Outcome prediction for late-onset sepsis after premature birth

Pediatric Research, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 17, 2025

Language: Английский

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Neonatal Shock: Current Dilemmas and Future Research Avenues

Children, Journal Year: 2025, Volume and Issue: 12(2), P. 128 - 128

Published: Jan. 24, 2025

Neonatal shock presents a complex clinical challenge and is one of the leading causes mortality. Traditionally, neonatal equated to hypotension, therapeutics are often initiated based on low blood pressure (BP) values alone. This fails address underlying goal optimizing tissue perfusion resulting in both over- under-treatment shock. Also, what defines normal BP neonates still contentious topic. Further, most appropriate way measuring with debated. Shock secondary transient circulatory instability patent ductus arteriosus, conditions that unique preterm neonates, have not been researched adequately. Treatment myocardial dysfunction perinatal asphyxia, cause mortality, conundrum. Quite similarly, there only handful controlled trials evaluating some other commonly encountered conditions, namely, septic hypoperfusion pulmonary hypertension. Even universally practiced intervention volume expansion crystalloid boluses backed by high-certainty evidence neonates. Though diagnostic modalities functional echocardiography near-infrared spectroscopy aided greatly management recent years, these proven be associated improved critical outcomes such as mortality major brain injury. To conclude, neonatologists rely limited evidence, mostly anecdotal, when treating review critically examines current respect various aspects an objective identify lacunae literature may fuel future research, eventually paving efficacious, safe evidence-based practice.

Language: Английский

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Fragile Flow: The Burden of Hypotension in Neonates on Cardio-Renal Pediatric Dialysis Emergency Machine (CARPEDIEM™)

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: May 5, 2025

Introduction: Infants and children with acute kidney injury requiring dialysis (AKI-D) historically used modified adult filters. The Cardio-Renal Pediatric Dialysis Emergency Machine (CARPEDIEM™) was designed for 2.5–10 kg. Hypotension is a known adverse event in pediatric continuous replacement therapy (CKRT), but its incidence on CARPEDIEM™ remains unknown. We aimed to assess the duration of hypotension receiving CKRT via compared matched controls Methods: conducted single-center retrospective case-control study neonates infants <10 kg CARPEDIEM™. Cases were by postmenstrual age (PMA), sex, vasoactive/inotropic use, mechanical ventilation, delivery mode. Mean arterial pressure (MAP) analyzed at 1-minute intervals over first 5 days therapy. Our primary outcome defined as MAP <3rd percentile PMA lasting ≥2 minutes. Results: included 34 patients (17 CARPEDIEM™, 17 controls). Median data collection 38.8 weeks (37.9–39.85); 53% male. All had daily hypotension, whereas highest cases day (82%). Total [2549 min (1500–3210) vs. 152 (34–820), p <0.01] episode [204 (153–271) 49 (9–110), significantly lower group. Conclusion: Patients incidence, though 82% still experienced our 5-day observation period. Future studies should explore risk factors associated development

Language: Английский

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Advocating for drug development in newborn infants

Early Human Development, Journal Year: 2024, Volume and Issue: 199, P. 106136 - 106136

Published: Oct. 30, 2024

Language: Английский

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