The impact of Neonatal Resuscitation Program courses on mortality and morbidity of newborn infants with perinatal asphyxia

Periviable infants (PIs) born at 22–25 weeks gestational age (wGA) have a variable survival rate (49.7–86.2%) among hospitals. One factor involved in this difference may be the definition of the threshold of viability. The American Academy of Pediatrics revised the neonatal resuscitation program in late 2015 (NRP 2015) and altered the threshold of viability from 23 to 22 wGA. The impact on the survival of PIs after the guideline alteration has seldom been discussed. Since 2016, the unit of this study has implemented the renewed guideline for PIs. We retrospectively reviewed and analyzed the survival and clinical variables of PIs before and after implementation of the guideline, which included a 10-year cohort in a single center in Taiwan. There were 168 PIs enrolled between 2010 and 2019 (Epoch-I, 2010–2015; Epoch-II, 2016–2019), after excluding those with congenital anomalies and parent-decided comfort care. Compared to those in Epoch-I, the PIs in Epoch-II had significantly higher odds ratios (2.602) (95% confidence interval: 1.170–5.789; p = 0.019) for survival. Younger gestational age, small size for gestational age, cesarean delivery, low blood pH at birth, and surfactant therapeutic treatment were found to be significant risk factors associated with the survival of PIs (p < 0.05 for each). The altered threshold of viability by NRP 2015 may impact the survival of PIs. However, long-term follow-up for surviving PI is required in the future.

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Heart Rate Assessment during Neonatal Resuscitation

Healthcare ◽

10.3390/healthcare8010043 ◽

2020 ◽

Vol 8 (1) ◽

pp. 43 ◽

Cited By ~ 1

Author(s):

Peter A. Johnson ◽

Georg M. Schmölzer

Keyword(s):

Heart Rate ◽

Infant Mortality ◽

Current Practice ◽

Clinical Status ◽

Newborn Infants ◽

Neonatal Resuscitation ◽

Novel Technologies ◽

Hypoxic Injury ◽

Neonatal Resuscitation Program ◽

Neonatal Transition

Approximately 10% of newborn infants require some form of respiratory support to successfully complete the fetal-to-neonatal transition. Heart rate (HR) determination is essential at birth to assess a newborn’s wellbeing. Not only is it the most sensitive indicator to guide interventions during neonatal resuscitation, it is also valuable for assessing the infant’s clinical status. As such, HR assessment is a key step at birth and throughout resuscitation, according to recommendations by the Neonatal Resuscitation Program algorithm. It is essential that HR is accurate, reliable, and fast to ensure interventions are delivered without delay and not prolonged. Ineffective HR assessment significantly increases the risk of hypoxic injury and infant mortality. The aims of this review are to summarize current practice, recommended techniques, novel technologies, and considerations for HR assessment during neonatal resuscitation at birth.

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Effect of neonatal resuscitation courses on long-term neurodevelopmental outcomes of newborn infants with perinatal asphyxia

Pediatrics International ◽

10.1111/j.1442-200x.2011.03463.x ◽

2011 ◽

Vol 54 (1) ◽

pp. 56-59 ◽

Cited By ~ 5

Author(s):

Rıdvan Duran ◽

Işık Görker ◽

Yasemin Küçükuğurluoğlu ◽

Nükhet AladağÇiftdemir ◽

Ülfet Vatansever Özbek ◽

...

Keyword(s):

Perinatal Asphyxia ◽

Newborn Infants ◽

Neonatal Resuscitation ◽

Neurodevelopmental Outcomes

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Prevalence of perinatal asphyxia and its associated factors in Ethiopia; A systematic review and meta-Analysis

10.21203/rs.2.17346/v1 ◽

2019 ◽

Author(s):

Moges Agazhe Assemie ◽

Getaye Tizazu ◽

Busha Gamachu Labata ◽

Alemu Simegn

Keyword(s):

Systematic Review ◽

Birth Weight ◽

Low Birth Weight ◽

Perinatal Asphyxia ◽

Data Extraction ◽

Meta Analysis ◽

Significant Risk ◽

Neonatal Resuscitation ◽

Mortality And Morbidity ◽

Prolonged Labour

Abstract Background: Perinatal asphyxia(PNA) is a severe health problem and main cause of neonatal mortality and morbidity worldwide. In Ethiopia, there are many studies conducted on PNA characterized by replete of inconsistent; unavailability of nation wide study to determines the prevalence of PNA and its determinants is an important gap. The aim of this study is to develop national consensus on pooled prevalence and associated factor key reports to enhance the quality and consistency of the evidence on perinatal asphyxia. Method: Systematic review and meta-analysis using computerized databases; searches were performed to locate all articles on the prevalence of perinatal asphyxia. Databases included were Pub Med, Cochran library, Google Scholar, Scopus and Science Direct systematically between 2014 and April 2019. All identified studies reporting the prevalence of PNA in Ethiopia were pooled. Two independent authors extracted the data using a standardized data extraction tool. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the studies. Random-effects model was used to calculate pooled estimates and determinant factor of PNA in Stata/se version-14. Result: The prevalence of PNA reported from fifteen studies was in the range of 3.1 to 47.5%. The pooled occurrence of PNA in Ethiopia based on 15 articles with a sample size of 17,091 was 21.1% (95% CI: 14, 28). There was high heterogeneity observed (I2 = 99.4%, p <0.001). Thus, Subgroup analysis in the study area was computed .Thus, the highest prevalence (40.4%) was observed from Oromia region and the lowest 8% noted from Dire Dawa city administration. Pooled odd ratio estimates from included studies revealed prolonged labour (OR=3.7, 95% CI 2.4, 5.7), low birth weight (OR=6.5, 95% CI 4.0, 10.3), and Meconium stained liquor (OR=6.6, 95% CI: 4.4, 10.1) are significant risk factors of perinatal asphyxia. Conclusion: In this review, prolonged labour, meconium stained liquor and low birth weight are significantly associated with perinatal asphyxia. Therefore, improve facility-based intra partum care and quality neonatal resuscitation service through capacity building for health professionals is needed.

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The practice of blood volume submitted for culture in a neonatal intensive care unit

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2019-318080 ◽

2020 ◽

Vol 105 (6) ◽

pp. 600-604

Author(s):

Moni Pankhuri Singh ◽

Kiran Kumar Balegar V ◽

Rajeshwar Reddy Angiti

Keyword(s):

Intensive Care ◽

Blood Culture ◽

Blood Volume ◽

Neonatal Intensive Care ◽

Newborn Infants ◽

Sample Volume ◽

Culture Bottle ◽

Culture Volume ◽

Mortality And Morbidity ◽

The Impact

BackgroundNeonatal sepsis is the leading cause of mortality and morbidity in neonatal intensive care units. The volume of blood taken for culture remains one of the most important factors in isolating microorganisms.ObjectivesTo evaluate the impact of the intervention on the blood volume submitted for culture and to identify factors influencing the volume as determined by the phlebotomist.MethodsBlood culture volume was determined by weighing the culture bottle before and immediately after blood inoculation. A 3-month preintervention audit revealed that in 126/130 samples (96.9%), the volume of blood submitted was suboptimal. Multiple intervention measures were instituted, and volume was monitored over the next 9 months.Results637 blood culture samples were included in the study, 130 were in preintervention and 507 were in postintervention epochs. Following the intervention, suboptimal volume samples reduced from 96.9% (126/130 samples) to 25% (126/507 samples), p<0.0001 and the median (IQR) sample volume improved from 0.36 (0.23) ml to 0.9 (0.27) ml, p<0.0001. Poor blood flow was identified as the most common reason for an inadequate sample.ConclusionThe study underscores the role of educational intervention in improving the blood culture volume in newborn infants. Poor backflow from the cannula is an important cause of inadequate volume collection.

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Key Aspects of Assessing Effectiveness and Efficiency of Implementation of the Federal Clean Air Project on the Example of the Comprehensive Emission Reduction Action Plan in Nizhny Tagil

ЗДОРОВЬЕ НАСЕЛЕНИЯ И СРЕДА ОБИТАНИЯ - ЗНиСО / PUBLIC HEALTH AND LIFE ENVIRONMENT ◽

10.35627/2219-5238/2020-330-9-48-60 ◽

2020 ◽

pp. 48-60

Author(s):

SV Yarushin ◽

DV Kuzmin ◽

AA Shevchik ◽

TM Tsepilova ◽

VB Gurvich ◽

...

Keyword(s):

Emission Reduction ◽

Action Plan ◽

Local Population ◽

Ambient Air ◽

Ambient Air Pollution ◽

Mortality And Morbidity ◽

Industrial Enterprises ◽

Clean Air ◽

Effectiveness And Efficiency ◽

The Impact

Introduction: Key issues of assessing effectiveness and economic efficiency of implementing the Federal Clean Air Project by public health criteria are considered based on the example of the Comprehensive Emission Reduction Action Plan realized in the city of Nizhny Tagil, Sverdlovsk Region. Materials and methods: We elaborated method approaches and reviewed practical aspects of evaluating measures taken in 2018–2019 at key urban industrial enterprises accounting for 95 % of stationary source emissions. Results: Summary calculations of ambient air pollution and carcinogenic and non-carcinogenic inhalation health risks including residual risks, evaluation of the impact of air quality on urban mortality and morbidity rates, economic assessment of prevented morbidity and premature mortality cases have enabled us not only to estimate health effects but also to develop guidelines for development and implementation of actions aimed at enhancing effectiveness and efficiency of industrial emission reduction in terms of health promotion of the local population. Conclusions: We substantiate proposals for the necessity and sufficiency of taking remedial actions ensuring achievement of acceptable health risk levels as targets of the Comprehensive Emission Reduction Action Plan in Nizhny Tagil until 2024 and beyond.

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Association between Intraoperative Blood Transfusion and Mortality and Morbidity in Patients Undergoing Noncardiac Surgery

Anesthesiology ◽

10.1097/aln.0b013e3182054d06 ◽

2011 ◽

Vol 114 (2) ◽

pp. 283-292 ◽

Cited By ~ 312

Author(s):

Laurent G. Glance ◽

Andrew W. Dick ◽

Dana B. Mukamel ◽

Fergal J. Fleming ◽

Raymond A. Zollo ◽

...

Keyword(s):

Blood Transfusion ◽

Noncardiac Surgery ◽

Pulmonary Complications ◽

Wound Complications ◽

Severe Anemia ◽

Thromboembolic Complications ◽

Mortality And Morbidity ◽

Risk Of Death ◽

Increased Risk ◽

The Impact

Background The impact of intraoperative erythrocyte transfusion on outcomes of anemic patients undergoing noncardiac surgery has not been well characterized. The objective of this study was to examine the association between blood transfusion and mortality and morbidity in patients with severe anemia (hematocrit less than 30%) who are exposed to one or two units of erythrocytes intraoperatively. Methods This was a retrospective analysis of the association of blood transfusion and 30-day mortality and 30-day morbidity in 10,100 patients undergoing general, vascular, or orthopedic surgery. We estimated separate multivariate logistic regression models for 30-day mortality and for 30-day complications. Results Intraoperative blood transfusion was associated with an increased risk of death (odds ratio [OR], 1.29; 95% CI, 1.03-1.62). Patients receiving an intraoperative transfusion were more likely to have pulmonary, septic, wound, or thromboembolic complications, compared with patients not receiving an intraoperative transfusion. Compared with patients who were not transfused, patients receiving one or two units of erythrocytes were more likely to have pulmonary complications (OR, 1.76; 95% CI, 1.48-2.09), sepsis (OR, 1.43; 95% CI, 1.21-1.68), thromboembolic complications (OR, 1.77; 95% CI, 1.32-2.38), and wound complications (OR, 1.87; 95% CI, 1.47-2.37). Conclusions Intraoperative blood transfusion is associated with a higher risk of mortality and morbidity in surgical patients with severe anemia. It is unknown whether this association is due to the adverse effects of blood transfusion or is, instead, the result of increased blood loss in the patients receiving blood.

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Detection of diarrhoea associated rotavirus and co-infection with diarrhoeagenic pathogens in the Littoral region of Cameroon using ELISA, RT-PCR and Luminex xTAG GPP assays

BMC Infectious Diseases ◽

10.1186/s12879-021-06318-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rahinatou N. Ghapoutsa ◽

Maurice Boda ◽

Rashi Gautam ◽

Valantine Ngum Ndze ◽

Akongnwi E. Mugyia ◽

...

Keyword(s):

Demographic Data ◽

Laboratory Diagnosis ◽

Epidemiological Studies ◽

Sub Saharan Africa ◽

Rt Pcr ◽

Mortality And Morbidity ◽

Vaccine Introduction ◽

Littoral Region ◽

Rotavirus Vaccines ◽

The Impact

Abstract Background Despite the global roll-out of rotavirus vaccines (RotaTeq/Rotarix / ROTAVAC/Rotasiil), mortality and morbidity due to group A rotavirus (RVA) remains high in sub-Saharan Africa, causing 104,000 deaths and 600,000 hospitalizations yearly. In Cameroon, Rotarix™ was introduced in March 2014, but, routine laboratory diagnosis of rotavirus infection is not yet a common practice, and vaccine effectiveness studies to determine the impact of vaccine introduction have not been done. Thus, studies examining RVA prevalence post vaccine introduction are needed. The study aim was to determine RVA prevalence in severe diarrhoea cases in Littoral region, Cameroon and investigate the role of other diarrheagenic pathogens in RVA-positive cases. Methods We carried out a study among hospitalized children < 5 years of age, presenting with acute gastroenteritis in selected hospitals of the Littoral region of Cameroon, from May 2015 to April 2016. Diarrheic stool samples and socio-demographic data including immunization and breastfeeding status were collected from these participating children. Samples were screened by ELISA (ProSpecT™ Rotavirus) for detection of RVA antigen and by gel-based RT-PCR for detection of the VP6 gene. Co-infection was assessed by multiplexed molecular detection of diarrheal pathogens using the Luminex xTAG GPP assay. Results The ELISA assay detected RVA antigen in 54.6% (71/130) of specimens, with 45, positive by VP6 RT-PCR and 54, positive using Luminex xTAG GPP. Luminex GPP was able to detect all 45 VP6 RT-PCR positive samples. Co-infections were found in 63.0% (34/54) of Luminex positive RVA infections, with Shigella (35.3%; 12/34) and ETEC (29.4%; 10/34) detected frequently. Of the 71 ELISA positive RVA cases, 57.8% (41/71) were fully vaccinated, receiving two doses of Rotarix. Conclusion This study provides insight on RVA prevalence in Cameroon, which could be useful for post-vaccine epidemiological studies, highlights higher than expected RVA prevalence in vaccinated children hospitalized for diarrhoea and provides the trend of RVA co-infection with other enteric pathogens. RVA genotyping is needed to determine circulating rotavirus genotypes in Cameroon, including those causing disease in vaccinated children.

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