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Article ; Online: Transfusions and neurodevelopmental outcomes in extremely low gestation neonates: to transfuse or not to transfuse, that is the question….

Piersigilli, Fiammetta

2021 Volume 90, Issue 1, Page(s) 16–17

MeSH term(s)	Erythrocyte Transfusion ; Humans ; Infant, Extremely Premature ; Infant, Newborn ; Intensive Care Units, Neonatal ; Iron/administration & dosage
Chemical Substances	Iron (E1UOL152H7)
Language	English
Publishing date	2021-04-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	4411-8
ISSN	1530-0447 ; 0031-3998
ISSN (online)	1530-0447
ISSN	0031-3998
DOI	10.1038/s41390-021-01470-1
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Zs.A 564: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Unusual cerebral intraventricular hemorrhage and cardiomyopathy related to congenital cytomegalovirus from non-primary maternal infection: a case report.

Malherbe, Victoria / Celen, Stefanie / Carkeek, Katherine / Carapancea, Evelina / Auriti, Cinzia / Piersigilli, Fiammetta

Italian journal of pediatrics

2024 Volume 50, Issue 1, Page(s) 71

Abstract: Background: Congenital cytomegalovirus (cCMV) infection, resulting from non-primary maternal infection or reactivation during pregnancy, can cause serious fetal abnormalities, complications in the immediate neonatal period, and severe sequelae later in ... ...

Abstract	Background: Congenital cytomegalovirus (cCMV) infection, resulting from non-primary maternal infection or reactivation during pregnancy, can cause serious fetal abnormalities, complications in the immediate neonatal period, and severe sequelae later in childhood. Maternal non-primary cytomegalovirus infection in pregnancy is transmitted to the fetus in 0.5-2% of cases (1). Case presentation: An African full term male newbornwas delivered by emergency caesarean section. Due to signs of asphyxia at birth and clinical moderate encephalopathy, he underwent therapeutic hypothermia. Continuous full video-electroencephalography monitoring showed no seizures during the first 72 h, however, soon after rewarming, he presented refractory status epilepticus due to an intracranial hemorrhage, related to severe thrombocytopenia. The patient also presented signs of sepsis (hypotension and signs of reduced perfusions). An echocardiography revealed severe cardiac failure with an ejection fraction of 33% and signs suggestive of cardiomyopathy. Research for CMV DNA Polymerase Chain Reaction (PCR) on urine, blood, cerebrospinal fluid, and nasopharyngeal secretions was positive.The mother had positive CMV IgG with negative IgM shortly before pregnancy. Serology for CMV was therefore not repeated during pregnancy, but CMV DNA performed on the Guthrie bloodspot taken at birth yielded a positive result, confirming the intrauterine transmission and congenital origin of the infection. The baby was discharged in good general condition and follow up showed a normal neurodevelopmental outcome at 9 months. Conclusion: Although uncommon, congenital cytomegalovirus infection should be included in the differential diagnosis of intraventricular hemorrhage and cardiomyopathy. Furthermore, this case highlights the possible severity of congenital cytomegalovirus infection, even in cases of previous maternal immunity.
MeSH term(s)	Infant, Newborn ; Pregnancy ; Male ; Humans ; Female ; Cytomegalovirus ; Pregnancy Complications, Infectious/diagnosis ; Cerebral Intraventricular Hemorrhage ; Cesarean Section ; Cytomegalovirus Infections/complications ; Cytomegalovirus Infections/diagnosis ; Cytomegalovirus Infections/drug therapy ; DNA, Viral/analysis ; Mothers ; Cardiomyopathies
Chemical Substances	DNA, Viral
Language	English
Publishing date	2024-04-16
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2088556-8
ISSN	1824-7288 ; 1720-8424
ISSN (online)	1824-7288
ISSN	1720-8424
DOI	10.1186/s13052-024-01637-6
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Article: Editorial: Perinatal assessment of biomarkers in invasive and non-invasive procedures of biological fluid collection.

Bersani, Iliana / Gazzolo, Diego / Piersigilli, Fiammetta

Frontiers in pediatrics

2022 Volume 10, Page(s) 1010205

Language	English
Publishing date	2022-09-06
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2022.1010205
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Article: A Metabolomic Approach in Search of Neurobiomarkers of Perinatal Asphyxia: A Review of the Current Literature.

Debuf, Marie Julie / Carkeek, Katherine / Piersigilli, Fiammetta

Frontiers in pediatrics

2021 Volume 9, Page(s) 674585

Abstract: Perinatal asphyxia and the possible sequelae of hypoxic-ischemic encephalopathy (HIE), are associated with high morbidity and mortality rates. The use of therapeutic hypothermia (TH) commencing within the first 6 h of life-currently the only treatment ... ...

Abstract	Perinatal asphyxia and the possible sequelae of hypoxic-ischemic encephalopathy (HIE), are associated with high morbidity and mortality rates. The use of therapeutic hypothermia (TH) commencing within the first 6 h of life-currently the only treatment validated for the management of HIE-has been proven to reduce the mortality rate and disability seen at follow up at 18 months. Although there have been attempts to identify neurobiomarkers assessing the severity levels in HIE; none have been validated in clinical use to date, and the lack thereof limits the optimal treatment for these vulnerable infants. Metabolomics is a promising field of the "omics technologies" that may: identify neurobiomarkers, help improve diagnosis, identify patients prone to developing HIE, and potentially improve targeted neuroprotection interventions. This review focuses on the current evidence of metabolomics, a novel tool which may prove to be a useful in the diagnosis, management and treatment options for this multifactorial complex disease. Some of the most promising metabolites analyzed are the group of acylcarnitines: Hydroxybutyrylcarnitine (Malonylcarnitine) [C3-DC (C4-OH)], Tetradecanoylcarnitine [C14], L-Palmitoylcarnitine [C16], Hexadecenoylcarnitine [C16:1], Stearoylcarnitine [C18], and Oleoylcarnitine [C18:1]. A metabolomic "fingerprint" or "index," made up of 4 metabolites (succinate × glycerol/(β-hydroxybutyrate × O-phosphocholine)), seems promising in identifying neonates at risk of developing severe HIE.
Language	English
Publishing date	2021-06-25
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2021.674585
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Article ; Online: Neonatal hydrops associated with placental mesenchymal dysplasia and multiple hepatic hemangioma.

Delens, Gilda / Danhaive, Olivier / Dumitriu, Dana / Baldin, Pamela / Piersigilli, Fiammetta

European journal of obstetrics, gynecology, and reproductive biology

2022 Volume 276, Page(s) 247–248

MeSH term(s)	Edema ; Female ; Hemangioma/complications ; Hemangioma/diagnostic imaging ; Humans ; Hydrops Fetalis/diagnostic imaging ; Hydrops Fetalis/etiology ; Infant, Newborn ; Infant, Newborn, Diseases ; Liver Neoplasms/complications ; Liver Neoplasms/diagnostic imaging ; Placenta/diagnostic imaging ; Placenta Diseases/diagnostic imaging ; Pregnancy
Language	English
Publishing date	2022-08-02
Publishing country	Ireland
Document type	Letter
ZDB-ID	190605-7
ISSN	1872-7654 ; 0301-2115 ; 0028-2243
ISSN (online)	1872-7654
ISSN	0301-2115 ; 0028-2243
DOI	10.1016/j.ejogrb.2022.07.030
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Article ; Online: Cyanoacrylate glue as part of a new bundle to decrease neonatal PICC-related complications.

Piersigilli, Fiammetta / Iacona, Giulia / Yazami, Sarah / Carkeek, Katherine / Hocq, Catheline / Auriti, Cinzia / Danhaive, Olivier

European journal of pediatrics

2023 Volume 182, Issue 12, Page(s) 5607–5613

Abstract: A "bundle" is defined as a combination of evidence-based interventions that, if followed collectively and reliably, improve patient outcomes. The aim of this quasi-experimental study, conducted in a level-III NICU in Belgium, was to assess the impact of ... ...

Abstract	A "bundle" is defined as a combination of evidence-based interventions that, if followed collectively and reliably, improve patient outcomes. The aim of this quasi-experimental study, conducted in a level-III NICU in Belgium, was to assess the impact of central line dressing and maintenance bundle implementation on the rate of catheter-related mechanical complications. We performed a quality improvement (QI) project. Prior to bundle implementation, neonatal PICC lines were secured by Steri-Strip Conclusion: The implementation of the new bundle to secure neonatal PICCs in our NICU was associated with a significant reduction in CLABSI and dislodgment rates, without glue-related complications. Active surveillance of CVC placement procedure, positioning, and management, as well as analysis of related complications is crucial for improving patient safety. Continuous implementation of up-to-date central line bundles based on best practice recommendations is a key for quality improvement in NICUs. What is known: • Stable vascular access is crucial in the NICU. Neonatal PICC securement issues can have serious consequences and are associated with device failure. What is new: • Catheter securement with tissue adhesive is safe and effective in reducing failure and complication rates in the neonatal population.
MeSH term(s)	Infant, Newborn ; Infant ; Humans ; Catheterization, Central Venous/methods ; Catheter-Related Infections/etiology ; Catheter-Related Infections/prevention & control ; Catheter-Related Infections/epidemiology ; Cyanoacrylates/adverse effects ; Central Venous Catheters ; Intensive Care Units, Neonatal
Chemical Substances	Cyanoacrylates
Language	English
Publishing date	2023-10-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-023-05253-0
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Article ; Online: Metabolomics of bronchopulmonary dysplasia.

Piersigilli, Fiammetta / Bhandari, Vineet

Clinica chimica acta; international journal of clinical chemistry

2019 Volume 500, Page(s) 109–114

Abstract: The pathogenesis of Bronchopulmonary dysplasia (BPD) remains poorly understood. It is a multifactorial disease having a genetic-environmental basis. Although attempts have been made to identify a biomarker, none have been validated for clinical use to ... ...

Abstract	The pathogenesis of Bronchopulmonary dysplasia (BPD) remains poorly understood. It is a multifactorial disease having a genetic-environmental basis. Although attempts have been made to identify a biomarker, none have been validated for clinical use to date. Metabolomics is a promising field of the "omics technologies" that could allow for better understanding of the pathogenesis and underlying mechanisms of BPD as well as facilitate detection of biomarkers. Identification of these biomarkers would improve diagnosis, identify patients in early disease stages and potentially target intervention. This review focuses on the evidence arising from metabolomics and its interaction with microbiomics and pharmacology with respect to pathogenesis and treatment options for this multifactorial complex disease.
MeSH term(s)	Bronchopulmonary Dysplasia/metabolism ; Bronchopulmonary Dysplasia/microbiology ; Humans ; Metabolomics
Language	English
Publishing date	2019-11-02
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	80228-1
ISSN	1873-3492 ; 0009-8981
ISSN (online)	1873-3492
ISSN	0009-8981
DOI	10.1016/j.cca.2019.09.025
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Article ; Online: Plasmatic profiles of cytokines/chemokines, glial fibrillary acidic protein (GFAP) and MRI brain damage in neonates with hypoxic ischemic encephalopathy (HIE).

Auriti, Cinzia / Mondì, Vito / Piersigilli, Fiammetta / Timelli, Laura / Del Pinto, Tamara / Prencipe, Giusi / Lucignani, Giulia / Longo, Daniela / Bersani, Iliana

Cytokine

2024 Volume 177, Page(s) 156565

Abstract: Background: Perinatal hypoxia triggers the release of cytokines and chemokines by neurons, astrocytes and microglia. In response to hypoxia-ischemia resting/ramified microglia proliferate and undergo activation, producing proinflammatory molecules. The ... ...

Abstract	Background: Perinatal hypoxia triggers the release of cytokines and chemokines by neurons, astrocytes and microglia. In response to hypoxia-ischemia resting/ramified microglia proliferate and undergo activation, producing proinflammatory molecules. The brain damage extension seems to be related to both the severity of hypoxia and the balance between pro and anti-inflammatory response and can be explored with neuroimaging. Aims: The aim of this preliminary study was to explore possible relationships between plasma levels of inflammatory cytokines/chemokines and the severe brain damage detectable by Magnetic Resonance Imaging (MRI), performed during the hospitalization. Methods: In 10 full terms neonates with hypoxic ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH), divided into cases and controls, according to MRI results, we measured and compared the plasma levels of CCL2/MCP-1, CXCL8, GFAP, IFN y, IL-10, IL-18, IL-6, CCL3, ENOLASE2, GM-CSF, IL-1b, IL-12p70, IL-33, TNFα, collected at four different time points during TH (24, 25-48, 49-72 h of life, and 7-10 days from birth). Five of enrolled babies had pathological brain MRI (cases) and 5 had a normal MRI examination (controls). Cytokines were measured by Magnetic Luminex Assay. MRI images were classified according to Barkovich's score. Results: Mean levels of all cytokines and molecules at time T1 were not significantly different in the two groups. Comparing samples paired by day of collection, the greatest differences between cases and controls were found at times T2 and T3, during TH. At T4, levels tended to get closer again (except for IL-6, IL10 and IL18). Infants with worse MRI showed higher plasmatic GFAP levels than those with normal MRI, while their IL-18 was lower. The mean levels of CCL3MIP1alpha, GMCSF, IL1BETA overlapped throughout the observation period in both groups. Conclusion: In a small number of infants with worse brain MRI, we found higher levels of GFAP and of IL-10 at T4 and a trend toward low IL-18 levels than in infants with normal MRI, considered early biomarker of brain damage and a predictor of adverse outcome, respectively. The greatest, although not significant, difference between the levels of molecules was found in cases and controls at time points T2 and T3, during TH.
MeSH term(s)	Infant, Newborn ; Infant ; Female ; Pregnancy ; Humans ; Hypoxia-Ischemia, Brain/diagnostic imaging ; Cytokines/metabolism ; Interleukin-10/metabolism ; Interleukin-18/metabolism ; Glial Fibrillary Acidic Protein/metabolism ; Interleukin-6/metabolism ; Brain/metabolism ; Magnetic Resonance Imaging/methods ; Chemokines/metabolism ; Brain Injuries ; Neuroimaging
Chemical Substances	Cytokines ; Interleukin-10 (130068-27-8) ; Interleukin-18 ; Glial Fibrillary Acidic Protein ; Interleukin-6 ; Chemokines
Language	English
Publishing date	2024-03-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1018055-2
ISSN	1096-0023 ; 1043-4666
ISSN (online)	1096-0023
ISSN	1043-4666
DOI	10.1016/j.cyto.2024.156565
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Article ; Online: How to minimize central line-associated bloodstream infections in a neonatal intensive care unit: a quality improvement intervention based on a retrospective analysis and the adoption of an evidence-based bundle.

Bierlaire, Stéphanie / Danhaive, Olivier / Carkeek, Katherine / Piersigilli, Fiammetta

European journal of pediatrics

2020 Volume 180, Issue 2, Page(s) 449–460

Abstract: Central line-associated bloodstream infection (CLABSI) is a significant cause of morbidity and mortality in neonatal intensive care units (NICUs). A "bundle" is defined as a combination of evidence-based interventions that provided they are followed ... ...

Abstract	Central line-associated bloodstream infection (CLABSI) is a significant cause of morbidity and mortality in neonatal intensive care units (NICUs). A "bundle" is defined as a combination of evidence-based interventions that provided they are followed collectively and reliably, are proven to improve patient outcomes. The aim of this quasi-experimental study was to assess the impact of new central line insertion, dressing, and maintenance "bundles" on the rate of CLABSI and catheter-related complications. We performed a quality improvement (QI), prospective, before-after study. In the first 9-month period, the old "bundles" and pre-existing materials were used/applied. An intervention period then occurred with changes made to materials used and the implementation of new "bundles" related to various aspects of central lines care. A second 6-month period was then assessed and the CLABSI rates were measured in the NICU pre- and post-intervention period. The QI measures were the rate of CLABSI and catheter-related complications. Data are still being collected after the study to verify sustainability. The implementation of the new "bundles" and the change of certain materials resulted in a significantly decreased rate of CLABSI (8.4 to 1.8 infections per 1000 central venous catheter (CVC) days, p = 0.02,) as well as decreased catheter-related complications (47 to 10, p < 0.007).Conclusions: The analysis of pre-existing "bundles" and the implementation of updated central line "bundles" based on best practice recommendations are crucial for reducing the rate of CLABSI in the NICU. The implementation of the new evidence-based central line "bundles" was associated with a significant reduction in CLABSI rate in our unit soon after implementation. What is Known: • Central line-associated bloodstream infection (CLABSI) is a major cause of morbidity and mortality in the neonatal population. • The implementation of evidence-based "bundles" in the NICU is associated with a reduction in the incidence of CLABSI. What is New: • For the improvement in quality care in the NICU, audits are necessary to assess the existing systems. • The "Plan-Do-Study-Act cycle" is an effective tool to use when tackling challenges in an existing system. Using this tool assisted in the approach to reducing CLABSI in our NICU.
MeSH term(s)	Catheter-Related Infections/epidemiology ; Catheter-Related Infections/prevention & control ; Catheterization, Central Venous/adverse effects ; Cross Infection/epidemiology ; Cross Infection/prevention & control ; Humans ; Infant, Newborn ; Infection Control ; Intensive Care Units, Neonatal ; Prospective Studies ; Quality Improvement ; Retrospective Studies ; Sepsis
Language	English
Publishing date	2020-10-20
Publishing country	Germany
Document type	Journal Article
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-020-03844-9
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Article ; Online: Nutrients and Microbiota in Lung Diseases of Prematurity: The Placenta-Gut-Lung Triangle.

Piersigilli, Fiammetta / Van Grambezen, Bénédicte / Hocq, Catheline / Danhaive, Olivier

Nutrients

2020 Volume 12, Issue 2

Abstract: Cardiorespiratory function is not only the foremost determinant of life after premature birth, but also a major factor of long-term outcomes. However, the path from placental disconnection to nutritional autonomy is enduring and challenging for the ... ...

Abstract	Cardiorespiratory function is not only the foremost determinant of life after premature birth, but also a major factor of long-term outcomes. However, the path from placental disconnection to nutritional autonomy is enduring and challenging for the preterm infant and, at each step, will have profound influences on respiratory physiology and disease. Fluid and energy intake, specific nutrients such as amino-acids, lipids and vitamins, and their ways of administration -parenteral or enteral-have direct implications on lung tissue composition and cellular functions, thus affect lung development and homeostasis and contributing to acute and chronic respiratory disorders. In addition, metabolomic signatures have recently emerged as biomarkers of bronchopulmonary dysplasia and other neonatal diseases, suggesting a profound implication of specific metabolites such as amino-acids, acylcarnitine and fatty acids in lung injury and repair, inflammation and immune modulation. Recent advances have highlighted the profound influence of the microbiome on many short- and long-term outcomes in the preterm infant. Lung and intestinal microbiomes are deeply intricated, and nutrition plays a prominent role in their establishment and regulation. There is an emerging evidence that human milk prevents bronchopulmonary dysplasia in premature infants, potentially through microbiome composition and/or inflammation modulation. Restoring antibiotic therapy-mediated microbiome disruption is another potentially beneficial action of human milk, which can be in part emulated by pre- and probiotics and supplements. This review will explore the many facets of the gut-lung axis and its pathophysiology in acute and chronic respiratory disorders of the prematurely born infant, and explore established and innovative nutritional approaches for prevention and treatment.
MeSH term(s)	Female ; Gastrointestinal Microbiome/physiology ; Humans ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Infant, Premature/growth & development ; Infant, Premature, Diseases/etiology ; Infant, Premature, Diseases/metabolism ; Infant, Premature, Diseases/microbiology ; Lung/growth & development ; Lung/microbiology ; Lung Diseases/etiology ; Lung Diseases/microbiology ; Lung Diseases/physiopathology ; Male ; Microbiota/physiology ; Milk, Human/microbiology ; Nutrients/metabolism ; Placenta/microbiology ; Pregnancy ; Premature Birth/microbiology ; Premature Birth/physiopathology
Language	English
Publishing date	2020-02-13
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu12020469
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