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3. Inhibition abilities and functional brain connectivity in school-aged term-born and preterm-born children

Author

Disselhoff, Vera, Jakab, Andras; https://orcid.org/0000-0001-6291-9889, Latal, Beatrice; https://orcid.org/0000-0003-1309-4790, Schnider, Barbara, Wehrle, Flavia M; https://orcid.org/0000-0001-5992-0424, Hagmann, Cornelia F; https://orcid.org/0000-0003-2647-9809, Held, Ulrike; https://orcid.org/0000-0003-3105-5840, O’Gorman, Ruth Tuura, Fauchere, Jean-Claude; https://orcid.org/0000-0001-8158-7410, Hüppi, Petra, Disselhoff, Vera, Jakab, Andras; https://orcid.org/0000-0001-6291-9889, Latal, Beatrice; https://orcid.org/0000-0003-1309-4790, Schnider, Barbara, Wehrle, Flavia M; https://orcid.org/0000-0001-5992-0424, Hagmann, Cornelia F; https://orcid.org/0000-0003-2647-9809, Held, Ulrike; https://orcid.org/0000-0003-3105-5840, O’Gorman, Ruth Tuura, Fauchere, Jean-Claude; https://orcid.org/0000-0001-8158-7410, and Hüppi, Petra

Abstract

Background Inhibition abilities are known to have impact on self-regulation, behavior, and academic success, and they are frequently impaired in children born preterm. We investigated the possible contributions of resting-state functional brain connectivity to inhibition following preterm birth. Methods Forty-four preterm and 59 term-born participants aged 8–13 years were administered two inhibition tasks and resting-state functional MRI was performed. Functional connectivity (FC) networks were compared between groups using network-based statistics. Associations of FCNs and inhibition abilities were investigated through multivariate linear regression models accounting for the interaction between birth status and inhibition. Results NBS revealed weaker FC in children born preterm compared to term-born peers in connections between motor and supplementary motor regions, frontal lobe, precuneus, and insula. Irrespective of birth status, connections between the cerebellum, frontal, and occipital lobes and inter-lobar, subcortical, intra-hemispheric long-range connections were positively correlated with one of the two inhibition tasks. Conclusions Preterm birth results in long-term alterations of FC at network level but these FCN alterations do not specifically account for inhibition problems in children born very preterm. Impact Irrespective of birth status, significant associations were found between the subdomain of response inhibition and functional connectivity in some subnetworks. A group comparisons of functional brain connectivity measured by rsfMRI in school-aged children born very preterm and at term. The investigation of network-level functional connectivity at rest does not appear adequate to explain differences in inhibition abilities between children born very preterm and at term, hence other imaging techniques might be more suited to explore the underlying neural mechanisms of inhibition abilities in school-aged children born very preterm.

Published
2024

5. Uncertainty and probability in neonatal end-of-life decision-making: analysing real-time conversations between healthcare professionals and families of critically ill newborns

Author

Limacher, Regula, Fauchere, Jean-Claude; https://orcid.org/0000-0001-8158-7410, Gubler, Deborah, Hendriks, Manya Jerina; https://orcid.org/0000-0001-7812-4909, Limacher, Regula, Fauchere, Jean-Claude; https://orcid.org/0000-0001-8158-7410, Gubler, Deborah, and Hendriks, Manya Jerina; https://orcid.org/0000-0001-7812-4909

Abstract

BACKGROUND A significant number of critically ill neonates face potentially adverse prognoses and outcomes, with some of them fulfilling the criteria for perinatal palliative care. When counselling parents about the critical health condition of their child, neonatal healthcare professionals require extensive skills and competencies in palliative care and communication. Thus, this study aimed to investigate the communication patterns and contents between neonatal healthcare professionals and parents of neonates with life-limiting or life-threatening conditions regarding options such as life-sustaining treatment and palliative care in the decision-making process. METHODS A qualitative approach to analysing audio-recorded conversations between neonatal team and parents. Eight critically ill neonates and a total of 16 conversations from two Swiss level III neonatal intensive care units were included. RESULTS Three main themes were identified: the weight of uncertainty in diagnosis and prognosis, the decision-making process, and palliative care. Uncertainty was observed to impede the discussion about all options of care, including palliative care. Regarding decision-making, neonatologists oftentimes conveyed to parents that this was a shared endeavour. However, parental preferences were not ascertained in the conversations analysed. In most cases, healthcare professionals were leading the discussion and parents expressed their opinion reactively to the information or options received. Only few couples proactively participated in decision-making. The continuation of therapy was often the preferred course of action of the healthcare team and the option of palliative care was not mentioned. However, once the option for palliative care was raised, the parents' wishes and needs regarding the end-of-life care of their child were obtained, respected, and implemented by the team. CONCLUSION Although shared decision-making was a familiar concept in Swiss neonatal intensive care u

Published
2023

6. Prediction of Late Death or Disability at Age 5 Years Using a Count of 3 Neonatal Morbidities in Very Low Birth Weight Infants

Author

Schmidt, Barbara, D'Ilario, Judy, Cairnie, Janice, Dix, Joanne, Adams, Beth Anne, Warriner, Erin, Marie Kim, Mee-Hai, Anderson, Peter, Davis, Peter, Doyle, Lex, Argus, Brenda, Callanan, Catherine, Davis, Noni, Duff, Julianne, McDonald, Marion, Asztalos, Elizabeth, Hohn, Denise, Lacy, Maralyn, Haslam, Ross, Barnett, Christopher, Goodchild, Louise, Lontis, Rosslyn Marie, Fraser, Simon, Keng, Julie, Saunders, Kerryn, Opie, Gillian, Kelly, Elaine, Woods, Heather, Marchant, Emma, Turner, Anne-Marie, Magrath, Emma, Williamson, Amanda, Bairam, Aida, Bélanger, Sylvie, Fraser, Annie, Blayney, Marc, Lemyre, Brigitte, Frank, Jane, Solimano, Alfonso, Synnes, Anne, Grunau, Ruth E., Hubber-Richard, Philippa, Rogers, Marilyn, Mackay, Margot, Petrie-Thomas, Julianne, Butt, Arsalan, van Wassenaer, Aleid, Nuytemans, Debbie, Houtzager, Bregje, van Sonderen, Loekie, Regev, Rivka, Itzchack, Netter, Arnon, Shmuel, Chalaf, Adiba, Ohlsson, Arne, O'Brien, Karel, Hamilton, Anne-Marie, Chan, May Lee, Sankaran, Koravangattu, Proctor, Pat, Golan, Agneta, Goldsch-Lerman, Esther, Reynolds, Graham, Dromgool, Barbara, Meskell, Sandra, Parr, Vanessa, Maher, Catherine, Broom, Margaret, Kecskes, Zsuzsoka, Ringland, Cathy, McMillan, Douglas, Spellen, Elizabeth, Sauve, Reginald S., Christianson, Heather, Anseeuw-Deeks, Deborah, Creighton, Dianne, Heath, Jennifer, Alvaro, Ruben, Chiu, Aaron, Porter, Ceceile, Turner, Gloria, Moddemann, Diane, Granke, Naomi, Penner, Karen, Bow, Jane, Mulder, Antonius, Wassenberg, Renske, van der Hoeven, Markus, Clarke, Maxine, Parfitt, Judy, Parker, Kevin, Nwaesei, Chukwuma, Ryan, Heather, Saunders, Cory, Schulze, Andreas, Wermuth, Inga, Hilgendorff, Anne, Flemmer, Andreas W., Herlenius, Eric, Legnevall, Lena, Lagercrantz, Hugo, Matthew, Derek, Amos, Wendy, Tulsiani, Suresh, Tan-Dy, Cherrie, Turner, Marilyn, Phelan, Constance, Shinwell, Eric S., Levine, Michael, Juster-Reicher, Ada, Khairy, May, Grier, Patricia, Vachon, Julie, Perepolkin, Larissa, Barrington, Keith J., Sinha, Sunil Kumar, Tin, Win, Fritz, Susan, Walti, Herve, Royer, Diane, Halliday, Henry, Millar, David, Mayes, Clifford, McCusker, Christopher, McLaughlin, Olivia, Fahnenstich, Hubert, Tillmann, Bettina, Weber, Peter, Wariyar, Unni, Embleton, Nicholas, Swamy, Ravi, Bucher, Hans U., Fauchere, Jean-Claude, Dietz, Vera, Harikumar, Chidambara, Anderson, Peter J., Asztalos, Elizabeth V., Davis, Peter G., Dewey, Deborah, Doyle, Lex W., Roberts, Robin S., Gent, Michael, Fraser, William, Hey, Edmund, Perlman, Max, Thorpe, Kevin, Gray, Shari, Chambers, Carole, Costantini, Lorrie, Yacura, Wendy, McGean, Erin, and Scapinello, Lori

Published
2015
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8. Social Variables Predict Gains in Cognitive Scores across the Preschool Years in Children with Birth Weights 500 to 1250 Grams

Author

Schmidt, Barbara, D'Ilario, Judy, Cairnie, Janice, Dix, Joanne, Anne Adams, Beth, Warriner, Erin, Kim, Mee-Hai Marie, Anderson, Peter, Davis, Peter, Doyle, Lex, Argus, Brenda, Callanan, Catherine, Davis, Noni, Duff, Julianne, McDonald, Marion, Asztalos, Elizabeth, Hohn, Denise, Lacy, Maralyn, Haslam, Ross, Barnett, Christopher, Goodchild, Louise, Lontis, Rosslyn Marie, Fraser, Simon, Keng, Julie, Saunders, Kerryn, Opie, Gillian, Kelly, Elaine, Woods, Heather, Marchant, Emma, Turner, Anne-Marie, Magrath, Emma, Williamson, Amanda, Bairam, Aida, Bélanger, Sylvie, Fraser, Annie, Blayney, Marc, Lemyre, Brigitte, Frank, Jane, Solimano, Alfonso, Synnes, Anne, Grunau, Ruth E., Hubber-Richard, Philippa, Rogers, Marilyn, Mackay, Margot, Petrie-Thomas, Julianne, Butt, Arsalan, van Wassenaer, Aleid, Nuytemans, Debbie, Houtzager, Bregje, van Sonderen, Loekie, Regev, Rivka, Itzchack, Netter, Arnon, Shmuel, Chalaf, Adiba, Ohlsson, Arne, O'Brien, Karel, Hamilton, Anne-Marie, Chan, May Lee, Sankaran, Koravangattu, Proctor, Pat, Golan, Agneta, Goldsch-Lerman, Esther, Reynolds, Graham, Dromgool, Barbara, Meskell, Sandra, Parr, Vanessa, Maher, Catherine, Broom, Margaret, Kecskes, Zsuzsoka, Ringland, Cathy, McMillan, Douglas, Spellen, Elizabeth, Sauve, Reginald S., Christianson, Heather, Anseeuw-Deeks, Deborah, Creighton, Dianne, Heath, Jennifer, Alvaro, Ruben, Chiu, Aaron, Porter, Ceceile, Turner, Gloria, Moddemann, Diane, Granke, Naomi, Penner, Karen, Bow, Jane, Mulder, Antonius, Wassenberg, Renske, van der Hoeven, Markus, Clarke, Maxine, Parfitt, Judy, Parker, Kevin, Nwaesei, Chukwuma, Ryan, Heather, Saunders, Cory, Schulze, Andreas, Wermuth, Inga, Hilgendorff, Anne, Flemmer, Andreas W., Herlenius, Eric, Legnevall, Lena, Lagercrantz, Hugo, Matthew, Derek, Amos, Wendy, Tulsiani, Suresh, Tan-Dy, Cherrie, Turner, Marilyn, Phelan, Constance, Shinwell, Eric S., Levine, Michael, Juster-Reicher, Ada, Khairy, May, Grier, Patricia, Vachon, Julie, Perepolkin, Larissa, Barrington, Keith J., Sinha, Sunil Kumar, Tin, Win, Fritz, Susan, Walti, Herve, Royer, Diane, Halliday, Henry, Millar, David, Mayes, Clifford, McCusker, Christopher, McLaughlin, Olivia, Fahnenstich, Hubert, Tillmann, Bettina, Weber, Peter, Wariyar, Unni, Embleton, Nicholas, Swamy, Ravi, Bucher, Hans U., Fauchere, Jean-Claude., Dietz, Vera, Harikumar, Chidambara, Anderson, Peter J., Asztalos, Elizabeth V., Davis, Peter G., Dewey, Deborah, Doyle, Lex W., Roberts, Robin S., Gent, Michael, Fraser, William, Hey, Edmund, Perlman, Max, Thorpe, Kevin, Gray, Shari, Chambers, Carole, Costantini, Lorrie, Yacura, Wendy, McGean, Erin, Scapinello, Lori, Manley, Brett J., Böhm, Birgitta, and van Wassenaer-Leemhuis, Aleid G.

Published
2015
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11. Variability of Cerebral Hemoglobin Concentration in Very Preterm Infants During the First 6 Hours of Life

Author

von Siebenthal, Kurt, Keel, Matthias, Fauchère, Jean-Claude, Dietz, Vera, Haensse, Daniel, Wolf, Ursula, Helfenstein, Urs, Bänziger, Oskar, Bucher, Hans U., Wolf, Martin, Back, Nathan, editor, Cohen, Irun R., editor, Kritchevsky, David, editor, Lajtha, Abel, editor, Paoletti, Rodolfo, editor, Okunieff, Paul, editor, Williams, Jacqueline, editor, and Chen, Yuhchyau, editor

Published
2005
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12. Safety and Short-term Outcomes of High-Dose Erythropoietin in Preterm Infants With Intraventricular Hemorrhage: The EpoRepair Randomized Clinical Trial

Author

Wellmann, Sven, Hagmann, Cornelia F; https://orcid.org/0000-0003-2647-9809, von Felten, Stefanie; https://orcid.org/0000-0002-5264-6394, Held, Leonard, Klebermass-Schrehof, Katrin, Truttmann, Anita C, Knöpfli, Claudia, Fauchere, Jean-Claude; https://orcid.org/0000-0001-8158-7410, Bührer, Christoph, Bucher, Hans Ulrich; https://orcid.org/0000-0003-4458-1161, Rüegger, Christoph M; https://orcid.org/0000-0003-1496-2625, Wellmann, Sven, Hagmann, Cornelia F; https://orcid.org/0000-0003-2647-9809, von Felten, Stefanie; https://orcid.org/0000-0002-5264-6394, Held, Leonard, Klebermass-Schrehof, Katrin, Truttmann, Anita C, Knöpfli, Claudia, Fauchere, Jean-Claude; https://orcid.org/0000-0001-8158-7410, Bührer, Christoph, Bucher, Hans Ulrich; https://orcid.org/0000-0003-4458-1161, and Rüegger, Christoph M; https://orcid.org/0000-0003-1496-2625

Abstract

IMPORTANCE Intraventricular hemorrhage (IVH) is a major cause of neonatal morbidity and mortality in preterm infants without a specific medical treatment to date. OBJECTIVE To assess the safety and short-term outcomes of high-dose erythropoietin in preterm infants with IVH. DESIGN, SETTING, AND PARTICIPANTS Between April 1, 2014, and August 3, 2018, a randomized double-blind clinical trial enrolled 121 preterm infants (gestational age <32 weeks or birth weight <1500 g) aged 8 or less days with moderate to severe IVH identified by cerebral ultrasonography from 8 Swiss and Austrian tertiary neonatal units. Statistical analyses were performed between October 1, 2019, and September 12, 2022. INTERVENTIONS Infants received intravenous high-dose erythropoietin (2000 units/kg body weight) or placebo at 4 time points between weeks 1 and 4 of life. MAIN OUTCOMES AND MEASURES Secondary outcomes included (1) mortality and morbidity rates and (2) brain magnetic resonance imaging findings at term-equivalent age (TEA). The primary outcome was the composite intelligence quotient at 5 years of age (not available before 2023). RESULTS Sixty infants (48% male [n = 29]) were randomly assigned to receive erythropoietin, and 61 infants (61% male [n = 37]) were randomly assigned to receive placebo. The median birth weight was 832 g (IQR, 687-990 g) in the erythropoietin group and 870 g (IQR, 680-1110 g) in the placebo group. Median gestation was 26.1 weeks (IQR, 24.8-27.3 weeks) in the erythropoietin group and 27.0 weeks (24.9-28.1 weeks) in the placebo group. The 2 groups had similar baseline characteristics and morbidities. Up to TEA, 10 newborns died (16.7%) in the erythropoietin group, and 5 newborns (8.2%) died in the placebo group (adjusted odds ratio, 2.24 [95% CI, 0.74-7.66]; P = .15). Infants receiving erythropoietin had higher mean hematocrit levels. Conventional magnetic resonance imaging at TEA for 100 infants showed no significant differences in global or regional brain inju

Published
2022

14. Predicting severe motor impairment in preterm children at age 5 years

Author

Synnes, Anne, Anderson, Peter J, Grunau, Ruth E, Dewey, Deborah, Moddemann, Diane, Tin, Win, Davis, Peter G, Doyle, Lex W, Foster, Gary, Khairy, May, Nwaesei, Chukwuma, Schmidt, Barbara, DʼIlario, Judy, Cairnie, Janice, Dix, Joanne, Adams, Beth Anne, Warriner, Erin, Kim, Mee-Hai Marie, Argus, Brenda, Callanan, Catherine, Davis, Noni, Duff, Julianne, McDonald, Marion, Asztalos, Elizabeth, Hohn, Denise, Lacy, Maralyn, Haslam, Ross, Barnett, Christopher, Goodchild, Louise, Lontis, Rosslyn Marie, Fraser, Simon, Keng, Julie, Saunders, Kerryn, Opie, Gillian, Kelly, Elaine, Woods, Heather, Marchant, Emma, Turner, Anne-Marie, Magrath, Emma, Williamson, Amanda, Bairam, Aida, Bélanger, Sylvie, Fraser, Annie, Blayney, Marc, Lemyre, Brigitte, Frank, Jane, Solimano, Alfonso, Hubber-Richard, Philippa, Rogers, Marilyn, Mackay, Margot, Petrie-Thomas, Julianne, Butt, Arsalan, van Wassenaer, Aleid, Nuytemans, Debbie, Houtzager, Bregje, van Sonderen, Loekie, Regev, Rivka, Itzchack, Netter, Arnon, Shmuel, Chalaf, Adiba, Ohlsson, Arne, OʼBrien, Karel, Hamilton, Anne-Marie, Chan, May Lee, Sankaran, Koravangattu, Proctor, Pat, Golan, Agneta, Goldsch-Lerman, Esther, Reynolds, Graham, Dromgool, Barbara, Meskell, Andra, Parr, Vanessa, Maher, Catherine, Broom, Margaret, Kecskes, Zsuzsoka, Ringland, Cathy, McMillan, Douglas, Spellen, Elizabeth, Sauve, Reginald S, Christianson, Heather, Anseeuw-Deeks, Deborah, Creighton, Dianne, Heath, Jennifer, Alvaro, Ruben, Chiu, Aaron, Porter, Ceceile, Turner, Gloria, Granke, Naomi, Penner, Karen, Bow, Jane, Mulder, Antonius, Wassenberg, Renske, van der Hoeven, Markus, Clarke, Maxine, Parfitt, Judy, Parker, Kevin, Ryan, Heather, Saunders, Cory, Schulze, Andreas, Wermuth, Inga, Hilgendorff, Anne, Flemmer, Andreas W, Herlenius, Eric, Legnevall, Lena, Lagercrantz, Hugo, Matthew, Derek, Amos, Wendy, Tulsiani, Suresh, Tan-Dy, Cherrie, Turner, Marilyn, Phelan, Constance, Shinwell, Eric S, Levine, Michael, Juster-Reicher, Ada, Grier, Patricia, Vachon, Julie, Perepolkin, Larissa, Barrington, Keith J, Sinha, Sunil Kumar, Fritz, Susan, Walti, Herve, Royer, Diane, Halliday, Henry, Millar, David, Mayes, Clifford, McCusker, Christopher, McLaughlin, Olivia, Fahnenstich, Hubert, Tillmann, Bettina, Weber, Peter, Wariyar, Unni, Embleton, Nicholas, Swamy, Ravi, Bucher, Hans U, Fauchere, Jean-Claude, Dietz, Vera, Harikumar, Chidambara, Anderson, Peter J, Asztalos, Elizabeth V, Barrington, Keith J, Davis, Peter G, Doyle, Lex W, Ohlsson, Arne, Solimano, Alfonso, Gent, Michael, Fraser, William, Hey, Edmund, Thorpe, Kevin, Gray, Shari, Roberts, Robin S, Chambers, Carole, Costantini, Lorrie, Yacura, Wendy, McGean, Erin, and Scapinello, Lori

Published
2015
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16. National Divergences in Perinatal Palliative Care Guidelines and Training in Tertiary NICUs

Author

Boan Pion, Antonio, Baenziger, Julia, Fauchere, Jean-Claude; https://orcid.org/0000-0001-8158-7410, Gubler, Deborah, Hendriks, Manya Jerina; https://orcid.org/0000-0001-7812-4909, Boan Pion, Antonio, Baenziger, Julia, Fauchere, Jean-Claude; https://orcid.org/0000-0001-8158-7410, Gubler, Deborah, and Hendriks, Manya Jerina; https://orcid.org/0000-0001-7812-4909

Abstract

Objectives: Despite established principles of perinatal palliative care (PnPC), implementation into practice has shown inconsistencies. The aim of this study was to assess PnPC services, examine healthcare professionals (HCPs) awareness and availability of PnPC guidelines, and describe HCPs satisfaction with PC and guidelines. Material and Methods: A nationwide survey was conducted in Swiss tertiary NICUs between April-November 2019. Data were examined by descriptive statistics and linear regression models. Results: Overall response rate was 54% (65% physicians; 49% nurses; 72% psychosocial staff). Half of professionals (50%) received education in PC during their medical/nursing school, whereas 36% indicated they obtained further training in PnPC at their center. PnPC guidelines were available in 4/9 centers, with 68% HCPs being aware of the guideline. Professionals who had access to a PnPC team (P = 0.001) or were part of the nursing (P = 0.003) or psychosocial staff (P = 0.001) were more likely aware of having a guideline. Twenty-eight percent indicated being satisfied with PC in their center. Professionals with guideline awareness (P = 0.025), further training (P = 0.001), and access to a PnPC team (P < 0.001) were more likely to be satisfied, whereas HCPs with a nursing background (P < 0.001) were more likely to be dissatisfied. A majority expressed the need for a PnPC guideline (80%) and further PC training (94%). Conclusion: This study reveals lacking PnPC guidelines and divergences regarding onsite opportunities for continued training across Swiss level III NICUs. Extending PnPC guidelines and training services to all centers can help bridge the barriers created by fragmented practice.

Published
2021

17. An approach to using recombinant erythropoietin for neuroprotection in very preterm infants

Author

Fauchere, Jean-Claude, Dame, Christof, Vonthein, Reinhard, Koller, Brigitte, Arri, Sandra, Wolf, Martin, and Bucher, Hans Ulrich

Subjects
Erythropoietin, Recombinant -- Dosage and administration, Erythropoietin, Recombinant -- Research, Infants (Premature) -- Drug therapy, Infants (Premature) -- Research, Brain -- Injuries, Brain -- Prevention
Published
2008

18. The influence of the timing of cord clamping on postnatal cerebral oxygenation in preterm neonates: a randomized, controlled trial

Author

Baenziger, Oskar, Stolkin, Florian, Keel, Mathias, von Siebenthal, Kurt, Fauchere, Jean-Claude, Das Kundu, Seema, Dietz, Vera, Bucher, Hans-Ulrich, and Wolf, Martin

Subjects
Postnatal care -- Methods, Infants (Premature) -- Diseases, Infants (Premature) -- Risk factors, Infants (Premature) -- Care and treatment, Infants (Premature) -- Analysis, Children -- Health aspects, Clinical trials
Abstract

OBJECTIVE. Our goal was to investigate the effect of placentofetal transfusion on cerebral oxygenation in preterm infants by near-infrared spectroscopy. SUBJECTS. A total of 39 preterm infants with a median gestational age of 30.4 weeks were randomly assigned to an experiment group (n = 15) and a control group (n = 24). INTERVENTIONS. The delivery of the infants in the experiment group was immediately followed by maternal administration of syntocinon, the infant was placed 15 cm below the placenta, and cord clamping was delayed by 60 to 90 seconds. The infants in the control group were delivered conventionally. At the ages of 4 and 24 hours, cerebral hemoglobin concentrations, cerebral blood volume, and regional tissue oxygenation were measured by near-infrared spectroscopy. RESULTS. Cerebral blood volume was not different between the 2 groups at the age of 4 hours (6.1 vs 5.8 mL/100 g of tissue) nor at the age of 24 hours (6.2 vs 6.2 mL/100 g of tissue). Mean regional tissue oxygenation of the experiment group was higher at the ages of 4 hours (69.9% vs 65.5%) and of 24 hours (71.3% vs 68.1%). CONCLUSION. Delayed clamping of the umbilical cord improves cerebral oxygenation in preterm infants in the first 24 hours., IN RECENT YEARS, delayed cord clamping and placentofetal transfusion (PFT) was advocated to reduce the rate of blood transfusion and improve hemodynamic stability by increasing the intravascular blood volume in [...]

Published
2007

19. Social Variables Predict Gains in Cognitive Scores across the Preschool Years in Children with Birth Weights 500 to 1250 Grams

Author

Manley, Brett J., Roberts, Robin S., Doyle, Lex W., Schmidt, Barbara, Anderson, Peter J., Barrington, Keith J., Böhm, Birgitta, Golan, Agneta, van Wassenaer-Leemhuis, Aleid G., Davis, Peter G., Schmidt, Barbara, DʼIlario, Judy, Cairnie, Janice, Dix, Joanne, Adams, Beth Anne, Warriner, Erin, Kim, Mee-Hai Marie, Anderson, Peter, Davis, Peter, Doyle, Lex, Argus, Brenda, Callanan, Catherine, Davis, Noni, Duff, Julianne, McDonald, Marion, Asztalos, Elizabeth, Hohn, Denise, Lacy, Maralyn, Haslam, Ross, Barnett, Christopher, Goodchild, Louise, Lontis, Rosslyn Marie, Fraser, Simon, Keng, Julie, Saunders, Kerryn, Opie, Gillian, Kelly, Elaine, Woods, Heather, Marchant, Emma, Turner, Anne-Marie, Magrath, Emma, Williamson, Amanda, Bairam, Aida, Bélanger, Sylvie, Fraser, Annie, Blayney, Marc, Lemyre, Brigitte, Frank, Jane, Solimano, Alfonso, Synnes, Anne, Grunau, Ruth E., Hubber-Richard, Philippa, Rogers, Marilyn, Mackay, Margot, Petrie-Thomas, Julianne, Butt, Arsalan, van Wassenaer, Aleid, Nuytemans, Debbie, Houtzager, Bregje, van Sonderen, Loekie, Regev, Rivka, Itzchack, Netter, Arnon, Shmuel, Chalaf, Adiba, Ohlsson, Arne, OʼBrien, Karel, Hamilton, Anne-Marie, Chan, May Lee, Sankaran, Koravangattu, Proctor, Pat, Goldsch-Lerman, Esther, Reynolds, Graham, Dromgool, Barbara, Meskell, Sandra, Parr, Vanessa, Maher, Catherine, Broom, Margaret, Kecskes, Zsuzsoka, Ringland, Cathy, McMillan, Douglas, Spellen, Elizabeth, Sauve, Reginald S., Christianson, Heather, Anseeuw-Deeks, Deborah, Creighton, Dianne, Heath, Jennifer, Alvaro, Ruben, Chiu, Aaron, Porter, Ceceile, Turner, Gloria, Moddemann, Diane, Granke, Naomi, Penner, Karen, Bow, Jane, Mulder, Antonius, Wassenberg, Renske, van der Hoeven, Markus, Clarke, Maxine, Parfitt, Judy, Parker, Kevin, Nwaesei, Chukwuma, Ryan, Heather, Saunders, Cory, Schulze, Andreas, Wermuth, Inga, Hilgendorff, Anne, Flemmer, Andreas W., Herlenius, Eric, Legnevall, Lena, Lagercrantz, Hugo, Matthew, Derek, Amos, Wendy, Tulsiani, Suresh, Tan-Dy, Cherrie, Turner, Marilyn, Phelan, Constance, Shinwell, Eric S., Levine, Michael, Juster-Reicher, Ada, Khairy, May, Grier, Patricia, Vachon, Julie, Perepolkin, Larissa, Barrington, Keith J., Sinha, Sunil Kumar, Tin, Win, Fritz, Susan, Walti, Herve, Royer, Diane, Halliday, Henry, Millar, David, Mayes, Clifford, McCusker, Christopher, McLaughlin, Olivia, Fahnenstich, Hubert, Tillmann, Bettina, Weber, Peter, Wariyar, Unni, Embleton, Nicholas, Swamy, Ravi, Bucher, Hans U., Fauchere, Jean-Claude., Dietz, Vera, Harikumar, Chidambara, Asztalos, Elizabeth V., Dewey, Deborah, Moddemann, Diane, Gent, Michael, Fraser, William, Hey, Edmund, Perlman, Max, Thorpe, Kevin, Gray, Shari, Chambers, Carole, Costantini, Lorrie, Yacura, Wendy, McGean, Erin, and Scapinello, Lori

Published
2015
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20. Hepatitis C virus in breast milk

Author

Zimmermann, Roland, Perucchini, Daniele, Fauchere, Jean-Claude, Joller-Jemelka, Helena, Geyer, Martin, Huch, Renate, and Huch, Albert

Published
1995

22. Special considerations for stage IV melanoma during pregnancy

Author

Beyeler, Mirjam, Hafner, Jurg, Beinder, Ernst, Fauchere, Jean-Claude, Stoeckli, Sandro J., Fehr, Mathias, and Dummer, Reinhard

Subjects
Melanoma -- Case studies, Pregnancy, Complications of -- Case studies, Tumor staging -- Evaluation, Health
Published
2005

23. Right atrial pressure as measure of ventricular constraint in newborn lambs

Author

FAUCHERE, JEAN-CLAUDE, WALKER, ADRIAN M., SKUZA, ELIZABETH M., and GRANT, DANIEL A.

Subjects
Lambs -- Research, Heart -- Medical examination, Infants (Newborn) -- Medical examination, Biological sciences
Abstract

Although the lungs and pericardium constrain the heart and limit cardiac output, no method exists to assess this constraint in sick newborns. We hypothesize that a useful estimate of ventricular constraint may be obtained by measuring right atrial pressure ([P.sub.RA]) in the newborn. To test this hypothesis, we measured [P.sub.RA], thoracic inferior vena caval pressure ([P.sub.IVC]; saline-filled catheters), and ventricular constraint (pericardial pressure, [P.sub.PER]; liquid-containing balloon) in 4-wk-old (neonatal, n = 12) and 3-day-old (newborn, n = 6) anesthetized lambs. The measurements were made while LV filling pressure was altered (0-20 mmHg) and while positive end-expiratory pressure (PEEP) was maintained at 2.5 or 15 cm[H.sub.2]O. In all of the lambs, a strong linear relationship (r) existed between [P.sub.RA] and [P.sub.PER] ([P.sub.RA] = 1.19 [P.sub.PER] + 0.0, r = 0.99) and between [P.sub.IVC and [P.sub.PER] ([P.sub.IVC] = 1.24 [P.sub.PER] + 0.1, r = 0.99; PEEP of 2.5 cm[H.sub.2]O). Similar relationships were also observed with increased PEEP ([P.sub.RA] = 1.29 [P.sub.PER] -1.2, r = 0.98 and [P.sub.IVC] = 1.32 [P.sub.PER] -1.2, r = 0.97). Because [P.sub.RA] provides an accurate measure of ventricular constraint in the normal lamb, it may be a useful measure of ventricular constraint in the sick newborn. airway pressure; mechanical ventilation; pericardial pressure; positive end-expiratory pressure

Published
2001

24. Correlation between recent thymic emigrants and CD31+ (PECAM-1) CD4+ T cells in normal individuals during aging and in lymphopenic children

Author

Junge, Sonja, primary, Kloeckener-Gruissem, Barbara, additional, Zufferey, Romain, additional, Keisker, Andre, additional, Salgo, Bettina, additional, Fauchere, Jean-Claude, additional, Scherer, Franziska, additional, Shalaby, Tarek, additional, Grotzer, Michael, additional, Siler, Ulrich, additional, Seger, Reinhard, additional, and Güngör, Tayfun, additional

Published
2007
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25. Slow blood sampling from an umbilical artery catheter prevents a decrease in cerebral oxygenation in the preterm newborn

Author

Schulz, Gabriele, Keller, Esther, Haensse, Daniel, Arlettaz, Romaine, Bucher, Hans Ulrich, and Fauchere, Jean-Claude

Subjects
Umbilical arteries, Cerebral circulation -- Physiological aspects, Arterial catheterization -- Complications, Infants (Premature) -- Physiological aspects
Abstract

Objective. Blood sampling from an umbilical artery catheter (UAC) placed in a high position (thoracal 6-9) has the potential to produce clinically significant changes in cerebral blood flow and, thereby, in cerebral oxygenation. This may contribute to cerebral impairment in preterm newborn infants. Therefore, we set up a study to determine the effects of different sampling speeds through a UAC on cerebral oxygenation in preterm infants. Methods. Thirty pairs of measurements were conducted on 20 preterm infants (median gestational age: 30.14 weeks; median birth weight: 1170 g). For each infant, 2 blood samplings (both 2.3 mL, including flush volume) through the UAC in high position were taken at 2 different speeds (20 and 40 seconds) in alternating sequence. Cerebral oxygenation was measured noninvasively by near-infrared spectroscopy. Concentration changes in cerebral oxygenated hemoglobin ([O.sub.2]Hb) and deoxygenated hemoglobin (HHb), along with the tissue oxygenation index (TOI; [O.sub.2]Hb/[[O.sub.2]Hb + HHb] x 100), were recorded while blood was withdrawn and subsequently reinfused. Results. A significant decrease in [O.sub.2]Hb and TOI occurred during blood sampling within 20 seconds (median [DELTA][O.sub.2]Hb: -1.5 [micro]mol/L; range: -4.1-2.3; median [DELTA] TOI: -0.6%; range: -6.3-2.3), whereas HHb increased (median [DELTA] HHb: 0.4 [micro]mol/L, range: -1.1-3.9). No significant change was found in [O.sub.2]Hb, HHb, and TOI when sampling time was extended to 40 seconds. Conclusion. Our results show that blood withdrawal over 20 seconds from a UAC in high position significantly decreases cerebral [O.sub.2]Hb and TOI in preterm infants. Prolonging sampling time to 40 seconds can prevent this phenomenon. Pediatrics 2002;111:e73-e76. URL: http://www.pediatrics.org/cgi/content/full/111/1/e73; near-infrared spectroscopy, cerebral tissue oxygenation, neonate, tissue oxygenation index.

Published
2003

26. Growth, developmental milestones and health problems in the first 2 years in very preterm infants compared with term infants: a population based study.

Author

Bucher, Hans Ulrich, Killer, Christa, Ochsner, Yvonne, Vaihinger, Svantje, Fauchere, Jean-Claude, and Fauchère, Jean-Claude

Subjects
PREMATURE infant diseases, PREGNANCY
Abstract

Unlabelled: The outcome of very preterm infants varies widely from centre to centre and from country to country. The aim of this study was to evaluate growth, developmental milestones and post-discharge morbidity of infants born before 32 weeks of gestation in Switzerland. A questionnaire was sent to the parents of 456 survivors born in 1996. A total of 309 (68%) parents responded and their infants were matched with 309 control infants born at term. At the corrected age of 24 months, the very preterm infants had significantly lower weight (-1.0 z-scores), lower length (-1.23 z-scores), and lower head circumference (-.64 z-scores). Very preterm infants were reported to eat with a spoon later than those born at term (50% at 7.5 months corrected for prematurity versus 10 months. P<0.001), to drink later out of a cup (50% at 16.5 months versus 13.5 months, P=0.03) and to walk later independently (50% at 14.5 months versus 13.5 months, P=0.04), whereas timing of sitting unsupported was no different (50% at 7.4 months versus 7.2 months, P=0.9). Of very preterm infants, 16% were not able to walk at least three steps unsupported at 18 months after term which puts them at an increased risk for cerebral palsy. Some 35% of very preterm infants had to be readmitted to hospital during the first 24 months compared with 20% of control infants born at term (P<0.05). There was no difference between very preterm and term infants in respect to episodes of fever > 38.5 degrees C, episodes of coughing > 3 days and treatment with antibiotics.Conclusion: these data based on a national survey allow to quantify growth retardation, developmental delay and post-discharge health problems within the first 2 years in preterm infants born before 32(0)/7 weeks. [ABSTRACT FROM AUTHOR]

Published
2002
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27. Maternal Side-Effects After Multiple Courses of Antenatal Corticosteroids (MACS): The Three- Month Follow-Up of Women in the Randomized Controlled Trial of MACS for Preterm Birth Study

Author

Murphy, Kellie E., Hannah, Mary E., Willan, Andrew R., Ohlsson, Arne, Kelly, Edmond N., Matthews, Stephen G., Saigal, Saroj, Asztalos, Elizabeth, Ross, Sue, Delisle, Marie-France, Tomat, Laura, Amankwah, Kofi, Guselle, Patricia, Gafni, Amiram, Lee, Shoo K., Anthony Armson, B., Group, for the MACS Collaborative, Murphy, Kellie E., Amankwah, Kofi, Armson, B. Anthony, Asztalos, Elizabeth, Delisle, MarieFrance, Gafni, Amiram, Guselle, Patricia, Hannah, Mary E., Hewson, Sheila A., Kelly, Edmond N., Lee, Shoo K., Matthews, Stephen G., Ohlsson, Arne, Ross, Sue, Rovet, Joanne, Saigal, Saroj, Sananes, Renee, Schmid, Isabelle, Willan, Andrew R., Kwiatkowski, Leonardo, Tortorella, Susana Marisa, Bertin, Marta Susana, Castaldi, José Luis, Deguer, Carlos, Klun, Milton, Besegato, Cintia, Izbizky, Gustavo, Vaneri, Maria Cristina, Fustinana, Carlos Alberto, Otano, Lucas, Palermo, Mario S.F., Murua, Emerson Javier, Valera, Dolores Montes, Sampietro, Hector, Monaco, Antonio, Savransky, Argentina Ricardo, Dunaiewsky, Armando, Basualdo, Maria Natalia, Andina, Elsa, Di Marco, Ingrid, Rivero, Mabel, Feu, Maria Celeste, Garcia, Sergio, Aguirre, Jesus Daniel, Morales, Elba Mirta, Ayala, Liana Elisa, De Sagastizabal, Maria Teresa, Abreo, Griselda, Uranga, Alfredo, Martin, Raquel de Lourdes, Arias, Carlos, Gorostiaga, Raul Abalos, Curioni, Miguel, Alvarado, Jorge, Fuchtner, Carlos, Flores, Desiree Mostajo, Tonoli Tessari, Dilma Maria, Madi, Jose Mauro, de Lorenzi, Dino Roberto Soares, Mattana, Maria do Carmo, Brunstein, Carla, Trapani, Alberto, Schmaltz, Luiza, de Souza, Goianice Ribero, de Assis, Maria Elaine, Melo Melgaco, Irene Angela, Moreira de Sa, Renato Augusto, Bornia, Rita Guerios, Demianczuk, Nestor N, Penttinen, Elizabeth, Butt, Kimberly, Hay, Kathryn, Sandwich, Vicki, Armson, B Anthony, Vincer, Michael, Allen, Victoria, Fanning, Cora, Kulkarni, Ramesh, Laplante, Joanne, Carson, George D, Williams, Suzanne, Holfeld, Sandy, Olatunbosun, Femi, Dalton, Shirley, Henry, April, Haughian, Janna, Moutquin, Jean-Marie, Blouin, Daniel, Bédard, Suzanne Kocsis, Murphy, Kellie, Ohlsson, Arne, Kelly, Edmond, Jordan, Anne, Shapiro, Jodi, Asztalos, Elizabeth, Barrett, Jon, Cohen, Howard, Andrews, Leigh, Owen, Holly, Delisle, Marie-France, Popovska, Vesna, Soanes, Shelley, Helewa, Michael E, Kenny-Lodewyks, Doris, Gomez, Ricardo, Silva, Karla, Poblete, Jorge Figueroa, Ferrand, Pedro, Belmar, Cristian, Vera, Claudio, Su, Qi Feng, Gu, Wei, Liu, Zhi Wei, Flores, Martha Marrugo, Santoro, Carlos Malabet, Ortiz, Edgar Ivan, Torres, Javier, Rodriguez, Adriana, Hvidman, Lone, Mouritzen, Anne, Vikre-Jørgensen, Jennifer, Hopp, Hartmut, Nonnenmacher, Andreas, Braig, Ute, Berg, Christoph, Bizjak, Gabriele, Gembruch, Ulrich, Schwarzer, Verena, Hoyme, U B, Bittrich, Hans-Jorg, Oletzky, Britta, Schneider, Joachim, Hollwitz, Bettina, Oehler, Katrin, Dressler, Frank, Ertan, A Kubilay, Hentschel, Juliane, Mack, Annegret, Schmidt, W., Faber, Renaldo, Stepan, Holger, Kuhnert, Maritta, Stiller, Susanne, Kuschel, Bettina, Schneider, K.T.M., Zimmermann, Andrea, Krause, Michael, Gröbe, H, Terzioglu, Neslisah, Seelbach-Goebel, Birgit, Falkert, Andreas, Mueller, Karin, Voss, Hana, Major, Tamas, Zoärd, Krasznai, Bartha, Tünde, Bea, Polonkai, Zsadänyi, Judit, Nachum, Zohar, Peniakov, Marina, Hallak, Mordechai, Harlev, Avraham, Harel, Linda, Chayen, Benny, Siev, Sima, Samberg, Ichel, Wolff, Leslie, Sadan, Oscar, Elyassi, Anat, Baider, Carolina, Kohelet, David, Golan, Abraham, Mankuta, David, Bar-Oz, Benjamin, Combs, Danielle, Rosen, Doron J.D., Kaneti, Hagai Y., Tzachi, Tal, Zausmer, Janice, Maman, Maor, Perri, Tamar, Taitelboum, Shani, Simchen, Michal, Shalev, Gilat, Goldinfeld, Michael, Levine, Orit, El-Zibdeh, Mazen Y, Al-Faris, Lama T, Ayyash, Hussein A, Ugarte, Pedro Saona, Preis, Krzysztof, Domzalska-Popadiuk, Iwona, Swiatkowska-Freund, Malgorzata, Janczewska, Iwona, Wilczynski, Jan, Krekora, Michael, Kesiak, Marcin, Gulczynska, Ewa, Ropacka, Mariola, Madejczyk, Mateusz, Rozycka, Joanna, Breborowicz, Grzegorz H, Szymankiewicz, Marta, Borzova, Nadezhda, Posiseeva, Lubov V, Khodjaeva, Zulfiya, Vikhlyaeva, Ekaterina, Palacio, Montse, Salvia, Dolors, Botet, Francesc, Massanes, Marta, Lopez, Marta, Hösli, Irene, Holzgreve, Wolfgang, Voekt, Cora A., Belhia, Fadhil, Hohlfeld, Patrick, Prince-dit-Clottu, Edmond, Beinder, Ernst, von Mandach, Ursula, Fauchere, Jean-Claude, Roumen, Frans J.M.E., Pieters, Mijntje, Smits, Frans, Bolaji, Ibrahim I, Adiotomre, Pauline, Al-Taher, Hamed, Barnes, Hayley, Abdul-Kadir, Rezan, Chi, Claudia, Van Someren, Vivienne, Dexter, Scott, Samelson, Renee, Horgan, Michael J, Valentini, Cathryn, Pardanani, Setul, Bebbington, Michael, Chazotte, Cynthia, Kilpatrick, Sarah, Drahos, Jessica L., Saldana, Luis, Mount, Beverly, Warner, Barbara, Wedig, Kathy, Lysikiewicz, Andrzej, Bsat, Fadi, Fleming, Jennie, Lee, Alison, Hoffman, Despina, Bracken, Michael, Crowley, Patricia, Donner, Allan, Duley, Lelia, and Tyson, Jon

Abstract

A single course of antenatal corticosteroids (ACS) is associated with a reduction in respiratory distress syndrome and neonatal death. Multiple Courses of Antenatal Corticosteroids Study(MACS), a study involving 1858 women, was a multicentre randomized placebo-controlled trial of multiple courses of ACS, given every 14 days until 33+6 weeks or birth, whichever came first. The primary outcome of the study, a composite of neonatal mortality and morbidity, was similar for the multiple ACS and placebo groups (12.9% vs. 12.5%), but infants exposed to multiple courses of ACS weighed less, were shorter, and had smaller head circumferences. Thus for women who remain at increased risk of preterm birth, multiple courses of ACS (every 14 days) are not recommended. Chronic use of corticosteroids is associated with numerous side effects including weight gain and depression The aim of this postpartum assessment was to ascertain if multiple courses of ACS were associated with maternal side effects.

Published
2011
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28. Performance Assessment of a Dedicated Reflectance Pulse Oximeter in a Neonatal Intensive Care Unit.

Author

Proenca M, Grossenbacher O, Dasen S, Moser V, Ostojic D, Lemkaddem A, Ferrario D, Lemay M, Wolf M, Fauchere JC, and Karen T

Subjects
Adult, Artifacts, Humans, Infant, Newborn, Oxygen analysis, Intensive Care Units, Neonatal, Monitoring, Physiologic instrumentation, Oximetry instrumentation
Abstract

The measurement of peripheral oxygen saturation (SpO2) in neonatal intensive care units (NICUs) poses a significant challenge. Motion artifacts due to the patient's limb motion induce many false alarms, which in turn cause an additional workload for the medical staff and anxiety for the parents. We developed a reflectance pulse oximeter dedicated to be placed at the patient's forehead, which is less prone to such artifacts. We trained our algorithms for SpO2 estimation on 8 adult healthy volunteers participating in a controlled desaturation study. We then validated our SpO2 monitoring system on 25 newborn patients monitored in an NICU. We further evaluated the versatility and resilience to low signal-tonoise ratios (SNR) of our solution by testing it on signals acquired in a low-perfusion region (upper right part of the chest) of our adult volunteers. We obtained an SpO2 estimation accuracy ($A &#95;{\mathbf {rms}}$) of 1.9 % and 3.1 % at the forehead and the chest in our adult volunteers, respectively. These performances were obtained after automatic rejection of 0.1 % and 30.0 %, respectively, of low-SNR signals by our dedicated quality index. In the dataset recorded on newborn patients in the NICU, we obtained an accuracy of 3.9 % after automatic rejection of 11.7 % of low-SNR signals by our quality index. These analyses were carried out following the procedures suggested by the ISO 80601-2-61:2011 standard, which specifies a target $A &#95;{\mathbf {rms}} \le $ 4 % for SpO2 monitoring applications. These promising results suggest that reflectance pulse oximeters can achieve clinically acceptable accuracy, while being placed at locations less sensitive to limb motion artifacts - such as the forehead - thereby reducing the amount of SpO2-related false alarms in NICUs.

Published
2018
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