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  1. Article ; Online: Neonatal Hyperbilirubinemia: An Updated Appraisal of National Guidelines.

    Capasso, Letizia / Palma, Marta / Coppola, Clara / Salomè, Serena / Esposito, Valentina / Grappone, Lidia / Raimondi, Francesco

    Current pediatric reviews

    2020  Volume 16, Issue 4, Page(s) 298–306

    Abstract: Recent reports from several developed countries have documented a resurgence of bilirubin encephalopathy causing both healthcare and forensic issues. For these reasons, many national pediatric societies have issued recommendations on the diagnosis and ... ...

    Abstract Recent reports from several developed countries have documented a resurgence of bilirubin encephalopathy causing both healthcare and forensic issues. For these reasons, many national pediatric societies have issued recommendations on the diagnosis and the treatment of clinically significant neonatal hyperbilirubinemia. The differences among individual national documents may have an impact on neonatal healthcare. This paper shortly reviews the advantages and the shortcomings of the main international guidelines with a focus on the available evidence.
    MeSH term(s) Child ; Humans ; Hyperbilirubinemia, Neonatal/diagnosis ; Hyperbilirubinemia, Neonatal/therapy ; Infant, Newborn ; Kernicterus/diagnosis ; Kernicterus/etiology ; Kernicterus/therapy
    Language English
    Publishing date 2020-09-28
    Publishing country United Arab Emirates
    Document type Journal Article
    ISSN 1875-6336
    ISSN (online) 1875-6336
    DOI 10.2174/1573396316666200928101553
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Recurrence of CCHS associated PHOX2B poly-alanine expansion mutation due to maternal mosaicism.

    Bachetti, Tiziana / Di Duca, Marco / Della Monica, Matteo / Grappone, Lidia / Scarano, Gioacchino / Ceccherini, Isabella

    Pediatric pulmonology

    2014  Volume 49, Issue 3, Page(s) E45–7

    Abstract: Heterozygous in frame trinucleotide duplications within the PHOX2B gene, leading to poly-alanine expansions, cause Congenital Central Hypoventilation Syndrome. Here we report about a CCHS patient, carrying a +13Ala PHOX2B expansion, whose asymptomatic ... ...

    Abstract Heterozygous in frame trinucleotide duplications within the PHOX2B gene, leading to poly-alanine expansions, cause Congenital Central Hypoventilation Syndrome. Here we report about a CCHS patient, carrying a +13Ala PHOX2B expansion, whose asymptomatic mother resulted with a low level of mosaicism for the same mutation in peripheral blood cells. Her second pregnancy ended with the spontaneous miscarriage of a fetus who had inherited the PHOX2B mutation, thus confirming germline mosaicism in the mother and the need of proper genetic counseling to CCHS families.
    MeSH term(s) Abortion, Spontaneous/genetics ; Alanine ; Electrophoresis, Capillary ; Female ; Genetic Counseling ; Germ-Line Mutation/genetics ; Homeodomain Proteins/genetics ; Humans ; Hypoventilation/congenital ; Hypoventilation/genetics ; Infant, Newborn ; Male ; Mosaicism ; Pregnancy ; Sleep Apnea, Central/genetics ; Transcription Factors/genetics ; Trinucleotide Repeat Expansion/genetics
    Chemical Substances Homeodomain Proteins ; NBPhox protein ; Transcription Factors ; Alanine (OF5P57N2ZX)
    Language English
    Publishing date 2014-03
    Publishing country United States
    Document type Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.22790
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  3. Article ; Online: Preterm birth, respiratory failure and BPD: which neonatal management?

    Castoldi, Francesca / Lista, Gianluca / Scopesi, Fabio / Somaschini, Marco / Cuttano, Armando / Grappone, Lidia / Maffei, Gianfranco

    Early human development

    2013  Volume 89 Suppl 2, Page(s) S39–40

    Abstract: Preterm birth is a significant problem in the world regarding perinatal mortality and morbidity in the long term, especially bronchopulmonary dysplasia (BPD). Premature delivery is often associated to failure in transition to create an early functional ... ...

    Abstract Preterm birth is a significant problem in the world regarding perinatal mortality and morbidity in the long term, especially bronchopulmonary dysplasia (BPD). Premature delivery is often associated to failure in transition to create an early functional residual capacity (FRC), since many preterm babies need frequently respiratory support. The first and most effective preventive measure to reduce the incidence of BPD is represented by the attempt to avoid preterm birth. Whenever this fails, the prevention of every known risk factors for BPD should start in the delivery room and should be maintained in the NICU through the use of tailored management of high-risk infants.
    MeSH term(s) Bronchopulmonary Dysplasia/therapy ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Neonatology/methods ; Premature Birth/therapy ; Respiration, Artificial/adverse effects ; Respiration, Artificial/methods ; Respiratory Insufficiency/therapy ; Risk Assessment ; Risk Factors ; Ventilator-Induced Lung Injury/prevention & control
    Language English
    Publishing date 2013-10
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 752532-1
    ISSN 1872-6232 ; 0378-3782
    ISSN (online) 1872-6232
    ISSN 0378-3782
    DOI 10.1016/j.earlhumdev.2013.08.003
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    Zs.A 1373: Show issues Location:
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  4. Article ; Online: Lung Ultrasound for Diagnosing Pneumothorax in the Critically Ill Neonate.

    Raimondi, Francesco / Rodriguez Fanjul, Javier / Aversa, Salvatore / Chirico, Gaetano / Yousef, Nadya / De Luca, Daniele / Corsini, Iuri / Dani, Carlo / Grappone, Lidia / Orfeo, Luigi / Migliaro, Fiorella / Vallone, Gianfranco / Capasso, Letizia

    The Journal of pediatrics

    2016  Volume 175, Page(s) 74–78.e1

    Abstract: Objectives: To evaluate the accuracy of lung ultrasound for the diagnosis of pneumothorax in the sudden decompensating patient.: Study design: In an international, prospective study, sudden decompensation was defined as a prolonged significant ... ...

    Abstract Objectives: To evaluate the accuracy of lung ultrasound for the diagnosis of pneumothorax in the sudden decompensating patient.
    Study design: In an international, prospective study, sudden decompensation was defined as a prolonged significant desaturation (oxygen saturation <65% for more than 40 seconds) and bradycardia or sudden increase of oxygen requirement by at least 50% in less than 10 minutes with a final fraction of inspired oxygen ≥0.7 to keep stable saturations. All eligible patients had an ultrasound scan before undergoing a chest radiograph, which was the reference standard.
    Results: Forty-two infants (birth weight = 1531 ± 812 g; gestational age = 31 ± 3.5 weeks) were enrolled in 6 centers; pneumothorax was detected in 26 (62%). Lung ultrasound accuracy in diagnosing pneumothorax was as follows: sensitivity 100%, specificity 100%, positive predictive value 100%, and negative predictive value 100%. Clinical evaluation of pneumothorax showed sensitivity 84%, specificity 56%, positive predictive value 76%, and negative predictive value 69%. After sudden decompensation, a lung ultrasound scan was performed in an average time of 5.3 ± 5.6 minutes vs 19 ± 11.7 minutes required for a chest radiography. Emergency drainage was performed after an ultrasound scan but before radiography in 9 cases.
    Conclusions: Lung ultrasound shows high accuracy in detecting pneumothorax in the critical infant, outperforming clinical evaluation and reducing time to imaging diagnosis and drainage.
    MeSH term(s) Critical Illness ; Drainage ; Emergencies ; Humans ; Infant, Newborn ; Lung/diagnostic imaging ; Pneumothorax/diagnostic imaging ; Pneumothorax/therapy ; Prospective Studies ; Radiography, Thoracic ; Sensitivity and Specificity ; Ultrasonography
    Language English
    Publishing date 2016-05-14
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Multicenter Study
    ZDB-ID 3102-1
    ISSN 1097-6833 ; 0022-3476
    ISSN (online) 1097-6833
    ISSN 0022-3476
    DOI 10.1016/j.jpeds.2016.04.018
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    Um IV Zs.116: Show issues Location:
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  5. Article ; Online: First year follow-up of extremely low birth weight premature sextuplets: case report.

    Orfeo, Luigi / Casani, Anna / Cocca, Francesco / Coletta, Concettina / De Luca, Maria Gabriella / Di Manso, Gaetano / Grappone, Lidia / Pozzi, Nicola / Scoppa, Alessandro

    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

    2011  Volume 24 Suppl 1, Page(s) 132–134

    Abstract: High order gestation rates have increased in many western countries in the last decades, which is mostly attributable to a contemporaneous increase in maternal age and infertility treatment. Multiple births have been associated with increased maternal ... ...

    Abstract High order gestation rates have increased in many western countries in the last decades, which is mostly attributable to a contemporaneous increase in maternal age and infertility treatment. Multiple births have been associated with increased maternal and foetal morbidity and mortality during pregnancy and delivery, including the higher risk for spontaneous abortion, preeclampsia, hydramnios, and maternal haemorrhage. A higher frequency of preterm infants and low birth weight infants have also been reported, as well as a higher rate of malformations, abnormal growth, and trauma at delivery, than in singleton pregnancies. We describe herein the case of six ELBW newborns delivered at 27 weeks and their first year follow-up. All the sextuplets survived and did not have extra uterine growth retardation (EUGR) when discharged from hospital. A developmental delay was detected in five infants at 12 months corrected age (CA), but none of them showed cerebral palsy or severe neurosensorial disabilities.
    MeSH term(s) Adult ; Age Factors ; Apgar Score ; Birth Weight/physiology ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Extremely Low Birth Weight/growth & development ; Infant, Extremely Low Birth Weight/physiology ; Infant, Newborn ; Infant, Premature/growth & development ; Infant, Premature/physiology ; Male ; Multiple Birth Offspring ; Pregnancy
    Language English
    Publishing date 2011-10
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2077261-0
    ISSN 1476-4954 ; 1057-0802 ; 1476-7058
    ISSN (online) 1476-4954
    ISSN 1057-0802 ; 1476-7058
    DOI 10.3109/14767058.2011.607680
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3510: Show issues Location:
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  6. Article ; Online: Lung recruitment before surfactant administration in extremely preterm neonates with respiratory distress syndrome (IN-REC-SUR-E): a randomised, unblinded, controlled trial.

    Vento, Giovanni / Ventura, Maria Luisa / Pastorino, Roberta / van Kaam, Anton H / Carnielli, Virgilio / Cools, Filip / Dani, Carlo / Mosca, Fabio / Polglase, Graeme / Tagliabue, Paolo / Boni, Luca / Cota, Francesco / Tana, Milena / Tirone, Chiara / Aurilia, Claudia / Lio, Alessandra / Costa, Simonetta / D'Andrea, Vito / Lucente, Mariella /
    Nigro, Gabriella / Giordano, Lucio / Roma, Vincenzina / Villani, Paolo E / Fusco, Francesca P / Fasolato, Valeria / Colnaghi, Maria Rosa / Matassa, Piero G / Vendettuoli, Valentina / Poggi, Chiara / Del Vecchio, Antonio / Petrillo, Flavia / Betta, Pasqua / Mattia, Carmine / Garani, Giampaolo / Solinas, Agostina / Gitto, Eloisa / Salvo, Vincenzo / Gargano, Giancarlo / Balestri, Eleonora / Sandri, Fabrizio / Mescoli, Giovanna / Martinelli, Stefano / Ilardi, Laura / Ciarmoli, Elena / Di Fabio, Sandra / Maranella, Eugenia / Grassia, Carolina / Ausanio, Gaetano / Rossi, Vincenzo / Motta, Angela / Tina, Lucia G / Maiolo, Kim / Nobile, Stefano / Messner, Hubert / Staffler, Alex / Ferrero, Federica / Stasi, Ilaria / Pieragostini, Luisa / Mondello, Isabella / Haass, Cristina / Consigli, Chiara / Vedovato, Stefania / Grison, Alessandra / Maffei, Gianfranco / Presta, Giuseppe / Perniola, Roberto / Vitaliti, Marcello / Re, Maria P / De Curtis, Mario / Cardilli, Viviana / Lago, Paola / Tormena, Francesca / Orfeo, Luigi / Gizzi, Camilla / Massenzi, Luca / Gazzolo, Diego / Strozzi, Maria Chiara M / Bottino, Roberto / Pontiggia, Federica / Berardi, Alberto / Guidotti, Isotta / Cacace, Caterina / Meli, Valerio / Quartulli, Lorenzo / Scorrano, Antonio / Casati, Alessandra / Grappone, Lidia / Pillow, J Jane

    The Lancet. Respiratory medicine

    2020  Volume 9, Issue 2, Page(s) 159–166

    Abstract: Background: The importance of lung recruitment before surfactant administration has been shown in animal studies. Well designed trials in preterm infants are absent. We aimed to examine whether the application of a recruitment manoeuvre just before ... ...

    Abstract Background: The importance of lung recruitment before surfactant administration has been shown in animal studies. Well designed trials in preterm infants are absent. We aimed to examine whether the application of a recruitment manoeuvre just before surfactant administration, followed by rapid extubation (intubate-recruit-surfactant-extubate [IN-REC-SUR-E]), decreased the need for mechanical ventilation during the first 72 h of life compared with no recruitment manoeuvre (ie, intubate-surfactant-extubate [IN-SUR-E]).
    Methods: We did a randomised, unblinded, controlled trial in 35 tertiary neonatal intensive care units in Italy. Spontaneously breathing extremely preterm neonates (24 + 0 to 27 + 6 weeks' gestation) reaching failure criteria for continuous positive airway pressure within the first 24 h of life were randomly assigned (1:1) with a minimisation algorithm to IN-REC-SUR-E or IN-SUR-E using an interactive web-based electronic system, stratified by clinical site and gestational age. The primary outcome was the need for mechanical ventilation in the first 72 h of life. Analyses were done in intention-to-treat and per-protocol populations, with a log-binomial regression model correcting for stratification factors to estimate adjusted relative risk (RR). This study is registered with ClinicalTrials.gov, NCT02482766.
    Findings: Of 556 infants assessed for eligibility, 218 infants were recruited from Nov 12, 2015, to Sept 23, 2018, and included in the intention-to-treat analysis. The requirement for mechanical ventilation during the first 72 h of life was reduced in the IN-REC-SUR-E group (43 [40%] of 107) compared with the IN-SUR-E group (60 [54%] of 111; adjusted RR 0·75, 95% CI 0·57-0·98; p=0·037), with a number needed to treat of 7·2 (95% CI 3·7-135·0). The addition of the recruitment manoeuvre did not adversely affect the safety outcomes of in-hospital mortality (19 [19%] of 101 in the IN-REC-SUR-E group vs 37 [33%] of 111 in the IN-SUR-E group), pneumothorax (four [4%] of 101 vs seven [6%] of 111), or grade 3 or worse intraventricular haemorrhage (12 [12%] of 101 vs 17 [15%] of 111).
    Interpretation: A lung recruitment manoeuvre just before surfactant administration improved the efficacy of surfactant treatment in extremely preterm neonates compared with the standard IN-SUR-E technique, without increasing the risk of adverse neonatal outcomes. The reduced need for mechanical ventilation during the first 72 h of life might facilitate implementation of a non-invasive respiratory support strategy.
    Funding: None.
    MeSH term(s) Airway Extubation/methods ; Critical Care/methods ; Female ; Humans ; Infant, Extremely Premature ; Infant, Newborn ; Intensive Care Units, Neonatal ; Intubation, Intratracheal/methods ; Italy ; Lung/physiopathology ; Male ; Pulmonary Surfactants/therapeutic use ; Respiration, Artificial/statistics & numerical data ; Respiratory Distress Syndrome, Newborn/therapy ; Treatment Outcome
    Chemical Substances Pulmonary Surfactants
    Language English
    Publishing date 2020-07-17
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 2686754-0
    ISSN 2213-2619 ; 2213-2600
    ISSN (online) 2213-2619
    ISSN 2213-2600
    DOI 10.1016/S2213-2600(20)30179-X
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    Zs.A 7041: Show issues Location:
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  7. Article ; Online: Efficacy of a new technique - INtubate-RECruit-SURfactant-Extubate - "IN-REC-SUR-E" - in preterm neonates with respiratory distress syndrome: study protocol for a randomized controlled trial.

    Vento, Giovanni / Pastorino, Roberta / Boni, Luca / Cota, Francesco / Carnielli, Virgilio / Cools, Filip / Dani, Carlo / Mosca, Fabio / Pillow, Jane / Polglase, Graeme / Tagliabue, Paolo / van Kaam, Anton H / Ventura, Maria Luisa / Tana, Milena / Tirone, Chiara / Aurilia, Claudia / Lio, Alessandra / Ricci, Cinzia / Gambacorta, Alessandro /
    Consigli, Chiara / D'Onofrio, Danila / Gizzi, Camilla / Massenzi, Luca / Cardilli, Viviana / Casati, Alessandra / Bottino, Roberto / Pontiggia, Federica / Ciarmoli, Elena / Martinelli, Stefano / Ilardi, Laura / Colnaghi, Mariarosa / Matassa, Piero Giuseppe / Vendettuoli, Valentina / Villani, Paolo / Fusco, Francesca / Gazzolo, Diego / Ricotti, Alberto / Ferrero, Federica / Stasi, Ilaria / Magaldi, Rosario / Maffei, Gianfranco / Presta, Giuseppe / Perniola, Roberto / Messina, Francesco / Montesano, Giovanna / Poggi, Chiara / Giordano, Lucio / Roma, Enza / Grassia, Carolina / Ausanio, Gaetano / Sandri, Fabrizio / Mescoli, Giovanna / Giura, Francesco / Garani, Giampaolo / Solinas, Agostina / Lucente, Maria / Nigro, Gabriella / Del Vecchio, Antonello / Petrillo, Flavia / Orfeo, Luigi / Grappone, Lidia / Quartulli, Lorenzo / Scorrano, Antonio / Messner, Hubert / Staffler, Alex / Gargano, Giancarlo / Balestri, Eleonora / Nobile, Stefano / Cacace, Caterina / Meli, Valerio / Dallaglio, Sara / Pasqua, Betta / Mattia, Loretta / Gitto, Eloisa / Vitaliti, Marcello / Re, Maria Paola / Vedovato, Stefania / Grison, Alessandra / Berardi, Alberto / Torcetta, Francesco / Guidotti, Isotta / di Fabio, Sandra / Maranella, Eugenia / Mondello, Isabella / Visentin, Stefano / Tormena, Francesca

    Trials

    2016  Volume 17, Page(s) 414

    Abstract: Background: Although beneficial in clinical practice, the INtubate-SURfactant-Extubate (IN-SUR-E) method is not successful in all preterm neonates with respiratory distress syndrome, with a reported failure rate ranging from 19 to 69 %. One of the ... ...

    Abstract Background: Although beneficial in clinical practice, the INtubate-SURfactant-Extubate (IN-SUR-E) method is not successful in all preterm neonates with respiratory distress syndrome, with a reported failure rate ranging from 19 to 69 %. One of the possible mechanisms responsible for the unsuccessful IN-SUR-E method, requiring subsequent re-intubation and mechanical ventilation, is the inability of the preterm lung to achieve and maintain an "optimal" functional residual capacity. The importance of lung recruitment before surfactant administration has been demonstrated in animal studies showing that recruitment leads to a more homogeneous surfactant distribution within the lungs. Therefore, the aim of this study is to compare the application of a recruitment maneuver using the high-frequency oscillatory ventilation (HFOV) modality just before the surfactant administration followed by rapid extubation (INtubate-RECruit-SURfactant-Extubate: IN-REC-SUR-E) with IN-SUR-E alone in spontaneously breathing preterm infants requiring nasal continuous positive airway pressure (nCPAP) as initial respiratory support and reaching pre-defined CPAP failure criteria.
    Methods/design: In this study, 206 spontaneously breathing infants born at 24(+0)-27(+6) weeks' gestation and failing nCPAP during the first 24 h of life, will be randomized to receive an HFOV recruitment maneuver (IN-REC-SUR-E) or no recruitment maneuver (IN-SUR-E) just prior to surfactant administration followed by prompt extubation. The primary outcome is the need for mechanical ventilation within the first 3 days of life. Infants in both groups will be considered to have reached the primary outcome when they are not extubated within 30 min after surfactant administration or when they meet the nCPAP failure criteria after extubation.
    Discussion: From all available data no definitive evidence exists about a positive effect of recruitment before surfactant instillation, but a rationale exists for testing the following hypothesis: a lung recruitment maneuver performed with a step-by-step Continuous Distending Pressure increase during High-Frequency Oscillatory Ventilation (and not with a sustained inflation) could have a positive effects in terms of improved surfactant distribution and consequent its major efficacy in preterm newborns with respiratory distress syndrome. This represents our challenge.
    Trial registration: ClinicalTrials.gov identifier: NCT02482766 . Registered on 1 June 2015.
    Language English
    Publishing date 2016-08-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 2040523-6
    ISSN 1745-6215 ; 1468-6694 ; 1468-6708
    ISSN (online) 1745-6215 ; 1468-6694
    ISSN 1468-6708
    DOI 10.1186/s13063-016-1498-7
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