A comparison of LISA versus insure: A single center experience

BACKGROUND: Less invasive surfactant replacement therapy (SRT) methods have been linked to better respiratory outcomes. The primary aim of this study was to determine if Less Invasive Surfactant Administration (LISA) altered the rate of bronchopulmonary dysplasia (BPD) in preterm infants. Secondary objectives were to determine if LISA compared to Intubation Surfactant Extubation (InSurE) resulted in different respiratory outcomes and hospital course. METHODS: In this retrospective chart review, outcomes were compared in two preterm infant groups (25–32 weeks gestation). Infants in Group 1 received surfactant replacement therapy (SRT) via InSurE method, while infants in Group 2 received SRT via LISA method. RESULTS: Regardless of SRT method utilized, there were no significant differences in rates of BPD between the two groups in infants born at 25–32 weeks gestation (30.6% vs 33.3% ; P = 0.47). CONCLUSIONS: Despite using LISA method rather than InSurE for SRT, premature infants continue to be at high risk for BPD. LISA shows promise as a safe, noninvasive SRT alternative to invasive methods like InSurE.

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Minimally or less invasive surfactant replacement therapy in neonates: A narrative review

Journal of Clinical Neonatology ◽

10.4103/jcn.jcn_2_21 ◽

2022 ◽

Vol 11 (1) ◽

pp. 45

Author(s):

Gengaimuthu Karthikeyan

Keyword(s):

Replacement Therapy ◽

Narrative Review ◽

Less Invasive ◽

Surfactant Replacement ◽

Surfactant Replacement Therapy

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Are aromatase inhibitors in boys with predicted short stature and/or rapidly advancing bone age effective and safe?

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2016-0219 ◽

2017 ◽

Vol 30 (3) ◽

Cited By ~ 4

Author(s):

Jessica A. Ferris ◽

Mitchell E. Geffner

Keyword(s):

Short Stature ◽

Chart Review ◽

Retrospective Chart Review ◽

Tanner Stage ◽

Bone Age ◽

Long Term Study ◽

Group 2 ◽

Endocrinology Clinic ◽

Group 1

AbstractBackground:The aim of this study was to assess aromatase inhibitor (AI) efficacy in increasing predicted adult height (PAH) and to describe clinical and biochemical safety profiles of AI-treated boys.Methods:A retrospective chart review was conducted at an academic children’s hospital endocrinology clinic. Twenty-one boys with predicted short stature and/or rapidly advancing bone age, divided as Tanner stage (TS) I–III Group 1 (G1, n=9) and TS IV–V Group 2 (G2, n=12), were treated with AIs, either letrozole or anastrozole (mean duration, G1: 2.4 years and G2: 0.9 years). Primary outcomes included PAH, hormonal/biochemical analytes, and clinical data.Results:PAH did not significantly change in either group. Mean peak testosterone significantly increased from baseline to 650±458 ng/dL (p=0.008) in G1 and to 1156±302 ng/dL (p=0.002) in G2. Estradiol did not significantly change in either group. Compared to baseline, G2 showed increased mean FSH (p=0.002), LH (p=0.002), hematocrit (p=0.0001), body mass index (BMI) z-score (p=0.0005), and acne (p=0.01).Conclusions:AIs did not increase PAH, regardless of TS. Boys in late puberty had significant increases in testosterone, gonadotropins, hematocrit, acne, and BMI, but no reduction in estradiol. The potential consequences of these findings are concerning and require long-term study, especially if AIs are started in late puberty.

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Evaluating IV Acetaminophen for Pain Management After Cardiac Surgery: A Retrospective Chart Review

10.28971/532019wj111 ◽

2019 ◽

Author(s):

Jason Wilhelm

Keyword(s):

Cardiac Surgery ◽

Pain Management ◽

Chart Review ◽

Retrospective Chart Review ◽

Management Approach ◽

Pain Scores ◽

Post Operative Pain ◽

Alternative Techniques ◽

Group 2 ◽

Group 1

Pain after surgery is one of greatest complaints patients have in the surgical process. It is important to decrease pain after surgery to promote a quicker recovery and minimize complications. Opioids alone have been used to manage post-operative pain in cardiac surgery; However, recently multimodal approaches to pain management are now being explored. This approach involves using multiple medications with varying mechanisms of action for pain relief in addition to decreased adverse effects. Ofirmev (IV acetaminophen) is a relatively new medication for use in cardiac surgery that has few contraindications and side effects. The purpose of this study was to investigate if utilizing the current pain management approach in addition to Ofirmev impacted pain scores in post-operative cardiothoracic patients in a non-experimental retrospective chart review. A two group comparative chart review was conducted for a total of 30 charts to meet inclusion criteria. Group 1 (n=15) received opioid only for pain management were compared to Group 2 (n=15) who received Ofirmev and opioids for pain management after cardiac surgery. Results showed that pain scores at hour 6 and 24 showed significance in favor of Group 2, the Ofirmev group. Results also showed Group 2, the Ofirmev group, consumed less morphine on average than Group 1, opioid only. Unexpectedly, length of stay was on average longer for the Ofirmev group than the non- ofirmev group. The research supports the need to utilize multimodal pain management and alternative techniques to manage pain. This study shows there is a need for further research for pain management with a multimodal approach in cardiac surgery.

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Effectiveness of a Double Air-Cushioned Shoe Compared with Physiotherapy in the Treatment of Plantar Fasciitis

BioMed Research International ◽

10.1155/2020/9468302 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

S. S. Eun ◽

S. Chachan ◽

S. H. Lee

Keyword(s):

Plantar Fasciitis ◽

Chart Review ◽

Early Stage ◽

Retrospective Chart Review ◽

Noninvasive Treatment ◽

Alternative Treatment Option ◽

Foot Function ◽

Group 2 ◽

Group 1

Objective. This study was aimed at comparing the plantar fasciitis treatment effect of a double air-cushioned shoe to that of physiotherapy combined with ESWT. Methods. Retrospective chart review of 40 patients diagnosed with plantar fasciitis was performed. Group 1 wore a double air-cushioned shoe for 2 months, and group 2 underwent physiotherapy with ESWT once/week over a 4-week period. The foot function index (FFI) score was obtained at the initial visit, 1 month, and 2 months. Results. There were 25 patients in group 1 and 15 patients in group 2. The pretreatment FFI was 62.6 for group 1 and 50 for group 2. The 1-month posttreatment FFI was 45.6 for group 1 and 35.7 for group 2. The 2-month posttreatment FFI was 35 for group 1 and 43.1 for group 2. In both groups 1 and 2, follow-up FFIs were significantly improved from the initial FFI (p<0.05) and there were no significant differences between two groups (p>0.05). Conclusions. The double air-cushioned shoe can be considered an alternative treatment option for noninvasive treatment of early-stage plantar fasciitis.

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Surfactant Replacement Therapy

10.1007/978-3-642-73305-5 ◽

1988 ◽

Cited By ~ 3

Keyword(s):

Replacement Therapy ◽

Surfactant Replacement ◽

Surfactant Replacement Therapy

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Veno-venous ECMO as a platform to evaluate lung lavage and surfactant replacement therapy in an animal model of severe ARDS

Intensive Care Medicine Experimental ◽

10.1186/s40635-020-00352-w ◽

2020 ◽

Vol 8 (1) ◽

Author(s):

Robert Qaqish ◽

Yui Watanabe ◽

Marcos Galasso ◽

Cara Summers ◽

A adil Ali ◽

...

Keyword(s):

Replacement Therapy ◽

Lung Lavage ◽

Post Injury ◽

Surfactant Replacement ◽

Recruitment Maneuvers ◽

Surfactant Replacement Therapy ◽

Dosing Strategies ◽

Yorkshire Pigs ◽

Saline Lavage ◽

Protective Systems

Abstract Background There are limited therapeutic options directed at the underlying pathological processes in acute respiratory distress syndrome (ARDS). Experimental therapeutic strategies have targeted the protective systems that become deranged in ARDS such as surfactant. Although results of surfactant replacement therapy (SRT) in ARDS have been mixed, questions remain incompletely answered regarding timing and dosing strategies of surfactant. Furthermore, there are only few truly clinically relevant ARDS models in the literature. The primary aim of our study was to create a clinically relevant, reproducible model of severe ARDS requiring extracorporeal membrane oxygenation (ECMO). Secondly, we sought to use this model as a platform to evaluate a bronchoscopic intervention that involved saline lavage and SRT. Methods Yorkshire pigs were tracheostomized and cannulated for veno-venous ECMO support, then subsequently given lung injury using gastric juice via bronchoscopy. Animals were randomized post-injury to either receive bronchoscopic saline lavage combined with SRT and recruitment maneuvers (treatment, n = 5) or recruitment maneuvers alone (control, n = 5) during ECMO. Results PaO2/FiO2 after aspiration injury was 62.6 ± 8 mmHg and 60.9 ± 9.6 mmHg in the control and treatment group, respectively (p = 0.95) satisfying criteria for severe ARDS. ECMO reversed the severe hypoxemia. After treatment with saline lavage and SRT during ECMO, lung physiologic and hemodynamic parameters were not significantly different between treatment and controls. Conclusions A clinically relevant severe ARDS pig model requiring ECMO was established. Bronchoscopic saline lavage and SRT during ECMO did not provide a significant physiologic benefit compared to controls.

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