition. Potential benefits of higher parenteral amino acid (AA) intake for improved nitrogen balance, growth, and infant health may be outweighed by the infant's ability to utilise high intake of parenteral AA, especially in the days after birth. OBJECTIVES: The primary objective (...) is to determine whether higher versus lower intake of parenteral AA is associated with improved growth and disability-free survival in newborn infants receiving parenteral nutrition.Secondary objectives include determining whether:• higher versus lower starting or initial intake of amino acids is associated with improved growth and disability-free survival without side effects;• higher versus lower intake of amino acids at maximal intake is associated with improved growth and disability-free survival without

Cochrane2018

95. Beta-blockers for prevention and treatment of retinopathy of prematurity in preterm infants.

Beta-blockers for prevention and treatment of retinopathy of prematurity in preterm infants. BACKGROUND: Retinopathy of prematurity (ROP) is a vision-threatening disease of preterm neonates. The use of beta-adrenergic blocking agents (beta-blockers), which modulate the vasoproliferative retinal process, may reduce the progression of ROP or even reverse established ROP. OBJECTIVES: To determine the effect of beta-blockers on short-term structural outcomes, long-term functional outcomes (...) , and the need for additional treatment, when used either as prophylaxis in preterm infants without ROP, stage 1 ROP (zone I), or stage 2 ROP (zone II) without plus disease or as treatment in preterm infants with at least prethreshold ROP. SEARCH METHODS: We searched the Cochrane Neonatal Review Group Specialized Register; CENTRAL (in the Cochrane Library Issue 7, 2017); Embase (January 1974 to 7 August 2017); PubMed (January 1966 to 7 August 2017); and CINAHL (January 1982 to 7 August 2017). We checked

Cochrane2018

96. Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger

Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger 29339564 2018 02 17 1098-4275 141 2 2018 Feb Pediatrics Pediatrics Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger. e20173068 10.1542/peds.2017-3068 Reports of the test accuracy of the urinalysis for diagnosing urinary tract infections (UTIs) in young febrile infants have been variable. We evaluated the test characteristics of the urinalysis (...) for diagnosing UTIs, with and without associated bacteremia, in young febrile infants. We performed a planned secondary analysis of data from a prospective study of febrile infants ≤60 days old at 26 emergency departments in the Pediatric Emergency Care Applied Research Network. We evaluated the test characteristics of the urinalysis for diagnosing UTIs, with and without associated bacteremia, by using 2 definitions of UTI: growth of ≥50 000 or ≥10 000 colony-forming units (CFUs) per mL of a uropathogen. We

EvidenceUpdates2018

97. Neurodevelopmental Outcomes of Infants Born at <29 Weeks of Gestation Admitted to Canadian Neonatal Intensive Care Units Based on Location of Birth

Neurodevelopmental Outcomes of Infants Born at <29 Weeks of Gestation Admitted to Canadian Neonatal Intensive Care Units Based on Location of Birth 29305231 2018 01 06 1097-6833 2018 Jan 03 The Journal of pediatrics J. Pediatr. Neurodevelopmental Outcomes of Infants Born at <29 Weeks of Gestation Admitted to Canadian Neonatal Intensive Care Units Based on Location of Birth. S0022-3476(17)31594-9 10.1016/j.jpeds.2017.11.038 To compare mortality and neurodevelopmental outcomes of outborn (...) and inborn preterm infants born at <29 weeks of gestation admitted to Canadian neonatal intensive care units (NICUs). Data were obtained from the Canadian Neonatal Network and Canadian Neonatal Follow-up Network databases for infants born at <29 weeks of gestation admitted to NICUs from April 2009 to September 2011. Rates of death, severe neurodevelopmental impairment (NDI), and overall NDI were compared between outborn and inborn infants at 18-21 months of age, corrected for prematurity. Of 2951

EvidenceUpdates2018

98. Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants

Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants 29306493 2018 02 01 1097-6833 2018 Jan 03 The Journal of pediatrics J. Pediatr. Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants. S0022-3476(17)31595-0 10.1016/j.jpeds.2017.11.039 To describe the frequency and extent of delivery room resuscitation and evaluate the association of delivery room resuscitation with neonatal outcomes in moderately preterm (MPT) infants (...) . This was an observational cohort study of MPT infants delivered at 29 0/7 to 33 6/7 weeks' gestational age (GA) enrolled in the Neonatal Research Network MPT registry. Infants were categorized into 5 groups based on the highest level of delivery room intervention: routine care, oxygen and/or continuous positive airway pressure, bag and mask ventilation, endotracheal intubation, and cardiopulmonary resuscitation including chest compressions and/or epinephrine use. The association of antepartum and intrapartum risk

EvidenceUpdates2018

99. Early population-based outcomes of infants born with congenital diaphragmatic hernia

Early population-based outcomes of infants born with congenital diaphragmatic hernia 29305406 2018 01 06 1468-2052 2018 Jan 04 Archives of disease in childhood. Fetal and neonatal edition Arch. Dis. Child. Fetal Neonatal Ed. Early population-based outcomes of infants born with congenital diaphragmatic hernia. fetalneonatal-2017-313933 10.1136/archdischild-2017-313933 This study aims to describe short-term outcomes of live-born infants with congenital diaphragmatic hernia (CDH) and to identify (...) prognostic factors associated with early mortality. A prospective population cohort study was undertaken between April 2009 and September 2010, collecting data on live-born infants with CDH from all 28 paediatric surgical centres in the UK and Ireland using an established surgical surveillance system. Management and outcomes are described. Prognostic factors associated with death before surgery are explored. Two hundred and nineteen live-born infants with CDH were reported within the data collection

EvidenceUpdates2018

100. Computerised interpretation of the fetal heart rate during labour: a randomised controlled trial (INFANT)

Computerised interpretation of the fetal heart rate during labour: a randomised controlled trial (INFANT) Computerised interpretation of the fetal heart rate during labour: a randomised controlled trial (INFANT) Computerised interpretation of the fetal heart rate during labour: a randomised controlled trial (INFANT) Brocklehurst P, Field D, Greene K, Juszczak E, Kenyon S, Linsell L, Mabey C, Newburn M, Plachcinski R, Quigley M, Steer P, Schroeder L & Rivero-Arias O Record Status (...) This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Brocklehurst P, Field D, Greene K, Juszczak E, Kenyon S, Linsell L, Mabey C, Newburn M, Plachcinski R, Quigley M, Steer P, Schroeder L & Rivero-Arias O. Computerised interpretation of the fetal heart rate during labour: a randomised controlled trial (INFANT) Health Technology Assessment 2018; 22(9) Authors' objectives

Health Technology Assessment (HTA) Database.2018