Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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We used data from the Groupe de pathologie infectieuse pédiatrique and Association clinique et thérapeutique infantile du Val-de-Marne (GPIP/ACTIV) National Survey of Bacterial Meningitis in children and the National Reference Center for Meningococci (CNRM) microbiological data to assess the potential impact of corticosteroids on the immediate management of invasive meningococcal disease (IMD) associated with different genotypes, including highly pro-inflammatory strains of the ST-11 clonal complex (genotype ST-11). ⋯ This study indicates that in the absence of corticosteroids, higher mortality in invasive meningococcal disease is associated with the ST-11 clonal complex strains. This suggests a possible positive effect of corticosteroid therapy depending on the genotype of the strain involved.
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Multicenter Study
[Bronchopulmonary dysplasia-associated pulmonary arterial hypertension of very preterm infants].
Bronchopulmonary dysplasia (BPD) of very preterm infants is a multifactorial chronic lung disease and its incidence has not decreased despite improvements in neonatal intensive care, including lung protective strategies. Pulmonary hypertension (PH) can complicate the course of BPD. Mortality in infants with BPD-associated PH is thought to be very high, but its incidence is unknown and a standard diagnostic and therapeutic strategy has not been well defined. ⋯ Animal studies and a few clinical studies suggest that medications targeting the nitric oxide (NO) signaling pathway (NO inhalation, oral sildenafil citrate) could be effective treatments for BPD-associated PH, but they have not been approved for this indication. The HTP-DBP study is a French multicenter prospective observational study. The objective is to evaluate the frequency of BPD-associated PH, to describe its physiopathology, its severity (morbidity and mortality), and the effectiveness of current treatments.
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Multicenter Study
[Very preterm birth: is maternal anesthesia a risk factor for neonatal intubation in the delivery room?].
To assess the risk of tracheal intubation at birth in very premature neonates related to the type of maternal anesthesia in case of elective cesarean. ⋯ Very preterm neonates delivered after cesarean with general anesthesia require tracheal intubation in the delivery room more often than those delivered with spinal anesthesia. This study cannot assess a causal link between anesthesia and the need for neonatal intubation. However, neonatologists have to be aware of the type of maternal anesthesia because it may interfere with the non-invasive ventilation support policy of the very preterm neonate.
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Multicenter Study
[Evaluation of an educational intervention on the standard of neonatal resuscitation: orotracheal versus nasotracheal intubation].
Proficiency in endotracheal intubation is an essential step in the neonatal resuscitation process. This skill is difficult to acquire and its mastery requires experience. Recent changes in neonatal resuscitation guidelines (ILCOR 2006) have resulted in a decrease in the opportunities to practice intubations. Appropriate education and training is therefore essential. The goal of this study was to assess the skills of neonatal care professionals in performing intubation via orotracheal (OT) and nasotracheal (NT) routes. ⋯ This study confirms that OT intubation training resulted in a higher success rate and lower duration for intubation. Practical courses in neonatal resuscitation should include training with OT intubation.