Disclosure COULD AUTOMATED CONTROL OF OXYGEN LEVELS IMPROVE SURVIVAL AND REDUCE NEC? Oxygen Dependency
|
|
- Rodger Mervin Newton
- 5 years ago
- Views:
Transcription
1 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 of Miami, Drs. Claure and Bancalari have a patent on the algorithm for automated adjustment of inspired oxygen and a licensing agreement with Carefusion Clio studies have been supported by Carefusion Oxygen Dependency GA wks Supplemental Oxygen for Preterm Infants: A Very Tight Balance CNS damage Multi organ failure: GI/NEC, Renal CV/PDA, PH Impaired growth Increased mortality Eye damage-rop CNS damage Lung injury-bpd Oxidative stress Increased mortality? Postnatal age (weeks) Too Little Too Much Infants born at UM-JMH, GA 2-3w Years Restricted (85-89)vs. Liberal (9-95) Oxygen Exposure SUPPORT 20, BOOST II 203, COT 203 Oxygen Saturation Target Range for Extremely Preterm Infants Outcomes RR (95% CI) Participants Q of evidence Death to discharge.8 ( ) 3757 Low Death 2 mo.6 ( ) 2783 Moderate Death/Disability.02 (0.9-.) 276 Moderate BPD 0.95 ( ) 2869 Moderate NEC.2 (.05-.7) 929 Moderate Severe ROP 0.72 (0.5-.0) 066 Low From Manja et al JAMA Pediatrics 205 Manja V et al. JAMA Pediatr 205; 69:
2 Achieved Versus Intended Pulse Oximeter Saturation in Infants Born Less Than 28wks The AVIOx Study Centers using different saturation targets Percent time Below target 6 (0-7) Within target 8 (6-75) Above target 36 (5-90) Hagadorn et al. Pediatrics 2006 Rosychuk et al. Neonatology 202 Why are we so bad in keeping oxygen targets? FiO 2 adjustments Blood oxygen level fluctuates constantly: Require close attention and tight alarm settings Delayed response: Lack of buy-in by staff, unknown consequences of transient deviations Desensitization to frequent alarms More concern with hypoxemia than hyperoxemia Response is not always the most appropriate for the cause of the hypoxemia SpO 2 FiO 2 2 hrs Nurse: patient ratio and achievement of oxygen saturation goals in premature infants How can oxygen target be improved? Implementing clear guidelines for oxygen monitoring and targets Setting alarms on or close to target Minimizing factors that induce fluctuations in oxygenation Continuous education of medical and nursing personnel Proper nurse patient ratio Monitoring compliance with oxygen targets systems for oxygen control Sink DW, et al. Arch Dis Child Fetal Neonatal Ed (20). Online First doi:.36/f2 of 6 adc
3 SpO 2 within target during manual and auto FiO 2 control SpO 2 target % Time within target changes in FiO 2 / 2h mode Auto Auto Bhutani, % n/a dedicated Morozoff, % Sun, 997 set ± 3% n/a n/a Claure, % dedicated Urschitz, % dedicated Morozoff, % Claure, % Claure, % Waitz, % n/a n/a Hallenberger, centers %, 80-92%, 83-93%, 85-9% Zapata, % Lal, % n/a n/a Van Kaam, % 9-95% Pulse oximeter Ventilator-CPAP-NIV SpO 2 FiO 2 Automatic FiO 2 control algorithm n/a: not available; : includes time with SpO2 > target while FiO2 = 0.2, : extrapolated to 2 h ClioClio Proportional-integral-derivative controller (PID controller). To determine what FiO2 should be delivered the algorithm responds to: The difference between the target and actual SpO2 The rate at which the SpO2 is changing The the patient is in (hyperoxemic, normoxemic or hypoxemic) as defined by the set high and low SpO2 targets How long the actual SpO2 is out of Adjustment of Inspired Oxygen in Mechanically Ventilated Preterm Infants: A Multicenter Crossover Trial N. Claure, E. Bancalari, C. D'Ugard, L. Nelin 2, M. Stein 2, R. Ramanathan 3, R. Hernandez 3, S.M. Donn, M. Becker and T. Bachman 5. Pediatrics 20 The study consisted of 2 consecutive periods: 2 h with FiO2 adjusted as done ly by clinical staff (Standard) 2 h of automated FiO2 adjustment () The sequence was assigned at random in blocks by center The intended SpO2 for both and Standard periods was 87-93% 32 infants were included in the analysis: Birthweight: 67 ± 56 grams Gestational age: 25 ± 2 weeks Postnatal age: 26 ± 5 days % of 2 hours Prolonged episodes with SpO 2 below intended SpO 2 < 85% (>20s) SpO 2 < 75% (>60s) Standard 0 < 75% < 87% 87-93% > 93% (@O2>2%) > 98% (@O2>2%) :p<0.00 Paired t-test (mean±sd) :p=0.003 Wilcoxon Signed Rank Test (median, IQR) SpO 2 Claure et al Pediatrics 20 :p<0.00 Paired t-test (mean±sd) :p=0.00 Wilcoxon Signed Rank Test (median and 25 th 75 th percentile) 3
4 Hourly SpO 2 and FiO 2 Workload:FiO 2 adjustments :p<0.00 Paired t-test (mean±sd) Claure et al. Pediatrics 20 Conclusions FiO 2 adjustment Improved maintenance of SpO 2 within intended Target 89-93% Target 9-95% Reduced hyperoxemia and supplemental O 2 Reduced longer hypoxemia episodes Increased number of mild episodes of SpO 2 below the intended, likely due to FiO 2 weaning and avoidance of hyperoxemia Reduced staff workload % Time Automatic <80% <89% 89-93% >93% >98% <80% <9% 9-95% >95% >98% There were no study related adverse events Range of SpO 2 From Van Kaam A et al. J Pediatr 205 IMCS CLIO2 Results Non-invasive Invasive FiO2-A FiO2-M FiO2-A FiO2-M %-time in target 60±7 5±5 6±7 59±6 %-time above target 23± 23± 20±2 2.± %-time below target 7± 23±8 6± 20±8 %-time SpO 2 >98% 0.5 (0.2-.7).2 ( ) 0.2 (0.-.2) 0.6 ( ) SpO 2 >98%, > min, n/2h 3 (0-) 9 (2-7) 2 (0-7) 5 (-7) %-time SpO 2 <80% SpO 2 <80%, > min, n/2h. (0.3-.9) 2.5 (.-.3) 0.5 ( ) 2.0 (0.6-6.) 5 (-) 5 (7-2) 3 (-) (3-33) Long episodes of hypoxemia during and Auto FiO 2 control SpO 2 target Claure, % Claure, % Waitz, % # of episodes / 2 h mode Auto Lal, % < 80% > 60s 2 2 Van Kaam, % 9-95% < 80% > 60s < 80% > 60s 5 3 From Van Kaam A et al. J Pediatr 205
5 Limitations of automatic FiO2 control Like manual control automated FiO 2 control is dependent on accuracy of pulse oximeter Observed differences are relative to the effectiveness of the standard of care Can produce more fluctuations in inspired oxygen levels and saturation FiO 2 change is not always the most appropriate intervention (e.g. in hypoventilation) FiO 2 may give false sense of confidence and reduce attentiveness Could automated control of oxygen levels improve survival, reduce NEC, ROP and NDI? Exposure to hyperoxia and hypoxia are associated with increased ROP and NDI Lower SpO2 targets are associated with increased mortality and NEC FiO2 control increases time on target and reduces prolonged episodes of hyper and hypoxemia Definitive answer to these questions will come only from RCT exploring long term use of automated oxygen control on relevant outcomes MIAMI NEONATOLOGY 0th Annual International Conference & Workshop: Advances in Neonatal Respiratory Care November 5 th 8 th, 206 Fontainebleau, Miami Beach 5
STOP 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 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 informationAutomated FiO 2 -SpO 2 control system in Neonates requiring respiratory support: a comparison of a standard to a narrow SpO 2 control range
Wilinska et al. BMC Pediatrics 2014, 14:130 RESEARCH ARTICLE Open Access Automated FiO 2 -SpO 2 control system in Neonates requiring respiratory support: a comparison of a standard to a narrow SpO 2 control
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 informationThe SUPPORT, BOOST II, and COT Trials You Must Understand Usual Care To Safeguard Patients and Make Firm Conclusions
The, BOOST II, and COT Trials You Must Understand Usual Care To Safeguard Patients and Make Firm Conclusions Charles Natanson M.D. Critical Care Medicine Department Clinical Center National Institutes
More informationSaturation Targets Are They Achievable? Preventing Intermittent Hypoxemia
Saturation Targets Are They Achievable? Preventing Intermittent Hypoxemia Professor and Chief Department of Neonatology Tuebingen University Hospital Prof. Poets graduated from Hannover Medical School
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 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 informationAdvance Pulse Oximetry: Settings, Data and Downloads
Advance Pulse Oximetry: Settings, Data and Downloads James I. Hagadorn MD, MS Assistant Professor of Pediatrics UCONN School of Medicine Attending Neonatologist Connecticut Children s Medical Center Hartford,
More informationMinimizing Lung Damage During Respiratory Support
Minimizing Lung Damage During Respiratory Support University of Miami Jackson Memorial Medical Center Care of the Sick Newborn 15 Eduardo Bancalari MD University of Miami Miller School of Medicine Jackson
More informationOxygen Delivery. Purpose. Policy Statement. Applicability
Approved by: Oxygen Delivery Gail Cameron Senior Director Operations, Maternal, Neonatal & Child Health Programs Dr. Paul Byrne Medical Director, Neonatology Neonatal Policy & Procedures Manual Policy
More informationGestational age-adapted oxygen saturation targeting and outcome of extremely low gestational age neonates (ELGANs)
Published 2 November 2015, doi:10.4414/smw.2015.14197 Cite this as: Gestational age-adapted oxygen saturation targeting and outcome of extremely low gestational age neonates (ELGANs) A Swiss single centre
More informationNEONATAL CLINICAL PRACTICE GUIDELINE
NEONATAL CLINICAL PRACTICE GUIDELINE Title: Brain Oxygen Monitoring in Newborns Using Near Infrared Spectroscopy (NIRS) Approval Date: Pages: June 2016 Approved by: Neonatal Patient Care Teams, HSC & SBH
More informationUsing Nightingale to Identify Opportunities for Improvement
Using Nightingale to Identify Opportunities for Improvement Erika M. Edwards PhD, MPH Director of Data Systems and Analytics Vermont Oxford Network Research Assistant Professor Mathematics and Statistics
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 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 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 informationBlood transfusion and intestinal perfusion in preterm infants Narendra Aladangady
Blood transfusion and intestinal perfusion in preterm infants Narendra Aladangady MD, FRCPCH, PhD Consultant Neonatologist Hon Clinical Professor in Child Health History of blood transfusion First report
More informationAutomatic Control of the Inspired Oxygen Fraction in Preterm Infants A Randomized Crossover Trial
Automatic Control of the Inspired Oxygen Fraction in Preterm Infants A Randomized Crossover Trial Michael S. Urschitz, Werner Horn, Andreas Seyfang, Antonella Hallenberger, Tina Herberts, Silvia Miksch,
More informationSupplementary Online Content
Supplementary Online Content Schmidt B, Whyte RK, Asztalos EV, et al; for the Canadian Oxygen Trial (COT) Group. Effects of targeting higher vs lower arterial oxygen saturations on death or disability
More informationtarget groups. The collective data suggest that risks associated with restricting the upper SpO 2
Oxygen Saturation Targets in Preterm Infants and Outcomes at 18 24 Months: A Systematic Review Veena Manja, MD, MS, a, b Ola D. Saugstad, MD, PhD, c Satyan Lakshminrusimha, MD, FAAP d CONTEXT: The optimal
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 informationOptimal Oxygenation of the Newborn
Optimal Oxygenation of the Newborn Ola Didrik Saugstad MD, PhD, FRCPE Department of Pediatric Research Oslo University Hospital, University of Oslo Norway 2 o Congreso Argentino de Neonatologia, Buenos
More informationQuality Improvement Approaches to BPD. Jay P. Goldsmith, M.D. Tulane University New Orleans, Louisiana
Quality Improvement Approaches to BPD Jay P. Goldsmith, M.D. Tulane University New Orleans, Louisiana goldsmith.jay@gmail.com No conflicts of interest to declare There is nothing more dangerous to the
More informationThe Oxygen Controversy Why can t Neonatologists get it Correct?
The Oxygen Controversy Why can t Neonatologists get it Correct? Richard A. Polin M.D. Morgan Stanley Children s Hospital Columbia University Cyanophobia Blue Objectives To review the benefits and risks
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 informationKing s Research Portal
King s Research Portal DOI: 10.1007/s00431-015-2595-4 Document Version Peer reviewed version Link to publication record in King's Research Portal Citation for published version (APA): Shetty, S., Bhat,
More informationOriginal Article. Effects of Pressure Support during an Acute Reduction of Synchronized Intermittent Mandatory Ventilation in Preterm Infants
Original Article Effects of Pressure Support during an Acute Reduction of Synchronized Intermittent Mandatory Ventilation in Preterm Infants Waldo Osorio, MD Nelson Claure, PhD Carmen D Ugard, RRT Kamlesh
More informationNon Invasive Ventilation In Preterm Infants. Manuel Sanchez Luna Hospital General Universitario Gregorio Marañón Complutense University Madrid
Non Invasive Ventilation In Preterm Infants Manuel Sanchez Luna Hospital General Universitario Gregorio Marañón Complutense University Madrid Summary Noninvasive ventilation begings in the delivery room
More informationInformed Consent for Standard of Care Research Interventions
Informed Consent for Standard of Care Research Interventions Jeffrey R Botkin, MD, MPH Associate Vice President for Research A case Two FDA approved drugs are commonly used for the treatment of hypertension.
More informationPresented By : Kamlah Olaimat
Presented By : Kamlah Olaimat 18\7\2010 Transient Tachpnea of the Definition:- newborn (TTN) TTN is a benign disease of near term or term infant who display respiratory distress shortly after delivery.
More informationWeaning and extubation in PICU An evidence-based approach
Weaning and extubation in PICU An evidence-based approach Suchada Sritippayawan, MD. Div. Pulmonology & Crit Care Dept. Pediatrics Faculty of Medicine Chulalongkorn University Kanokporn Udomittipong, MD.
More informationUSE OF INHALED NITRIC OXIDE IN THE NICU East Bay Newborn Specialists Guideline Prepared by P Joe, G Dudell, A D Harlingue Revised 7/9/2014
USE OF INHALED NITRIC OXIDE IN THE NICU East Bay Newborn Specialists Guideline Prepared by P Joe, G Dudell, A D Harlingue Revised 7/9/2014 ino for Late Preterm and Term Infants with Severe PPHN Background:
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 informationBronchopulmonary dysplasia: incidence and risk factors
Original article Arch Argent Pediatr 2017;115(5):476-482 / 476 Bronchopulmonary dysplasia: incidence and risk factors Pablo H. Brener Dik, M.D. a, Yeimy M. Niño Gualdron, M.D. a, María F. Galletti, M.D.
More informationAdvanced Monitoring of Cardiovascular and Respiratory Systems in Infants Kuwait 2018 Dr. Yasser Elsayed, MD, PhD Director of the Targeted Neonatal
Advanced Monitoring of Cardiovascular and Respiratory Systems in Infants Kuwait 2018 Dr. Yasser Elsayed, MD, PhD Director of the Targeted Neonatal Echocardiography, Point of Care and Hemodynamics Program
More informationDisclosures. Learning Objectives. Mechanical Ventilation of Infants with Severe BPD: An Interdisciplinary Approach 3/10/2017
Mechanical Ventilation of Infants with Severe BPD: An Interdisciplinary Approach Steven H. Abman, MD Professor, Department of Pediatrics Director, Pediatric Heart Lung Center University of Colorado School
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 informationUsing NAVA titration to determine optimal ventilatory support in neonates
The University of Toledo The University of Toledo Digital Repository Master s and Doctoral Projects Using NAVA titration to determine optimal ventilatory support in neonates Stacey Leigh Fisher The University
More informationDr. AM MAALIM KPA 2018
Dr. AM MAALIM KPA 2018 Journey Towards Lung protection Goals of lung protection Strategies Summary Conclusion Before 1960: Oxygen; impact assessed clinically. The 1960s:President JFK, Ventilators mortality;
More informationKing s Research Portal
King s Research Portal DOI: 10.1007%2Fs00431-015-2595-4 Document Version Peer reviewed version Link to publication record in King's Research Portal Citation for published version (APA): Shetty, S., Bhat,
More informationGuidelines and Best Practices for Vapotherm High Velocity Nasal Insufflation (Hi-VNI ) NICU POCKET GUIDE
Guidelines and Best Practices for Vapotherm High Velocity Nasal Insufflation (Hi-VNI ) TM NICU POCKET GUIDE Patient Selection Diagnoses Patient presents with one or more of the following symptoms: These
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 informationPrevention of retinopathy of prematurity in preterm infants through changes in clinical practice and SpO 2 technology
Acta Pædiatrica ISSN 0803 5253 REGULAR ARTICLE Prevention of retinopathy of prematurity in preterm infants through changes in clinical practice and SpO 2 technology Armando Castillo 1, Richard Deulofeut
More informationNAVA. In Neonates. Howard Stein, M.D. Director Neonatology. Neurally Adjusted Ventilatory Assist. Toledo Children s Hospital Toledo, Ohio
NAVA Neurally Adjusted Ventilatory Assist In Neonates Howard Stein, M.D. Director Neonatology Toledo Children s Hospital Toledo, Ohio Disclaimers Dr Stein: Is discussing products made by Maquet Has no
More informationOxygen Saturation Target Range for Extremely Preterm Infants A Systematic Review and Meta-analysis
Research Original Investigation Saturation Target Range for Extremely Preterm Infants A Systematic Review and Meta-analysis Veena Manja, MD; Satyan Lakshminrusimha, MD; Deborah J. Cook, MSc, MD IMPORTANCE
More informationSARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE
SARASOTA MEMORIAL HOSPITAL TITLE: NURSING PROCEDURE Management, Monitoring & Documentation of a Clinically Significant Cardiopulmonary Event (CSCPE) (NUR47) DATE: REVIEWED: PAGES: 9/09 9/17 1 of 6 PS1094
More informationOxygen Targeting in Extremely Low Birth Weight Infants James J. Cummings, MD, FAAP, Richard A. Polin, MD, FAAP, COMMITTEE ON FETUS AND NEWBORN
CLINICAL REPORT Guidance for the Clinician in Rendering Pediatric Care Oxygen Targeting in Extremely Low Birth Weight Infants James J. Cummings, MD, FAAP, Richard A. Polin, MD, FAAP, COMMITTEE ON FETUS
More informationSatellite Symposium. Sponsored by
Satellite Symposium Sponsored by Management of fluids and electrolytes in the preterm infant in the first week of life Pam Cairns St Michaels Hospital Bristol Healthy, term, breast fed babies Limited intake
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 informationPost Arrest Ventilation/Oxygenation Management
Post Arrest Ventilation/Oxygenation Management Richard Branson MSc RRT Professor of Surgery University of Cincinnati Editor-In-Chief Respiratory Care 0 Presenter Disclosure Information Richard Branson
More informationPrematurity: Optimizing Growth in the NICU for Later Metabolic Outcomes
Prematurity: Optimizing Growth in the NICU for Later Metabolic Outcomes Malki Miller MS, RD, CNSC Neonatal Dietitian, Maimonides Infants and Children s Hospital Adjunct Lecturer of Human and Pediatric,
More informationVolume Guarantee Initiation and ongoing clinical management of an infant supported by Volume Guarantee A Case Study
D-32084-2011 Volume Guarantee Initiation and ongoing clinical management of an infant supported by Volume Guarantee A Case Study Robert DiBlasi RRT-NPS, FAARC Respiratory Care Manager of Research & Quality
More informationGuidelines and Best Practices for High Flow Nasal Cannula (HFNC) Pediatric Pocket Guide
Guidelines Best Practices for High Flow Nasal Cannula (HFNC) Pediatric Pocket Guide Patient Selection Diagnoses Patient presents with one or more of the following signs or symptoms of respiratory distress:
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 informationNeonatal Resuscitation in What is new? How did we get here? Steven Ringer MD PhD Harvard Medical School May 25, 2011
Neonatal Resuscitation in 2011- What is new? How did we get here? Steven Ringer MD PhD Harvard Medical School May 25, 2011 Conflicts I have no actual or potential conflict of interest in relation to this
More informationUsing histogram and event review feature on multichannel monitors to improve point of care decision making in NICU
Using histogram and event review feature on multichannel monitors to improve point of care decision making in NICU Sandesh Shivananda Associate Professor, Medical Director University of British Columbia,
More informationOriginal Policy Date
MP 8.01.17 Inhaled Nitric Oxide Medical Policy Section Therapy Issue 12/2013 Original Policy Date 12/2013 Last Review Status/Date Reviewed with literature search/12/2013 Return to Medical Policy Index
More informationSteven Ringer MD PhD April 5, 2011
Steven Ringer MD PhD April 5, 2011 Disclaimer Mead Johnson sponsors programs such as this to give healthcare professionals access to scientific and educational information provided by experts. The presenter
More informationEdinburgh Research Explorer
Edinburgh Research Explorer Oxygen targeting in preterm infants using the Masimo SET Radical pulse oximeter Citation for published version: Johnston, ED, Boyle, B, Juszczak, E, King, A, Brocklehurst, P
More informationStellar 100 Stellar 150
Stellar 100 Stellar 150 Invasive and noninvasive ventilator Data Management Guide English The following table shows where data from the Stellar device can be viewed. Data displayed in ResScan can be downloaded
More informationNon-Invasive Monitoring
Grey Nuns and Misericordia Community Hospital Approved by: Non-Invasive Monitoring Neonatal Policy & Procedures Manual : Assessment : Oct 2015 Date Effective Oct 2015 Gail Cameron Senior Director Operations,
More informationResearch in Medical Physics: Physiological Signals and Dynamics
Research in Medical Physics: Physiological Signals and Dynamics Incidents of apnea or of sepsis create critical situations in a neonatal intensive care unit (NICU). Of the 4.2 million babies born annually
More informationHome Cardiorespiratory Monitoring. Description. Section: Durable Medical Equipment Effective Date: April 15, 2017
Subject: Home Cardiorespiratory Monitoring Page: 1 of 9 Last Review Status/Date: March 2017 Home Cardiorespiratory Monitoring Description Home cardiorespiratory monitors track respiratory effort and heart
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 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 informationAdvances in respiratory support for high risk newborn infants
Bancalari and Claure Maternal Health, Neonatology, and Perinatology (2015) 1:13 DOI 10.1186/s40748-015-0014-5 REVIEW Open Access Advances in respiratory support for high risk newborn infants Eduardo Bancalari
More informationProvide guidelines for the management of mechanical ventilation in infants <34 weeks gestation.
Page 1 of 5 PURPOSE: Provide guidelines for the management of mechanical ventilation in infants
More informationOxygen targeting in preterm infants using the Masimo SET Radical pulse oximeter
1 Simpson Centre for Reproductive Health, Royal Infi rmary of Edinburgh, Edinburgh, UK 2 National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK Correspondence to Dr B J Stenson, Simpson
More informationProportional Assist Ventilation Andreas Schulze, Peter Schaller, Bernd Höhne, Susanne Herber-Jonat
1 Proportional Assist Ventilation Andreas Schulze, Peter Schaller, Bernd Höhne, Susanne Herber-Jonat In proportional assist ventilation (PAV, also referred to as elastic and resistive unloading), the patient
More informationVon Reuss and CPAP, Disclosures CPAP. Noninvasive respiratory therapieswhy bother? Noninvasive respiratory therapies- types
Noninvasive respiratory therapiesby a nose? NEO- The Conference for Neonatology February 21, 2014 Disclosures I have no relevant financial relationships to disclose or conflicts of interest to release.
More informationThe Art and Science of Weaning from Mechanical Ventilation
The Art and Science of Weaning from Mechanical Ventilation Shekhar T. Venkataraman M.D. Professor Departments of Critical Care Medicine and Pediatrics University of Pittsburgh School of Medicine Some definitions
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 informationINTRAVENOUS FLUID THERAPY
INTRAVENOUS FLUID THERAPY PRINCIPLES Postnatal physiological weight loss is approximately 5 10% in first week of life Preterm neonates have more total body water and may lose 10 15% of their weight in
More informationMedStar Health considers Continuous Home Pulse Oximetry medically necessary for the following indications:
MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.006.MH Continuous Home Pulse Oximetry This policy applies to the following lines of business: MedStar Employee (Select) MedStar MA DSNP CSNP MedStar
More informationLumis Tx: the all-in-one hospital ventilation solution
Lumis Tx: the all-in-one hospital ventilation solution The Lumis Tx is a multi-purpose non-invasive ventilator that treats the full range of respiratory conditions and is suitable for a variety of hospital
More informationGE Healthcare. Non Invasive Ventilation (NIV) For the Engström Ventilator. Relief, Relax, Recovery
GE Healthcare Non Invasive Ventilation (NIV) For the Engström Ventilator Relief, Relax, Recovery COPD is currently the fourth leading cause of death in the world, and further increases in the prevalence
More information** SURFACTANT THERAPY**
** SURFACTANT THERAPY** Full Title of Guideline: Surfactant Therapy Author (include email and role): Stephen Wardle (V4) Reviewed by Dushyant Batra Consultant Neonatologist Division & Speciality: Division:
More informationNeonatal Resuscitation Using a Nasal Cannula: A Single-Center Experience
Original Article Neonatal Resuscitation Using a Nasal Cannula: A Single-Center Experience Pedro Paz, MD, MPH 1 Rangasamy Ramanathan, MD 1,2 Richard Hernandez, RCP 2 Manoj Biniwale, MD 1 1 Division of Neonatal
More informationThe Objective Use of Pulse Oximetry to Predict Respiratory Support Transition in Preterm Infants: An Observational Pilot Study
The Objective Use of Pulse Oximetry to Predict Respiratory Support Transition in Preterm Infants: An Observational Pilot Study Kemi K Mascoll-Robertson MBBS, Rose M Viscardi MD, and Hyung C Woo MD BACKGROUND:
More informationSWISS SOCIETY OF NEONATOLOGY. Supercarbia in an infant with meconium aspiration syndrome
SWISS SOCIETY OF NEONATOLOGY Supercarbia in an infant with meconium aspiration syndrome January 2006 2 Wilhelm C, Frey B, Department of Intensive Care and Neonatology, University Children s Hospital Zurich,
More informationThis is a pre-copyedited, author-produced PDF of an article accepted for publication in Journal of Neonatal Nursing following peer review.
This is a pre-copyedited, author-produced PDF of an article accepted for publication in Journal of Neonatal Nursing following peer review. The version of record [Journal of Neonatal Nursing (February 2013)
More informationHyaline membrane disease. By : Dr. Ch Sarishma Peadiatric Pg
Hyaline membrane disease By : Dr. Ch Sarishma Peadiatric Pg Also called Respiratory distress syndrome. It occurs primarily in premature infants; its incidence is inversely related to gestational age and
More information1/21/19. The History of Oxygen Therapy Fun Facts!
The Evolution of Oxygen Therapy; Where Are We At Now? Patti DeJuilio, MS, RRT-ACCS, RRT-NPS Disclosures Southmedic is sponsoring this lecture The Evolution of Oxygen Therapy; Where Are We At Now? Objectives
More informationNon-Invasive PCO 2 Monitoring in Infants Hospitalized with Viral Bronchiolitis
Non-Invasive PCO 2 Monitoring in Infants Hospitalized with Viral Bronchiolitis Gal S, Riskin A, Chistyakov I, Shifman N, Srugo I, and Kugelman A Pediatric Department and Pediatric Pulmonary Unit Bnai Zion
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 informationMcMASTER NICU INHALED STEROIDS FOR EVOLVING BPD (GA < 29 WEEKS)
McMASTER NICU INHALED STEROIDS FOR EVOLVING BPD (GA < 29 WEEKS) Developed by: Amit Mukerji, Samira Samiee-Zafarghandy, Jennifer Twiss, Ereny Bassilious, Elizabeth Vo, Shari Gray, Salhab el Helou on behalf
More informationLate pulmonary hypertension in preterm infants How to sort things out? V.Gournay, FCPC, La Martinique, Nov 23,2015
Late pulmonary hypertension in preterm infants How to sort things out? V.Gournay, FCPC, La Martinique, Nov 23,2015 Epidemiology Incidence of extreme prematurity (
More informationInnovations in Neonatal Ventilation
Innovations in Neonatal Ventilation NAVA Neurally Adjusted Ventilatory Assist Howard Stein, M.D. Director Neonatology, Promedica Toledo Children s Hospital Clinical Professor of Pediatrics, University
More informationStreamline Automation, LLC
Streamline Automation, LLC Non-Invasive Cardiac Output Measurement Based on Pulse Oximetry Streamline Automation, LLC 3100 Fresh Way SW Huntsville, AL 35805 Phone: 256-713-1220 Prepared by: Alton Reich,
More informationTitle of Program: Preventing and Treating Retinopathy of Prematurity: Evidence from Cochrane Systematic Reviews
Title of Program: Preventing and Treating Retinopathy of Prematurity: Evidence from Cochrane Systematic Reviews Speakers/Moderators: Roger F. Soll, MD, James Hagadorn, MD Planning Committee: Jeffery D.
More informationShort-Term Outcome Of Different Treatment Modalities Of Patent Ductus Arteriosus In Preterm Infants. Five Years Experiences In Qatar
ISPUB.COM The Internet Journal of Cardiovascular Research Volume 7 Number 2 Short-Term Outcome Of Different Treatment Modalities Of Patent Ductus Arteriosus In Preterm Infants. Five Years Experiences In
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 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 informationBy Mark Bachand, RRT-NPS, RPFT. I have no actual or potential conflict of interest in relation to this presentation.
By Mark Bachand, RRT-NPS, RPFT I have no actual or potential conflict of interest in relation to this presentation. Objectives Review state protocols regarding CPAP use. Touch on the different modes that
More informationPrepared by : Bayan Kaddourah RN,MHM. GICU Clinical Instructor
Mechanical Ventilation Prepared by : Bayan Kaddourah RN,MHM. GICU Clinical Instructor 1 Definition Is a supportive therapy to facilitate gas exchange. Most ventilatory support requires an artificial airway.
More informationAvoiding hyperoxia in infants p1250 g is associated with improved short- and long-term outcomes
(2006) 26, 700 705 r 2006 Nature Publishing Group All rights reserved. 0743-8346/06 $30 www.nature.com/jp ORIGINAL ARTICLE Avoiding hyperoxia in infants p1250 g is associated with improved short- and long-term
More informationRespiratory Management and Outcome of Preterm Infants
Respiratory Management and Outcome of Preterm Infants 6 th Annual Care Of The Sick Newborn Conference Shu Wu, MD. Department of Pediatrics Division of Neonatology University of Miami School of Medicine
More informationAdherence to oxygenation and ventilation targets in mechanically ventilated premature and sick newborns: a retrospective study
Solberg et al. BMC Pediatrics 2013, 13:126 RESEARCH ARTICLE Open Access Adherence to oxygenation and ventilation targets in mechanically ventilated premature and sick newborns: a retrospective study Marianne
More information