Frontiers in pediatrics
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Frontiers in pediatrics · Jan 2020
Asphyxiated Female and Male Newborn Piglets Have Similar Outcomes With Different Cardiopulmonary Resuscitation Interventions.
Background: Male newborns have a greater risk of poor cardiovascular and respiratory outcomes compared to females. The mechanisms associated with the "male disadvantage" remains unclear. We have previously shown no difference between male and female newborn piglets during hypoxia, asphyxia, resuscitation, and post-resuscitation recovery. ⋯ Main results: Regardless of resuscitation technique, there was no significant difference between males and females in the number achieving return of spontaneous circulation (ROSC) [95/123 (77%) vs. 48/61 (79%)], the time to achieve ROSC [112 (80-185) s vs. 110 (77-186) s], and the 4-h survival rate [81/95 (85%) vs. 40/48 (83%)]. Levels of the injury markers interleukin (IL)-1ß, IL-6, IL-8, and tumor necrosis factor-α in frontoparietal cortex tissue homogenates were similar between males and females. Conclusions: Regardless of resuscitation technique, there was no significant effect of sex on resuscitation outcome, survival, and hemodynamic recovery in asphyxiated newborn piglets.
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Frontiers in pediatrics · Jan 2020
Feasibilty of Transcutaneous pCO2 Monitoring During Immediate Transition After Birth-A Prospective Observational Study.
Background: According to recommendations, non-invasive monitoring during neonatal resuscitation after birth includes heart rate (HR) and oxygen saturation (SpO2). Continuous transcutaneous monitoring of carbon dioxide partial pressure (tcpCO2) may further offer quantitative information on neonatal respiratory status. Objective: We aimed to investigate feasibility of tcpCO2 measurements in the delivery room during immediate neonatal transition and to compare the course of tcpCO2 between stable term and preterm infants. ⋯ Mean tcpCO2 values 15 min after birth were 46.2 (95% CI 34.5-57.8) mmHg in term neonates and 48.5 (95%CI 43.0-54.1) mmHg in preterm neonates. Preterm and term infants did not show significant differences in the tcpCO2 values at any time point. Conclusion: This study demonstrates that tcpCO2 measurement is feasible during immediate neonatal transition after birth and that tcpCO2 values were comparable in stable term and preterm neonates.
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Frontiers in pediatrics · Jan 2020
Video Laryngoscopy Improves the Success of Neonatal Tracheal Intubation for Novices but Not for Experienced Medical Staff.
Background: There is limited evidence on the use of video laryngoscopy (VL) in neonatal tracheal intubation (NTI) during neonatal resuscitation. In this study, we aimed to compare the difference between direct laryngoscopy (DL) and VL in NTI of trainees during neonatal resuscitation training. Materials and Methods: A prospective observational study was conducted during a neonatal resuscitation training course to examine three circumstances: NTI by experienced medical staff (EMS) and less-experienced medical staff (LEMS) in a neonatal resuscitation scenario; NTI by EMS and LEMS with an ongoing chest compression; and NTI by midwives who were novices in the procedure. ⋯ In the group of midwives who were novices in NTI, after they watched a demonstration teaching NTI, the intubation time using VL (19.6 ± 9.0 s) was significantly shorter than that using DL (28.0 ± 6.7 s, P < 0.001). The success rate of NTI using VL was significantly higher (96.2%; 25/26) than that using DL (69.2%; 18/26). Conclusion: The video laryngoscopy could be an effective training tool for inexperienced staff in developing the skill of tracheal intubation.
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Frontiers in pediatrics · Jan 2020
Attention-Deficit/Hyperactivity Disorder Mimics the Post-concussion Syndrome in Adolescents.
The objective of this study was to evaluate concussion-like symptom reporting among uninjured adolescents with Attention-deficit/hyperactivity disorder (ADHD), stratified by several cooccurring conditions, and to examine the base rate and predictors of uninjured adolescents with ADHD meeting diagnostic criteria for the International Classification of Diseases, 10th Revision (ICD-10) post-concussional syndrome (PCS). Participants in this cross-sectional, observational study, were drawn from a cohort of 48,834 adolescent student athletes from Maine (ages 13-18) with no concussion in the past 6 months who completed a preseason, baseline testing program between 2009 and 2015. The final sample included 3,031 students with ADHD, 2,146 (70.8%) boys and 885 (29.2%) girls. ⋯ Adolescents with ADHD commonly endorse concussion-like symptoms in the absence of a recent concussion. Demographic characteristics (sex) and the presence of co-occurring conditions are related to symptom reporting in adolescents with ADHD. Understanding factors associated with baseline symptom reporting, such as pre-existing ADHD, is important when evaluating youth who have persistent symptoms following concussion as well as making both return to school and return to athletics decisions.
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Frontiers in pediatrics · Jan 2020
Association Between Lactates, Blood Glucose, and Systemic Oxygen Delivery in Children After Cardiopulmonary Bypass.
Objective: Lactate is often used as a surrogate marker of inappropriate oxygen delivery. It has been shown that hyperlactatemia is associated with worse clinical outcome in children after cardiac surgery. The purpose of this study is to evaluate the association of hyperlactatemia, low systemic oxygen delivery, and hyperglycemia, in children admitted to the pediatric critical care unit after cardiopulmonary bypass. ⋯ At 12 h after PICU admission, there was a very week correlation between lactate and blood glucose (R = 0.27, p = 0.007), but none between lactate and oxygen extraction (R = 0.13, p = 0.20). Conclusion: In children after cardiopulmonary bypass, lactates are not correlated with higher oxygen extraction, but are correlated with hyperglycemia, at both 4 and 12 h after PICU admission. Future research is warranted to better define this relationship.