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1. Comparison of “IN-REC-SUR-E” and LISA in preterm neonates with respiratory distress syndrome: a randomized controlled trial (IN-REC-LISA trial)

Author

Vento, Giovanni, Paladini, Angela, Aurilia, C., Ozdemir, S. Alkan, Carnielli, V. P., Cools, F., Costa, S., Cota, F., Dani, C., Davis, P. G., Fattore, S., Fè, C., Finer, N., Fusco, F. P., Gizzi, C., Herting, E., Jian, M., Lio, A., Lista, G., Mosca, F., Nobile, S., Perri, A., Picone, S., Pillow, J. J., Polglase, G., Pasciuto, T., Pastorino, R., Tana, M., Tingay, D., Tirone, C., van Kaam, A. H., Ventura, M. L., Aceti, A., Agosti, M., Alighieri, G., Ancora, G., Angileri, V., Ausanio, G., Aversa, S., Balestri, E., Baraldi, E., Barbini, M. C., Barone, C., Beghini, R., Bellan, C., Berardi, A., Bernardo, I., Betta, P., Binotti, M., Bizzarri, B., Borgarello, G., Borgione, S., Borrelli, A., Bottino, R., Bracaglia, G., Bresesti, I., Burattini, I., Cacace, C., Calzolari, F., Campagnoli, M. F., Capasso, L., Capozza, M., Capretti, M. G., Caravetta, J., Carbonara, C., Cardilli, V., Carta, M., Castoldi, F., Castronovo, A., Cavalleri, E., Cavigioli, F., Cecchi, S., Chierici, V., Cimino, C., Cocca, F., Cocca, C., Cogo, P., Coma, M., Comito, V., Condò, V., Consigli, C., Conti, R., Corradi, M., Corsello, G., Corvaglia, L. T., Costa, A., Coscia, A., Cresi, F., Crispino, F., D’Amico, P., De Cosmo, L., De Maio, C., Del Campo, G., Di Credico, S., Di Fabio, S., Di Nicola, P., Di Paolo, A., Di Valerio, S., Distilo, A., Duca, V., Falcone, A., Falsaperla, R., Fasolato, V. A., Fatuzzo, V., Favini, F., Ferrarello, M. P., Ferrari, S., Nastro, F. Fiori, Forcellini, C. A., Fracchiolla, A., Gabriele, A., Galdo, F., Gallini, F., Gangemi, A., Gargano, G., Gazzolo, D., Gentile, M. P., Ghirardello, S., Giardina, F., Giordano, L., Gitto, E., Giuffrè, M., Grappone, L., Grasso, F., Greco, I., Grison, A., Guglielmino, R., Guidotti, I., Guzzo, I., La Forgia, N., La Placa, S., La Torre, G., Lago, P., Lanciotti, L., Lavizzari, A., Leo, F., Leonardi, V., Lestingi, D., Li, J., Liberatore, P., Lodin, D., Lubrano, R., Lucente, M., Luciani, S., Luvarà, D., Maffei, G., Maggio, A., Maggio, L., Maiolo, K., Malaigia, L., Mangili, G., Manna, A., Maranella, E., Marciano, A., Marcozzi, P., Marletta, M., Marseglia, L., Martinelli, D., Martinelli, S., Massari, S., Massenzi, L., Matina, F., Mattia, L., Mescoli, G., Migliore, I. V., Minghetti, D., Mondello, I., Montano, S., Morandi, G., Mores, N., Morreale, S., Morselli, I., Motta, M., Napolitano, M., Nardo, D., Nicolardi, A., Nider, S., Nigro, G., Nuccio, M., Orfeo, L., Ottaviano, C., Paganin, P., Palamides, S., Palatta, S., Paolillo, P., Pappalardo, M. G., Pasta, E., Patti, L., Paviotti, G., Perniola, R., Perotti, G., Perrone, S., Petrillo, F., Piazza, M. S., Piccirillo, A., Pierro, M., Piga, E., Pingitore, G. A., Pisu, S., Pittini, C., Pontiggia, F., Pontrelli, G., Primavera, A., Proto, A., Quartulli, L., Raimondi, F., Ramenghi, L., Rapsomaniki, M., Ricotti, A., Rigotti, C., Rinaldi, M., Risso, F. M., Roma, E., Romanini, E., Romano, V., Rosati, E., Rosella, V., Rulli, I., Salvo, V., Sanfilippo, C., Sannia, A., Saporito, A., Sauna, A., Scapillati, E., Schettini, F., Scorrano, A., Mantelli, S. Semeria, Sepporta, V., Sindico, P., Solinas, A., Sorrentino, E., Spaggiari, E., Staffler, A., Stella, M., Termini, D., Terrin, G., Testa, A., Tina, G., Tirantello, M., Tomasini, B., Tormena, F., Travan, L., Trevisanuto, D., Tuling, G., Tulino, V., Valenzano, L., Vedovato, S., Vendramin, S., Villani, P. E., Viola, S., Viola, V., Vitaliti, G., Vitaliti, M., Wanker, P., Yang, Y., Zanetta, S., and Zannin, E.

Published
2024
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3. Caution advised regarding lung recruitment before surfactant – Authors’ reply

Author

Vento, Giovanni, Ventura, M. L., Pastorino, Roberta, van Kaam, A. H., Carnielli, V., Cools, F., Dani, C., Mosca, F., Polglase, G., Tagliabue, P., Boni, L., Cota, Francesco, Tana, Milena, Tirone, Chiara, Aurilia, Claudia, Lio, Alessandra, Cost, S., D'Andrea, Vito, Lucente, Monica Christine, Nigro, G., Giordano, Lucia, Roma, V., Villani, P., Fusco, Francesca Paola, Fasolato, V., Colnaghi, M. R., Matassa, P. G., Vendettuoli, V., Poggi, C., Del Vecchi, A., Petrillo, F., Betta, P., Mattia, C., Garani, G., Solinas, A., Gitto, E., Salvo, V., Gargano, G., Balestri, E., Sandri, F., Mescoli, G., Martinelli, Silvia, Ilardi, L., Ciarmoli, E., Di Fabio, S., Maranella, E., Grassia, C., Ausanio, G., Rossi, V., Motta, A., Tina, L. G., Maiolo, K., Nobile, Stefano, Messner, H., Staffler, Alex, Ferrero, F., Stasi, I., Pieragostini, L., Mondello, I., Haass, C., Consigli, C., Vedovato, S., Grison, A., Maffei, G., Presta, G., Perniola, R., Vitaliti, M., Re, M. P., De Curtis, M., Cardilli, V., Lago, P., Tormena, F., Orfeo, L., Gizzi, C., Massenzi, L., Gazzolo, D., Strozzi, M. C. M., Bottino, R., Pontiggia, F., Berardi, A., Guidotti, I., Cacace, C., Meli, V., Quartulli, L., Scorrano, A., Casati, A., Grappone, L., Pillow, J. J., Vento G. (ORCID:0000-0002-8132-5127), Pastorino R. (ORCID:0000-0001-5013-0733), Cota F. (ORCID:0000-0002-9009-3997), Tana M., Tirone C., Aurilia C., Lio A., D'Andrea V. (ORCID:0000-0002-0980-799X), Lucente M., Giordano L., Fusco F. P., Martinelli S., Nobile S. (ORCID:0000-0002-5304-1485), Staffler A., Vento, Giovanni, Ventura, M. L., Pastorino, Roberta, van Kaam, A. H., Carnielli, V., Cools, F., Dani, C., Mosca, F., Polglase, G., Tagliabue, P., Boni, L., Cota, Francesco, Tana, Milena, Tirone, Chiara, Aurilia, Claudia, Lio, Alessandra, Cost, S., D'Andrea, Vito, Lucente, Monica Christine, Nigro, G., Giordano, Lucia, Roma, V., Villani, P., Fusco, Francesca Paola, Fasolato, V., Colnaghi, M. R., Matassa, P. G., Vendettuoli, V., Poggi, C., Del Vecchi, A., Petrillo, F., Betta, P., Mattia, C., Garani, G., Solinas, A., Gitto, E., Salvo, V., Gargano, G., Balestri, E., Sandri, F., Mescoli, G., Martinelli, Silvia, Ilardi, L., Ciarmoli, E., Di Fabio, S., Maranella, E., Grassia, C., Ausanio, G., Rossi, V., Motta, A., Tina, L. G., Maiolo, K., Nobile, Stefano, Messner, H., Staffler, Alex, Ferrero, F., Stasi, I., Pieragostini, L., Mondello, I., Haass, C., Consigli, C., Vedovato, S., Grison, A., Maffei, G., Presta, G., Perniola, R., Vitaliti, M., Re, M. P., De Curtis, M., Cardilli, V., Lago, P., Tormena, F., Orfeo, L., Gizzi, C., Massenzi, L., Gazzolo, D., Strozzi, M. C. M., Bottino, R., Pontiggia, F., Berardi, A., Guidotti, I., Cacace, C., Meli, V., Quartulli, L., Scorrano, A., Casati, A., Grappone, L., Pillow, J. J., Vento G. (ORCID:0000-0002-8132-5127), Pastorino R. (ORCID:0000-0001-5013-0733), Cota F. (ORCID:0000-0002-9009-3997), Tana M., Tirone C., Aurilia C., Lio A., D'Andrea V. (ORCID:0000-0002-0980-799X), Lucente M., Giordano L., Fusco F. P., Martinelli S., Nobile S. (ORCID:0000-0002-5304-1485), and Staffler A.

Abstract

N/A

Published
2021

4. Lung recruitment before surfactant administration in extremely preterm neonates with respiratory distress syndrome (IN-REC-SUR-E): a randomised, unblinded, controlled trial

Author

Vento, Giovanni, Ventura, M. L., Pastorino, Roberta, van Kaam, A. H., Carnielli, V., Cools, F., Dani, C., Mosca, F., Polglase, G., Tagliabue, P., Boni, L., Cota, Francesco, Tana, Milena, Tirone, Chiara, Aurilia, Claudia, Lio, Alessandra, Costa, Simonetta, D'Andrea, Vito, Lucente, M., Nigro, G., Giordano, Liliana, Roma, V., Villani, P. E., Fusco, Francesca Paola, Fasolato, V., Colnaghi, M. R., Matassa, P. G., Vendettuoli, V., Poggi, C., Del Vecchio, Arianna, Petrillo, F., Betta, P., Mattia, C., Garani, G., Solinas, A., Gitto, E., Salvo, V., Gargano, G., Balestri, E., Sandri, F., Mescoli, G., Martinelli, S., Ilardi, L., Ciarmoli, E., Di Fabio, S., Maranella, E., Grassia, C., Ausanio, G., Rossi, V., Motta, Alessandro, Tina, L. G., Maiolo, K., Nobile, Stefano, Messner, H., Staffler, Alex, Ferrero, Mattia Francesco, Stasi, I., Pieragostini, L., Mondello, I., Haass, C., Consigli, C., Vedovato, S., Grison, A., Maffei, G., Presta, G., Perniola, R., Vitaliti, M., Re, M. P., De Curtis, M., Cardilli, V., Lago, P., Tormena, F., Orfeo, L., Gizzi, C., Massenzi, L., Gazzolo, D., Strozzi, M. C. M., Bottino, R., Pontiggia, F., Berardi, A., Guidotti, I., Cacace, C., Meli, V., Quartulli, L., Scorrano, A., Casati, A., Grappone, L., Pillow, J. J., Vento G. (ORCID:0000-0002-8132-5127), Pastorino R. (ORCID:0000-0001-5013-0733), Cota F. (ORCID:0000-0002-9009-3997), Tana M., Tirone C., Aurilia C., Lio A., Costa S., D'Andrea V. (ORCID:0000-0002-0980-799X), Giordano L., Fusco F. P., Del Vecchio A., Motta A., Nobile S. (ORCID:0000-0002-5304-1485), Staffler A., Ferrero F., Vento, Giovanni, Ventura, M. L., Pastorino, Roberta, van Kaam, A. H., Carnielli, V., Cools, F., Dani, C., Mosca, F., Polglase, G., Tagliabue, P., Boni, L., Cota, Francesco, Tana, Milena, Tirone, Chiara, Aurilia, Claudia, Lio, Alessandra, Costa, Simonetta, D'Andrea, Vito, Lucente, M., Nigro, G., Giordano, Liliana, Roma, V., Villani, P. E., Fusco, Francesca Paola, Fasolato, V., Colnaghi, M. R., Matassa, P. G., Vendettuoli, V., Poggi, C., Del Vecchio, Arianna, Petrillo, F., Betta, P., Mattia, C., Garani, G., Solinas, A., Gitto, E., Salvo, V., Gargano, G., Balestri, E., Sandri, F., Mescoli, G., Martinelli, S., Ilardi, L., Ciarmoli, E., Di Fabio, S., Maranella, E., Grassia, C., Ausanio, G., Rossi, V., Motta, Alessandro, Tina, L. G., Maiolo, K., Nobile, Stefano, Messner, H., Staffler, Alex, Ferrero, Mattia Francesco, Stasi, I., Pieragostini, L., Mondello, I., Haass, C., Consigli, C., Vedovato, S., Grison, A., Maffei, G., Presta, G., Perniola, R., Vitaliti, M., Re, M. P., De Curtis, M., Cardilli, V., Lago, P., Tormena, F., Orfeo, L., Gizzi, C., Massenzi, L., Gazzolo, D., Strozzi, M. C. M., Bottino, R., Pontiggia, F., Berardi, A., Guidotti, I., Cacace, C., Meli, V., Quartulli, L., Scorrano, A., Casati, A., Grappone, L., Pillow, J. J., Vento G. (ORCID:0000-0002-8132-5127), Pastorino R. (ORCID:0000-0001-5013-0733), Cota F. (ORCID:0000-0002-9009-3997), Tana M., Tirone C., Aurilia C., Lio A., Costa S., D'Andrea V. (ORCID:0000-0002-0980-799X), Giordano L., Fusco F. P., Del Vecchio A., Motta A., Nobile S. (ORCID:0000-0002-5304-1485), Staffler A., and Ferrero F.

Abstract

Background: The importance of lung recruitment before surfactant administration has been shown in animal studies. Well designed trials in preterm infants are absent. We aimed to examine whether the application of a recruitment manoeuvre just before surfactant administration, followed by rapid extubation (intubate-recruit-surfactant-extubate [IN-REC-SUR-E]), decreased the need for mechanical ventilation during the first 72 h of life compared with no recruitment manoeuvre (ie, intubate-surfactant-extubate [IN-SUR-E]). Methods: We did a randomised, unblinded, controlled trial in 35 tertiary neonatal intensive care units in Italy. Spontaneously breathing extremely preterm neonates (24 + 0 to 27 + 6 weeks' gestation) reaching failure criteria for continuous positive airway pressure within the first 24 h of life were randomly assigned (1:1) with a minimisation algorithm to IN-REC-SUR-E or IN-SUR-E using an interactive web-based electronic system, stratified by clinical site and gestational age. The primary outcome was the need for mechanical ventilation in the first 72 h of life. Analyses were done in intention-to-treat and per-protocol populations, with a log-binomial regression model correcting for stratification factors to estimate adjusted relative risk (RR). This study is registered with ClinicalTrials.gov, NCT02482766. Findings: Of 556 infants assessed for eligibility, 218 infants were recruited from Nov 12, 2015, to Sept 23, 2018, and included in the intention-to-treat analysis. The requirement for mechanical ventilation during the first 72 h of life was reduced in the IN-REC-SUR-E group (43 [40%] of 107) compared with the IN-SUR-E group (60 [54%] of 111; adjusted RR 0·75, 95% CI 0·57–0·98; p=0·037), with a number needed to treat of 7·2 (95% CI 3·7–135·0). The addition of the recruitment manoeuvre did not adversely affect the safety outcomes of in-hospital mortality (19 [19%] of 101 in the IN-REC-SUR-E group vs 37 [33%] of 111 in the IN-SUR-E group), pneumothorax (

Published
2020

5. Caution advised regarding lung recruitment before surfactant – Authors’ reply

Author

Vento, Giovanni, primary, Ventura, M L, additional, Pastorino, R, additional, van Kaam, A H, additional, Carnielli, V, additional, Cools, F, additional, Dani, C, additional, Mosca, F, additional, Polglase, G, additional, Tagliabue, P, additional, Boni, L, additional, Cota, F, additional, Tana, M, additional, Tirone, C, additional, Aurilia, C, additional, Lio, A, additional, Cost, S, additional, D'Andrea, V, additional, Lucente, M, additional, Nigro, G, additional, Giordano, L, additional, Roma, V, additional, Villani, P, additional, Fusco, F P, additional, Fasolato, V, additional, Colnaghi, M R, additional, Matassa, P G, additional, Vendettuoli, V, additional, Poggi, C, additional, Del Vecchi, A, additional, Petrillo, F, additional, Betta, P, additional, Mattia, C, additional, Garani, G, additional, Solinas, A, additional, Gitto, E, additional, Salvo, V, additional, Gargano, G, additional, Balestri, E, additional, Sandri, F, additional, Mescoli, G, additional, Martinelli, S, additional, Ilardi, L, additional, Ciarmoli, E, additional, Di Fabio, S, additional, Maranella, E, additional, Grassia, C, additional, Ausanio, G, additional, Rossi, V, additional, Motta, A, additional, Tina, L G, additional, Maiolo, K, additional, Nobile, S, additional, Messner, H, additional, Staffler, A, additional, Ferrero, F, additional, Stasi, I, additional, Pieragostini, L, additional, Mondello, I, additional, Haass, C, additional, Consigli, C, additional, Vedovato, S, additional, Grison, A, additional, Maffei, G, additional, Presta, G, additional, Perniola, R, additional, Vitaliti, M, additional, Re, M P, additional, De Curtis, M, additional, Cardilli, V, additional, Lago, P, additional, Tormena, F, additional, Orfeo, L, additional, Gizzi, C, additional, Massenzi, L, additional, Gazzolo, D, additional, Strozzi, M C M, additional, Bottino, R, additional, Pontiggia, F, additional, Berardi, A, additional, Guidotti, I, additional, Cacace, C, additional, Meli, V, additional, Quartulli, L, additional, Scorrano, A, additional, Casati, A, additional, Grappone, L, additional, and Pillow, J J, additional

Published
2021
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6. Intersociety policy statement on the use of whole-exome sequencing in the critically ill newborn infant

Author

Borghesi, A, Mencarelli, Ma, Memo, L, Ferrero, Gb, Bartuli, A, Genuardi, M, Stronati, M, Villani, A, Renieri, A, Corsello, G, Their Respective Scientific Societies, Agostiniani, R, Staiano, A, Del Vecchio, A, Banderali, G, Peroni, D, Piazzolla, R, Turra, R, Bozzola, E, Vecchio, D, Rosati, Gv, Macrì, F, Romagnoli, C, De Curtis, M, Orfeo, L, Mangili, G, Mosca, F, Fanos, V, Paolillo, P, Raimondi, F, Rizzo, A, Chirico, G, Corvaglia, Lt, Cacace, Concetta, Poggiani, C, Zuppa, Aa, Pisano, D, Melis, D, Giuffrè, M, Carbone, Mt, Macchiaiolo, M, Tarani, L, Selicorni, A, Andria, G, Coviello, D, Gentile, M, Ghiorzo, P, Novelli, A, Ragusa, A, Scarano, G, Giardino, D., Borghesi A, Mencarelli MA, Memo L, Ferrero GB, Bartuli A, Genuardi M, Stronati M, Villani A, Renieri A, Corsello G, Borghesi, Alessandro, Mencarelli, Maria Antonietta, Memo, Luigi, Ferrero, Giovanni Battista, Bartuli, Andrea, Genuardi, Maurizio, Stronati, Mauro, Villani, Alberto, Renieri, Alessandra, Corsello, Giovanni, and Agostiniani R, Staiano A, Del Vecchio A, Banderali G, Peroni D, Piazzolla R, Turra R, Bozzola E, Vecchio D, Rosati GV, Macrì F, Romagnoli C, De Curtis M, Orfeo L, Mangili G, Mosca F, Fanos V, Paolillo P, Raimondi F, Rizzo A, Chirico G, Corvaglia LT, Cacace C, Poggiani C, Zuppa AA, Pisano D, Melis D, Giuffrè M, Carbone MT, Macchiaiolo M, Tarani L, Selicorni A, Andria G, Coviello D, Gentile M, Ghiorzo P, Novelli A, Ragusa A, Scarano G, Giardino D.

Subjects
0301 basic medicine, Male, Neonatal intensive care unit, Disease, Review, 030105 genetics & heredity, Pediatrics, Whole Exome Sequencing, Neonate, Neonatal, Outcome Assessment, Health Care, Diagnosis, Policy Making, Exome sequencing, Sanger sequencing, Genome, lcsh:RJ1-570, Perinatology and Child Health, Settore MED/38, Intensive Care Units, Italy, Whole-exome sequencing, Practice Guidelines as Topic, symbols, WES, Female, Human, Diagnosi, NICU, medicine.medical_specialty, Mendelian, 03 medical and health sciences, symbols.namesake, Outcome Assessment (Health Care), Neonatal Screening, Genetic, Intensive Care Units, Neonatal, Exome Sequencing, medicine, WGS, Pediatrics, Perinatology and Child Health, Humans, Genetic Testing, Intensive care medicine, Settore MED/06 - ONCOLOGIA MEDICA, Genetic heterogeneity, Critically ill, business.industry, Genome, Human, Infant, Newborn, Infant, lcsh:Pediatrics, Newborn, Infant newborn, 030104 developmental biology, Differential diagnosis, business
Abstract

The rapid advancement of next-generation sequencing (NGS) technology and the decrease in costs for whole-exome sequencing (WES) and whole-genome sequening (WGS), has prompted its clinical application in several fields of medicine. Currently, there are no specific guidelines for the use of NGS in the field of neonatal medicine and in the diagnosis of genetic diseases in critically ill newborn infants. As a consequence, NGS may be underused with reduced diagnostic success rate, or overused, with increased costs for the healthcare system. Most genetic diseases may be already expressed during the neonatal age, but their identification may be complicated by nonspecific presentation, especially in the setting of critical clinical conditions. The differential diagnosis process in the neonatal intensive care unit (NICU) may be time-consuming, uncomfortable for the patient due to repeated sampling, and ineffective in reaching a molecular diagnosis during NICU stay. Serial gene sequencing (Sanger sequencing) may be successful only for conditions for which the clinical phenotype strongly suggests a diagnostic hypothesis and for genetically homogeneous diseases. Newborn screenings with Guthrie cards, which vary from country to country, are designed to only test for a few dozen genetic diseases out of the more than 6000 diseases for which a genetic characterization is available. The use of WES in selected cases in the NICU may overcome these issues. We present an intersociety document that aims to define the best indications for the use of WES in different clinical scenarios in the NICU. We propose that WES is used in the NICU for critically ill newborn infants when an early diagnosis is desirable to guide the clinical management during NICU stay, when a strong hypothesis cannot be formulated based on the clinical phenotype or the disease is genetically heterogeneous, and when specific non-genetic laboratory tests are not available. The use of WES may reduce the time for diagnosis in infants during NICU stay and may eventually result in cost-effectiveness.

Published
2017

7. Caution advised regarding lung recruitment before surfactant – Authors’ reply

Author

Ventura, M L, Pastorino, R, van Kaam, A H, Carnielli, V, Cools, F, Dani, C, Mosca, F, Polglase, G, Tagliabue, P, Boni, L, Cota, F, Tana, M, Tirone, C, Aurilia, C, Lio, A, Cost, S, D'Andrea, V, Lucente, M, Nigro, G, Giordano, L, Roma, V, Villani, P, Fusco, F P, Fasolato, V, Colnaghi, M R, Matassa, P G, Vendettuoli, V, Poggi, C, Del Vecchi, A, Petrillo, F, Betta, P, Mattia, C, Garani, G, Solinas, A, Gitto, E, Salvo, V, Gargano, G, Balestri, E, Sandri, F, Mescoli, G, Martinelli, S, Ilardi, L, Ciarmoli, E, Di Fabio, S, Maranella, E, Grassia, C, Ausanio, G, Rossi, V, Motta, A, Tina, L G, Maiolo, K, Nobile, S, Messner, H, Staffler, A, Ferrero, F, Stasi, I, Pieragostini, L, Mondello, I, Haass, C, Consigli, C, Vedovato, S, Grison, A, Maffei, G, Presta, G, Perniola, R, Vitaliti, M, Re, M P, De Curtis, M, Cardilli, V, Lago, P, Tormena, F, Orfeo, L, Gizzi, C, Massenzi, L, Gazzolo, D, Strozzi, M C M, Bottino, R, Pontiggia, F, Berardi, A, Guidotti, I, Cacace, C, Meli, V, Quartulli, L, Scorrano, A, Casati, A, Grappone, L, Pillow, J J, and Vento, Giovanni

Published
2021
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8. Risk factors for bronchiolitis hospitalization during the first year of life in a multicenter Italian birth cohort

Author

Lanari M, Prinelli F, Adorni F, Di Santo S, Vandini S, Silvestri M, Musicco M, Faldella G, Spinelli M, Corsello G, Gabriele B, La Forgia N, Loprieno S, Boldrini A, Vuerich M, Del Vecchio A, Bertino E, Fabris C, Coscia A, Fanos V, Puddu M, Gargano G, Braibanti S, Corso G, Orfeo L, De Luca MG, Paolillo P, Fabiano A, Barberi I, Arco A, Barboni G, Molinari L, Bonomi A, Ladetto L, Carlucci A, Zorzi G, Dall’Agnola A, Girardi E, Di Fabio S, Faccia P, Bottau P, Macagno F, Ellero S, Magaldi R, Rinaldi M, Memo L, Nicolini G, Ngalikpima CJ, Nosari N, Sarnelli P, Parmigiani S, Agosti M, Negri C, Corona MF, Piano F, Scarcella A, Umbaldo A, De Curtis M, Natale F, Aurilia C, Romagnoli C, Lanari, Marcello, Prinelli, Federica, Adorni, Fulvio, Di Santo, Simona, Vandini, Silvia, Silvestri, Michela, Musicco, Massimo, and Lanari M, Prinelli F, Adorni F, Di Santo S, Vandini S, Silvestri M, Musicco M, Faldella G, Spinelli M, Corsello G, Gabriele B, La Forgia N, Loprieno S, Boldrini A, Vuerich M, Del Vecchio A, Bertino E, Fabris C, Coscia A, Fanos V, Puddu M, Gargano G, Braibanti S, Corso G, Orfeo L, De Luca MG, Paolillo P, Fabiano A, Barberi I, Arco A, Barboni G, Molinari L, Bonomi A, Ladetto L, Carlucci A, Zorzi G, Dall’Agnola A, Girardi E, Di Fabio S, Faccia P, Bottau P, Macagno F, Ellero S, Magaldi R, Rinaldi M, Memo L, Nicolini G, Ngalikpima CJ, Nosari N, Sarnelli P, Parmigiani S, Agosti M, Negri C, Corona MF, Piano F, Scarcella A, Umbaldo A, De Curtis M, Natale F, Aurilia C, Romagnoli C

Subjects
Palivizumab, Male, Pediatrics, medicine.medical_specialty, Multivariate analysis, Gestational Age, Respiratory Syncytial Virus Infections, Respiratory syncytial virus, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Risk Factors, 030225 pediatrics, medicine, Bronchiolitis, Viral, Humans, 030212 general & internal medicine, Bronchiolitis, Children, Hospitalization, Prophylaxis, Risk factor, Breast Feeding, Crowding, Female, Infant, Infant, Newborn, Italy, Multivariate Analysis, Pediatrics, Perinatology and Child Health, Viral, Bronchiolitis, Hospitalization, Risk factor, Respiratory syncytial virus, Prophylaxis, Palivizumab, Children, business.industry, Research, Gestational age, Perinatology and Child Health, medicine.disease, Newborn, 3. Good health, Gestation, business, Breast feeding, medicine.drug, Cohort study
Abstract

Background: Respiratory Syncytial Virus (RSV) is one of the main causes of respiratory infections during the first year of life. Very premature infants may contract more severe diseases and 'late preterm infants' may also be more susceptible to the infection. The aim of this study is to evaluate the risk factors for hospitalization during the first year of life in children born at different gestational ages in Italy. Methods: A cohort of 33-34 weeks gestational age (wGA) newborns matched by sex and age with two cohort of newborns born at 35-37 wGA and >37 wGA were enrolled in this study for a three-year period (2009-2012). Hospitalization for bronchiolitis (ICD-9 code 466.1) during the first year of life was assessed through phone interview at the end of the RSV season (November-March) and at the completion of the first year of life. Results: The study enrolled 2314 newborns, of which 2210 (95.5 %) had a one year follow-up and were included in the analysis; 120 (5.4 %) were hospitalized during the first year of life for bronchiolitis. Children born at 33-34 wGA had a higher hospitalization rate compared to the two other groups. The multivariate analysis carried out on the entire population associated the following factors with higher rates for bronchiolitis hospitalization: male gender; prenatal treatment with corticosteroids; prenatal exposure to maternal smoking; singleton delivery; respiratory diseases in neonatal period; surfactant therapy; lack of breastfeeding; siblings

Published
2015
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9. Prenatal tobacco smoke exposure increases hospitalizations for bronchiolitis in infants

Author

Lanari M, Vandini S, Adorni F, Prinelli F, Di Santo S, Silvestri M, Musicco M, ' Faldella G, Spinelli M, Corsello G, La Forgia N, Loprieno S, Boldrini A, Vuerich M, Del Vecchio A, Fabris C, Bertino E, Gaudino M, Coscia A, Fanos V, Puddu M, Gargano G, Braibanti S, Corso G, Orfeo L, De Luca MG, Paolillo P, Fabiano A, Barberi I, Barboni G, Molinari L, Bonomi A, Ladetto L, Carlucci A, Zorzi G, De Curtis M, Natale F, Di Fabio S, Faccia P, Bottau P, Macagno F, Ellero S, Magaldi R, Rinaldi M, Memo L, Nicolini G, Ngalikpima CJ, Nosari N, Sarnelli P, Parmigiani S, Agosti M, Negri C, Corona MF, Piano F, Umbaldo A, Dall’Agnola A, Girardi E, Gabriele B, Aurilia C, Romagnoli C, Lanari M, Vandini S, Adorni F, Prinelli F, Di Santo S, Silvestri M, Musicco M, ' Faldella G, Spinelli M, Corsello G, La Forgia N, Loprieno S, Boldrini A, Vuerich M, Del Vecchio A, Fabris C, Bertino E, Gaudino M, Coscia A, Fanos V, Puddu M, Gargano G, Braibanti S, Corso G, Orfeo L, De Luca MG, Paolillo P, Fabiano A, Barberi I, Barboni G, Molinari L, Bonomi A, Ladetto L, Carlucci A, Zorzi G, De Curtis M, Natale F, Di Fabio S, Faccia P, Bottau P, Macagno F, Ellero S, Magaldi R, Rinaldi M, Memo L, Nicolini G, Ngalikpima CJ, Nosari N, Sarnelli P, Parmigiani S, Agosti M, Negri C, Corona MF, Piano F, Umbaldo A, Dall’Agnola A, Girardi E, Gabriele B, Aurilia C, Romagnoli C, Lanari, Marcello, Vandini, Silvia, Adorni, Fulvio, Prinelli, Federica, Di Santo, Simona, Silvestri, Michela, and Musicco, Massimo

Subjects
Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, Pediatrics, Time Factors, Time Factor, Offspring, Longitudinal Studie, Risk Assessment, Tobacco smoke exposure, Pregnancy, Infant, Bronchiolitis, Hospitalization, Risk factor, Bronchiolitis, Hospitalization, Infant, Pregnancy, Risk factor, Tobacco smoke exposure, Age Factors, Female, Humans, Infant, Newborn, Inhalation Exposure, Italy, Longitudinal Studies, Maternal Exposure, Risk Factors, Smoking, Tobacco Smoke Pollution, Prenatal Exposure Delayed Effects, medicine, Age Factor, Bronchioliti, Intensive care medicine, Inhalation exposure, business.industry, Research, Gestational age, Newborn, medicine.disease, Risk assessment, business, Human, Cohort study
Abstract

Background Tobacco smoke exposure (TSE) is a worldwide health problem and it is considered a risk factor for pregnant women’s and children’s health, particularly for respiratory morbidity during the first year of life. Few significant birth cohort studies on the effect of prenatal TSE via passive and active maternal smoking on the development of severe bronchiolitis in early childhood have been carried out worldwide. Methods From November 2009 to December 2012, newborns born at ≥33 weeks of gestational age (wGA) were recruited in a longitudinal multi-center cohort study in Italy to investigate the effects of prenatal and postnatal TSE, among other risk factors, on bronchiolitis hospitalization and/or death during the first year of life. Results Two thousand two hundred ten newborns enrolled at birth were followed-up during their first year of life. Of these, 120 (5.4 %) were hospitalized for bronchiolitis. No enrolled infants died during the study period. Prenatal passive TSE and maternal active smoking of more than 15 cigarettes/daily are associated to a significant increase of the risk of offspring children hospitalization for bronchiolitis, with an adjHR of 3.5 (CI 1.5–8.1) and of 1.7 (CI 1.1–2.6) respectively. Conclusions These results confirm the detrimental effects of passive TSE and active heavy smoke during pregnancy for infants’ respiratory health, since the exposure significantly increases the risk of hospitalization for bronchiolitis in the first year of life. Electronic supplementary material The online version of this article (doi:10.1186/s12931-015-0312-5) contains supplementary material, which is available to authorized users.

Published
2015
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11. Work environment, volume of activity and staffing in neonatal intensive care units in Italy: results of the SONAR-nurse study

Author

Corchia, C, Fanelli, S, Gagliardi, L, Bellù, R, Zangrandi, A, Persico, A, Zanini, R, SONAR-Nurse Study Group including Bellù, R, Bertino, E, Casati, M, Cazzaniga, A, Plevani, L, Mosca, F, Baracchetti, R, Villa, E, Tandoi, F, Boccacci, S, Martinelli, S, Coscia, P, Poggiani, C, Ferrari, D, Barera, G, Poloniato, A, Ruggeri, V, Burgio, G, Carrera, G, D'Alterio, R, Merazzi, D, Lomazzi, M, Coscia, A, Borgione, S, Anselmo, C, Galletto, P, Gancia, Gp, Parola, A, Sabatini, M, Gazzolo, D, Carli, G, Filippone, M, Lago, P, Heun, N, Visentin, S, Bertolini, A, Padovani, Em, Bellettato, M, Gasparin, B, Serra, A, Santuz, P, Ellero, S, Fantini, M, Contiero, Rm, Gallo, C, Mammoliti, Pm, Ancora, G, Faldella, G, Sandri, F, Stella, M, Biasini, A, Fioravanti, L, Dessì, S, Sigali, E, Vuerich, M, Cacciavellani, R, Bragetti, P, De Curtis, M, Lucchini, R, Parente, G, Massenzi, L, Calibita, G, Haass, C, Scapillati, E, Pietro, S, Dotta, A, D'Agostino, G, Picone, S, Messina, F, Napolitano, M, Salvia, G, Moschella, S, Orfeo, L, Chello, G, Carpentieri, M, Vacchiano, T, Vetrano, G, Rabuano, R, Simonetti, Dm, Quartulli, L, Rinaldi, M, Magaldi, R, Presta, G, Greco, F, Forziati, V, Acito, A, Gatta, A, Quitadamo, P, Rotondo, S, Laforgia, N, Grassi, A, Del Cuore, F, Lucente, M, Costabile, Cd, Nicolò, A, Arco, A, Marseglia, L, Pinna, G, Rosella, V, Giuffrè, M, Marchesano, G, Inferiore, N, Corso, G, Cannuscio, A, Gargano, G, Pedoni, S, Poloni, G, Di Leo, L, Crescenzi, F, Celi, F, Betta, P, Carlo Corchia, Simone Fanelli, Luigi Gagliardi, Roberto Bellù, Antonello Zangrandi, Anna Persico, Rinaldo Zanini, SONAR-Nurse Study GroupCorchia [.., Giacomo Faldella, ], Corchia, C., Fanelli, S., Gagliardi, L., Bellù, R., Zangrandi, A., Persico, A., Zanini, R., Giuffre, M., and SONAR-Nurse Study Group

Subjects
Cross-sectional study, Staffing, Workload, Critical Care Nursing, Pediatrics, 03 medical and health sciences, 0302 clinical medicine, Settore MED/38 - Pediatria Generale E Specialistica, Nursing, 030225 pediatrics, Intensive care, Critical care nursing, Surveys and Questionnaires, Neonatal, Intensive Care Units, Neonatal, Medicine, Humans, Surveys and Questionnaire, 030212 general & internal medicine, Location, Workplace, Cross-Sectional Studie, business.industry, Research, Nurse-Patient Relation, Infant, Newborn, Patient Acuity, Infant, Perinatology and Child Health, Newborn, Nurse-Patient Relations, Cross-Sectional Studies, Italy, Pediatric Nursing, Intensive Care Units, Workforce, Intensive care units, Nurse-patient relations, Patient acuity, Pediatrics, Perinatology and Child Health, Pediatric nursing, business, Human
Abstract

Background Neonatal units’ volume of activity, and other quantitative and qualitative variables, such as staffing, workload, work environment, care organization and geographical location, may influence the outcome of high risk newborns. Data about the distribution of these variables and their relationships among Italian neonatal units are lacking. Methods Between March 2010-April 2011, 63 neonatal intensive care units adhering to the Italian Neonatal Network participated in the SONAR Nurse study. Their main features and work environment were investigated by questionnaires compiled by the chief and by physicians and nurses of each unit. Twelve cross-sectional monthly-repeated surveys on different shifts were performed, collecting data on number of nurses on duty and number and acuity of hospitalized infants. Results Six hundred forty five physicians and 1601 nurses compiled the questionnaires. In the cross-sectional surveys 702 reports were collected, with 11082 infant and 3226 nurse data points. A high variability was found for units’ size (4–50 total beds), daily number of patients (median 14.5, range 3.4-48.7), number of nurses per shift (median 4.2, range 0.7-10.8) and number of team meetings per month. Northern regions performed better than Central and Southern regions for frequency of training meetings, qualitative assessment of performance, motivation within the unit and nursing work environment; mean physicians’ and nurses’ age increased moving from North to South. After stratification by terciles of the mean daily number of patients, the median number of nurses per shift increased at increasing volume of activity, while the opposite was found for the nurse-to-patient ratio adjusted by patients’ acuity. On average, in units belonging to the lower tercile there was 1 nurse every 2.5 patients, while in those belonging to the higher tercile the ratio was 1 nurse every 5 patients. Conclusions In Italy, there is a high variability in organizational characteristics and work environment among neonatal units and an uneven distribution of human resources in relation to volume of activity, suggesting that the larger the unit the greater the workload for each nurse. Urgent modifications in planning and organization of services are needed in order to pursue more efficient, homogeneous and integrated regionalized neonatal care systems.

Published
2016

12. Efficacy of a new technique - INtubate-RECruit-SURfactant-Extubate - 'IN-REC-SUR-E' - in preterm neonates with respiratory distress syndrome: study protocol for a randomized controlled trial.

Author

Vento, Giovanni, Pastorino, Roberta, Boni, L, Cota, Francesco, Carnielli, V, Cools, F, Dani, C, Mosca, F, Pillow, J, Polglase, G, Tagliabue, Roberta Piera, van Kaam, Ah, Ventura, Ml, Tana, Milena, Tirone, Chiara, Aurilia, Claudia, Lio, Alessandra, Ricci, C, Gambacorta, Maria Antonietta, Consigli, C, D'Onofrio, D, Gizzi, C, Massenzi, L, Cardilli, V, Casati, A, Bottino, R, Pontiggia, Federico, Ciarmoli, E, Martinelli, S, Ilardi, L, Colnaghi, M, Matassa, Piero Giuseppe, Vendettuoli, Valentina, Villani, P, Fusco, Francesca Paola, Gazzolo, D, Ricotti, A, Ferrero, F, Stasi, I, Magaldi, R, Maffei, G, Presta, G, Perniola, R, Messina, F, Montesano, G, Poggi, C, Giordano, L, Roma, E, Grassia, C, Ausanio, G, Sandri, F, Mescoli, G, Giura, F, Garani, G, Solinas, A, Lucente, Michele, Nigro, G, Del Vecchio, Angela Maria, Petrillo, F, Orfeo, L, Grappone, L, Quartulli, L, Scorrano, Antonio, Messner, H, Staffler, Alex, Gargano, G, Balestri, E, Nobile, Stefano, Cacace, C, Meli, V, Dallaglio, S, Pasqua, B, Mattia, L, Gitto, E, Vitaliti, M, Re, Mp, Vedovato, S, Grison, A, Berardi, A, Torcetta, F, Guidotti, I, di Fabio, S, Maranella, E, Mondello, I, Visentin, S, Tormena, F., Vento, Giovanni (ORCID:0000-0002-8132-5127), Pastorino, Roberta (ORCID:0000-0001-5013-0733), Cota, Francesco (ORCID:0000-0002-9009-3997), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Nobile, S (ORCID:0000-0002-5304-1485), Vento, Giovanni, Pastorino, Roberta, Boni, L, Cota, Francesco, Carnielli, V, Cools, F, Dani, C, Mosca, F, Pillow, J, Polglase, G, Tagliabue, Roberta Piera, van Kaam, Ah, Ventura, Ml, Tana, Milena, Tirone, Chiara, Aurilia, Claudia, Lio, Alessandra, Ricci, C, Gambacorta, Maria Antonietta, Consigli, C, D'Onofrio, D, Gizzi, C, Massenzi, L, Cardilli, V, Casati, A, Bottino, R, Pontiggia, Federico, Ciarmoli, E, Martinelli, S, Ilardi, L, Colnaghi, M, Matassa, Piero Giuseppe, Vendettuoli, Valentina, Villani, P, Fusco, Francesca Paola, Gazzolo, D, Ricotti, A, Ferrero, F, Stasi, I, Magaldi, R, Maffei, G, Presta, G, Perniola, R, Messina, F, Montesano, G, Poggi, C, Giordano, L, Roma, E, Grassia, C, Ausanio, G, Sandri, F, Mescoli, G, Giura, F, Garani, G, Solinas, A, Lucente, Michele, Nigro, G, Del Vecchio, Angela Maria, Petrillo, F, Orfeo, L, Grappone, L, Quartulli, L, Scorrano, Antonio, Messner, H, Staffler, Alex, Gargano, G, Balestri, E, Nobile, Stefano, Cacace, C, Meli, V, Dallaglio, S, Pasqua, B, Mattia, L, Gitto, E, Vitaliti, M, Re, Mp, Vedovato, S, Grison, A, Berardi, A, Torcetta, F, Guidotti, I, di Fabio, S, Maranella, E, Mondello, I, Visentin, S, Tormena, F., Vento, Giovanni (ORCID:0000-0002-8132-5127), Pastorino, Roberta (ORCID:0000-0001-5013-0733), Cota, Francesco (ORCID:0000-0002-9009-3997), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), and Nobile, S (ORCID:0000-0002-5304-1485)

Abstract

BACKGROUND: Although beneficial in clinical practice, the INtubate-SURfactant-Extubate (IN-SUR-E) method is not successful in all preterm neonates with respiratory distress syndrome, with a reported failure rate ranging from 19 to 69 %. One of the possible mechanisms responsible for the unsuccessful IN-SUR-E method, requiring subsequent re-intubation and mechanical ventilation, is the inability of the preterm lung to achieve and maintain an "optimal" functional residual capacity. The importance of lung recruitment before surfactant administration has been demonstrated in animal studies showing that recruitment leads to a more homogeneous surfactant distribution within the lungs. Therefore, the aim of this study is to compare the application of a recruitment maneuver using the high-frequency oscillatory ventilation (HFOV) modality just before the surfactant administration followed by rapid extubation (INtubate-RECruit-SURfactant-Extubate: IN-REC-SUR-E) with IN-SUR-E alone in spontaneously breathing preterm infants requiring nasal continuous positive airway pressure (nCPAP) as initial respiratory support and reaching pre-defined CPAP failure criteria. METHODS/DESIGN: In this study, 206 spontaneously breathing infants born at 24(+0)-27(+6) weeks' gestation and failing nCPAP during the first 24 h of life, will be randomized to receive an HFOV recruitment maneuver (IN-REC-SUR-E) or no recruitment maneuver (IN-SUR-E) just prior to surfactant administration followed by prompt extubation. The primary outcome is the need for mechanical ventilation within the first 3 days of life. Infants in both groups will be considered to have reached the primary outcome when they are not extubated within 30 min after surfactant administration or when they meet the nCPAP failure criteria after extubation. DISCUSSION: From all available data no definitive evidence exists about a positive effect of recruitment before surfactant instillation, but a rationale exists for testing the following h

Published
2016

14. Abstracts of ESPNIC 2013, the 24th Annual Meeting of the European Society of Paediatric and Neonatal Intensive Care. June 12-15, 2013. Rotterdam, Netherlands PAEDIATRIC INTENSIVE CARE TRAINING FOR NEONATOLOGISTS: A NEW COURSE S58

Author

Pozzi, N., De Luca, M. G., Grappone, L., Tortorolo, L., Scoppa, A., Papoff, Paola, and Orfeo, L.

Subjects
Intensive Care Units, Critical Care, Neonatal, Humans, Infant, Neonatology, Child, Newborn, Pediatrics, Infant, Newborn, Intensive Care Units, Neonatal
Published
2013

15. The multicenter Italian birth cohort study on incidence and determinants of lower respiratory tract infection hospitalization in infants at 33 weeks GA or more: preliminary results

Author

Lanari, M, Adorni, F, Silvestri, M, Coscia, A, Musicco, M, Carlucci, A, Zorzi, G, Di Fabio, S, Faccia, P, La Forgia, N, Loprieno, S, Del Vecchio, A, Corso, G, Orfeo, L, De Luca MG, Faldella, G, Spinelli, M, Bottau, P, Fanos, V, Puddu, M, Rinaldi, M, Barberi, Ignazio, Pagano, Giuseppina, Scarcella, A, Umbaldo, A, Corsello, G, Gabriele, B, Barboni, G, Molinari, L, Boldrini, A, Vuerich, M, Ngalikpima, Cj, Gargano, G, Braibanti, S, Romagnoli, C, Aurilia, C, Paolillo, P, Picone, S, De Curtis, M, Natale, F, Romeo, N, Piano, F, Nosari, N, Sarnelli, P, Parmigiani, S, Corona, Mf, Fabris, C, Gaudino, M, Manzoni, P, Bonomi, A, Ladetto, L, Memo, L, Nicolini, G, Macagno, F, Roadaro, E, Dall'Agnola, A, and Zardini, F.

Published
2011

16. ABSTRACT 467

Author

Scoppa, A., primary, Casani, A., additional, Pozzi, N., additional, and Orfeo, L., additional

Published
2014
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17. Pathophysiology of coarctation of the aorta in dichorionic twins with growth discordance.

Author

Piacentini, G., Mastromoro, G., Bottoni, A., Romano, V., Riccardi, R., and Orfeo, L.

Subjects
FETOFETAL transfusion, AORTIC coarctation, PATHOLOGICAL physiology, TWINS, VASCULAR resistance, LOW birth weight, FETAL growth retardation, GESTATIONAL age, SYMPTOMS, MULTIPLE pregnancy
Abstract

Unequal distribution of uteroplacental blood flow between twins, aberrant placental insertion of the umbilical cord and TTTS represent contributing causes of birth-weight discordance in monochorionic twins. Coarctation of the aorta (CoA) is an abnormal narrowing of the aorta which can occur as an isolated defect or in association with other intracardiac anomalies, in syndromic and non-syndromic patients, with a prevalence of 4 per 1000 live births1. 5 van den Boom J, Battin M, Hornung T. Twin-twin transfusion syndrome, coarctation of the aorta and hypoplastic aortic arch: a case series report. [Extracted from the article]

Published
2022
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20. aEEG in preterm infants

Author

Scoppa, A., primary, Casani, A., additional, Cocca, F., additional, Coletta, C., additional, De Luca, M. G., additional, Di Manso, G., additional, Grappone, L., additional, Pozzi, N., additional, and Orfeo, L., additional

Published
2012
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21. A47 Breastfeeding protects infants against lower respiratory tract infections caused by respiratory syncytial virus. Results from the Italian Cohort Study Group on RSV

Author

Prinelli, F., primary, Musico, M., additional, Adorni, F., additional, Silvestri, M., additional, Coscia, A., additional, Carlucci, A., additional, Zorzi, G., additional, Di Fabio, S., additional, Faccia, P., additional, LaForgia, N., additional, Loprieno, S., additional, Del Vecchio, A., additional, Corso, G., additional, Orfeo, L., additional, De Luca, M.G., additional, Faldella, G., additional, Spinelli, M., additional, Bottau, P., additional, Fanos, V., additional, Puddu, M., additional, Rinaldi, M., additional, Barberi, I., additional, Pagano, G., additional, Scarcella, A., additional, Umbaldo, A., additional, Corsello, G., additional, Gabriele, B., additional, Barboni, G., additional, Molinari, L., additional, Boldrini, A., additional, Vuerich, M., additional, Ngalikpima, C.J., additional, Gargano, G., additional, Braibanti, S., additional, Romagnoli, C., additional, Aurilia, C., additional, Paolillo, P., additional, Picone, S., additional, De Curtis, M., additional, Natale, F., additional, Romeo, N., additional, Piano, F., additional, Nosari, N., additional, Sarnelli, P., additional, Parmigiani, S., additional, Corona, M.F., additional, Fabris, C., additional, Gaudino, M., additional, Bonomi, A., additional, Ladetto, L., additional, Memo, L., additional, Nicolini, G., additional, Macagno, F., additional, Rodaro, E., additional, Dall'Agnola, A., additional, Zardini, F., additional, Manzoni, P., additional, and Lanari, M., additional

Published
2012
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23. Survey of neonatal respiratory care and surfactant administration in very preterm infants in the Italian neonatal network

Author

Bellù R, Gagliardi L, Tagliabue P, Corchia C, Vendettuoli V, Mosca F, Zanini R, Condò M, Turoli D, Weissmann G, Vanzati M, De Nisi G, Villa E, Moro G, Guerrini P, Contiero R, Ellero S, Furlan R, Abbiati L, Borroni C, Prandi G, Fabris C, Vielmi F, Agosti M, Tandoi F, Guidali, De Curtis M, Tozzi C, Lucchini R, Battaglioli M, Lista GL, Introvini P, Ferrari F, Gallo C, Cervello P, Bellante E, Bottura C, Pasquali F, Boccacci S, Latini G, Giannuzzi R, Martinelli S, Brunelli A, Motta G, Di Nunzio ML, Vendemiati A, Zorzi C, Carli G, Alfiero, Romeo N, Mammoliti P, Mastretta E, Barberis L, Farina D, Gancia G, Dalmazzo C, Napolitano M, Messina F, Rinaldi G, Magaldi R, Rinaldi M, Litta R, Lago P, Zanardo V, Chiandetti L, Visentin S, Presta G, Cella D, Poggiani C, Ferrari D, Parati S, Lombardo F, Grigorio R, Barera G, Franco M, Poloniato A, Colombo A, Burgio G, Sala E, Barberi I, Tiralongo V, Arco A, Careggi F, Dani C, Pratesi S, Mignatti V, Ancora G, Faldella G, Grandi S, Stronati M, Perotti G, Chirico G, Migliori C, De Marini S, Forleo V, Mansi G, Bona G, Stucchi I, Savastio, Ferrero F, Parola A, Padovani EM, Viviani E, Pecoraro L, Tiberina FI, Agostino R, Gizzi C, Massenzi L, Messner H, Staffier A, Salvia G, Esposito L, Forziati V, Latorre G, Sandri F, Alati S, Demaria F, Lombardi O, Costabile CD, Scarpelli G, Cavalli C, Volante E, Proietti D, Ganguzza O, Spinella B, Pietro RS, Haass C, Scapillati E, Consigli C, Gatta A, Quitadamo P, Boldrini A, Vuerich M, Sigali E, Ghirri P, Fiorini P, Petrucci L, Moroni M, Braghetti P, Casucci P, Minelli L, Mezzetti D, Orfeo L, De Luca MG, Laforgia N, Grassi A, Gesu RB, Dotta A, Savignoni F, Bagnoli F, De Felice C, Badii S, Biasini A, Belluzzi A, Stella M, Romagnoli C, Zecca E, Barone G, Colleselli P, Vecchiato L, Nicolussi D, Monaldi N, Giliberti P, Chello G, Rojo S, Giovanettoni C, Colnaghi CA, Verucci E, Placidi G, Belloni C, Carrera G, Zambetti C, Biban P, Serra A, Carnielli V, Pedini A, Vetrano G, Furcolo G, Pasquariello B, Falco L, Ausanio G, Bernardo I, Marchesano G, Nosari N, Sarnelli P, Maccabruni M, Merazzi D, Gazzolo D, Sabatini FT, Colivicchi M, Del Vecchio A, Tarantino M, Gargano G, Pedori S, Bellettato M, Pesavento R, Cesaro A, Nicolò A, Mondello I, Pugliese A, Iervolino C, Corsello G, Giuffré M, Betta M, Romeo MG, Saporito A, D'Incecco C, Perrone B, Rodonò MG, Serra G, Franceschi A, Risso FM, Carpentieri M, Cigliano MP, Casilino R, Paolillo P, Picone S, Marra A, Rossetti D, Testa T, Del Cuore F., PALUDETTO, ROBERTO, CAPASSO, LETIZIA, RAIMONDI, FRANCESCO, Bellù, R, Gagliardi, L, Tagliabue, P, Corchia, C, Vendettuoli, V, Mosca, F, Zanini, R, Corsello, G, Giuffrè, M, Italian Neonatal Network., Condò, M, Turoli, D, Weissmann, G, Vanzati, M, De Nisi, G, Villa, E, Moro, G, Guerrini, P, Contiero, R, Ellero, S, Furlan, R, Abbiati, L, Borroni, C, Prandi, G, Fabris, C, Vielmi, F, Agosti, M, Tandoi, F, Guidali, De Curtis, M, Tozzi, C, Lucchini, R, Battaglioli, M, Lista, Gl, Introvini, P, Ferrari, F, Gallo, C, Cervello, P, Bellante, E, Bottura, C, Pasquali, F, Boccacci, S, Latini, G, Giannuzzi, R, Martinelli, S, Brunelli, A, Motta, G, Di Nunzio, Ml, Vendemiati, A, Zorzi, C, Carli, G, Alfiero, Romeo, N, Mammoliti, P, Mastretta, E, Barberis, L, Farina, D, Gancia, G, Dalmazzo, C, Napolitano, M, Messina, F, Rinaldi, G, Magaldi, R, Rinaldi, M, Litta, R, Lago, P, Zanardo, V, Chiandetti, L, Visentin, S, Presta, G, Cella, D, Poggiani, C, Ferrari, D, Parati, S, Lombardo, F, Grigorio, R, Barera, G, Franco, M, Poloniato, A, Colombo, A, Burgio, G, Sala, E, Barberi, I, Tiralongo, V, Arco, A, Careggi, F, Dani, C, Pratesi, S, Mignatti, V, Ancora, G, Faldella, G, Grandi, S, Stronati, M, Perotti, G, Chirico, G, Migliori, C, De Marini, S, Forleo, V, Paludetto, Roberto, Capasso, Letizia, Mansi, G, Raimondi, Francesco, Bona, G, Stucchi, I, Savastio, Ferrero, F, Parola, A, Padovani, Em, Viviani, E, Pecoraro, L, Tiberina, Fi, Agostino, R, Gizzi, C, Massenzi, L, Messner, H, Staffier, A, Salvia, G, Esposito, L, Forziati, V, Latorre, G, Sandri, F, Alati, S, Demaria, F, Lombardi, O, Costabile, Cd, Scarpelli, G, Cavalli, C, Volante, E, Proietti, D, Ganguzza, O, Spinella, B, Pietro, R, Haass, C, Scapillati, E, Consigli, C, Gatta, A, Quitadamo, P, Boldrini, A, Vuerich, M, Sigali, E, Ghirri, P, Fiorini, P, Petrucci, L, Moroni, M, Braghetti, P, Casucci, P, Minelli, L, Mezzetti, D, Orfeo, L, De Luca, Mg, Laforgia, N, Grassi, A, Gesu, Rb, Dotta, A, Savignoni, F, Bagnoli, F, De Felice, C, Badii, S, Biasini, A, Belluzzi, A, Stella, M, Romagnoli, C, Zecca, E, Barone, G, Colleselli, P, Vecchiato, L, Nicolussi, D, Monaldi, N, Giliberti, P, Chello, G, Rojo, S, Giovanettoni, C, Colnaghi, Ca, Verucci, E, Placidi, G, Belloni, C, Carrera, G, Zambetti, C, Biban, P, Serra, A, Carnielli, V, Pedini, A, Vetrano, G, Furcolo, G, Pasquariello, B, Falco, L, Ausanio, G, Bernardo, I, Marchesano, G, Nosari, N, Sarnelli, P, Maccabruni, M, Merazzi, D, Gazzolo, D, Sabatini, Ft, Colivicchi, M, Del Vecchio, A, Tarantino, M, Gargano, G, Pedori, S, Bellettato, M, Pesavento, R, Cesaro, A, Nicolò, A, Mondello, I, Pugliese, A, Iervolino, C, Giuffré, M, Betta, M, Romeo, Mg, Saporito, A, D'Incecco, C, Perrone, B, Rodonò, Mg, Serra, G, Franceschi, A, Risso, Fm, Carpentieri, M, Cigliano, Mp, Casilino, R, Paolillo, P, Picone, S, Marra, A, Rossetti, D, Testa, T, and Del Cuore, F.

Subjects
Preterm infants, Ventilation, Ventilatory support, Medicine (all), Drug Utilization, Humans, Infant Mortality, Infant, Newborn, Infant, Very Low Birth Weight, Intubation, Intratracheal, Italy, Oxygen Inhalation Therapy, Pulmonary Surfactants, Respiration, Artificial, Infant, Premature, Settore MED/38 - Pediatria Generale E Specialistica, Premature, Very Low Birth Weight, Respiration, Infant, Newborn, national survay, Intratracheal, Very preterm infant, national survay, neonatal respiratory care, Very preterm infant, Artificial, Preterm infant, neonatal respiratory care, Intubation
Abstract

INTRODUCTION: Variation of respiratory care is described between centers around the world. The Italian Neonatal Network (INN), as a national group of the Vermont-Oxford Network (VON) allows to perform a wide analysis of respiratory care in very low birth weight infants. METHODS: We analyzed the dataset of infants enrolled in the INN in 2009 and 2010 and, for surfactant administration only, from 2006 to 2010 from 83 participating centers. All definitions are those of the (VON). A questionnaire analysis was also performed with a questionnaire on centers practices. RESULTS: We report data for 8297 infants. Data on ventilator practices and outcomes are outlined. Variation for both practices and outcome is found. Trend in surfactant administration is also analyzed. CONCLUSIONS. The great variation across hospitals in all the surveyed techniques points to the possibility of implementing potentially better practices with the aim of reducing unwanted variation. These data also show the power of large neonatal networks in identifying areas for potential improvement.

25. 'Prove di lettura M.T : comprensione'

Author

Formica, M. M., Benafozzil, Benincasa, P, Damico, A, Deidda, L, DI CUBO, A, Feda, I, Frascarelli, M, Guarino, C, Minardi, A, Moreschini, Oreste, Orfeo, L, Rocchi, L, and Scivittaro

Published
1985

27. 'La chirurgia ortopedica nelle D.M.P.'

Author

Formica, M. M., Benafozzil, Benincasa, P, Damico, A, Deidda, L, DI CUBO, A, Feda, I, Frascarelli, M, Guarino, C, Minardi, A, Moreschini, Oreste, Orfeo, L, Rocchi, L, and Scivittaro

Published
1985

30. [Phototherapy: recent acquisitions, indications and limits]

Author

Paludetto, R, Orfeo, L, DE CURTIS, Mario, and Manzi, F.

Subjects
Male, Exchange Transfusion, Whole Blood, Infant, Newborn, Infant, Jaundice, Phototherapy, Newborn, Jaundice, Neonatal, Neonatal, Humans, Female, Hyperbilirubinemia, Exchange Transfusion, Whole Blood
Published
1982

37. Periferie al centro

Author

Renato Capozzi, A. Attatdemo, E. Bassolino, C. Orfeo, L. Veronese, and Capozzi, Renato

Published
2021

39. Il rione e la parte urbana. Soccavo-Canzanella, 1955-1963

Author

P. Galante, A. Attademo, E. Bassolino, C. Orfeo, L. Veronesi, and Galante, P.

Subjects
Parte Urbana, Strada, Specie di Spazi
Abstract

Il contributo prende in esame il quartiere di edilizia pubblica Soccavo Canzanella come esempio rappresentativo dei principi e delle linee guida emanati nel secondo settennio di attività di INA-CASA.

Published
2020

40. Lo studio dell'osso al microscopio

Author

GUARINO, FABIO MARIA, Salvatore Forgione, Orfeo L. A. Picariello, and Guarino, FABIO MARIA

Subjects
osso antico, Microscopia ottica
Published
2015

41. Prune Belly appearance in a Turner subject

Author

M Stabile, G. Esposito, S Iannuzzi, V Ventruto, U De Bellis, L. Orfeo, A. Savanelli, Savanelli, Antonio, Orfeo, L, Stabile, M, Iannuzzi, S, De Bellis, U, Esposito, G, and Ventruto, V.

Subjects
Genetics, Male, Turner Syndrome, Subject (documents), Karyotype, Anatomy, Biology, medicine.disease, Chromosome Banding, Phenotype, Prune belly syndrome, Prune belly, Turner syndrome, medicine, Humans, Prune Belly Syndrome, Female, Genetics (clinical), Research Article
Published
1986

42. Lung Recruitment Before Surfactant Administration in Extremely Preterm Neonates: 2-Year Follow-Up of a Randomized Clinical Trial.

Author

Gallini F, De Rose DU, Iuliano R, Romeo DM, Tana M, Paladini A, Fusco FP, Nobile S, Cota F, Tirone C, Aurilia C, Lio A, Esposito A, Costa S, D'Andrea V, Ventura ML, Carnielli V, Dani C, Mosca F, Fumagalli M, Scarpelli G, Giordano L, Fasolato V, Petrillo F, Betta P, Solinas A, Gitto E, Gargano G, Mescoli G, Martinelli S, Di Fabio S, Bernardo I, Tina LG, Staffler A, Stasi I, Mondello I, Scapillati E, Vedovato S, Maffei G, Bove A, Vitaliti M, Terrin G, Lago P, Gizzi C, Strozzi C, Villani PE, Berardi A, Cacace C, Bracaglia G, Pascucci E, Cools F, Pillow JJ, Polglase G, Pastorino R, van Kaam AH, Mercuri E, Orfeo L, Vento G, Malguzzi S, Rigotti C, Cecchi A, Nigro G, Costabile CD, Roma E, Sindico P, Venafra R, Mattia C, Conversano M, Ballardini E, Manganaro A, Balestri E, Gallo C, Catenazzi P, Astori MG, Maranella E, Grassia C, Maiolo K, Castellano D, Massenzi L, Chiodin E, Gallina MR, Consigli C, Sorrentino E, Bonato S, Mancini M, Perniola R, Giannuzzo S, Tranchina E, Cardilli V, Dito L, Regoli D, Tormena F, Battajon N, Arena R, Allais B, Guidotti I, Roversi F, Meli V, Tulino V, and Casati A

Subjects
Humans, Male, Female, Infant, Newborn, Follow-Up Studies, High-Frequency Ventilation methods, Child, Preschool, Intensive Care Units, Neonatal statistics & numerical data, Treatment Outcome, Italy, Infant, Pulmonary Surfactants administration & dosage, Pulmonary Surfactants therapeutic use, Infant, Extremely Premature, Respiratory Distress Syndrome, Newborn therapy, Respiratory Distress Syndrome, Newborn drug therapy
Abstract

Importance: A multicenter randomized clinical trial (RCT) showed a lung recruitment maneuver using high-frequency oscillatory ventilation just before surfactant administration (ie, intubate-recruit-surfactant-extubate [IN-REC-SUR-E]) improved the efficacy of treatment compared with the standard intubate-surfactant-extubate (IN-SUR-E) technique without increasing the risk of adverse neonatal outcomes., Objective: To examine follow-up outcomes at corrected postnatal age (cPNA) 2 years of preterm infants previously enrolled in an RCT and treated with IN-REC-SUR-E or IN-SUR-E in 35 tertiary neonatal intensive care units., Design, Setting, and Participants: This was a follow-up study of infants recruited into the primary RCT from 2015 to 2018 at 35 tertiary neonatal intensive care units (NICUs) in Italy. Follow-up examinations included neurodevelopmental, growth, and respiratory outcomes of these children at cPNA 2 years. Participants included spontaneously breathing extremely preterm neonates (24 0/7 to 27 6/7 weeks' gestation) reaching failure criteria for continuous positive airway pressure within the first 24 hours of life. Data were analyzed from April 2023 to January 2024., Intervention: Infants were randomly assigned (1:1) to IN-REC-SUR-E or IN-SUR-E and then followed up., Main Outcomes and Measures: The primary outcome was the occurrence of death after discharge or major disability at cPNA 2 years. Secondary outcomes were neurodevelopmental outcomes (major disability, cerebral palsy, cognitive impairment, visual deficit, or auditory deficit), anthropometric measurements (weight, length, and head circumference), and recurrent respiratory infections and hospitalizations because of respiratory causes at 2y cPNA., Results: A total of 137 extremely preterm infants (median [IQR] gestational age, 26.5 [25.3-27.5] weeks and 75 [54.7%] female), initially enrolled in the original RCT, were followed up at cPNA 2 years, including 64 infants in the IN-SUR-E group and 73 infants in the IN-REC-SUR-E group. There were no significant differences in the occurrence of death after discharge or major disability at cPNA 2 years (IN-SUR-E: 13 children [20.3%] vs IN-REC-SUR-E: 10 children [13.7%]; P = .36). There were no significant differences in incidence of disability, cerebral palsy, or cognitive impairment in the IN-REC-SUR-E group compared with the IN-SUR-E group. There were no significant differences in anthropometric measurements (weight, length, and head circumference) between groups. There were no significant differences in the incidence of recurrent respiratory infections or in hospitalizations because of respiratory causes between groups., Conclusions and Relevance: In this RCT of lung recruitment before surfactant vs standard care there were no significant differences between the 2 groups in death, neurodevelopmental outcomes, anthropometric measurements, or recurrent respiratory infections at the 2-year follow-up. These findings can aid clinicians in decision-making for the best strategy to administer surfactant, considering long-term outcomes.

Published
2024
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44. Safe and efficient practice of parenteral nutrition in neonates and children aged 0-18 years - The role of licensed multi-chamber bags.

Author

Senterre T, van den Akker CHP, Domellof M, Saenz de Pipaon M, Arnell H, Tabbers M, Valla FV, Tomlin S, Paulsson M, Wackernagel D, Haiden N, Luukkainen P, Orfeo L, Carnielli VP, and Rigo J

Subjects
Humans, Infant, Newborn, Infant, Child, Child, Preschool, Adolescent, Parenteral Nutrition Solutions standards, Infant, Premature, Practice Guidelines as Topic, Infant, Very Low Birth Weight, Parenteral Nutrition standards, Parenteral Nutrition methods
Abstract

Parenteral nutrition (PN) is recognized as a complex high-risk therapy. Its practice is highly variable and frequently suboptimal in pediatric patients. Optimizing care requires evidence, consensus-based guidelines, audits of practice, and standardized strategies. Several pediatric scientific organizations, expert panels, and authorities have recently recommended that standardized PN should generally be used over individualized PN in the majority of pediatric patients including very low birth weight premature infants. In addition, PN admixtures produced and validated by a suitably qualified institution are recommended over locally produced PN. Licensed multi chamber bags are standardized PN bags that comply with Good Manufacturing Practice and high-quality standards for the finished product in the frame of their full manufacturing license. The purpose of this article is to review the practical aspects of PN and the evidence for using such multi-chamber bags in pediatric patients. It highlights the safety characteristics and the limitations of the different PN practices and provides some guidance for ensuring safe and efficient therapy in pediatric patients., Competing Interests: Conflict of Interest VC, MD, NH, JR, MSDP, ST, FV, DW, and CvdA have received honoraria from Baxter Healthcare Corporation for symposium participation or scientific education activity. HA has received honoraria from Baxter Healthcare Corporation and Fresenius Kabi for symposium participation or scientific education activity. MP has received honoraria from Baxter Healthcare Corporation, Fresenius Kabi, and B. Braun for symposium participation or education scientific activity. MD, VC and MT have received investigator-initiated research grants from the Baxter Healthcare Corporation (money paid to their institutions). TS is an employee of Baxter Healthcare Corporation. PL and LO have no conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2024
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45. Trends in hospitalizations of children with respiratory syncytial virus aged less than 1 year in Italy, from 2015 to 2019.

Author

Cutrera R, d'Angela D, Orso M, Guadagni L, Vittucci AC, Bertoldi I, Polistena B, Spandonaro F, Carrieri C, Montuori EA, Iantomasi R, and Orfeo L

Subjects
Humans, Italy epidemiology, Retrospective Studies, Infant, Female, Male, Infant, Newborn, Length of Stay statistics & numerical data, Respiratory Syncytial Virus Infections epidemiology, Respiratory Syncytial Virus Infections therapy, Hospitalization statistics & numerical data
Abstract

Background: Respiratory syncytial virus (RSV) affects 60-80% of children below 1 year and it's the first cause of acute bronchiolitis. The aim of this study was to assess the trend and characteristics of hospitalizations for RSV infections in Italy., Methods: This is a retrospective study based on the Italian Hospital Discharge Record (HDR) database. We analysed HDRs from June 2015 to May 2019, considering two groups of infants: Group 1 had a confirmed diagnosis of RSV; Group 2 had a diagnosis of acute bronchiolitis not RSV-coded., Results: There were 67,746 overall hospitalizations (40.1% Group 1, and 59.9% Group 2). Hospitalization rate increased for Group 1 from 125 to 178 per 10,000 infants (+ 42.4%), and for Group 2 from 210 to 234 per 10,000 (+ 11.4%). The mean hospitalization length was 6.3 days in Group 1, longer than Group 2 (+ 1.0 day). A further analysis revealed that infants with heart disease or born premature had longer mean hospital stay compared to infants without risk factors (10.7 days versus 6.1 days, p < 0.0001; 34.0 days versus 6.1 days, p < 0.0001, respectively). Group 1 required more critical care (oxygen therapy and/or mechanical ventilation) than Group 2. We found that, in proportion to hospital admissions in pediatric and general hospitals, RSV was more frequently diagnosed in the first ones. The mean hospitalization cost increased for Group 1 (from € 2,483 to € 2,617) and Group 2 (from € 2,007 to € 2,180)., Conclusions: Our results confirmed that RSV pulmonary disease in infants is seasonal and often requires hospitalization. Our study suggested that RSV is responsible for an increasing hospitalization rate and related costs during the study period., (© 2024. The Author(s).)

Published
2024
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46. Laryngeal Mask Airway in Neonatal Resuscitation: A Survey of the Union of European Neonatal and Perinatal Societies.

Author

Trevisanuto D, Gizzi C, Cavallin F, Beke A, Buonocore G, Charitou A, Cucerea M, Filipović-Grčić B, Jekova NG, Koç E, Saldanha J, Stoniene D, Varendi H, De Bernardo G, Madar J, Hogeveen M, Orfeo L, Mosca F, Vertecchi G, and Moretti C

Abstract

Introduction: Laryngeal mask airway (LMA) use in neonatal resuscitation is limited despite existing evidence and recommendations. This survey investigated the knowledge and experience of healthcare providers on the use of the LMA and explored barriers and solutions for implementation., Methods: This online, cross-sectional survey on LMA in neonatal resuscitation involved healthcare professionals of the Union of European Neonatal and Perinatal Societies (UENPS)., Results: A total of 858 healthcare professionals from 42 countries participated in the survey. Only 6% took part in an LMA-specific course. Some delivery rooms were not equipped with LMA (26.1%). LMA was mainly considered after the failure of a face mask (FM) or endotracheal tube (ET), while the first choice was limited to neonates with upper airway malformations. LMA and FM were considered easier to position but less effective than ET, while LMA was considered less invasive than ET but more invasive than FM. Participants felt less competent and experienced with LMA than FM and ET. The lack of confidence in LMA was perceived as the main barrier to its implementation in neonatal resuscitation. More training, supervision, and device availability in delivery wards were suggested as possible actions to overcome those barriers., Conclusion: Our survey confirms previous findings on limited knowledge, experience, and confidence with LMA, which is usually considered an option after the failure of FM/ET. Our findings highlight the need for increasing the availability of LMA in delivery wards. Moreover, increasing LMA training and having an LMA expert supervisor during clinical practice may improve the implementation of LMA use in neonatal clinical practice., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Published
2024
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47. Ototoxic and nephrotoxic drugs in neonatal intensive care units: results of a Spanish and Italian survey.

Author

Arribas C, Decembrino N, Raffaeli G, Amodeo I, González-Caballero JL, Riaza M, Ortiz-Movilla R, Massenzi L, Gizzi C, Araimo G, Cattarelli D, Aversa S, Martinelli S, Frezza S, Orfeo L, Mosca F, Cavallaro G, and Garrido F

Subjects
Humans, Italy, Infant, Newborn, Cross-Sectional Studies, Prospective Studies, Spain, Drug Monitoring methods, Drug Monitoring statistics & numerical data, Ibuprofen adverse effects, Sodium Potassium Chloride Symporter Inhibitors adverse effects, Surveys and Questionnaires, Female, Kidney Diseases chemically induced, Kidney Diseases epidemiology, Infant, Premature, Male, Intensive Care Units, Neonatal statistics & numerical data, Aminoglycosides adverse effects, Ototoxicity etiology, Vancomycin adverse effects
Abstract

Neonates face heightened susceptibility to drug toxicity, often exposed to off-label medications with dosages extrapolated from adult or pediatric studies. Premature infants in Neonatal Intensive Care Units (NICUs) are particularly at risk due to underdeveloped pharmacokinetics and exposure to multiple drugs. The study aimed to survey commonly used medications with a higher risk of ototoxicity and nephrotoxicity in Spanish and Italian neonatal units. A prospective cross-sectional study was conducted in Italian and Spanish neonatal units using a web-based survey with 43 questions. A modified Delphi method involved experts refining the survey through online consensus. Ethical approval was obtained, and responses were collected from January to July 2023. The survey covered various aspects, including drug-related ototoxic and nephrotoxic management, hearing screening, and therapeutic drug monitoring. Responses from 131 participants (35.9% from Spain and 64.1% from Italy) revealed awareness of drug toxicity risks. Varied practices were observed in hearing screening protocols, and a high prevalence of ototoxic and nephrotoxic drug use, including aminoglycosides (100%), vancomycin (70.2%), loop diuretics (63.4%), and ibuprofen (62.6%). Discrepancies existed in guideline availability and adherence, with differences between Italy and Spain in therapeutic drug monitoring practices., Conclusions: The study underscores the need for clinical guidelines and uniform practices in managing ototoxic and nephrotoxic drugs in neonatal units. Awareness is high, but inconsistencies in practices indicate a necessity for standardization, including the implementation of therapeutic drug monitoring and the involvement of clinical pharmacologists. Addressing these issues is crucial for optimizing neonatal care in Southern Europe., What Is Known: • Neonates in intensive care face a high risk of nephrotoxicity and ototoxicity from drugs like aminoglycosides, vancomycin, loop diuretics, and ibuprofen. • Therapeutic drug monitoring is key for managing these risks, optimizing dosing for efficacy and minimizing side effects., What Is New: • NICUs in Spain and Italy show high drug toxicity awareness but differ in ototoxic/nephrotoxic drug management. • Urgent need for standard guidelines and practices to address nephrotoxic risks from aminoglycosides, vancomycin, loop diuretics, and ibuprofen., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2024
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48. SARS-CoV-2 perinatal transmission and neonatal outcomes across four different waves of COVID-19 pandemic: A nationwide prospective cohort study from the Italian Society of Neonatology.

Author

Pugni L, Crippa BL, Raimondi F, Vento G, Mangili G, Coscia A, Artieri G, Ronchi A, Ventura ML, Lago P, Pietrasanta C, Crimi R, Bonfante G, Perrone S, Boncompagni A, Solinas A, Agosti M, Poggi C, Falcone A, Pagliotta C, Gianotti D, Gottardi G, Paviotti G, Allodi A, Maffei G, Proto A, Travierso A, Salomè S, Costa S, Ferrari S, Peila C, Sinelli M, Fanelli F, Giordano L, Saruggia M, Capasso L, Spada E, Gizzi C, Orfeo L, and Mosca F

Subjects
Infant, Newborn, Female, Pregnancy, Humans, Infant, SARS-CoV-2, Pandemics, Prospective Studies, Cohort Studies, Infectious Disease Transmission, Vertical, Italy epidemiology, Mothers, COVID-19 epidemiology, Neonatology, Pregnancy Complications, Infectious epidemiology
Abstract

Objectives: To describe how SARS-CoV-2 infection at the time of delivery affected maternal and neonatal outcomes across four major waves of the COVID-19 pandemic in Italy., Methods: This is a large, prospective, nationwide cohort study collecting maternal and neonatal data in case of maternal peripartum SARS-CoV-2 infection between February 2020 and March 2022. Data were stratified across the four observed pandemic waves., Results: Among 5201 COVID-19-positive mothers, the risk of being symptomatic at delivery was significantly higher in the first and third waves (20.8-20.8%) than in the second and fourth (13.2-12.2%). Among their 5284 neonates, the risk of prematurity (gestational age <37 weeks) was significantly higher in the first and third waves (15.6-12.5%). The risk of intrauterine transmission was always very low, while the risk of postnatal transmission during rooming-in was higher and peaked at 4.5% during the fourth wave. A total of 80% of positive neonates were asymptomatic., Conclusion: The risk of adverse maternal and neonatal outcomes was significantly higher during the first and third waves, dominated by unsequenced variants and the Delta variant, respectively. Postnatal transmission accounted for most neonatal infections and was more frequent during the Omicron period. However, the paucity of symptoms in infected neonates should lead us not to separate the dyad., Competing Interests: Declaration of Competing Interest All authors have no competing interests to declare., (Copyright © 2023. Published by Elsevier Ltd.)

Published
2024
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49. Brain Growth Evaluation Assessed with Transfontanellar (B-GREAT) Ultrasound. Old and New Bedside Markers to Estimate Cerebral Growth in Preterm Infants: a Pilot Study.

Author

Arena R, Gallini F, De Rose DU, Conte F, Giraldi L, Pianini T, Perri A, Catenazzi P, Orfeo L, Vento G, and Govaert P

Subjects
Infant, Infant, Newborn, Humans, Pilot Projects, Prospective Studies, Reproducibility of Results, Gestational Age, Infant, Premature, Brain diagnostic imaging
Abstract

Objective: We aimed to investigate the feasibility of evaluating overall preterm brain growth using a gathered set of measurements of brain structures in standard cranial ultrasound planes. We called this method of assessment Brain Growth Evaluation Assessed with Transfontanellar ultrasound (B-GREAT)., Study Design: In this prospective observational cohort study, cranial ultrasound was regularly performed (on day 1, 2, 3, and 7 of life, and then weekly until discharge, and at term) in preterm infants born with gestational age (GA) less than 32 weeks. We evaluated corpus callosum length, corpus callosum-fastigium length, anterior horn width, frontal white matter height, total brain surface, deep grey matter height, hemisphere height, transverse cerebellar diameter in the axial view, and transverse cerebellar diameter coronal view. Measurements obtained were used to develop growth charts for B-GREAT markers as a function of postmenstrual age. Reproducibility of B-GREAT markers was studied., Results: A total of 528 cranial ultrasounds were performed in 80 neonates (median birth GA: 28 +5 weeks and interquartile range: 27 +3 -30 +5 ). The intraclass correlation coefficients for intra-observer and inter-observer analyses showed substantial agreement for all B-GREAT markers. Growth curves for B-GREAT markers were developed., Conclusion: B-GREAT is a feasible and reproducible method for bedside monitoring of the growth of the main brain structures in preterm neonates., Key Points: · Overall neonatal brain growth is not routinely monitored using ultrasound.. · Old and new markers were used to build a standardized and non-invasive tool to monitor brain growth.. · All B-GREAT measurements had a good intra-observer and inter-observer agreement.., Competing Interests: None declared., (Thieme. All rights reserved.)

Published
2024
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50. Intersociety Position Statement on the Prevention of Ophthalmia Neonatorum in Italy.

Author

Tzialla C, Auriti C, Aversa S, Merazzi D, Martinelli S, Araimo G, Massenzi L, Cavallaro G, Gagliardi L, Giuffrè M, Mosca F, Cetin I, Trojano V, Valensise H, Colacurci N, Orfeo L, Mondì V, and On Behalf Of Their Respective Scientific Societies

Abstract

There is currently no worldwide agreement on the real need to administer conjunctival antibiotics to neonates at birth to prevent neonatal conjunctivitis (usually defined as ophthalmia neonatorum) by Chlamydia trachomatis and Neisseria gonorrhoeae . Therefore, there is wide variability in antibiotic administration, conditioned mainly by the social and health context. In Italy, a law enacted in 1940 required doctors and midwives to administer ophthalmic prophylaxis with 2% silver nitrate to all newborns at birth. This law was repealed in 1975 and since then there has been no clear guidance on the use of ophthalmia neonatorum prophylaxis at birth. Since neonatal conjunctivitis caused by C. trachomatis and N. gonorrhoeae is not reported, we carried out a nationwide survey of 1,041,384 neonates across all Italian birth centers to evaluate the incidence of ophthalmia neonatorum and the current practice of prophylaxis. After analyzing the results, we formulated an intersociety position statement on the prevention of ophthalmia neonatorum to update and standardize this prevention strategy in Italy.

Published
2023
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