scholarly journals Feasibility of combining two individualized lung recruitment maneuvers at birth for very low gestational age infants: a retrospective cohort study

2020 ◽  
Author(s):  
Zalfa Kanaan ◽  
Coralie Bloch-Queyrat ◽  
Marouane Boubaya ◽  
Vincent Lévy ◽  
Pascal Bolot ◽  
...  
Keyword(s):  
Gestational Age ◽  
Animal Studies ◽  
Controlled Trial ◽  
Optimal Level ◽  
Progressive Increase ◽  
Lung Recruitment ◽  
Short Term ◽  
Mortality And Morbidity ◽  
Recruitment Maneuvers ◽  
Before And After

Abstract BACKGROUND Lung recruitment at birth has been advocated as an effective method of improving the respiratory transition at birth. Sustained inflations (SI) and dynamic positive end-expiratory pressure (PEEP) were assessed in clinical and animal studies to define the optimal level. Our working hypothesis was that very low gestational age infants (VLGAI) < 32 weeks’ gestation require an individualized lung recruitment based on combining both manoeuvers. METHODS Between 2014 and 2016, 91 and 72 inborn VLGAI, requiring a respiratory support beyond a continuous positive airway pressure (CPAP) = 5 cmH2O, were enrolled before and after introducing these manoeuvers based on progressive increase in SI up to 15 seconds, with simultaneous gradual increase in PEEP up to 15 cmH2O, according to the cardiorespiratory response. Retrospective comparisons of the incidence of mechanical ventilation (MV) < 72h of life, short-term and before discharge morbidity were then performed. RESULTS Among extremely low gestational age infants (ELGAI) < 29 weeks’ gestation, the following outcomes decreased significantly: intubation (90% to 55%) and surfactant administration (54% to 12%) in the delivery room, MV (92% to 71%) and its mean duration < 72h of life (45h to 13h), administration of a 2nd dose of surfactant (35% to 12%) and postnatal corticosteroids (52% to 19%), and the rate of bronchopulmonary dysplasia (23 to 5%). Among VLGAI, all of these results were also significant. Neonatal mortality and morbidity were not different. CONCLUSIONS In our setting, combining two individualized lung recruitment maneuvers at birth was feasible and may be beneficial on short-term and before discharge pulmonary outcomes. A randomized controlled trial is needed to confirm these results.

scholarly journals Feasibility of combining two individualized lung recruitment maneuvers at birth for very low gestational age infants: a retrospective cohort study

2020 ◽  
Author(s):  
Zalfa Kanaan ◽  
Coralie Bloch-Queyrat ◽  
Marouane Boubaya ◽  
Vincent Lévy ◽  
Pascal Bolot ◽  
...  
Keyword(s):  
Gestational Age ◽  
Animal Studies ◽  
Controlled Trial ◽  
Optimal Level ◽  
Progressive Increase ◽  
Lung Recruitment ◽  
Short Term ◽  
Mortality And Morbidity ◽  
Recruitment Maneuvers ◽  
Before And After

Abstract BACKGROUND Lung recruitment at birth has been advocated as an effective method of improving the respiratory transition at birth. Sustained inflations (SI) and dynamic positive end-expiratory pressure (PEEP) were assessed in clinical and animal studies to define the optimal level. Our working hypothesis was that very low gestational age infants (VLGAI) < 32 weeks’ gestation require an individualized lung recruitment based on combining both manoeuvers. METHODS Between 2014 and 2016, 91 and 72 inborn VLGAI, requiring a respiratory support beyond a continuous positive airway pressure (CPAP) = 5 cmH2O, were enrolled before and after introducing these manoeuvers based on progressive increase in SI up to 15 seconds, with simultaneous gradual increase in PEEP up to 15 cmH2O, according to the cardiorespiratory response. Retrospective comparisons of the rate of mechanical ventilation (MV) < 72h of life, short-term and before discharge morbidity were then performed. RESULTS Among extremely low gestational age infants (ELGAI) < 29 weeks’ gestation, the following outcomes decreased significantly: intubation (90% to 55%) and surfactant administration (54% to 12%) in the delivery room, MV (92% to 71%) and its mean duration < 72h of life (45h to 13h), administration of a 2nd dose of surfactant (35% to 12%) and postnatal corticosteroids (52% to 19%), and the rate of bronchopulmonary dysplasia (23 to 5%). Among VLGAI, all of these results were also significant. Neonatal mortality and morbidity were not different. CONCLUSIONS In our setting, combining two individualized lung recruitment maneuvers at birth was feasible and may be beneficial on short-term and before discharge pulmonary outcomes. A randomized controlled trial is needed to confirm these results.

scholarly journals Feasibility of combining two individualized lung recruitment maneuvers at birth for very low gestational age infants: a retrospective cohort study

2019 ◽  
Author(s):  
Zalfa Kanaan ◽  
Coralie Bloch-Queyrat ◽  
Marouane Boubaya ◽  
Vincent Lévy ◽  
Pascal Bolot ◽  
...  
Keyword(s):  
Gestational Age ◽  
Animal Studies ◽  
Controlled Trial ◽  
Optimal Level ◽  
Progressive Increase ◽  
Lung Recruitment ◽  
Mortality And Morbidity ◽  
Recruitment Maneuvers ◽  
Before And After ◽  
Life Consumption

Abstract BACKGROUND Lung recruitment at birth has been advocated as an effective method of improving the respiratory transition at birth. Sustained inflations (SI) and dynamic positive end-expiratory pressure (PEEP) were assessed in clinical and animal studies to define the optimal level. Our working hypothesis was that very low gestational age infants (VLGAI) < 32 weeks’ gestation require an individualized lung recruitment based on combining both manoeuvers. METHODS Between 2014 and 2016, 100 and 102 inborn VLGAI were enrolled before and after introducing these manoeuvers based on progressive increase in SI up to 15 seconds, with simultaneous gradual increase in PEEP up to 15 cmH2O, according to the cardiorespiratory response. Retrospective comparisons of the rate of mechanical ventilation (MV) < 72h of life, short- and mid-term morbidity were then performed. RESULTS Among extremely low gestational age infants (ELGAI) < 29 weeks’ gestation, MV and its mean duration < 72h of life, consumption of a 2 nd dose of surfactant, and postnatal corticosteroids decreased significantly from 92 to 71%, 42 to 12h, 35 to 12%, and 49 to 24%, respectively. Among VLGAI, most of these results, and the rate of bronchopulmonary dysplasia (decreasing from 14 to 6%), were significant after a multivariate analysis. Neonatal mortality and morbidity were not different. CONCLUSIONS In our setting, combining two individualized lung recruitment maneuvers at birth was feasible and may be beneficial on short- and mid-term pulmonary outcomes, especially in ELGAI < 29 weeks’ gestation. A randomized controlled trial is needed to confirm these results.

Neonatal Outcomes at Extreme Prematurity by Gestational Age Versus Birth Weight in a Contemporary Cohort

2021 ◽  
Author(s):  
Elizabeth B. Ausbeck ◽  
Phillip Hunter Allman ◽  
Jeff M. Szychowski ◽  
Akila Subramaniam ◽  
Anup Katheria
Keyword(s):  
Birth Weight ◽  
Umbilical Cord ◽  
Gestational Age ◽  
Predictive Value ◽  
Neonatal Death ◽  
Controlled Trial ◽  
Neonatal Morbidity ◽  
Mortality And Morbidity ◽  
Severe Morbidity ◽  
Multicenter Randomized Controlled Trial

Objective The aim of the study is to describe the rates of neonatal death and severe neonatal morbidity in a contemporary cohort, as well as to evaluate the predictive value of birth gestational age (GA) and birth weight, independently and combined, for neonatal mortality and morbidity in the same contemporary cohort. Study Design We performed a secondary analysis of an international, multicenter randomized controlled trial of delayed umbilical cord clamping versus umbilical cord milking in preterm infants born at 23 0/7 to 31 6/7 weeks of gestation. The current analysis was restricted to infants delivered <28 weeks. The primary outcomes of this analysis were neonatal death and a composite of severe neonatal morbidity. Incidence of outcomes was compared by weeks of GA, with planned subanalysis comparing small for gestational age (SGA) versus non-SGA neonates. Multivariable logistic regression was then used to model these outcomes based on birth GA, birth weight, or a combination of both as primary independent predictors to determine which had superior ability to predict outcomes. Results Of 474 neonates in the original trial, 180 (38%) were included in this analysis. Overall, death occurred in 27 (15%) and severe morbidity in 139 (77%) neonates. Rates of mortality and morbidity declined with increasing GA (mortality 54% at 23 vs. 9% at 27 weeks). SGA infants (n = 25) had significantly higher mortality compared with non-SGA infants across all GAs (p < 0.01). There was no difference in the predictive value for neonatal death or severe morbidity between the three prediction options (GA, birth weight, or GA and birth weight). Conclusion Death and severe neonatal morbidity declined with advancing GA, with higher rates of death in SGA infants. Birth GA and birth weight were both good predictors of outcomes; however, combining the two was not more predictive, even in SGA infants. Key Points

scholarly journals Acute and Chronic Periocular Massage for Ocular Blood Flow and Vision: a Randomized Controlled Trial

2021 ◽  
Vol 14 (2) ◽  
pp. 5-13
Author(s):  
Naoyuki Hayashi, PhD ◽  
Lanfei Du, MSc
Keyword(s):  
Blood Flow ◽  
Visual Acuity ◽  
Vascular Function ◽  
Controlled Trial ◽  
Ocular Blood Flow ◽  
Control Group ◽  
Long Term Effects ◽  
Short Term ◽  
Before And After

Introduction: The ocular blood flow (OBF) is responsible for supplying nutrition to the retina, which plays a fundamental role in visual function. Massage is expected to improve the blood flow and, consequently, vascular function. The aim of this study was to determine the shortterm and long-term effects of periocular massage on OBF and visual acuity. Methods: The OBF and visual acuity were measured in 40 healthy adults aged 20–30 years before and after massage, and also in control subjects. Three massage methods were used: applying periocular acupressure (“Chinese eye exercise”: CE), using a facial massage roller (MR), and using an automated eye massager (AM). The OBF and visual acuity were first measured before and after applying each type of massage for 5 min. Eye massage was then applied for 5 min once daily over a 60-day period, while the control group received no massage. The same measurements were then performed again. Results: Performing short-term periocular massage showed significant interactions in time and massage effects on visual acuity in CE and AM groups, and on OBF in AM group, while 60-day massage period exerted no significant effects. No significant relationship was found between OBF and visual acuity changes. Conclusions: These results suggest that short-term periocular massage with Chinese eye exercise and automated eye massager can improve OBF and visual acuity, although no causal relationship was supported.

scholarly journals Effects of Natural Reduced Water on Cognitive Function, Body Composition, and Psychological Function in Older Adults: Study Protocol for a Randomized Controlled Trial

2021 ◽  
Vol 4 (4) ◽  
pp. 73
Author(s):  
Takamitsu Shinada ◽  
Yuji Takano ◽  
Keisuke Kokubun ◽  
Hikari Iki ◽  
Yasuyuki Taki
Keyword(s):  
Body Composition ◽  
Cognitive Function ◽  
Animal Studies ◽  
Tap Water ◽  
Controlled Trial ◽  
Psychological Function ◽  
Water Group ◽  
Before And After ◽  
The Relationship ◽  
Reduced Water

Natural reduced water is natural water that contains active hydrogen and reduces oxidation. It is rare in the world, and in Japan, it is produced in the Hita area of Oita Prefecture (Hita Tenryosui water). Previous studies in humans have examined the effects of natural reduced water on diabetes, which is one of the known risks for dementia. Animal studies of natural reduced water have revealed anti-obesity and anti-anxiety effects. However, the effects of natural reduced water on cognitive function, body composition, and psychological function in humans are unknown. Therefore, we investigated the relationship between these items in elderly people who continuously consume natural reduced water. In this study, we recruited participants aged between 65 and 74 years. The participants were randomly and blindly assigned to a natural reduced water (Hita Tenryosui water) group or a control (tap water) group and drank 1 L of water daily for 6 months. Cognitive function, body composition, and psychological function were measured before and after the 6-month intervention period.

Short-term weight gain after adenotonsillectomy in children with obstructive sleep apnoea: systematic review

2015 ◽  
Vol 130 (3) ◽  
pp. 214-218 ◽  
Author(s):  
M Van ◽  
I Khan ◽  
S S M Hussain
Keyword(s):  
Weight Gain ◽  
Obstructive Sleep Apnoea ◽  
Controlled Trial ◽  
Paediatric Population ◽  
Sleep Apnoea ◽  
Current Evidence ◽  
Short Term ◽  
Obstructive Sleep ◽  
Before And After ◽  
Randomised Controlled

AbstractBackground:Children with obstructive sleep apnoea commonly undergo adenotonsillectomy as first-line surgical treatment. This paper aimed to investigate whether this intervention was associated with weight gain after surgery in the paediatric population with obstructive sleep apnoea.Method:Two independent researchers systematically reviewed the literature from 1995 to 2014 for studies on patients who underwent adenotonsillectomy with weight-based measurements before and after surgery. The databases used were Ovid Medline, Embase and PubMed.Results:Six papers satisfied all inclusion criteria. Four of these papers showed a significant weight increase and the others did not. The only high quality, randomised, controlled trial showed a significant increase of weight gain at seven months follow up, even in patients who were already overweight before their surgery.Conclusion:The current evidence points towards an association between adenotonsillectomy and weight gain in patients with obstructive sleep apnoea in the short term.

The Link Between Verbal Short-Term Memory and Anomia Treatment Gains

2019 ◽  
Vol 28 (3) ◽  
pp. 1039-1052
Author(s):  
Reva M. Zimmerman ◽  
JoAnn P. Silkes ◽  
Diane L. Kendall ◽  
Irene Minkina
Keyword(s):  
Short Term Memory ◽  
Controlled Trial ◽  
Treatment Success ◽  
Linear Regression Models ◽  
Language Performance ◽  
Short Term ◽  
Term Memory ◽  
Treatment Gains ◽  
Post Hoc

Purpose A significant relationship between verbal short-term memory (STM) and language performance in people with aphasia has been found across studies. However, very few studies have examined the predictive value of verbal STM in treatment outcomes. This study aims to determine if verbal STM can be used as a predictor of treatment success. Method Retrospective data from 25 people with aphasia in a larger randomized controlled trial of phonomotor treatment were analyzed. Digit and word spans from immediately pretreatment were run in multiple linear regression models to determine whether they predict magnitude of change from pre- to posttreatment and follow-up naming accuracy. Pretreatment, immediately posttreatment, and 3 months posttreatment digit and word span scores were compared to determine if they changed following a novel treatment approach. Results Verbal STM, as measured by digit and word spans, did not predict magnitude of change in naming accuracy from pre- to posttreatment nor from pretreatment to 3 months posttreatment. Furthermore, digit and word spans did not change from pre- to posttreatment or from pretreatment to 3 months posttreatment in the overall analysis. A post hoc analysis revealed that only the less impaired group showed significant changes in word span scores from pretreatment to 3 months posttreatment. Discussion The results suggest that digit and word spans do not predict treatment gains. In a less severe subsample of participants, digit and word span scores can change following phonomotor treatment; however, the overall results suggest that span scores may not change significantly. The implications of these findings are discussed within the broader purview of theoretical and empirical associations between aphasic language and verbal STM processing.

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