Predicting Mortality and Intestinal Failure in Neonates with Surgical Necrotizing Enterocolitis
|
|
- Nicholas Harrell
- 5 years ago
- Views:
Transcription
1 Predicting Mortality and Intestinal Failure in Neonates with Surgical Necrotizing Enterocolitis Darshna Bhatt MHA DO, Curtis Travers MPH, Ravi M. Patel MD MSc, Julia Shinnick MD, Kelly Arps MD, Sarah Keene, MD, Mehul V. Raval MD MS Affiliations: Division of Neonatology, Department of Pediatrics, Emory University School of Medicine, Children s Healthcare of Atlanta, Atlanta, GA, USA; Biostatistical Core, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Children s Healthcare of Atlanta, Atlanta, GA, USA
2 Disclosures Speaker: Dr. Mehul V. Raval, MD, MS Dr. Raval has documented that he has nothing to disclose.
3 NEC is BAD 10% of NICU deaths Surgical NEC = ~50% mortality SBS & intestinal failure (IF) Existing risk prediction models Neu and Walker. NEJM (2011) Richardson DK et al. Journal of Peds (2001) Medlock S et al. PLoS ONE (2011) Zupancic JA et al Pediatrics (2007) Stey A et al. Pediatrics. (2015) The ideal prediction model should: Be simple to use with a small set of inputs that are easily accessible preoperatively Be appropriately validated and calibrated
4 Objectives The primary purpose of this study was to evaluate and compare existing tools in the prediction of death or IF in patients with surgical NEC A secondary aim was to derive and validate a novel hybrid model to predict death or IF
5 Methods Retrospective, observational cohort study (9/09-5/15) Inclusion criteria: 1) gestational age < 37 weeks 2) diagnosis of NEC requiring surgical intervention Exclusion criteria: 1) diagnosis of spontaneous intestinal perforation (SIP) 2) or congenital intestinal anomalies The primary outcome was death or IF 1) All cause in-hospital mortality 2) IF = failure to full enteral feeds 90d post op Duro D et al. The Journal of Pediatrics (2010) Kelleher J et al. (2013)
6 Methods Data collection All variables collected were measured before surgery Physiologic parameters were obtained within 3 hours before surgery Statistical Analysis Logistic regression modelling was used Discrimination was assessed using the AUC Hybrid model: Variables with bivariate p-values < 0.1 were considered candidate variables Backward step-wise selection used to create model Model validation & calibration Hosmer DW et al. Statistics In Medicine (1997)
7 Sample Selection for Derivation Model 520 patients identified in hospital database using ICD-9 codes (9/01-5/15) Gestational Age, weeks (IQR) Derivation cohort (n =147) 27.1 ( ) Validation cohort (n= 76) 27.0 ( ) P value duplicate patients Birthweight, g (IQR) 940 ( ) 880 ( ) charts examined for confirming diagnosis of surgical NEC 147 patients met inclusion criteria 329 patients excluded 140 Other (incorrectly coded- suspicion/ concern for NEC) 70 Medical NEC (no surgical intervention) 101 Spontaneous Intestinal Perforations 2 Omphaloceles 16 Gastroschisis Male 60% 54% 0.39 Antenatal Steroids (>1 doses) 67% 58% 0.19 Exp Lap 92% 82% Primary Drain 8% 18% 0.02 Mortality or IF 64% 70% 0.39 Mortality 38% 36% 0.71 IF 35% 34% 0.86
8 8 Models VON-RA Model SNAPPE-II Model NSQIP-P Model Hybrid Model Ge/stational age Gestational age (squared) multiple gestation/ singleton gestation Outborn status Apgar score 1 min Apgar score 5 min Gender Cesarean delivery Presence of a congenital anomaly Mean blood pressure Temperature PO 2 /FiO 2 Lowest serum ph Multiple seizures Urine output Preterm Small for gestational age Birthweight Mode of delivery Case type Nutritional supplement Dialysis Cardiac risk factors Apgar score 1 min Apgar score 5 min Inotrope use 24hrs pre-op Blood transfusion 48hours prior to op procedure Hepatobiliary disease Hereditary bleeding disorder Intracranial hemorrhage Systemic sepsis Apgar score 1 min Inotrope use Mean blood pressure Sepsis
9 AUC
10 Observed Probabilities Observed Probabilities Observed vs Predicted Probabilities for Death or IF Calibration Plots (derivation cohort) & (validation cohort) Predicted Probabilities Predicted Probabilities
11 Conclusions Prediction of death or IF among infants with surgical NEC is possible using existing prediction tools and, to a greater extent, using a newly proposed hybrid model Our hybrid model utilizes four pre-operative variables: Apgar score at 1 minute Inotrope use Mean arterial pressure Sepsis
12 Next Steps The proposed hybrid model can be used to provide risk-adjusted comparisons of surgical outcomes among centers This tool may help centers understand how their surgical outcomes among infants with NEC compare to other centers by providing less biased comparisons We are currently in the process of validating this tool at additional tertiary care centers
SWISS SOCIETY OF NEONATOLOGY. Spontaneous intestinal perforation or necrotizing enterocolitis?
SWISS SOCIETY OF NEONATOLOGY Spontaneous intestinal perforation or necrotizing enterocolitis? June 2004 2 Stocker M, Berger TM, Neonatal and Pediatric Intensive Care Unit, Children s Hospital of Lucerne,
More informationRecommendations for Hospital Quality Measures in 2011:
Pediatric Measures: Recommendations for Hospital Quality Measures in 2011: Based on the input of a group of healthcare stakeholders, the following new hospital measures are recommended: 1) Home Management
More informationNoah Hillman M.D. IPOKRaTES Conference Guadalajaira, Mexico August 23, 2018
Postnatal Steroids Use for Bronchopulmonary Dysplasia in 2018 + = Noah Hillman M.D. IPOKRaTES Conference Guadalajaira, Mexico August 23, 2018 AAP Policy Statement - 2002 This statement is intended for
More informationOur Journey Toward Elimination of. Necrotizing Enterocolitis 4/16/2018. Disclosure. Presentation Outline. Clinical Presentation of NEC
Our Journey Toward Elimination of Necrotizing Enterocolitis RAY SATO, M.D. TACOMA GENERAL HOSPITAL NICU APRIL 2018 Disclosure Ray Sato, MD has no financial relationship to disclose or conflicts of interest
More informationAdmission/Discharge Form for Infants Born in Please DO NOT mail or fax this form to the CPQCC Data Center. This form is for internal use ONLY.
Selection Criteria Admission/Discharge Form for Infants Born in 2016 To be eligible, you MUST answer YES to at least one of the possible criteria (A-C) A. 401 1500 grams o Yes B. GA range 22 0/7 31 6/7
More informationIs It Possible to Prevent Necrotizing Enterocolitis?
Is It Possible to Prevent Necrotizing Enterocolitis? Ravi Mangal Patel, MD MSc Associate Professor of Pediatrics Emory University School of Medicine, Atlanta, GA, USA @institutopgg @ravimpatelmd Disclosures
More informationADMISSION/DISCHARGE FORM FOR INFANTS BORN IN 2019 DO NOT mail or fax this form to the CPQCC Data Center. This form is for internal use ONLY.
1 Any eligible inborn infant who dies in the delivery room or at any other location in your hospital within 12 hours after birth and prior to admission to the NICU is defined as a "Delivery Room Death."
More informationNEC- What Lies Under the Big Umbrella?
NEC- What Lies Under the Big Umbrella? Instructor in Surgery Associate Surgical Director, Center for Advanced Intestinal Rehabilitation Department of Surgery, Boston Children's Hospital Harvard Medical
More informationPatent Ductus Arteriosus: Philosophy or Pathology?
Patent Ductus Arteriosus: Philosophy or Pathology? Disclosure Ray Sato, MD is a speaker for Prolacta Biosciences, Inc. This presentation will discuss off-label uses of acetaminophen and ibuprofen. RAY
More informationA Multi center Randomized Trial of Laparotomy vs. Drainage
A Multi center Randomized Trial of Laparotomy vs. Drainage as the Initial Surgical Therapy for ELBW Infants with Necrotizing Enterocolitis (NEC) or Isolated Intestinal Perforation (IP): Outcomes at 18
More informationKugelman A, Riskin A, Said W, Shoris I, Mor F, Bader D.
Heated, Humidified High-Flow Nasal Cannula (HHHFNC) vs. Nasal Intermittent Positive Pressure Ventilation (NIPPV) for the Primary Treatment of RDS, A Randomized, Controlled, Prospective, Pilot Study Kugelman
More informationThe Case Begins. The case continued. Necrotizing Enterocolitis
Bugs, Drugs and Things that go Bump in the Night From ghoulies to ghosties and long leggety beasties & things that go bump in the night, good lord deliver us Old Cornish Prayer Caring for premature infant
More informationResuscitating neonatal and infant organs and preserving function. GI Tract and Kidneys
Resuscitating neonatal and infant organs and preserving function GI Tract and Kidneys Australian and New Zealand Resuscitation Council Joint Guidelines Outline Emphasis on the infant - PICU Kidney Gastrointestinal
More informationThe jury is still out: changes in gastroschisis management over the last decade are associated with both benefits and shortcomings
Journal of Pediatric Surgery (2012) 47, 119 124 www.elsevier.com/locate/jpedsurg The jury is still out: changes in gastroschisis management over the last decade are associated with both benefits and shortcomings
More informationARTIFICIAL INTELLIGENCE FOR PREDICTION OF SEPSIS IN VERY LOW BIRTH WEIGHT INFANTS
ARTIFICIAL INTELLIGENCE FOR PREDICTION OF SEPSIS IN VERY LOW BIRTH WEIGHT INFANTS Markus Leskinen MD PhD, Neonatologist Children s Hospital, University of Helsinki and Helsinki University Hospital The
More informationIs NEC requiring surgery precipitated by a change in feeds? Observations from 50 consecutive cases. David Burge SIGNEC September 2015
Is NEC requiring surgery precipitated by a change in feeds? Observations from 50 consecutive cases. David Burge SIGNEC September 2015 Clinical series Specific cases Other scenarios Published experience
More informationEffects of Indomethacin Prophylaxis Timing on IVH and PDA in Extremely Low Birth Weight (ELBW) Infants
Effects of Indomethacin Prophylaxis Timing on IVH and PDA in Extremely Low Birth Weight (ELBW) Infants Hussnain Mirza, University of Central Florida Abbot R. Laptook, Brown University William Oh, Brown
More informationSeverity of Illness in the Early Pre- Surgical Management of Congenital Diaphragmatic Hernia
Severity of Illness in the Early Pre- Surgical Management of Congenital Diaphragmatic Hernia Bradley A. Kuch MHA, RRT-NPS, FAARC Director: Respiratory Care Services and Transport Team Children s Hospital
More informationKimberly M. Thornton, 1,2 Hongying Dai, 3 Seth Septer, 2,4 and Joshua E. Petrikin 1,2. 1. Introduction
International Pediatrics, Article ID 643689, 7 pages http://dx.doi.org/10.1155/2014/643689 Research Article Effects of Whole Body Therapeutic Hypothermia on Gastrointestinal Morbidity and Feeding Tolerance
More informationDoes Targeted Neonatal Echocardiography(TnECHO) can help prevent Postoperative Cardiorespiratory instability following PDA ligation?
Does Targeted Neonatal Echocardiography(TnECHO) can help prevent Postoperative Cardiorespiratory instability following PDA ligation? Amish Jain, Mohit Sahni, Afif El Khuffash, Arvind Sehgal, Patrick J
More informationAuthors: Shuling Li, PhD 1, Julia Molony, MS 1, Karynsa Cetin, MPH 2, Jeffrey Wasser, MD 3, Ivy Altomare, MD 4
Rate of Bleeding-Related Episodes (BREs) in Elderly Patients with Primary Immune Thrombocytopenia (ITP): A Population-Based Retrospective Cohort Study Using Medicare 20% Sample Data Authors: Shuling Li,
More informationCigdem Benlice, Ipek Sapci, T. Bora Cengiz, Luca Stocchi, Michael Valente, Tracy Hull, Scott R. Steele, Emre Gorgun 07/23/2018
Does preoperative oral antibiotic or mechanical bowel preparation increase Clostridium difficile colitis after colon surgery? An assessment from ACS-NSQIP procedure-targeted database Cigdem Benlice, Ipek
More informationThe spectrum and outcome of the. neonates with inborn errors of. metabolism at a tertiary care hospital
The spectrum and outcome of the neonates with inborn errors of metabolism at a tertiary care hospital Dr. Sevim Ünal Neonatology Division, Ankara Children s Hematology Oncology Research Hospital, Ankara,
More informationGS3. Understanding How to Use Statistics to Evaluate an Article. Session Summary. Session Objectives. References. Session Outline
GS3 Understanding How to Use Statistics to Evaluate an Article Reese H. Clark, MD Director of Research Pediatrix Medical Group Neonatologist Greenville Memorial Hospital, Greenville, SC The speaker has
More informationAdjusted poor weight gain for birth weight and gestational age as a predictor of severe ROP in VLBW infants
(2011) 25, 725 729 & 2011 Macmillan Publishers Limited All rights reserved 0950-222X/11 www.nature.com/eye Adjusted poor weight gain for birth weight and gestational age as a predictor of severe ROP in
More informationSTOP ROP The STOP-ROP Multicenter Study Group: Pediatrics 105:295, 2000 Progression to Threshold Conventional Sat 89-94% STOP ROP
Hrs TcPO2 > 80 nnhg (weeks 1 4) OXYGEN TARGETS: HOW GOOD ARE WE IN ACHIEVING THEM Oxygen Dependency GA wks Eduardo Bancalari MD University of Miami Miller School of Medicine Jackson Memorial Medical Center
More informationBy: Armend Lokku Supervisor: Dr. Lucia Mirea. Maternal-Infant Care Research Center, Mount Sinai Hospital
By: Armend Lokku Supervisor: Dr. Lucia Mirea Maternal-Infant Care Research Center, Mount Sinai Hospital Background My practicum placement was at the Maternal-Infant Care Research Center (MiCare) at Mount
More informationNeonatal Perforated Gut: Etiology and Risk Factors
Cronicon OPEN ACCESS EC PAEDIATRICS Research Article Mostafa Kotb 1 * and Marwa Beyaly 2 1 Pediatric Surgery Department, Alexandria Faculty of Medicine, Egypt. 2 Human Genetics Department, Medical Research
More informationResearch Article Bowel Perforation in Premature Infants with Necrotizing Enterocolitis: Risk Factors and Outcomes
Gastroenterology Research and Practice Volume 2016, Article ID 6134187, 6 pages http://dx.doi.org/10.1155/2016/6134187 Research Article Bowel Perforation in Premature Infants with Necrotizing Enterocolitis:
More informationNeonatal Intensive Care Unit Skills Checklist
_ XXX-XX- Print Name Last 4 of SS # Date Completed Directions Please circle a value for each question to provide us and the interested facilities with an assessment of your clinical experience. These values
More informationObjectives. Apnea Definition and Pitfalls. Pathophysiology of Apnea. Apnea of Prematurity and hypoxemia episodes 5/18/2015
Apnea of Prematurity and hypoxemia episodes Deepak Jain MD Care of Sick Newborn Conference May 2015 Objectives Differentiating between apnea and hypoxemia episodes. Pathophysiology Diagnosis of apnea and
More informationPerforated Necrotizing Enterocolitis: What Is The Rational Approach? Peritoneal Drainage or Laparotomy?
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-853, p-issn: 2279-861.Volume 17, Issue 5 Ver. 12(May. 218), PP 19-23 www.iosrjournals.org Perforated Necrotizing Enterocolitis: What
More informationSWISS SOCIETY OF NEONATOLOGY. Neonatal gastric perforation
SWISS SOCIETY OF NEONATOLOGY Neonatal gastric perforation September 2002 2 Zankl A, Stähelin J, Roth K, Boudny P and Zeilinger G, Children s Hospital of Aarau (ZA, SJ, RK, ZG) and Institute of Pathology
More informationSWISS SOCIETY OF NEONATOLOGY. Severe apnea and bradycardia in a term infant
SWISS SOCIETY OF NEONATOLOGY Severe apnea and bradycardia in a term infant October 2014 2 Walker JH, Arlettaz Mieth R, Däster C, Division of Neonatology, University Hospital Zurich, Switzerland Swiss Society
More informationInsults to the Developing Brain & Effect on Neurodevelopmental Outcomes
Insults to the Developing Brain & Effect on Neurodevelopmental Outcomes Ira Adams-Chapman, MD Assistant Professor of Pediatrics Director, Developmental Progress Clinic Emory University School of Medicine
More informationGastroschisis is one of the most common birth
Delivery room surgery: an applicable therapeutic strategy for gastroschisis in developing countries Lei Du, Wei-Hua Pan, Wei Cai, Jun Wang, Ye-Ming Wu, Cheng-Ren Shi Shanghai, China Background: The survival
More informationState of Florida Systemic Supportive Care Guidelines. Michael D. Weiss, M.D. Associate Professor of Pediatrics Division of Neonatology
State of Florida Systemic Supportive Care Guidelines Michael D. Weiss, M.D. Associate Professor of Pediatrics Division of Neonatology I. FEN 1. What intravenous fluids should be initiated upon admission
More informationAMERICAN COLLEGE OF SURGEONS NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM - PEDIATRIC Data Collection Worksheet
AMERICAN COLLEGE OF SURGEONS NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM - PEDIATRIC Data Collection Worksheet *IDN LMRN Cycle Number Case Number DEMOGRAPHICS PATIENT First Name: MI: Last Name: Street
More informationName and title of the investigators responsible for conducting the research: Dr Anna Lavizzari, Dr Mariarosa Colnaghi
Protocol title: Heated, Humidified High-Flow Nasal Cannula vs Nasal CPAP for Respiratory Distress Syndrome of Prematurity. Protocol identifying number: Clinical Trials.gov NCT02570217 Name and title of
More informationProfessor and Director. Children s Hospital of Richmond
Evaluation of AKI in term and premature infants Timothy E. Bunchman Professor and Director Pediatric Nephrology & Transplantation Children s Hospital of Richmond Virginia Commonwealth Univ. School of Medicine
More informationDelivery Room Resuscitation of Newborns with Congenital Anomalies
Delivery Room Resuscitation of Newborns with Congenital Anomalies Anne Ades, MD, MSEd Director of Neonatal Education The Children s Hospital of Philadelphia Associate Professor of Clinical Pediatrics Perelman
More informationSAMPLE. V.12.1 Special Report: Very Low Birthweight Neonates. I. Introduction
I. Introduction V.12.1 Special Report: Very Low Birthweight Neonates The delivery of a very low birth weight infant continues to present many challenges to families and health care providers in spite of
More information2015 Prolacta Bioscience
Housekeeping Items 1 Presentation will be available on-demand http://www.prolacta.com/webinars/feeding-protocols 2 Turn up your speaker volume 3 Use the Ask a Question feature 4 Use the full screen feature
More informationCorrelation of Neurodevelopmental Outcome and brain MRI/EEG findings in term HIE infants
Correlation of Neurodevelopmental Outcome and brain MRI/EEG findings in term HIE infants Ajou University School of Medicine Department of Pediatrics Moon Sung Park M.D. Hee Cheol Jo, M.D., Jang Hoon Lee,
More informationUpdated NSQIP Frailty Index
Updated NSQIP Frailty Index Adam P. Johnson, MD, MPH; 1 Sarah E. Koller, MD; 2 Emily A. Busch, MD; 2 Matt M. Philp, MD; 2 Howard Ross, MD; 2 Paul J DiMuzio, MD; 1 Scott W. Cowan, MD; 1 Henry A. Pitt, MD
More informationAdvanced Necrotizing Enterocolitis Part 1: Mortality
8 Original Article Advanced Necrotizing Enterocolitis Part 1: Mortality M. Thyoka 1 P. de Coppi 1 S. Eaton 1 K. Khoo 1 N.J. Hall 1 J. Curry 1 E. Kiely 1 D. Drake 1 K. Cross 1 A. Pierro 1 1 Department of
More informationA guideline on Neonatal Hypertension
A guideline on Neonatal Hypertension Authors: Dr Aravind Shastri, Consultant (Neonatology and Cardiology), Colchester General Hospital For use in: Eastern Neonatal Units Guidance specific to the care of
More informationRango de saturacion de oxigeno: Cual es la evidencia?
Rango de saturacion de oxigeno: Cual es la evidencia? Wally Carlo, M.D. University of Alabama at Birmingham Department of Pediatrics Division of Neonatology wcarlo@peds.uab.edu 1 2 Stevie Wonder 4 Objectives
More informationDoes a Blush on CT following Blunt Abdominal Injury Necessitate an Invasive Intervention?
Does a Blush on CT following Blunt Abdominal Injury Necessitate an Invasive Intervention? Ragavan V Siddharthan, MD, Martha-Conley Ingram, BS., Andrew Morris, MD, Curtis Travers, MPH, Courtney McCracken,
More informationOriginal Article. Defining reduced urine output in neonatal ICU: importance for mortality and acute kidney injury classification
Nephrol Dial Transplant (2013) 28: 901 909 doi: 10.1093/ndt/gfs604 Advance Access publication 24 January 2013 Original Article Defining reduced urine output in neonatal ICU: importance for mortality and
More informationOutcomes of Babies with Surgical Necrotizing Enterocolitis in the Children s Hospitals Neonatal Consortium
Outcomes of Babies with Surgical Necrotizing Enterocolitis in the Children s Hospitals Neonatal Consortium Toby Debra Yanowitz, MD, MS Associate Professor of Pediatrics Division of Newborn Medicine University
More informationRisk Factors for Spontaneous Intestinal Perforation in Extremely Low Birth Weight Infants
The Open Pediatric Medicine Journal, 28, 2, 11-15 11 Risk Factors for Spontaneous Intestinal Perforation in Extremely Low Birth Weight Infants Irfan Ahmad 1, Kristy F. Davis 2, Sherif Emil *,2, Cherry
More informationCOMPLICATIONS OF PRE-GESTATIONAL AND GESTATIONAL DIABETES IN SAUDI WOMEN: ANALYSIS FROM RIYADH MOTHER AND BABY COHORT STUDY (RAHMA)
COMPLICATIONS OF PRE-GESTATIONAL AND GESTATIONAL DIABETES IN SAUDI WOMEN: ANALYSIS FROM RIYADH MOTHER AND BABY COHORT STUDY (RAHMA) Prof. Hayfaa Wahabi, King Saud University, Riyadh Saudi Arabia Hayfaa
More informationMaternal and Fetal Complications in Diabetes Pregnancy
Maternal and Fetal Complications in Diabetes Pregnancy Helen R Murphy Professor of Medicine (Diabetes & Antenatal Care), UEA Professor of Women s Health, Kings College London hm386@medschl.cam.ac.uk 1
More informationDepartment of Pediatrics, Coimbatore Medical College Hospital, Coimbatore, Tamilnadu, India Correspondence to: Senthilkumar P,
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 8 Ver. VIII (Aug. 2017), PP 40-45 www.iosrjournals.org A Randomized Trial of Intravenous Fluid
More informationPARENTERAL NUTRITION
PARENTERAL NUTRITION DEFINITION Parenteral nutrition [(PN) or total parenteral nutrition (TPN)] is the intravenous infusion of some or all nutrients for tissue maintenance, metabolic requirements and growth
More informationGastroschisis Sequelae and Management
Gastroschisis Sequelae and Management Mary Finn Gillian Lieberman, MD Primary Care Radiology Beth Israel Deaconess Medical Center Harvard Medical School April 2014 Outline I. Definition and Epidemiology
More informationHazards and Benefits of Postnatal Steroids. David J. Burchfield, MD Professor and Chief, Neonatology University of Florida
Hazards and Benefits of Postnatal Steroids David J. Burchfield, MD Professor and Chief, Neonatology University of Florida Disclosures I have no financial affiliations or relationships to disclose. I will
More informationProduct Catalog. Pediatric Learning Solutions. Listing of all current products (as of May, 2013) offered by Children's Hospital Association.
Product Catalog Pediatric Learning Solutions Listing of all current products (as of May, 2013) offered by Children's Hospital Association. Acquired Heart Disease in Children WBT Acute Respiratory Distress
More informationFEV1 predicts length of stay and in-hospital mortality in patients undergoing cardiac surgery
EUROPEAN SOCIETY OF CARDIOLOGY CONGRESS 2010 FEV1 predicts length of stay and in-hospital mortality in patients undergoing cardiac surgery Nicholas L Mills, David A McAllister, Sarah Wild, John D MacLay,
More informationState of Florida Hypothermia Protocol. Michael D. Weiss, M.D. Associate Professor of Pediatrics Division of Neonatology
State of Florida Hypothermia Protocol Michael D. Weiss, M.D. Associate Professor of Pediatrics Division of Neonatology I. Entry Criteria 1. Gestational Age greater than or equal to 35 weeks gestation
More informationCover Page. The handle holds various files of this Leiden University dissertation
Cover Page The handle http://hdl.handle.net/1887/22368 holds various files of this Leiden University dissertation Author: Lugt, Neeltje Margaretha van der Title: Neonatal pearls : safety and efficacy of
More informationStabilization and Transportation guidelines for Neonates and infants with Heart disease:
Stabilization and Transportation guidelines for Neonates and infants with Heart disease: Background: Referral Pediatric Cardiac Units, frequently receive neonates and infants referred and transported from
More informationThe Role Of Modified Ventilatory Index In Defining The Prognosis In Surgical And Non-Surgical Pediatric Patients
ISPUB.COM The Internet Journal of Pulmonary Medicine Volume 5 Number 1 The Role Of Modified Ventilatory Index In Defining The Prognosis In Surgical And Non-Surgical Pediatric Z?lçe, C Güney, N Eray, B
More informationIs There a Treatment for BPD?
Is There a Treatment for BPD? Amir Kugelman, Pediatric Pulmonary Unit and Department of Neonatology Bnai Zion Medical Center, Rappaport Faculty of Medicine Haifa, Israel Conflict of Interest Our study
More informationNIH Public Access Author Manuscript Hosp Pediatr. Author manuscript; available in PMC 2014 June 30.
NIH Public Access Author Manuscript Published in final edited form as: Hosp Pediatr. 2013 October ; 3(4): 335 341. doi:10.1542/hpeds.2013-0036. Practice Variance, Prevalence, and Economic Burden of Premature
More informationAn Update on Caffeine Therapy
An Update on Caffeine Therapy Emory University School of Medicine Atlanta, GA Wally Carlo, MD University of Alabama at Birmingham Department of Pediatrics Division of Neonatology wcarlo@peds.uab.edu Objectives
More informationNeonatal Transcutaneous Carbon Dioxide Monitoring Effect on Clinical Management and Outcomes
Neonatal Transcutaneous Carbon Dioxide Monitoring Effect on Clinical Management and Outcomes Sagori Mukhopadhyay MD MMSc, Rie Maurer MA, and Karen M Puopolo MD PhD BACKGROUND: This work aimed to compare
More informationLesta Whalen, MD Medical Director, Sanford ECMO Pediatric Critical Care
Lesta Whalen, MD Medical Director, Sanford ECMO Pediatric Critical Care Disclosures I have no financial disclosures. The use of certain devises for providing long-term cardiopulmonary support is investigational.
More information1
1 2 3 RIFAI 5 6 Dublin cohort, retrospective review. Milrinone was commenced at an initial dose of 0.50 μg/kg/minute up to 0.75 μg/kg/minute and was continued depending on clinical response. No loading
More informationFANNP 28TH NATIONAL NNP SYMPOSIUM: CLINICAL UPDATE AND REVIEW OCTOBER 17-21, 2017
Pulse Oximetry in the Delivery Room: Principles and Practice GS2 3 Jonathan P. Mintzer, MD, FAAP Assistant Professor of Pediatrics Stony Brook Children s Hospital, Division of Neonatal-Perinatal Medicine,
More informationResearch Article Timing of Caffeine Therapy and Neonatal Outcomes in Preterm Infants: A Retrospective Study
International Pediatrics Volume 2016, Article ID 9478204, 6 pages http://dx.doi.org/10.1155/2016/9478204 Research Article Timing of Caffeine Therapy and Neonatal Outcomes in Preterm Infants: A Retrospective
More informationOriginal Article. Associated Anomalies and Clinical Outcomes in Infants with Omphalocele: A Single-centre 10-year Review
HK J Paediatr (new series) 2018;23:220-224 Original Article Associated Anomalies and Clinical Outcomes in Infants with Omphalocele: A Single-centre 10-year Review YY CHEE, MSC WONG, RMS WONG, KY WONG,
More informationNecrotizing Enterocolitis: the role of ultrasound in the assessment of bowel viability
Necrotizing Enterocolitis: the role of ultrasound in the assessment of bowel viability Ricardo Faingold, MD. Department of Medical Imaging The Montreal Children s Hospital McGill University SPR Vancouver
More informationNIRS utilization during first hours and days of life
NIRS utilization during first hours and days of life Berndt Urlesberger, MD Professor of Neonatology Division of Neonatology, Department of Pediatrics Medical University Graz, Austria Email: berndt.urlesberger@medunigraz.at
More informationManagement of Short Bowel Syndrome in the Era of Teduglutide. Charlene Compher, PhD, RD University of Pennsylvania
Management of Short Bowel Syndrome in the Era of Teduglutide Charlene Compher, PhD, RD University of Pennsylvania compherc@nursing.upenn.edu Disclosures Research funding for clinical trials by NPS Pharmaceuticals
More informationTransfusion & Mortality. Philippe Van der Linden MD, PhD
Transfusion & Mortality Philippe Van der Linden MD, PhD Conflict of Interest Disclosure In the past 5 years, I have received honoraria or travel support for consulting or lecturing from the following companies:
More information(1 280 ± 286) g; (1 436 ± 201) g
259 ( 100730) : 34 1 800 g 24 (, 11 ) (, 13 ) 50%, 100 ml / (kg d) FM85, ; (30.6 ± 2.9), (1 280 ± 286) g; (31.6 ± 1.9), (1 436 ± 201) g, 81.6%, 34.1 24.6 d [18.9 vs 17.1 g / (kg d), P = 0.364] (1.16 vs
More informationRECTAL PROLAPSE objectives
RECTAL PROLAPSE objectives 1.Classify rectal prolapse 2. Enumerate the causes of rectal prolapse 3. Differentiate between complete rectal prolapse and intussusception 4. List the modalities of treatment
More informationBubble CPAP for Respiratory Distress Syndrome in Preterm Infants
R E S E A R C H P A P E R Bubble CPAP for Respiratory Distress Syndrome in Preterm Infants JAGDISH KOTI*, SRINIVAS MURKI, PRAMOD GADDAM, ANUPAMA REDDY AND M DASARADHA RAMI REDDY From Fernandez Hospital
More informationImproved survival in a multidisciplinary short bowel syndrome program
Journal of Pediatric Surgery (2008) 43, 20 24 www.elsevier.com/locate/jpedsurg Improved survival in a multidisciplinary short bowel syndrome program Biren P. Modi a,b, Monica Langer a,b, Y. Avery Ching
More informationUpdate on mangement of patent ductus arteriosus in preterm infants. Dr. Trinh Thi Thu Ha
Update on mangement of patent ductus arteriosus in preterm infants Dr. Trinh Thi Thu Ha Outline 1. Overview of PDA 2. Timing of screening PDA? 3. When to treat PDA? Timing of ductal closure Prenatal
More informationDisclosure COULD AUTOMATED CONTROL OF OXYGEN LEVELS IMPROVE SURVIVAL AND REDUCE NEC? Oxygen Dependency
COULD AUTOMATED CONTROL OF OXYGEN LEVELS IMPROVE SURVIVAL AND REDUCE NEC? Eduardo Bancalari MD University of Miami Miller School of Medicine Jackson Memorial Medical Center Sydney 206 Disclosure The University
More informationOptimal Distribution and Utilization of Donated Human Breast Milk: A Novel Approach
653738JHLXXX10.1177/0890334416653738Journal of Human LactationSimpson et al research-article2016 Original Research: Brief Report Optimal Distribution and Utilization of Donated Human Breast Milk: A Novel
More informationENTERAL NUTRITION Identifying risk of patients for enteral feeding problems: Low risk: Moderate risk: High risk:
ENTERAL NUTRITION Statement of best practice Feeding with mother s own breastmilk is protective against sepsis, NEC and death All mothers should be informed about this and strongly encouraged to express
More informationCPAP failure in preterm infants: incidence, predictors and consequences
CPAP failure in preterm infants: incidence, predictors and consequences SUPPLEMENTAL TEXT METHODS Study setting The Royal Hobart Hospital has an 11-bed combined Neonatal and Paediatric Intensive Care Unit
More informationPediatric Learning Solutions course alignment with the Neonatal/Pediatric Specialty Examination Detailed Content Outline.
Pediatric Learning Solutions course alignment with the Neonatal/Pediatric Specialty Examination Detailed Content Outline. The following Pediatric Learning Solutions courses align to focus areas of the
More informationWhat s new in neonatal resuscitation?
What s new in neonatal resuscitation? Anup Katheria, M.D. Director, Neonatal Research Institute Sharp Mary Birch Hospital for Women & Newborns Disclosures I have no financial Disclosures. Overview Delivery
More informationROLE OF EARLY POSTNATAL DEXAMETHASONE IN RESPIRATORY DISTRESS SYNDROME
INDIAN PEDIATRICS VOLUME 35-FEBRUAKY 1998 ROLE OF EARLY POSTNATAL DEXAMETHASONE IN RESPIRATORY DISTRESS SYNDROME Kanya Mukhopadhyay, Praveen Kumar and Anil Narang From the Division of Neonatology, Department
More informationPRACTICE GUIDELINES WOMEN S HEALTH PROGRAM
C Title: NEWBORN: HYPOGLYCEMIA IN NEONATES BORN AT 35+0 WEEKS GESTATION AND GREATER: DIAGNOSIS AND MANAGEMENT IN THE FIRST 72 HOURS Authorization Section Head, Neonatology, Program Director, Women s Health
More informationEfficacy of Breast Milk Gastric Lavage in Preterm Neonates. Archana B. Patel and Samiuddin Shaikh
Research Papers Efficacy of Breast Milk Gastric Lavage in Preterm Neonates Archana B. Patel and Samiuddin Shaikh From the Department of Pediatrics and Clinical Epidemiology Unit, Indira Gandhi Medical
More informationDosing of Antimicrobials in the Neonatal Intensive Care Unit: Does Clinical Practice Reflect Published Recommendations?
Dosing of Antimicrobials in the Neonatal Intensive Care Unit: Does Clinical Practice Reflect Published Recommendations? Morgan England The University of Texas at Austin A project of the Best Pharmaceuticals
More informationAEROSURF Phase 2 Program Update Investor Conference Call
AEROSURF Phase 2 Program Update Investor Conference Call November 12, 2015 Forward Looking Statement To the extent that statements in this presentation are not strictly historical, including statements
More informationTransfusions, Necrotizing Enterocolitis (NEC), Cytomegalovirus (CMV) and more.. Oh my. Updates on Neonatal Transfusion Medicine
Transfusions, Necrotizing Enterocolitis (NEC), Cytomegalovirus (CMV) and more.. Oh my Updates on Neonatal Transfusion Medicine Cassandra D. Josephson, MD Professor, Pathology and Pediatrics Emory University
More informationACS-NSQIP 2015 Julietta Chang MD, Ali Aminian MD, Stacy A Brethauer MD, Philip R Schauer MD Bariatric and Metabolic Institute
ACS-NSQIP 2015 Julietta Chang MD, Ali Aminian MD, Stacy A Brethauer MD, Philip R Schauer MD Bariatric and Metabolic Institute Disclosures Authors: No disclosures ACS-NSQIP Disclaimer: The American College
More informationObjectives. Birth Depression Management. Birth Depression Terms
Objectives Birth Depression Management Regional Perinatal Outreach Program 2016 Understand the terms and the clinical characteristics of birth depression. Be familiar with the evidence behind therapeutic
More informationCover Page. The handle holds various files of this Leiden University dissertation
Cover Page The handle http://hdl.handle.net/1887/46692 holds various files of this Leiden University dissertation Author: Zanten, Henriëtte van Title: Oxygen titration and compliance with targeting oxygen
More informationNon-invasive ventilatory strategies, such as
R E S E A R C H P A P E R Heated Humidified High Flow Nasal Cannula versus Nasal Continuous Positive Airway Pressure as Primary Mode of Respiratory Support for Respiratory Distress in Preterm Infants DEEPARAJ
More informationEnteral Nutrition in the Critically Ill Child: Challenges and Current Guidelines
Enteral Nutrition in the Critically Ill Child: Challenges and Current Guidelines 1 Presented on January 24, 2017 Jorge A. Coss-Bu, MD Associate Professor of Pediatrics Section of Critical Care Baylor College
More information