Topic number
3 . 2015
Content
Editorial

Editorial

Abstract
News of Cochrane database

News of Cochrane database (# 3, 2015)

Abstract
Neonatology news

Neonatology news (# 3, 2015)

Abstract
International practice

Cooling neonates who do not fulfil the standard cooling criteria – short- and long-term outcomes

Abstract

Aim. Therapeutic hypothermia is effective and without serious adverse effects in term infants with hypoxicischaemic encephalopathy. It is unknown whether other neonatal patient groups could benefit from therapeutic hypothermia. Since 2006, our centre has offered cooling to infants fulfilling the standard cooling criteria, but also to those who did not.

Methods. Observational study with prospective data collection over a 6-year period in a regional cooling centre. Complications and outcome were compared between infants who were cooled not fulfilling the standard inclusion and exclusion criteria as set out in the CoolCap/TOBY protocol (n=36) and infants who fulfilled the standard entry criteria (n=129).

Results. 21.8% of cooled infants did not fulfil standard cooling entry criteria. This included infants cooled >6 postnatal hours, late preterm infants, and infants with postnatal collapse, major cranial haemorrhage, congenital cardiac disease and surgical conditions. Complication rates and long-term outcome did not differ significantly between the groups, apart from in infants with a major cranial haemorrhage, who had higher rates of coagulopathy and the worst outcome (80% death/disability).

Conclusion. Cooling can be considered for infants with neonatal encephalopathy following postnatal collapse or preterm birth, those with underlying surgical or cardiac conditions, and infants starting cooling >6 postnatal hours.

Plasma asymmetric dimethylarginine levels are increased in neonates with bronchopulmonary dysplasia-associated pulmonary hypertension

Abstract

Aim. To test the hypothesis that levels of the endogenous inhibitor of nitric oxide production, asymmetric dimethylarginine (ADMA), would be greater in preterm infants with bronchopulmonary dysplasia (BPD)-associated pulmonary hypertension (PH) than in infants with BPD alone.

Study design. A case-control study of 23 patients with both BPD and PH (cases) and 95 patients with BPD but no evidence of PH (controls). Levels of ADMA were compared between cases and controls by t test.

Results. Patients with both BPD and PH had greater plasma levels of ADMA than patients with BPD alone (р=0.04). In samples drawn before 28 days of life, greater levels of ADMA were again found in cases compared with controls (р=0.02). The plasma arginine-to-ADMA ratio was lower in cases than in controls (р=0.03), suggesting a greater likelihood of inhibition of nitric oxide production in patients with both BPD and PH than in patients with BPD alone.

Conclusion. In this neonatal BPD cohort, ADMA levels are increased in patients with BPD who develop PH. We speculate that ADMA may be both a biomarker and a potential therapeutic target for preterm infants with BPDassociated PH.

Effects of automated adjustment of the inspired oxygen on fluctuations of arterial and regional cerebral tissue oxygenation in preterm infants with frequent desaturations

Abstract

Objective. To assess the effect of automated adjustment of the inspired oxygen fraction (FiO2) on arterial oxygen saturation (SpO2) and cerebral tissue oxygen saturation (SctO2) in very low birth weight infants with frequent fluctuations in oxygenation.

Study design. Fifteen infants (median gestational age, 25 weeks [range, 23–28 weeks]; median age, 34 days [range, 19–74 days]) were assigned in random sequence to 24 hours of automated adjustment of FiO2 or manual adjustment of FiO2. Primary outcome measurements were time within the SpO2 target range and the area under the curve above and below a defined SctO2 range.

Results. Percentage of time within the SpO2 target range increased during automated FiO2 control (76.3±9.2% vs 69.1±8.2% for manual; p<0.01). Prolonged episodes with SpO2 60 seconds duration (median, 115 episodes [range, 67–240] vs 54 episodes [range, 7–184]; p<0.01) and of >180 seconds duration (median, 13 episodes [range, 6–39] vs 2 episodes [range, 0–5]; р<0.01) decreased significantly during the automated period. Percentage of time with SpO2 >96% decreased during automated control (6.6%±4.4% vs 10.4±3.3%; p<0.02). There was no significant difference in FiO2 exposure. The area (deviation time) below and above the defined SctO2 threshold did not differ between the 2 periods (median, 59.7%×seconds [range, 17.2–208.3%] for manual vs 49.0%×seconds [range, 4.3–193.7%] for automated; p=0.36).

Conclusion. Automated FiO2 control in preterm infants with frequent SpO2 fluctuations significantly increased the time within the SpO2 target range and reduced the incidence of prolonged hypoxemic events compared with manual FiO2 adjustment, but did not significantly affect cerebral tissue oxygenation.

Review

Molecular genetic mechanisms of bronchopulmonary dysplasia development

Abstract
In the article an overview of recent data about basic molecular genetic mechanisms of bronchopulmonary dysplasia (BPD) are presented. The research results of possible BPD candidate genes in different patient populations, as well as information about the products of the genes and their role in the pathogenesis of BPD are presented.
Original research

Newborn heart rate contactless measurements

Abstract

We have developed a means of measuring heart rate, the distinguishing feature of which is the lack of direct contact with the body of the child. The principle of non-contact measurement of heart rate based on digital signal processing of photoplethysmography skin of the human face. The photoplethysmogram signal is recorded through a webcam and special software and algorithmic processing of the video image of the face. Testing tools for the measurement was conducted in the V.I. Kulakov Obstetrics, Gynecology and Perinatology Research Center. The absolute error measurement has been determined on the basis of the experiment, and amounted to 5 beats per minute in the frequency range from 100 to 160 beats per minute.

SHARING EXPERIENCES

Vitamin K deficiency bleeding in newborns and children during the first months of life

Abstract

The article is devoted to hemorrhagic disease of the newborn (HDN). Provides information on the biological role of vitamin K and its metabolism in newborn infants. Describes the incidence, causes and clinical symptoms of early, classical and late forms of the disease. Based on the review of national and foreign publications discussed matters of laboratory diagnosis, prevention and treatment HDN. Given the risk of life-threatening bleeding focuses on the need for maximum coverage of newborns prophylactic administration of vitamin K in accordance with the "Clinical guidelines for the diagnosis and treatment of hemorrhagic disease of the newborn", developed by the Association of Neonatologists (2015). Presents a clinical case of late form of the disease at the child who was exclusively breastfed and had not received prophylactic administration of vitamin K after birth.

Practical aspects of Kabrita Gold® milk formula usage as infant nutrition in neonatal hospital conditions

Abstract

Newborn nutrition is one of the fundamental factors that might influenсе newborn health, psychomotor development and intellectual potential. However, there are situations when breastfeeding is limited or not available. So some certain percentage of infants have to receive only infant formula or formula and breast milk. There were developed a range of goat milk nutrition formulas for newborns and infants in the past decades. These formulas have a number of advantages compared to cow milk infant nutrition. The aim goal of the work was to evaluate the efficiency and tolerance of Kabrita Gold® dry goat milk for infants with various conditions originating during perinatal period, which do not require clinical nutrition in hospital conditions.

Announcements

Announcements (# 3, 2015)

Abstract

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITOR
CHIEF EDITOR
Degtyarev Dmitriy Nikolaevich
Doctor of Medical Sciences, Professor, Deputy Director for Scientific Research of the V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Head of the Chair of Neonatology at the Clinical Institute of Children's Health named after N.F. Filatov, I.M. Sechenov First Moscow State Medical University, Chairman of the Ethics Committee of the Russian Society of Neonatologists, Moscow, Russian Federation

ORCID iD 0000-0001-8975-2425

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