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[PMID]:28658507
[Au] Autor:Kelly LE; Shivananda S; Murthy P; Srinivasjois R; Shah PS
[Ad] Endereço:Department of Paediatrics, University of Toronto Mount Sinai Hospital, Toronto, Canada.
[Ti] Título:Antibiotics for neonates born through meconium-stained amniotic fluid.
[So] Source:Cochrane Database Syst Rev;6:CD006183, 2017 06 28.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Approximately 1 in 10 pregnancies is affected by meconium passage at delivery, which can result in meconium aspiration syndrome (MAS). MAS can cause respiratory complications and, very rarely, death. Antibiotics have been prescribed for neonates exposed to meconium in amniotic fluid, with the intention of preventing infection due to potential bacterial contaminants. OBJECTIVES: We conducted this review to assess the efficacy and safety of antibiotics for:1. prevention of infection, morbidity, and mortality among infants born through meconium-stained amniotic fluid (MSAF) who are asymptomatic at birth; and2. prevention of infection, morbidity, and mortality among infants born through MSAF who have signs and symptoms compatible with meconium aspiration syndrome (MAS). SEARCH METHODS: We performed a literature search using the following databases: MEDLINE (1966 to July 2016); Embase (1980 to July 2016); the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to July 2016); and the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 7) in the Cochrane Library. We also searched clinical trials databases, conference proceedings, and reference lists of retrieved articles. SELECTION CRITERIA: We included randomised and quasi-randomised controlled trials that compared antibiotics administered via any route versus placebo or no treatment for prevention of infection among neonates exposed to MSAF, or who developed MAS. We excluded cohort, case control, and any other non-randomised studies and applied no language restrictions. We included studies of term and preterm infants, and we included studies examining use of any antibacterial antibiotics. We included studies that reported on any outcomes of interest. DATA COLLECTION AND ANALYSIS: We assessed the methodological quality of included trials by reviewing information provided in study reports and obtained by personal communication with study authors. We extracted data on relevant outcomes, estimated effect size, and reported values as risk ratios (RRs), risk differences (RDs), and mean differences (MDs), as appropriate. We conducted subgroup analyses for treatment of MAS and for prophylaxis (asymptomatic neonates exposed to meconium). MAIN RESULTS: Four randomised controlled studies including a total of 695 participants were eligible for inclusion. Three studies evaluated neonates with MAS, and one study assessed asymptomatic neonates exposed to meconium in amniotic fluid. These studies exhibited varying degrees of methodological rigour: Two studies were at low risk of bias, and two were at unclear risk. We graded evidence derived from these studies as low quality. We downgraded overall evidence owing to the large number of participants lost to follow-up in one trial, the small sample sizes of all trials, and unclear methodological details provided for two trials.The primary outcome was risk of early- and late-onset neonatal sepsis. Antibiotics did not decrease the risk of sepsis in neonates with a diagnosis of MAS (RR 1.54, 95% confidence interval (CI) 0.27 to 8.96; RD 0.00, 95% CI -0.02 to 0.03; 445 participants, three studies; I² = 0%) nor in asymptomatic neonates exposed to meconium in amniotic fluid (RR 0.76, 95% CI 0.25 to 2.34; RD -0.01, 95% CI -0.07 to 0.04; 250 participants, one study; I² = 0%). Results show no significant differences in mortality or duration of stay in hospital between groups given antibiotics and control groups of symptomatic and asymptomatic neonates. One study in asymptomatic neonates reported a significant reduction in duration of mechanical ventilation for the control group compared with the antibiotic group (MD 0.26, 95% CI 0.15 to 0.37; 250 participants, one study; I² = 0%). AUTHORS' CONCLUSIONS: Upon review of available evidence, we found no differences in infection rates following antibiotic treatment among neonates born through meconium-stained fluid and those with meconium aspiration syndrome. The overall quality of evidence is low owing to the small number of included studies. Well-controlled studies of adequate power are needed.
[Mh] Termos MeSH primário: Líquido Amniótico
Antibacterianos/uso terapêutico
Infecções Bacterianas/tratamento farmacológico
Síndrome de Aspiração de Mecônio/tratamento farmacológico
Mecônio/microbiologia
Sepse Neonatal/tratamento farmacológico
[Mh] Termos MeSH secundário: Amicacina/uso terapêutico
Ampicilina/uso terapêutico
Infecções Bacterianas/mortalidade
Infecções Bacterianas/prevenção & controle
Gentamicinas/uso terapêutico
Seres Humanos
Incidência
Recém-Nascido
Tempo de Internação
Síndrome de Aspiração de Mecônio/epidemiologia
Sepse Neonatal/mortalidade
Sepse Neonatal/prevenção & controle
Ensaios Clínicos Controlados Aleatórios como Assunto
Respiração Artificial/estatística & dados numéricos
Insuficiência Respiratória/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Gentamicins); 7C782967RD (Ampicillin); 84319SGC3C (Amikacin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD006183.pub2


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[PMID]:28407823
[Au] Autor:Gao XY; Feng L; Qiu YF; Pan XN
[Ad] Endereço:Department of Neonatology, Guangxi Maternal and Child Health Care Hospital, Nanning 530001, China. pxn16892003@163.com.
[Ti] Título:[Application of humidified high-flow nasal cannula in neonates with meconium aspiration syndrome and pulmonary hypertension after extubation].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;19(4):393-397, 2017 Apr.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To investigate the clinical value of humidified high-flow nasal cannula (HHFNC) as a respiratory support after extubation by comparing it with nasal continuous positive airway pressure (NCPAP) in neonates with meconium aspiration syndrome (MAS) and persistent pulmonary hypertension of the newborn (PPHN). METHODS: A total of 78 neonates with MAS and PPHN were randomly administered with HHFNC or NCPAP immediately after extubation. The following indices were compared between the two groups: blood gas parameters, duration of noninvasive ventilation, rate of extubation failure, and incidence of complications, such as nasal damage, abdominal distension, and intraventricular hemorrhage. RESULTS: There were no significant differences in the rate of extubation failure, PaO , PCO , and PaO /FiO ratio at one hour after NCPAP or HHFNC, duration of noninvasive ventilation, time to full enteral feeding, length of hospital stay, and incidence of intraventricular hemorrhage between the two groups (P>0.05). The HHFNC group had significantly lower incidence of nasal damage (5.0% vs 31.6%; P<0.05) and incidence of abdominal distension (7.5% vs 34.2%; P<0.05) than the NCPAP group. CONCLUSIONS: Both NCPAP and HHFNC can be used as the sequential therapy for neonates with MSA and PPHN after extubation, and they both have a definite effect. As a new strategy of respiratory support, HHFNC is better tolerated, and has fewer side effects than NCPAP.
[Mh] Termos MeSH primário: Extubação/efeitos adversos
Pressão Positiva Contínua nas Vias Aéreas/métodos
Hipertensão Pulmonar/terapia
Síndrome de Aspiração de Mecônio/terapia
Ventilação não Invasiva/métodos
[Mh] Termos MeSH secundário: Pressão Positiva Contínua nas Vias Aéreas/instrumentação
Feminino
Seres Humanos
Recém-Nascido
Masculino
Ventilação não Invasiva/instrumentação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170801
[Lr] Data última revisão:
170801
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170415
[St] Status:MEDLINE


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[PMID]:28341439
[Au] Autor:Echaide M; Autilio C; Arroyo R; Perez-Gil J
[Ad] Endereço:Dept. Biochemistry, Faculty of Biology, and Research Institute "Hospital 12 de Octubre", Complutense University, Madrid, Spain.
[Ti] Título:Restoring pulmonary surfactant membranes and films at the respiratory surface.
[So] Source:Biochim Biophys Acta;1859(9 Pt B):1725-1739, 2017 09.
[Is] ISSN:0006-3002
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Pulmonary surfactant is a complex of lipids and proteins assembled and secreted by the alveolar epithelium into the thin layer of fluid coating the respiratory surface of lungs. There, surfactant forms interfacial films at the air-water interface, reducing dramatically surface tension and thus stabilizing the air-exposed interface to prevent alveolar collapse along respiratory mechanics. The absence or deficiency of surfactant produces severe lung pathologies. This review describes some of the most important surfactant-related pathologies, which are a cause of high morbidity and mortality in neonates and adults. The review also updates current therapeutic approaches pursuing restoration of surfactant operative films in diseased lungs, mainly through supplementation with exogenous clinical surfactant preparations. This article is part of a Special Issue entitled: Membrane Lipid Therapy: Drugs Targeting Biomembranes edited by Pablo V. Escribá.
[Mh] Termos MeSH primário: Pulmão/química
Surfactantes Pulmonares/uso terapêutico
[Mh] Termos MeSH secundário: Animais
Seres Humanos
Síndrome de Aspiração de Mecônio/tratamento farmacológico
Síndrome de Aspiração de Mecônio/etiologia
Surfactantes Pulmonares/farmacologia
Síndrome do Desconforto Respiratório do Adulto/tratamento farmacológico
Síndrome do Desconforto Respiratório do Adulto/etiologia
Síndrome do Desconforto Respiratório do Recém-Nascido/tratamento farmacológico
Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Pulmonary Surfactants)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170326
[St] Status:MEDLINE


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[PMID]:28277364
[Au] Autor:Raghuraman N; Temming LA; Stout MJ; Macones GA; Cahill AG; Tuuli MG
[Ad] Endereço:Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
[Ti] Título:Intrauterine Hyperoxemia and Risk of Neonatal Morbidity.
[So] Source:Obstet Gynecol;129(4):676-682, 2017 Apr.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To test the hypothesis that intrauterine hyperoxemia is associated with an increased risk of neonatal morbidity. METHODS: This was a secondary analysis of a prospective study of singleton, nonanomalous deliveries at or beyond 37 weeks of gestation at an institution with a universal umbilical cord gas policy from 2010 to 2014. The primary outcome was a composite of neonatal morbidity including neonatal death, meconium aspiration syndrome, intubation, mechanical ventilation, hypoxic-ischemic encephalopathy, and hypothermic therapy. Intrauterine hyperoxemia was defined as umbilical vein partial pressure of oxygen 90th percentile or greater of the cohort. Adjusted relative risks (RRs) were estimated for neonatal morbidity controlling for confounders. Analysis was performed for the entire cohort and stratified by the presence of acidemia defined as umbilical artery pH less than 7.1. RESULTS: Of 7,789 patients with validated paired cord gases, 106 (1.4%) had the composite neonatal morbidity. There was no difference in composite neonatal morbidity in patients with and without intrauterine hyperoxemia in the entire cohort (1.5% compared with 1.3%, adjusted RR 1.5, 95% confidence interval [CI] 0.9-2.7). The rate of acidemia was not significantly different in the two groups (1.9% compared with 1.8%, adjusted RR 1.5, 95% CI 0.9-2.5). In stratified analysis, there was evidence of effect modification (P for interaction <.001) with a significant association between intrauterine hyperoxemia and neonatal morbidity in the presence of acidemia (41.2% compared with 21.4%, adjusted RR 2.3, 95% CI 1.1-3.5), but not in its absence (0.8% compared with 1.0%, adjusted RR 1.0, 95% CI 0.5-2.2). CONCLUSION: Intrauterine hyperoxemia, compared with normoxemia, is associated with a small but significantly increased risk of neonatal morbidity in acidemic neonates.
[Mh] Termos MeSH primário: Gasometria/métodos
Sangue Fetal
Doenças Fetais
Hiperóxia
Hipóxia-Isquemia Encefálica
Síndrome de Aspiração de Mecônio
Respiração Artificial/estatística & dados numéricos
[Mh] Termos MeSH secundário: Estudos de Coortes
Feminino
Doenças Fetais/sangue
Doenças Fetais/epidemiologia
Seres Humanos
Concentração de Íons de Hidrogênio
Hiperóxia/sangue
Hiperóxia/complicações
Hiperóxia/epidemiologia
Hipóxia-Isquemia Encefálica/epidemiologia
Hipóxia-Isquemia Encefálica/etiologia
Recém-Nascido
Síndrome de Aspiração de Mecônio/epidemiologia
Síndrome de Aspiração de Mecônio/etiologia
Gravidez
Estudos Prospectivos
Medição de Risco
Fatores de Risco
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170819
[Lr] Data última revisão:
170819
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000001931


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[PMID]:28225424
[Au] Autor:Committee on Obstetric Practice
[Ti] Título:Committee Opinion No 689: Delivery of a Newborn With Meconium-Stained Amniotic Fluid.
[So] Source:Obstet Gynecol;129(3):e33-e34, 2017 03.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns. However, the 2005 guidelines did support intubation of the trachea and suctioning of meconium or other aspirated material from beneath the glottis in nonvigorous newborns. In 2015, the guidelines were updated. Routine intubation and tracheal suctioning are no longer required. If the infant is vigorous with good respiratory effort and muscle tone, the infant may stay with the mother to receive the initial steps of newborn care. If the infant born through meconium-stained amniotic fluid presents with poor muscle tone and inadequate breathing efforts, the initial steps of resuscitation should be completed under the radiant warmer. Appropriate intervention to support ventilation and oxygenation should be initiated as indicated for each infant. Infants with meconium-stained amniotic fluid should no longer routinely receive intrapartum suctioning, whether they are vigorous or not. In addition, meconium-stained amniotic fluid is a condition that requires the notification and availability of an appropriately credentialed team with full resuscitation skills, including endotracheal intubation. Resuscitation should follow the same principles for infants with meconium-stained fluid as for those with clear fluid.
[Mh] Termos MeSH primário: Líquido Amniótico
Mecônio
Equipe de Assistência ao Paciente
Assistência Perinatal/normas
[Mh] Termos MeSH secundário: Seres Humanos
Recém-Nascido
Intubação Intratraqueal
Síndrome de Aspiração de Mecônio/prevenção & controle
Ressuscitação
Sucção
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170616
[Lr] Data última revisão:
170616
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000001950


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[PMID]:28225419
[Ti] Título:Committee Opinion No.689 Summary: Delivery of a Newborn With Meconium-Stained Amniotic Fluid.
[So] Source:Obstet Gynecol;129(3):593-594, 2017 Mar.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns. However, the 2005 guidelines did support intubation of the trachea and suctioning of meconium or other aspirated material from beneath the glottis in nonvigorous newborns. In 2015, the guidelines were updated. Routine intubation and tracheal suctioning are no longer required. If the infant is vigorous with good respiratory effort and muscle tone, the infant may stay with the mother to receive the initial steps of newborn care. If the infant born through meconium-stained amniotic fluid presents with poor muscle tone and inadequate breathing efforts, the initial steps of resuscitation should be completed under the radiant warmer. Appropriate intervention to support ventilation and oxygenation should be initiated as indicated for each infant. Infants with meconium-stained amniotic fluid should no longer routinely receive intrapartum suctioning, whether they are vigorous or not. In addition, meconium-stained amniotic fluid is a condition that requires the notification and availability of an appropriately credentialed team with full resuscitation skills, including endotracheal intubation. Resuscitation should follow the same principles for infants with meconium-stained fluid as for those with clear fluid.
[Mh] Termos MeSH primário: Líquido Amniótico
Mecônio
[Mh] Termos MeSH secundário: Parto Obstétrico
Feminino
Seres Humanos
Recém-Nascido
Síndrome de Aspiração de Mecônio/prevenção & controle
Gravidez
Sucção
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000001946


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[PMID]:28079811
[Au] Autor:Chen SW; Fu W; Liu J; Wang Y
[Ad] Endereço:aDepartment of Neonatology and NICU of Bayi Children's Hospital,the Army General Hospital of the Chinese PLA affiliated to Southern Medical University, Beijing bDepartment of Pediatrics, Shenzhen Baoan Maternal and Child Health Hospital, Shenzhen, China.
[Ti] Título:Routine application of lung ultrasonography in the neonatal intensive care unit.
[So] Source:Medicine (Baltimore);96(2):e5826, 2017 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to study the features of lung ultrasonography (LUS) in lung disease and to evaluate the usefulness of LUS in the neonatal intensive care unit (NICU).All of 3405 neonates included in this study underwent an LUS examination. Diagnoses were based on medical history, clinical manifestation, laboratory examination, and signs on chest radiography (CR) and/or computed tomography (CT). A single expert physician performed all LUS examinations.There were 2658 cases (78.9%) with lung disease and 747 cases (21.9%) without lung disease. The main signs of neonates with lung disease on LUS were as follows: absence of A-lines, pleural-line abnormalities, interstitial syndrome, lung consolidation, air bronchograms, pulmonary edema, and lung pulse. These abnormal signs were reduced or eliminated on LUS as patient conditions improved. There were 81 cases that could not be diagnosed as lung disease by CR but were discovered as pneumonia, respiratory distress syndrome (RDS), or transient tachypnea of newborn (TTN) on LUS. Likewise, 23 cases misdiagnosed as RDS by CR were diagnosed as TTN on LUS. Among 212 cases of long-term oxygen dependence (LTOD) that failed to yield signs of pulmonary edema and lung consolidation on CR, 103 cases showed abnormal signs on LUS. Among 747 cases without lung disease, B-lines of 713 neonates (95.4%) could be found within 3 days after birth, and 256 neonates (34.3%) could be observed from 3 days to 1 week after birth. B-lines of 19 cases could be detected from 1 to 2 weeks after birth. The longest time at which B-lines could still be observed was 19 days after birth.LUS has clinical value for the diagnosis of lung disease and the discrimination of causes of LTOP in premature infants, particularly for the diagnosis and identification of RDS and TTN. Moreover, LUS has additional advantages, including its lack of radiation exposure and its ability to noninvasively monitor treatment progress. Therefore, LUS should be routinely used in the NICU.
[Mh] Termos MeSH primário: Unidades de Terapia Intensiva Neonatal
Pneumopatias/diagnóstico por imagem
Pulmão/diagnóstico por imagem
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Recém-Nascido
Recém-Nascido Prematuro
Masculino
Síndrome de Aspiração de Mecônio/diagnóstico por imagem
Pneumonia/diagnóstico por imagem
Radiografia Torácica
Respiração Artificial
Síndrome do Desconforto Respiratório do Recém-Nascido/diagnóstico por imagem
Fatores de Tempo
Taquipneia Transitória do Recém-Nascido/diagnóstico por imagem
Ultrassonografia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170224
[Lr] Data última revisão:
170224
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170113
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000005826


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[PMID]:27543379
[Au] Autor:Lu Q; Cheng S; Zhou M; Yu J
[Ad] Endereço:Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014,
[Ti] Título:Risk Factors for Necrotizing Enterocolitis in Neonates: A Retrospective Case-Control Study.
[So] Source:Pediatr Neonatol;58(2):165-170, 2017 Apr.
[Is] ISSN:2212-1692
[Cp] País de publicação:Singapore
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Necrotizing enterocolitis (NEC) in neonates is devastating, and risk-factor identification is crucial. This study aimed to evaluate risk factors for NEC in different gestational age (GA) groups. METHODS: Risk factors associated with NEC were investigated using a retrospective case-control design. Patients with Bell's Stage NEC≥II were divided into three groups based on GA: I, <34 weeks; II, ≥34 weeks but <37 weeks; III, ≥37 weeks. Each case was paired with two GA- and weight-matched controls. Data were collected from medical records, and univariate and conditional logistic regression analyses employed. RESULTS: A total of 238 cases and 476 controls were enrolled. Variation in the months when NEC was diagnosed was noted, with a peak in January and a trough in August. Intrahepatic cholestasis of pregnancy and transfusion with packed red blood cells were significantly associated with NEC in preterm infants. Meconium aspiration syndrome was an independent risk factor for a greater chance of NEC development in full-term infants. Postnatal asphyxia and sepsis were associated with an increased risk of NEC in all groups. Probiotic use was associated with a reduced risk of NEC. Patients aged >34 weeks with congenital heart disease were more likely than controls to have NEC. CONCLUSION: Intrahepatic cholestasis of pregnancy and meconium aspiration syndrome may be new risk factors for NEC.
[Mh] Termos MeSH primário: Enterocolite Necrosante/epidemiologia
[Mh] Termos MeSH secundário: Asfixia Neonatal/epidemiologia
Estudos de Casos e Controles
China/epidemiologia
Colestase Intra-Hepática/epidemiologia
Transfusão de Eritrócitos
Feminino
Idade Gestacional
Cardiopatias Congênitas/epidemiologia
Seres Humanos
Lactente
Recém-Nascido
Masculino
Síndrome de Aspiração de Mecônio/epidemiologia
Sepse Neonatal/epidemiologia
Gravidez
Complicações na Gravidez/epidemiologia
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170609
[Lr] Data última revisão:
170609
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160821
[St] Status:MEDLINE


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[PMID]:28006947
[Au] Autor:Mikolka P; Kopincová J; Kosútová P; Cierny D; Calkovská A; Mokrá D
[Ad] Endereço:Biomedical Center Martin and Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic. mokra@jfmed.uniba.sk.
[Ti] Título:Lung inflammatory and oxidative alterations after exogenous surfactant therapy fortified with budesonide in rabbit model of meconium aspiration syndrome.
[So] Source:Physiol Res;65(Supplementum 5):S653-S662, 2016 Dec 22.
[Is] ISSN:1802-9973
[Cp] País de publicação:Czech Republic
[La] Idioma:eng
[Ab] Resumo:Meconium aspiration syndrome (MAS) triggers inflammatory and oxidative pathways which can inactivate both pulmonary surfactant and therapeutically given exogenous surfactant. Glucocorticoid budesonide added to exogenous surfactant can inhibit inflammation and thereby enhance treatment efficacy. Neonatal meconium (25 mg/ml, 4 ml/kg) was administered intratracheally (i.t.) to rabbits. When the MAS model was prepared, animals were treated with budesonide i.t. (Pulmicort, 0.25 mg/kg, M+B); with surfactant lung lavage (Curosurf®, 10 ml/kg, 5 mg phospholipids/ml, M+S) followed by undiluted Curosurf® i.t. (100 mg phospholipids/kg); with combination of budesonide and surfactant (M+S+B); or were untreated (M); or served as controls with saline i.t. instead of meconium (C). Animals were oxygen-ventilated for additional 5 h. Cell counts in the blood and bronchoalveolar lavage fluid (BAL), lung edema formation (wet/dry weight ratio), oxidative damage of lipids/ proteins and inflammatory expression profiles (IL-2, IL-6, IL-13, TNF-alpha) in the lung homogenate and plasma were determined. Combined surfactant+budesonide therapy was the most effective in reduction of neutrophil counts in BAL, oxidative damage, levels and mRNA expression of cytokines in the lung, and lung edema formation compared to untreated animals. Curosurf fortified with budesonide mitigated lung inflammation and oxidative modifications what indicate the perspectives of this treatment combination for MAS therapy.
[Mh] Termos MeSH primário: Budesonida/administração & dosagem
Modelos Animais de Doenças
Mediadores da Inflamação/metabolismo
Síndrome de Aspiração de Mecônio/metabolismo
Estresse Oxidativo/efeitos dos fármacos
Surfactantes Pulmonares/administração & dosagem
[Mh] Termos MeSH secundário: Animais
Anti-Inflamatórios/administração & dosagem
Quimioterapia Combinada
Feminino
Mediadores da Inflamação/antagonistas & inibidores
Peroxidação de Lipídeos/efeitos dos fármacos
Peroxidação de Lipídeos/fisiologia
Masculino
Síndrome de Aspiração de Mecônio/tratamento farmacológico
Estresse Oxidativo/fisiologia
Coelhos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Inflammation Mediators); 0 (Pulmonary Surfactants); 51333-22-3 (Budesonide)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170523
[Lr] Data última revisão:
170523
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161224
[St] Status:MEDLINE


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Fotocópia
[PMID]:27974114
[Au] Autor:Tan XZ; Wu SG; Zhang JH; Li XF; Gao PM; Wang Y
[Ad] Endereço:Department of Neonatology, The 6th People's Hospital of Foshan Nanhai District, Foshan, Guangdong 528248, China. 275828141@qq.com.
[Ti] Título:[Clinical efficacy of porcine pulmonary surfactant combined with budesonide suspension intratracheal instillation in the treatment of neonatal meconium aspiration syndrome].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;18(12):1237-1241, 2016 Dec.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To study the clinical efficacy of porcine pulmonary surfactant (PS) combined with budesonide suspension intratracheal instillation in the treatment of neonatal meconium aspiration syndrome (MAS). METHODS: Seventy neonates with MAS were enrolled for a prospective study. The neonates were randomly assigned to PS alone treatment group and PS+budesonide treatment group (n=35 each). The PS alone treatment group was given PS (100 mg/kg) by intratracheal instillation. The treatment group was given budesonide suspension (0.25 mg/kg) combined with PS (100 mg/kg). RESULTS: The rate of repeated use of PS in the PS+ budesonide group was significantly lower than that in the PS alone group 12 hours after treatment (p<0.05). The improvement of PaO /FiO , TcSaO , PaO , and PaCO in the PS+ budesonide group was significantly greater than that in the PS alone group 6, 12, and 24 hours after treatment (p<0.05). The chest X-ray examination showed that the pulmonary inflammation absorption in the PS+ budesonide group was significantly better than that in the PS alone group 48 hours after treatment (p<0.05). The incidence of complications in the PS+budesonide group was significantly lower than that in the PS alone group (p<0.05), and the average hospitalization duration was significantly shorter than that in the PS alone group (p<0.01). CONCLUSIONS: PS combined with budesonide suspension intratracheal instillation for the treatment of neonatal MAS is effective and superior to PS alone treatment.
[Mh] Termos MeSH primário: Budesonida/administração & dosagem
Síndrome de Aspiração de Mecônio/tratamento farmacológico
Surfactantes Pulmonares/administração & dosagem
[Mh] Termos MeSH secundário: Animais
Feminino
Seres Humanos
Recém-Nascido
Tempo de Internação
Masculino
Síndrome de Aspiração de Mecônio/complicações
Estudos Prospectivos
Suspensões
Suínos
Traqueia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Pulmonary Surfactants); 0 (Suspensions); 51333-22-3 (Budesonide)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170601
[Lr] Data última revisão:
170601
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161216
[St] Status:MEDLINE



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