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3. Repeated intravenous doses of human umbilical cord-derived mesenchymal stromal cells for bronchopulmonary dysplasia: results of a phase 1 clinical trial with 2-year follow-up

Author

Cerro Marín, Maria Jesús del, Ormazábal, Itziar Garcia, Gimeno-Navarro, Ana, Álvarez-Fuente, María, López-Ortego, Paloma, Avila-Alvarez, Alejandro, Arruza Gómez, Luis, González-Menchen, Cristina, Labrandero de Lera, Carlos, Lozano Balseiro, María, Moreno Gutiérrez, Laura, Melen Frajilich, Gustavo, Ramírez Orellana, Manuel, Saldaña García, Natalia, Pavón Delgado, Antonio, and Vento Torres, Máximo

Published
2024
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7. Variations in Neonatal Length of Stay of Babies Born Extremely Preterm: An International Comparison Between iNeo Networks

Author

Lui, Kei, Marshall, Peter, Schmidt, Peter, Dhawan, Anjali, Korostenski, Larissa, Travadi, Javeed Travadi, Sharp, Mary, Gill, Andy, Pillow, Jane, Stack, Jacqueline, Birch, Pita, Nothdurft, Karen, Cooke, Lucy, Casalaz, Dan, Holberton, Jim, Stewart, Alice, Downe, Lyn, Stewart, Michael, Berry, Andrew, Hunt, Rod, Morris, Peter, Paoli, Tony De, Bolisetty, Srinivas, Paradisis, Mary, Greenhalgh, Mark, Koorts, Pieter, Kuschel, Carl, Jacobs, Sue, Doyle, Lex, Craven, John, Numa, Andrew, Carlisle, Hazel, Badawi, Nadia, Popat, Himanshu, Koh, Guan, Davis, Jonathan, Luig, Melissa, Headley, Bevan, Andersen, Chad, Ng, Linda, Chambers, Georgina, Austin, Nicola, Lynn, Adrienne, Darlow, Brian, Edmonds, Liza, Mildenhall, Lindsay, Buksh, Mariam, Battin, Malcolm, Boom, Jutta van den, Richardson, Vaughan, Barker, David, Hammond, Barbara, Rajadurai, Victor Samuel, Lam, Simon, Fung, Genevieve, Shah, Prakesh S., Beltempo, Marc, Kanungo, Jaideep, Ting, Joseph, Cieslak, Zenon, Sherlock, Rebecca, Mehrem, Ayman Abou, Toye, Jennifer, Aziz, Khalid, Fajardo, Carlos, Bodani, Jaya, Strueby, Lannae, Seshia, Mary, Louis, Deepak, Alvaro, Ruben, Mukerji, Amit, Da Silva, Orlando, Adie, Mohammad, Lee, Kyong-Soon, Ng, Eugene, Lemyre, Brigitte, Daboval, Thierry, Khurshid, Faiza, Pelausa, Ermelinda, Barrington, Keith, Lapoint, Anie, Ethier, Guillaume, Drolet, Christine, Piedboeuf, Bruno, Claveau, Martine, St-Hilaire, Marie, Bertelle, Valerie, Masse, Edith, Canning, Roderick, Makary, Hala, Ojah, Cecil, Monterrosa, Luis, Emberley, Julie, Afifi, Jehier, Kajetanowicz, Andrzej, Lee, Shoo K., Metsäranta, Marjo, Lehtonen, Liisa, Tammela, Outi, Sankilampi, Ulla, Saarela, Timo, Morag, Iris, Zangen, Shmuel, Smolkin, Tatyana, Mimouni, Francis, Bader, David, Rothschild, Avi, Strauss, Zipora, Felszer, Clari, Omari, Hussam, Tov-Friedman, Smadar Even, Bar-Oz, Benjamin, Feldman, Michael, Saad, Nizar, Flidel-Rimon, Orna, Weisbrod, Meir, Lubin, Daniel, Litmanovitz, Ita, Kugelman, Amir, Shinwell, Eric, Klinger, Gil, Nijim, Yousif, Bin-Nun, Alona, Golan, Agneta, Mandel, Dror, Fleisher-Sheffer, Vered, Oron, Anat, Bakhrakh, Lev, Hattori, Satoshi, Shirai, Masaru, Ishioka, Toru, Mori, Toshihiko, Amizuka, Takasuke, Huchimukai, Toru, Yoshida, Hiroshi, Sasaki, Ayako, Shimizu, Junichi, Nakamura, Toshihiko, Maruyama, Mami, Matsumoto, Hiroshi, Hosokawa, Shinichi, Taki, Atsuko, Nakagawa, Machiko, Ko, Kyone, Uozumi, Azusa, Nakata, Setsuko, Shimazaki, Akira, Yoda, Tatsuya, Numata, Osamu, Imamura, Hiroaki, Kobayashi, Azusa, Tokuriki, Shuko, Uchida, Yasushi, Arai, Takahiro, Ito, Mitsuhiro, Ieda, Kuniko, Ono, Toshiyuki, Hayashi, Masashi, Maki, Kanemasa, Yamakawa, MieToru, Kawai, Masahiko, Fujii, Noriko, Shiomi, Kozue, Nozaki, Koji, Wada, Hiroshi, Kim, Taho, Tokunaga, Yasuyuki, Takatera, Akihiro, Oshima, Toshio, Sumida, Hiroshi, Michinomae, Yae, Kusumoto, Yoshio, Yoshimoto, Seiji, Morisawa, Takeshi, Ohashi, Tamaki, Takahashi, Yukihiro, Sugimoto, Moriharu, Ono, Noriaki, Miyagawa, Shinichiro, Saijo, Takahiko, Yamagami, Takashi, Koyano, Kosuke, Kobayashi, Shoko, Kanda, Takeshi, Sakemi, Yoshihiro, Aoki, Mikio, Iida, Koichi, Goshi, Mitsushi, Maruyama, Yuko, Avila-Alvarez, Alejandro, Fernandez-Trisac, José Luis, Pico, M<ce:sup loc='post">a</ce:sup> Luz Couce, Fernández Seara, María José, Gutiérrez, Andrés Martínez, Vizcaíno, Carolina, Iglesias, Miriam Salvador, Zaplana, Honorio Sánchez, Colomer, Belén Fernández, García López, José Enrique, Mozo, Rafael García, González Martínez, M. Teresa, Sebastián, M<ce:sup loc='post">a</ce:sup> Dolores Muro, Carbonell, Marta Balart, Barnusell, Joan Badia, Puiggròs, Mònica Domingo, Aloy, Josep Figueras, Mussons, Francesc Botet, Sanz, Israel Anquela, Galiana, Gemma Ginovart, Coroleu, W., Iriondo, Martin, Vilella, Laura Castells, Porta, Roser, Demestre, Xavier, Nadal, Silvia Martínez, de Frutos Martínez, Cristina, López Cuesta, María Jesús, Mora, Dolores Esquivel, Tardío, Joaquín Ortiz, Benavente, Isabel, Alonso, Almudena, Olmos, Ramón Aguilera, García Cabezas, Miguel A., Jiménez, M<ce:sup loc='post">a</ce:sup> Dolores Martínez, Caballero, M<ce:sup loc='post">a</ce:sup> Pilar Jaraba, Díaz, M<ce:sup loc='post">a</ce:sup> Dolores Ordoñez, Fagundo, Alberto Trujillo, Canals, Lluis Mayol, García-Muñoz Rodrigo, Fermín, Martí, Lourdes Urquía, Moreno Galdo, María Fernanda, Suazo, José Antonio Hurtado, López, Eduardo Narbona, Fernández, José Uberos, Cortajarena Altuna, Miguel A., Zuriarrain, Oihana Muga, Navarro, David Mora, Domínguez, María Teresa, Ruiz del Prado, M<ce:sup loc='post">a</ce:sup> Yolanda, Díez, Inés Esteban, Palau Benavides, María Teresa, Lapeña, Santiago, Prada, Teresa, Mir, Eduard Soler, Sánchez, Araceli Corredera, Vega, Enrique Criado, Prado, Náyade del, Fernández, Cristina, Vilaplana, Lucía Cabanillas, Pérez, Irene Cuadrado, Gómez, Luisa López, Comeche, Laura Domingo, Martín, Isabel Llana, Armengod, Carmen González, Labián, Carmen Muñoz, Muñoz, M<ce:sup loc='post">a</ce:sup> José Santos, Bravo, Dorotea Blanco, Pérez, Vicente, Fernández, M<ce:sup loc='post">a</ce:sup> Dolores Elorza, González, Celia Díaz, Segura, Susana Ares, Azorín, Manuela López, Jimenez, Ana Belén, Sánchez-Tamayo, Tomás, Moreno, Elías Tapia, González, María, Sánchez Martínez, José Enrique, Lloreda García, José María, Orayen, Concepción Goñi, González, Javier Vilas, Albo, María Suárez, Colmenero, Eva González, Gutiérrez González, Elena Pilar, Vacas del Arco, Beatriz, Fernández, Josefina Márquez, Gordillo, Laura Acosta, Asensio, Mercedes Granero, Díaz, Carmen Macías, Albújar, Mar, Jorge, Pedro Fuster, Romero, Sabina, Falero, Mónica Rivero, Escobar Izquierdo, Ana Belén, Capell, Javier Estañ, Macián, M<ce:sup loc='post">a</ce:sup> Isabel Izquierdo, Vicente, M<ce:sup loc='post">a</ce:sup> Mar Montejo, Caballero, Raquel Izquierdo, Martínez, M<ce:sup loc='post">a</ce:sup> Mercedes, Euba, Aintzane, Serna, Amaya Rodríguez, López de Heredia Goya, Juan María, Legorburu, Alberto Pérez, Amorós, Ana Gutiérrez, Marugán Isabel, Víctor Manuel, González, Natalio Hernández, Gracia, Segundo Rite, Faci, M<ce:sup loc='post">a</ce:sup> Purificación Ventura, Villagrasa, M<ce:sup loc='post">a</ce:sup> Pilar Samper, Kofron, Jiri, Brodd, Katarina Strand, Odlind, Andreas, Alberg, Lars, Arwehed, Sofia, Hafström, Ola, Kasemo, Anna, Nederman, Karin, Åhman, Lars, Ingemarsson, Fredrik, Petersson, Henrik, Thurn, Pernilla, Albinsson, Eva, Selander, Bo, Abrahamsson, Thomas, Heimdahl, Ingela, Sveinsdottir, Kristbjorg, Wejryd, Erik, Hedlund, Anna, Söderberg, Maria Katarina, Navér, Lars, Brune, Thomas, Bäckström, Jens, Robinson, Johan, Farooqi, Aijaz, Normann, Erik, Fredriksson, Magnus, Palm, Anders, Rosenqvist, Urban, Walde, Bengt, Hagman, Cecilia, Ohlin, Andreas, Florell, Rein, Smedsaas-Löfvenberg, Agneta, Adams, Mark, Meyer, Philipp, Kusche, Rachel, Schulzke, Sven, Nelle, Mathias, Wagner, Bendicht, Riedel, Thomas, Kaczala, Grégoire, Pfister, Riccardo E., Tolsa, Jean-François, Roth, Matthias, Stocker, Martin, Laubscher, Bernhard, Malzacher, Andreas, Micallef, John P., Hegi, Lukas, Bassler, Dirk, Arlettaz, Romaine, Bernet, Vera, Dani, Carlo, Fiorini, Patrizio, Ghirri, Paolo, Tomasini, Barbara, Mittal, Anita, Kefas, Jonathan, Kamalanathan, Anand, Grosdenier, Michael, Dewhurst, Christopher, Bontea, Andreea, Webb, Delyth, Garr, Ross, Hassan, Ahmed, Ambadkar, Priyadarshan, Dyke, Mark, McDevitt, Katharine, Rewitzky, Glynis, D'Amore, Angela, Kamath, P., Settle, Paul, Maddock, Natasha, Edi-Osagie, Ngozi, Zipitis, Christos, Heal, Carrie, Birch, Jacqeline, Hasib, Abdul, Soe, Aung, Abdul-Malik, Bushra, Kisat, Hamudi, Vasu, Vimal, Sivashankar, Savi, Gupta, Richa, Rawlingson, Chris, Wickham, Tim, Theron, Marice, Kendall, Giles, Gupta, Aashish, Aladangady, Narendra, Ali, Imdad, Jain, Neeraj, Mannan, Khalid, Murthy, Vadivelam, Sullivan, Caroline, Chuang, Shu-Ling, Bate, Tristan, Tyszcuzk, Lidia, Lee, Geraint, Obi, Ozioma, Chang, John, Pai, Vinay, Huddy, Charlotte, Yasin, Salim, Nicholl, Richard, Pandey, Poornima, Cusack, Jonathan, Kairamkonda, Venkatesh, Muogbo, Dominic, Harry, Liza, Surana, Pinki, Broggio, Penny, Pillay, Tilly, Deshpande, Sanjeev, Mahadevan, Moore, Alison, Bastani, Porus, Garbash, Mehdi, Lal, Mithilesh, Abu-Harb, Majd, Allwood, Alex, Selter, Michael, Munyard, Paul, Bartle, David, Paul, Siba, Whincup, Graham, Rekha, Sanghavi, Amess, Philip, Obi, Ben, Reynolds, Peter, Misra, Indranil, De Halpert, Peter, Salgia, Sanjay, Sanghavi, Rekha, Paul, Nicola, Deketelaere, Abby, Khashu, Minesh, Johnson, Mark, Groves, Charlotte, Baird, Jim, Brennan, Nick, Vamvakiti, Katia, McIntyre, John, Holman, Jennifer, Jones, Stephen, Pike, Alison, Cairns, Pamela, Eaton, Megan, Schwarz, Karin, Gibson, David, Miall, Lawrence, Krishnamurthy, Dr, Narayanan, Sankara, Seaton, Sarah E., Draper, Elizabeth S., Kusuda, Satoshi, Håkansson, Stellan, Helenius, Kjell, Reichman, Brian, Vento, Maximo, Darlow, Brian A., Rusconi, Franca, Isayama, Tetsuya, Norman, Mikael, Yang, Junmin, and Modi, Neena

Published
2021
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18. Preventing bronchopulmonary dysplasia: new tools for an old challenge

Author

Álvarez-Fuente, María, Moreno, Laura, Mitchell, Jane A., Reiss, Irwin K., Lopez, Paloma, Elorza, Dolores, Duijts, Liesbeth, Avila-Alvarez, Alejandro, Arruza, Luis, Ramirez Orellana, Manuel, Baraldi, Eugenio, Zaramella, Patrizia, Rueda, Santiago, Gimeno-Díaz de Atauri, Álvaro, Guimarães, Hercília, Rocha, Gustavo, Proença, Elisa, Thébaud, Bernard, and del Cerro, Maria Jesús

Published
2019
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28. Morbidity and Mortality of Very-Low-Birthweight Twin Infants according to Their Sex and the Sex of the Co-Twin: A Retrospective Cohort Study.

Author

García-Muñoz Rodrigo, Fermin, Urquía Martí, Lourdes, Zozaya Nieto, Carlos, Galán Henríquez, Gloria, Reyes Suárez, Desiderio, Avila-Alvarez, Alejandro, Figueras Aloy, Josep, and Vento, Maximo

Subjects
INFANTS, COHORT analysis, MULTIPLE pregnancy, FETOFETAL transfusion, TWINS, BRONCHOPULMONARY dysplasia
Abstract

Introduction: The concept of male disadvantage regarding the prognosis of premature newborns was introduced more than half a century ago, and it has been corroborated over time. However, the influence of the sex of one twin on the outcomes of the other has yielded contradictory results. Objective: The aim of the study was to determine if, in twin pregnancies of VLBW infants, the outcomes of one twin are modified by the sex of the co-twin. Methods: A multicentre retrospective study of a cohort of infants admitted to the collaborating units of the Spanish SEN1500 neonatal network was conducted. Liveborn VLBW twin infants, from 23+0 to 31+6 weeks of gestational age (GA), admitted from 2011 to 2020 were included. Outborn patients, infants with major congenital anomalies, and cases with only one twin admitted were excluded. The main outcomes were survival until first hospital discharge, survival without moderate or severe bronchopulmonary dysplasia (BPD), survival without major brain damage (MBD), and survival without major morbidity. Incidence rate ratios (IRR) and 95% confidence intervals (CI) were calculated. Results: 2,111 twin pairs were included. Male infants exhibited worse outcomes than females (IRR; 95% CI) regarding survival (0.96; 0.94, 0.98), survival without moderate or severe BPD (0.89; 0.86, 0.93), survival without MBD (0.94; 0.91, 0.97), and survival without major morbidity (0.87; 0.81, 0.93). Differences disappeared when the co-twin was a female infant: survival (1.00; 0.97, 1.03), survival without moderate or severe BPD (0.96; 0.91, 1.01), survival without MBD (0.99; 0.95, 1.04), and survival without major morbidity (0.94; 0.85, 1.03). Results for female infants did not change significantly with co-twin sex. Conclusions: Among VLBW twins from 23+0 to 31+6 weeks of GA, male infants have higher risk of morbidity and mortality overall. In cases of pregnancies with different-sex foetuses, males seem to improve their results, while these do not change for females. The underlying mechanism of this influence deserves further investigation. [ABSTRACT FROM AUTHOR]

Published
2023
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29. Sedation and analgesia practices in neonatal intensive care units (EUROPAIN): results from a prospective cohort study

Author

Carbajal, Ricardo, Eriksson, Mats, Courtois, Emilie, Boyle, Elaine, Avila-Alvarez, Alejandro, Andersen, Randi Dovland, Sarafidis, Kosmas, Polkki, Tarja, Matos, Cristina, Lago, Paola, Papadouri, Thalia, Montalto, Simon Attard, Ilmoja, Mari-Liis, Simons, Sinno, Tameliene, Rasa, van Overmeire, Bart, Berger, Angelika, Dobrzanska, Anna, Schroth, Michael, Bergqvist, Lena, Lagercrantz, Hugo, and Anand, Kanwaljeet J S

Published
2015
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34. Human Milk Feeding Is Associated with Decreased Incidence of Moderate-Severe Bronchopulmonary Dysplasia in Extremely Preterm Infants.

Author

Verd, Sergio, Porta, Roser, Ginovart, Gemma, Avila-Alvarez, Alejandro, García-Muñoz Rodrigo, Fermín, Izquierdo Renau, Montserrat, and Ventura, Paula Sol

Subjects
BRONCHOPULMONARY dysplasia prevention, BREAST milk, DISEASE incidence, GESTATIONAL age, TREATMENT duration, INFANT nutrition, RISK assessment, SEX distribution, ARTIFICIAL respiration, SEPSIS, BIRTH weight, BRONCHOPULMONARY dysplasia, NITRIC oxide, DISEASE risk factors
Abstract

Background: An increased rate of bronchopulmonary dysplasia (BPD) is reported in extremely preterm infants. A potential role of human milk feeding in protecting against this condition has been suggested. Methods: A retrospective descriptive study was conducted based on data about morbidity in the population of infants born between 22+0 and 26+6 weeks of gestation, included in the Spanish network SEN1500 during the period 2004–2019 and discharged alive. The primary outcome was moderate-severe BPD. Associated conditions were studied, including human milk feeding at discharge. The temporal trends of BPD and human milk feeding rates at discharge were also studied. Results: In the study population of 4341 infants, the rate of moderate-severe BPD was 43.7% and it increased to >50% in the last three years. The factors significantly associated with a higher risk of moderate-severe BPD were birth weight, male sex, high-frequency oscillatory ventilation, duration of invasive mechanical ventilation, inhaled nitric oxide, patent ductus arteriosus, and late-onset sepsis. Exclusive human milk feeding and any amount of human milk at discharge were associated with a lower incidence of moderate-severe BPD (OR 0.752, 95% CI 0.629–0.901 and OR 0.714, 95% CI 0.602–0.847, respectively). During the study period, the proportion of infants with moderate-severe BPD fed any amount of human milk at discharge increased more than twofold. And the proportion of infants with moderate-severe BPD who were exclusively fed human milk at discharge increased at the same rate. Conclusions: Our work shows an inverse relationship between human milk feeding at discharge from the neonatal unit and the occurrence of BPD. [ABSTRACT FROM AUTHOR]

Published
2023
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35. Birth order and morbidity and mortality to hospital discharge among inborn very low-birthweight, very preterm twin infants admitted to neonatal intensive care: a retrospective cohort study.

Author

Del Pino Hernández, Iris L., García Domínguez, María J., Urquía Martí, Lourdes, Reyes Suárez, Desiderio, Avila-Alvarez, Alejandro, and García-Muñoz Rodrigo, Fermín

Subjects
PREMATURE rupture of fetal membranes, NEONATAL sepsis, BIRTH order, NEONATAL intensive care, PREMATURE infants, HOSPITAL admission & discharge, HOSPITAL mortality
Published
2023
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38. Active approach in delivery room and survival of infants born between 22 and 26 gestational weeks are increasing in Spain.

Author

Porta, Roser, García‐Muñoz Rodrigo, Fermín, Avila‐Alvarez, Alejandro, Ventura, Paula Sol, Izquierdo Renau, Montserrat, and Ginovart, Gemma

Subjects
INFANTS, PREMATURE infants, DELIVERY (Obstetrics), TIME series analysis, SPANIARDS
Abstract

Aim: To describe the trends in the delivery room approach and survival of extremely premature infants over the past two decades. Methods: Time‐series analysis of infants included in the Spanish SEN1500 network from 2004 to 2019. Patients born from 22 + 0 to 26 + 6 weeks were included. The primary outcome was an active approach in the delivery room. Survival and temporal trends were also studied. Results: The study population included 8284 patients. At 22 and 23 weeks, an active approach was followed in 41.4% and 80.8%. A temporal trend toward a more active approach was observed at 23 weeks. Antenatal steroids were administered in 19.6% and 58.1% at 22 and 23 weeks. From 24 weeks, an active approach was applied in nearly all cases throughout the period, and more than 80% of patients received antenatal steroids. The rates of survival after an active approach were 8.7%, 21.6%, 40.6%, 59.9%, and 74.7% at 22, 23, 24, 25, and 26 weeks and significantly increased over the period, except for infants born at 22 weeks. Conclusion: Active management and survival of infants born from 23 weeks increased over the period, but the frequency of antenatal steroid administration was lower than the intention to resuscitate. [ABSTRACT FROM AUTHOR]

Published
2023
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39. The Respiratory Management of the Extreme Preterm in the Delivery Room.

Author

Escrig-Fernández, Raquel, Zeballos-Sarrato, Gonzalo, Gormaz-Moreno, María, Avila-Alvarez, Alejandro, Toledo-Parreño, Juan Diego, and Vento, Máximo

Subjects
AIRWAY (Anatomy), HOSPITAL birthing centers, PREGNANCY outcomes, ARTIFICIAL respiration, REACTIVE oxygen species, OXYGEN in the body
Abstract

The fetal-to-neonatal transition poses an extraordinary challenge for extremely low birth weight (ELBW) infants, and postnatal stabilization in the delivery room (DR) remains challenging. The initiation of air respiration and the establishment of a functional residual capacity are essential and often require ventilatory support and oxygen supplementation. In recent years, there has been a tendency towards the soft-landing strategy and, subsequently, non-invasive positive pressure ventilation has been generally recommended by international guidelines as the first option for stabilizing ELBW in the delivery room. On the other hand, supplementation with oxygen is another cornerstone of the postnatal stabilization of ELBW infants. To date, the conundrum concerning the optimal initial inspired fraction of oxygen, target saturations in the first golden minutes, and oxygen titration to achieve desired stability saturation and heart rate values has not yet been solved. Moreover, the retardation of cord clamping together with the initiation of ventilation with the patent cord (physiologic-based cord clamping) have added additional complexity to this puzzle. In the present review, we critically address these relevant topics related to fetal-to-neonatal transitional respiratory physiology, ventilatory stabilization, and oxygenation of ELBW infants in the delivery room based on current evidence and the most recent guidelines for newborn stabilization. [ABSTRACT FROM AUTHOR]

Published
2023
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41. Incidence, Risk Factors and Prediction of Secondary Hyperparathyroidism in Preterm Neonates under 32 Weeks' Gestational Age.

Author

Avila-Alvarez, Alejandro, Perez Tato, Helena, Sucasas Alonso, Andrea, Prado Carro, Ana, and Fuentes Carballal, Jesus

Abstract

In preterm newborns, secondary hyperparathyroidism (HPTH) is an underdiagnosed and undertreated entity. Its detection in the context of metabolic bone mineral disease (MBD) screening programs may be important to guide nutritional treatment. We designed a retrospective cohort study to determine the incidence of HPTH in very premature infants. As secondary objectives, we studied the risk factors, morbidities, and biochemical alterations associated with HPTH. A total of 154 preterm newborns ≤32 weeks gestational age (GA) were included. Of these, 40.3% (n = 62) presented with HPTH. In the multivariate analysis, independent risk factors for HPTH were cesarean section (OR: 4.00; 95% CI: 1.59–10.06), oxygen during resuscitation (OR: 3.43; 95% CI: 1.09–10.81), invasive mechanical ventilation (OR: 3.56; 95% CI: 1.63–7.77) and anemia requiring transfusion (OR: 2.37; 95% CI: 1.01–5.57). Among the analytical variables, serum calcium (OR: 0.53; 95% CI: 0.29–0.97), serum phosphate (OR: 2.01; 95% CI: 1.39–2.92), vitamin D (OR: 0.96; 95% CI: 0.93–1), and the calcium/creatinine ratio in urine (OR: 0.05; 95% CI: 0.01–0.28) were independently associated with HPTH. The simplified predictive model included GA and calcium/creatinine ratio in urine and demonstrated an AUC of 0.828. We concluded that HPTH is a frequent entity among very premature infants and that further studies are required to determine the role of HPTH in MBD and the clinical applicability of prediction models. [ABSTRACT FROM AUTHOR]

Published
2022
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43. Pain assessment during eye examination for retinopathy of prematurity screening: Skin conductance versus PIPP-R.

Author

Avila‐Alvarez, Alejandro, Pertega‐Diaz, Sonia, Vazquez Gomez, Lorena, Sucasas Alonso, Andrea, Romero Rey, Henar, Eiriz Barbeito, Dolores, Cabana Vazquez, Montserrat, Avila-Alvarez, Alejandro, and Pertega-Diaz, Sonia

Subjects
*RETROLENTAL fibroplasia, *EYE examination, *PREMATURE infants, *SKIN, *PAIN
Abstract

Aim: To assess changes in skin conductance during retinopathy of prematurity screening and to study the correlation between the skin conductance and a validated pain scale.Methods: Prospective observational study. Fifty-three eye examinations were performed in 32 preterm infant candidates for retinopathy of prematurity screening. Outcome measures were changes in Premature Infant Pain Profile-Revised (PIPP-R) scale and number of skin conductance fluctuations.Results: There was a significant increase from baseline in the number of skin conductance fluctuations and PIPP-R during the procedure. The maximum value of number of skin conductance fluctuations was 0.64 ± 0.44 peaks/sec, and the maximum value of PIPP-R was 10.8 ± 3.3. A correlation between the skin conductance and PIPP-R was not found at any time during the eye examination. Repeated measures correlation analyses showed only a moderate positive correlation between PIPP-R and number of skin conductance fluctuation values.Conclusion: There were significant changes in both PIPP-R and number of skin conductance fluctuations during retinopathy of prematurity screening, reaffirming that this procedure is painful and stressful. The number of skin conductance fluctuations and PIPP-R are not significantly correlated, which likely reflects that these parameters evaluate different but complementary aspects of neonatal pain responses. [ABSTRACT FROM AUTHOR]

Published
2020
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44. Incidence, Predictors and Outcomes of Noninvasive Ventilation Failure in Very Preterm Infants.

Author

Fernandez-Gonzalez, Sara M., Sucasas Alonso, Andrea, Ogando Martinez, Alicia, and Avila-Alvarez, Alejandro

Subjects
SURVIVAL, RESPIRATORY insufficiency, CEREBRAL hemorrhage, CONFIDENCE intervals, HEALTH outcome assessment, RETROSPECTIVE studies, GESTATIONAL age, DISEASE incidence, ARTIFICIAL respiration, RISK assessment, DESCRIPTIVE statistics, BRONCHOPULMONARY dysplasia, DATA analysis software, ODDS ratio, LONGITUDINAL method
Abstract

Non-invasive ventilation (NIV) is now considered the first-line treatment for respiratory distress syndrome in preterm infants. We aimed to evaluate the rates of non-invasive ventilation failure rate in very preterm infants, as well as to identify its predictors and associated outcomes. We designed a single-center retrospective cohort study including infants ≤32 weeks gestational age and ≤1500 g. The NIV failure was defined as the need for intubation at <72 h of life. After applying inclusion and exclusion criteria, 154 patients were included in the study, with a mean GA of 29.7 ± two weeks. The NIV failure rate was 16.2% (n = 25) and it was associated with lower bronchopulmonary dysplasia (BPD)-free survival (OR 0.08; 95% CI 0.02–0.32) and higher incidence of intraventricular hemorrhage > II (OR 6.22; 95% CI 1.36–28.3). These infants were significantly smaller in GA and weight. Higher FiO2 during resuscitation (OR 1.14; 95% CI 1.06–1.22) and after surfactant administration (OR 1.17; 95% CI 1.05–1.31) represented independent risk factors for NIV failure. In conclusion, NIV failure is frequent and it could be predicted by a higher oxygen requirement during resuscitation and a modest response to surfactant therapy. Importantly, this NIV failure is associated with worse clinical outcomes. [ABSTRACT FROM AUTHOR]

Published
2022
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45. Temporal trends in respiratory care and bronchopulmonary dysplasia in very preterm infants over a 10-year period in Spain.

Author

Avila-Alvarez, Alejandro, Zozaya, Carlos, Pértega-Diaz, Sonia, Sanchez-Luna, Manuel, Iriondo-Sanz, Martin, Elorza, Maria Dolores, García-Muñoz Rodrigo, Fermín, and Spanish Neonatal Network SEN1500

Subjects
BRONCHOPULMONARY dysplasia, PREMATURE infants, HOSPITAL birthing centers, NEONATAL intensive care units, POSITIVE pressure ventilation, POISSON regression, RESPIRATORY distress syndrome treatment, PREMATURE infant diseases, POSITIVE end-expiratory pressure, RETROSPECTIVE studies, SURVIVAL analysis (Biometry), INTERMITTENT positive pressure breathing
Abstract

Objective: To evaluate trends in respiratory care practices and bronchopulmonary dysplasia (BPD) among very preterm infants born in Spain between 2010 and 2019.Study Design: This was a retrospective cohort study of data obtained from a national population-based database (SEN1500 network). Changes in respiratory care and BPD-free survival of infants with gestational age (GA) of 230-316 weeks and <1500 g were assessed over two 5-year periods. Temporal trends were examined by joinpoint and Poisson regression models and expressed as the annual per cent change and adjusted relative risk (RR) for the change per year.Results: A total of 17 952 infants were included. In the second period, infants were less frequently intubated in the delivery room and during neonatal intensive care unit stay. This corresponded with an increase in use of non-invasive ventilation techniques. There were no significant differences between the periods in BPD-free survival or survival without moderate-to-severe BPD. After adjusting for covariates, the RR for the change per year was significant for the following variables: never intubated (RR 1.03, 95% CI 1.02 to 1.04); intubation in the delivery room (RR 0.98, 95% CI 0.97 to 0.99); use of nasal intermittent positive pressure ventilation (RR 1.08, 95% CI 1.05 to 1.11); and BPD-free survival (only in the group with the lowest GA; RR 0.98, 95% CI 0.97 to 0.99).Conclusion: Our findings reveal significant changes in respiratory care practices between 2009 and 2019. Despite an increase in use of non-invasive respiratory strategies, BPD-free survival did not improve and even worsened in the group with the lowest GA (230-256). [ABSTRACT FROM AUTHOR]

Published
2022
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47. Cohort study showed that growth rate increment has not been enough to prevent growth retardation of preterm infants and raised concerns about unbalanced growth.

Author

Zozaya, Carlos, Avila‐Alvarez, Alejandro, Couce, María L., García‐Muñoz Rodrigo, Fermín, Arruza, Luis, Fernandez‐Perez, Cristina, Castro, Abdón, Cuesta, María Teresa, Vacas, Beatriz, Vento, Máximo, Saenz de Pipaón, Miguel, Avila-Alvarez, Alejandro, García-Muñoz Rodrigo, Fermín, and Fernandez-Perez, Cristina

Subjects
*PREMATURE infants, *COHORT analysis, *WEIGHT gain, *GROWTH disorders
Abstract

Aim: We describe the postnatal weight gain, linear and head growth trends of surviving preterm infants from 2005 to 2017.Methods: Multicentre cohort study, including surviving preterm infants <32 weeks (n = 21 084), from the Spanish Neonatal Network database, without major congenital malformations who were less than 50 weeks postmenstrual age at discharge. Outcomes were weight gain (g/kg/day), linear and head growth (cm/week) and changes in weight, length and head circumference z-scores from birth to discharge. The study period was divided into 2005-8, 2009-11, 2012-14 and 2015-17.Results: Weight gain, linear growth and head growth were slightly higher in 2015-2017 than in 2005-2008: 12.2 ± 2.6 to 13.1 ± 2.5 g/kg/day, 0.98 ± 0.6 to 1.03 ± 0.6 cm/week and 0.76 ± 0.2 to 0.77 ± 0.3 cm/week, respectively. It was associated with a decreased fall in weigh, length and head circumference z-scores from birth to discharge (-1.32 ± 0.9 to -1.01 ± 0.84, -1.38 ± 1.2 to -1.18 ± 1.2 and -0.41 ± 1.2 to -0.33 ± 1.3, respectively).Conclusion: Postnatal growth restriction remained a common complication of prematurity despite some increment over the last years. Growth disproportionality seemed to be worsening as weight gain was increased more than linear growth. [ABSTRACT FROM AUTHOR]

Published
2019
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48. Documentation during neonatal resuscitation: a systematic review.

Author

Avila-Alvarez, Alejandro, Davis, Peter Graham, Kamlin, Camille Omar Farouk, and Thio, Marta

Subjects
CEREBRAL anoxia-ischemia, RESUSCITATION, DOCUMENTATION, DOCUMENTATION standards, NEONATAL intensive care, OXYGEN, NEONATAL intensive care units, ARTIFICIAL respiration, HEART beat, VIDEO recording
Abstract

Objective: Accurate documentation in healthcare is necessary for ethical, legal, research and quality improvement purposes. In this review, we aimed to evaluate the accuracy of methods of documentation of delivery room resuscitations.Methods: A systematic literature search in MEDLINE was conducted to identify original studies that reported the quality of documentation records during newborn resuscitation in the delivery room. Data extracted from the studies included population characteristics, methodology, documentation protocols, use of gold standard and main results (initial assessment of heart rate and peripheral oxygen saturation, respiratory support and supplementary oxygen).Results: In total, 197 records were screened after initial database search, of which seven studies met the inclusion criteria and were finally included in this review. Four studies were chart reviews and three studies compared conventional documentation methods with video recording. Only one study tested an intervention to improve documentation. Documentation was often inaccurate and important resuscitation events and interventions were poorly recorded. Lack of uniformity among studies preclude pooled analysis, but it seems that complex or advanced procedures were more accurately reported than basic interventions.Conclusions: There is little literature regarding accuracy of documentation during neonatal resuscitation, but current quality of documentation seems to be unsatisfactory. There is a need for consensus guidelines and innovative solutions in newborn resuscitation documentation. [ABSTRACT FROM AUTHOR]

Published
2021
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