Transpyloric Feeding in the Newborn: Use in Neonates with and without Respiratory Failure

1983 ◽  
Vol 28 (4) ◽  
pp. 347-349 ◽  
Author(s):  
M. Mulla ◽  
I. Mitchell
Keyword(s):  
Body Weight ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Respiratory Disease ◽  
Low Birthweight ◽  
Standard Technique ◽  
Respiratory Illness ◽  
Maternity Hospital ◽  
Major Complications ◽  
One Year

In a peripheral maternity hospital providing Intensive Care for 5274 deliveries per annum, NJ feeding was attempted, in one year, in 57 neonates. One third of these weighed less than 1500 g at birth and 41 (71.9%) had respiratory disease. A standard technique, and a commercially available tube was used, and the tube was passed to the jejunum within 24 hours in 46 (80.7%) of the babies. NJ feeding was continued for varying periods, up to 50 days. The volume of milk given varied with the duration of the feed but feeds of up to 244 ml of milk/Kg body weight/day were achieved. Thirty-eight (66.6%) of the babies regained their birthweight by 20 days and major complications were uncommon. We have shown that NJ feeding can be used in low birthweight babies with serious respiratory illness, even when resources are limited.

scholarly journals Bichat guidelines for the clinical management of botulism and bioterrorism-related botulism

2004 ◽  
Vol 9 (12) ◽  
pp. 31-32 ◽  
Author(s):  
P Bossi ◽  
A Tegnell ◽  
A Baka ◽  
A Werner ◽  
F van Loock ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Body Weight ◽  
Intensive Care ◽  
Botulinum Toxin ◽  
Respiratory Failure ◽  
Clinical Management ◽  
Clostridium Botulinum ◽  
Deliberate Release

Botulism is a rare but serious paralytic illness caused by botulinum toxin, which is produced by the Clostridium botulinum. This toxin is the most poisonous substance known. It 100 000 times more toxic than sarin gas. Eating or breathing this toxin causes illness in humans. Four distinct clinical forms are described: foodborne, wound, infant and intestinal botulism. The fifth form, inhalational botulism, is caused by aerosolised botulinum toxin that could be used as a biological weapon. A deliberate release may also involve contamination of food or water supplies with toxin or C. botulinum bacteria. By inhalation, the dose that would kill 50% of exposed persons (LD50) is 0.003 microgrammes/kg of body weight. Patients with respiratory failure must be admitted to an intensive care unit and require long-term mechanical ventilation. Trivalent equine antitoxins (A,B,E) must be given to patients as soon as possible after clinical diagnosis. Heptavalent human antitoxins (A-G) are available in certain countries.

scholarly journals Study protocol for the POPART study—Prophylactic Oropharyngeal surfactant for Preterm infants: A Randomised Trial

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e035994
Author(s):  
Madeleine Claire Murphy ◽  
Marie Galligan ◽  
Brenda Molloy ◽  
Rabia Hussain ◽  
Peter Doran ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Preterm Infants ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Ethics Committees ◽  
Maternity Hospital ◽  
Parallel Group ◽  
Study Results ◽  
Registration Number

IntroductionMany preterm infants develop respiratory distress syndrome (RDS), a condition characterised by a relative lack of surfactant. Endotracheal surfactant therapy revolutionised the care of preterm infants in the 1990s. However, supporting newborns with RDS with continuous positive airway pressure (CPAP) and reserving endotracheal surfactant for those who develop respiratory failure despite CPAP yield better results than intubating all infants for surfactant. Half of preterm infants born before 29 weeks gestation initially managed with CPAP are intubated for surfactant. Intubation is difficult to learn and associated with adverse effects. Surfactant administration into the oropharynx has been reported in preterm animals and humans and may be effective. We wished to determine whether giving oropharyngeal surfactant at birth reduces the rate of endotracheal intubation for respiratory failure in preterm infants within 120 hours of birth.Methods and analysisProphylactic Oropharyngeal surfactant for Preterm infants: A Randomised Trial (POPART, Eudract No. 2016-004198-41) is an investigator-led, unblinded, multicentre, randomised, parallel group, controlled trial. Infants are eligible if born at a participating centre before 29 weeks gestational age (GA) and there is a plan to offer intensive care. Infants are excluded if they have major congenital anomalies. Infants are randomised at birth to treatment with oropharyngeal surfactant (120 mg vial <26 weeks GA stratum; 240 mg vial 26–28+6 weeks GA stratum) in addition to CPAP or CPAP alone. The primary outcome is intubation within 120 hours of birth, for bradycardia and/or apnoea despite respiratory support in the delivery room or respiratory failure in the intensive care unit. Secondary outcomes include incidence of mechanical ventilation, endotracheal surfactant use, chronic lung disease and death before hospital discharge.Ethics and disseminationApproval for the study has been granted by the Research Ethics Committees at the National Maternity Hospital, Dublin, Ireland (EC31.2016) and at each participating site. The trial is being conducted at nine centres in six European countries. The study results will be submitted for publication in a peer-reviewed journal.Trial registration number2016-004198-41; Pre-results.

scholarly journals Outcome of early bubble CPAP in children presenting at paediatric in-tensive care unit from 2016-2017

2017 ◽  
Vol 1 (1) ◽  
pp. 35
Author(s):  
Madia Kazmi
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Respiratory Distress ◽  
Ventilatory Support ◽  
Respiratory Illness ◽  
Cross Sectional Study ◽  
Paediatric Intensive Care ◽  
Cross Sectional ◽  
Bubble Cpap

The aim of this study is to analyze the introduction of early continuous positive  airway pressure(CPAP) for children admitted in PICU in correcting respiratory  distress with or without hypoxaemia and impending respiratory failure in order to improve respiratory function, avoid the need for mechanical ventilation and its  complications. Objective: To determine the outcome of early bubble CPAP in   children admitted in paediatric intensive care of Abbasi Shaheed hospital. Methods: This pilot study is being conducted in paediatric intensive care of paediatric unit 2 department at Abbasi Shaheed hospital Karachi. The study was conducted from march 2016 to December 2016. The study design was cross-sectional study and sample  technique was non probability(purposive).Total 70 patients of both genders having age ranging between 0-12years exhibiting clinical features of respiratory distress with hypoxaemia (SpO2 <92%) and impending respiratory failure initially received oxygen supplementation through bCPAP delivered via an underwater tube through nasal prongs. Data regarding outcome after receiving bCPAP and need for mechanical  ventilation was collected and analyzed. Results: Oxygen was initiated by bCPAP in 70 patients. Out of these, forty-one (58.5%) were male and twenty-nine (41.2%) were females. The age group ranges from 0- 12years. Forty-nine (70%) patients survived after bCPAP and shift to ward. Twenty-one (30%) were intubated for worsening  distress and hypoxaemia. Eight (11.4%) were removed from vent, put on bCPAP and survived. Ten (14.2%) expired on ventilatory support. Conclusion: According to our results early bubble CPAP supplementation helps in correcting respiratory illness and contributes to reduce the number of children requiring endotracheal tube intubation and mechanical ventilation. In addition to the benefits mentioned above, it is a simple device which can be made locally, very cheap and effective.

The Halting Shadow

2017 ◽  
Author(s):  
Deirdre David
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Sexual Desire ◽  
Respiratory Illness ◽  
Perforated Ulcer ◽  
Respiratory Illnesses ◽  
Dylan Thomas ◽  
One Year

The last years of Pamela’s life were marked by further illness but also by a remarkable dedication to work. She was hospitalized several times for respiratory illnesses, but in 1974 she published a book of autobiographical essays, Important to Me, which covered such topics as memories of her father, her relationship with Dylan Thomas, her visits to the USSR, and her friendship with other writers such as Edith Sitwell. After months of undiagnosed pain, Snow died in 1980 of a perforated ulcer and Pamela died almost one year later of congestive heart failure and respiratory illness exacerbated by having smoked since the age of fourteen. Yet characteristically she worked courageously until the very end on a novel published posthumously: A Bonfire, which similarly to her first novel deals explicitly with sexual desire. Her ashes were scattered at Stratford-upon-Avon, a place she visited every year on Shakespeare’s birthday.

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