46 results on '"Sibasis Daspal"'
Search Results
2. Screening for Retinopathy of Prematurity Through Utilization a Pediatric Retinal Camera at Jim Pattison Children’s Hospital: A Vision for Improved Care
- Author
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Malshi Karunatilake MD, Sibasis Daspal MD, Veronica Mugarab Samedi MD, Shehla Rubab MD, and Vasudha Erraguntla MD
- Subjects
Pediatrics ,RJ1-570 - Abstract
Retinopathy of Prematurity (ROP) is a vascular proliferative disorder of preterm infants, with increased disease severity and incidence occurring with lower gestational age and birth weight. An alternate approach to ROP screening with wide-field digital retinal imaging helps with the early detection of ROP, especially during the pandemic.
- Published
- 2021
- Full Text
- View/download PDF
3. Rainbow of colors: Inspissated bile syndrome secondary to hemolytic disease of the newborn and concomitant serum dynamics
- Author
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Veronica Mugarab Samedi, Mehrieh Rahimi, Kaartigean Kalaniti, Martha Lyon, and Sibasis Daspal
- Subjects
Medicine (General) ,R5-920 - Abstract
The recent clinical experience with hemolytic disease of the newborn and its post-icteric sequelae is limited among high-income countries because of nearly over four decades of effective prevention care. In this case, we will discuss the sequelae of a baby born with hemolytic disease of the newborn to an Rh negative mother with no prenatal care from remote northern Saskatchewan. Inspissated bile syndrome is a rare but serious complication of hemolytic disease of the newborn. The concentration of hemolytic products parallels with serum color changes.
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- 2021
- Full Text
- View/download PDF
4. Is Video Laryngoscopy the Optimal Tool for Successful Intubation in a Neonatal Simulation Setting? A Single-Center Experience
- Author
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Iram Musharaf, Sibasis Daspal, and John Shatzer
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direct laryngoscopy ,intubation ,neonatal ,simulation ,video laryngoscopy ,Gynecology and obstetrics ,RG1-991 - Abstract
Background Endotracheal intubation is a skill required for resuscitation. Due to various reasons, intubation opportunities are decreasing for health care providers. Objective To compare the success rate of video laryngoscopy (VL) and direct laryngoscopy (DL) for interprofessional neonatal intubation skills in a simulated setting. Methods This was a prospective nonrandomized simulation crossover trial. Twenty-six participants were divided into three groups based on their frequency of intubation. Group 1 included pediatric residents; group 2 respiratory therapists and transport nurses; and group 3 neonatal nurse practitioners and physicians working in neonatology. We compared intubation success rate, intubation time, and laryngoscope preference. Results Success rates were 100% for both DL and VL in groups 1 and 2, and 88.9% for DL and 100% for VL in group 3. Median intubation times for DL and VL were 22 seconds (interquartile range [IQR] 14.3–22.8 seconds) and 12.5 seconds (IQR 10.3–38.8 seconds) in group 1 (p = 0.779); 17 seconds (IQR 8–21 seconds) and 12 seconds (IQR 9–16.5 seconds) in group 2 (p = 0.476); and 11 seconds (IQR 7.5–15.5 seconds) and 15 seconds (IQR 11.5–36 seconds) in group 3 (p = 0.024). Conclusion We conclude that novice providers tend to perform better with VL, while more experienced providers perform better with DL. In this era of decreased clinical training opportunities, VL may serve as a useful tool to teach residents and other novice health care providers.
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- 2020
- Full Text
- View/download PDF
5. The Value of Different Radiological Modalities in Assessment of Spontaneous Pneumomediastinum: Case Review and Diagnostic Perspective
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Poonam Singh Jariwala, Kaarthigeyan Kalaniti, Neil Wonko, Sibasis Daspal, and Veronica Mugarab Samedi
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neonate ,pneumomediastinum ,lung ultrasound ,chest radiography ,computerized tomography scan ,Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Pneumomediastinum (PM), or a mediastinal air leak, is a known morbidity in neonates. Among predisposing factors, the most significant are mixed lung diseases, such as pneumonia or meconium aspiration syndrome, with coexisting atelectasis and airway obstruction. We report an unusual presentation of significant spontaneous pneumomediastinum in a term newborn delivered by elective cesarean section with no history of active resuscitation at birth. Timely diagnosis of SPM is important for both management and prognosis. We believe that lung ultrasound (LUS) is a promising screening tool for early detection of PM in neonates, and could help avoid unnecessary exposure to radiation in delicate neonates. More simultaneous studies comparing chest X-ray (CXR), LUS, and computed tomography (CT) scans may help to prove the utility value of point-of-care ultrasounds as a primary diagnostic tool in identifying this morbidity.
- Published
- 2019
- Full Text
- View/download PDF
6. Tactile Stimulation During Newborn Resuscitation: The Good, the Bad, and the Ugly
- Author
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Kaarthigeyan Kalaniti, Anil Chacko, and Sibasis Daspal
- Subjects
Newborn ,Medicine - Published
- 2018
- Full Text
- View/download PDF
7. 1203 Lung ultrasound could be used as a screening for Hemodynamically Significant Patent Ductus Arteriosus (HPDA) – prospective study
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Amelie Cyr, Prosanta Mondal, Veronica Samedi, and Sibasis Daspal
- Published
- 2022
8. Evaluation of transport-related outcomes for neonatal transport teams with and without physicians
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Louis Beaumier, Sumesh Thomas, Jennifer Toye, Thérèse Perrault, Paul Byrne, William Bingham, Michael Narvey, Geneviève Piuze, Akhil Deshpandey, Don Ilodigwe, Avash Singh, Gregory Hansen, Poornima Murthy, Zarin Kalapesi, Krista Jangaard, Joseph Ting, Ernesto Phillips, Kyong-Soon Lee, Michael Marrin, Stephanie Redpath, Anne Tierney, Henry Roukema, Mohamed Abdelmawla, Hilary Whyte, Rebecca Caces, Edith Masse, and Sibasis Daspal
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03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,030225 pediatrics ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Medicine ,030212 general & internal medicine ,Online Only Original Articles ,business ,Neonatal transport ,3. Good health - Abstract
Objective The aim of this study was to evaluate if the presence of a physician in the neonatal transport team (NTT) affects transport-related outcomes and procedural success. Design Retrospective cohort study with propensity score matching. Setting Canadian national study. Patients Neonatal transports from nontertiary centres between January 2014 and December 2017. Interventions Comparison of transports conducted by NTTs with physicians (MD Group) and without physicians (noMD Group). Main outcome measures The primary outcome was the change in patient acuity as measured by the transport risk index of physiologic severity (TRIPS) score. Secondary outcomes included mortality within 24 hours of NICU admission, clinical complications during transport, procedural success, and stabilization time. Results Among 9,703 eligible cases, 899 neonatal transports attended by NTTs with physicians were compared to 899 neonatal transports without physicians using propensity score matching. No differences were seen in the improvement of TRIPS score or mortality ≤24 hours of NICU admission. The MD Group had more clinical complications (7.7% versus 5.0%, P=0.02). No differences were seen in success rates of invasive procedures. The MD Group had shorter stabilization times. In multivariable analysis, the MD Group was not a significant predictor for the improvement in TRIPS score after adjustment for covariates. Conclusions Neonatal transports conducted by teams including physicians compared to teams without physicians, did not have higher improvement in TRIPS scores and had similar success rates for procedures. These results provide insights for the planning of the structure and training of specialized interfacility neonatal transport programs.
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- 2021
9. Association of Co-Exposure of Antenatal Steroid and Prophylactic Indomethacin with Spontaneous Intestinal Perforation
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Annie Ouellet, Prakesh S. Shah, Lannae Strueby, James Andrews, Graeme N. Smith, Ermelinda Pelausa, Guillaume Ethier, Lara Wesson, Stephen J. Wood, Candace O’Quinn, Kyong-Soon Lee, Christine Drolet, Amy Metcalfe, Hayley Boss, Khalid Aziz, Zenon Cieslak, Jason Burrows, Jagdeep Ubhi, Michelle Morais, Luis Monterrosa, Anie Lapoint, Hala Makary, Karen Wou, Kimberly Butt, Andrzej Kajetanowicz, Ayman Abou Mehrem, Hemasree Kandraju, Leanne Dahlgren, Ruben Alvaro, Rob Gratton, Orlando da Silva, Sibasis Daspal, Jaya Bodani, Darine El-Chaar, Jaideep Kanungo, Christy Pylypjuk, Brigitte Lemyre, Carlos Fajardo, Marie St-Hilaire, Mohammad Adie, Marc Beltempo, Sue Chandra, Joseph Ting, Michael Helewa, Haim A. Abenhaim, Jehier Afifi, Julie Emberley, Ariadna Grigoriu, George Carson, Katherine Theriault, Faiza Khurshid, Vicky Allen, Bruno Piedboeuf, Fatima Taboun, Shoo K. Lee, Cecil Ojah, Rebecca Sherlock, Edith Masse, Xiang Y. Ye, Thierry Daboval, Eugene Ng, Joan Crane, Mary Seshia, Amit Mukerji, Catherine Taillefer, Isabelle Boucoiran, Erin MacLellan, Jon Dorling, Wendy Whittle, Valerie Bertelle, Nir Melamed, Deepak Louis, Martine Claveau, Jennifer Toye, Keith J. Barrington, and Roderick Canning
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Canada ,medicine.medical_specialty ,Indomethacin ,Gestational Age ,Logistic regression ,Antenatal steroid ,03 medical and health sciences ,0302 clinical medicine ,Primary outcome ,indomethacin ,Pregnancy ,030225 pediatrics ,Spontaneous Intestinal Perforation ,Humans ,Medicine ,030212 general & internal medicine ,Retrospective Studies ,intestinal perforation ,business.industry ,Obstetrics ,steroid ,Infant, Newborn ,Infant ,Retrospective cohort study ,infant ,3. Good health ,Intestinal Perforation ,Brain Injuries ,Pediatrics, Perinatology and Child Health ,Female ,Steroids ,Co exposure ,business ,preterm ,Infant, Premature - Abstract
Objective: To evaluate the association of a combined exposure to antenatal steroids and prophylactic indomethacin with the outcome of spontaneous intestinal perforation (SIP) among neonates born at 7 days before birth) exposures. The co-exposure was prophylactic indomethacin. The primary outcome was SIP. Multivariable logistic regression analysis was used to calculate aORs. Results: Among 4720 eligible infants, 4121 (87%) received antenatal steroids and 1045 (22.1%) received prophylactic indomethacin. Among infants exposed to antenatal steroids, those who received prophylactic indomethacin had higher odds of SIP (aOR 1.61, 95% CI 1.14-2.28) compared with no prophylactic indomethacin. Subgroup analyses revealed recent antenatal steroids exposure with prophylactic indomethacin had higher odds of SIP (aOR 1.67, 95% CI 1.15-2.43), but latent antenatal steroids exposure with prophylactic indomethacin did not (aOR 1.24, 95% CI 0.48-3.21), compared with the respective groups with no prophylactic indomethacin. Among those not exposed to antenatal steroids, mortality was lower among those who received prophylactic indomethacin (aOR 0.45, 95% CI 0.28-0.73) compared with no prophylactic indomethacin. Conclusions: In preterm neonates of
- Published
- 2021
10. Rainbow of colors: Inspissated bile syndrome secondary to hemolytic disease of the newborn and concomitant serum dynamics
- Author
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Martha E. Lyon, Mehrieh Rahimi, Sibasis Daspal, Veronica Mugarab Samedi, and Kaartigean Kalaniti
- Subjects
Medicine (General) ,business.industry ,serum dynamics ,Inspissated Bile Syndrome ,Physiology ,Case Report ,General Medicine ,Prenatal care ,030204 cardiovascular system & hematology ,medicine.disease ,hemolytic disease of the newborn ,03 medical and health sciences ,R5-920 ,0302 clinical medicine ,Color changes ,030220 oncology & carcinogenesis ,Concomitant ,biliary sludge ,medicine ,Biliary sludge ,Complication ,Hemolytic disease of the newborn (anti-Kell) ,business ,Rh blood group system ,Inspissated bile syndrome - Abstract
The recent clinical experience with hemolytic disease of the newborn and its post-icteric sequelae is limited among high-income countries because of nearly over four decades of effective prevention care. In this case, we will discuss the sequelae of a baby born with hemolytic disease of the newborn to an Rh negative mother with no prenatal care from remote northern Saskatchewan. Inspissated bile syndrome is a rare but serious complication of hemolytic disease of the newborn. The concentration of hemolytic products parallels with serum color changes.
- Published
- 2021
11. The Value of Different Radiological Modalities in Assessment of Spontaneous Pneumomediastinum: Case Review and Diagnostic Perspective
- Author
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Veronica Mugarab Samedi, Sibasis Daspal, Neil Wonko, Kaarthigeyan Kalaniti, and Poonam Singh Jariwala
- Subjects
Resuscitation ,medicine.medical_specialty ,computerized tomography scan ,Atelectasis ,Case Report ,lcsh:Gynecology and obstetrics ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Meconium aspiration syndrome ,Pneumomediastinum ,lcsh:RG1-991 ,lung ultrasound ,Lung ,pneumomediastinum ,business.industry ,Obstetrics and Gynecology ,030208 emergency & critical care medicine ,Airway obstruction ,chest radiography ,medicine.disease ,Pneumonia ,medicine.anatomical_structure ,030228 respiratory system ,Radiological weapon ,Pediatrics, Perinatology and Child Health ,Radiology ,neonate ,business - Abstract
Pneumomediastinum (PM), or a mediastinal air leak, is a known morbidity in neonates. Among predisposing factors, the most significant are mixed lung diseases, such as pneumonia or meconium aspiration syndrome, with coexisting atelectasis and airway obstruction. We report an unusual presentation of significant spontaneous pneumomediastinum in a term newborn delivered by elective cesarean section with no history of active resuscitation at birth.Timely diagnosis of SPM is important for both management and prognosis. We believe that lung ultrasound (LUS) is a promising screening tool for early detection of PM in neonates, and could help avoid unnecessary exposure to radiation in delicate neonates. More simultaneous studies comparing chest X-ray (CXR), LUS, and computed tomography (CT) scans may help to prove the utility value of point-of-care ultrasounds as a primary diagnostic tool in identifying this morbidity.
- Published
- 2019
12. Neonatal
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Dylan, Ehman, Veronica, Mugarab Samedi, Kaarthigeyan, Kalaniti, and Sibasis, Daspal
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Male ,Twins ,Bacteremia ,Case Report ,Young Adult ,neonatal intensive care ,Diseases in Twins ,Pneumonia, Bacterial ,Humans ,infections ,Escherichia coli Infections ,Respiratory Distress Syndrome, Newborn ,Continuous Positive Airway Pressure ,Cesarean Section ,Infant, Newborn ,Abscess ,Anti-Bacterial Agents ,Scrotum ,paediatric surgery ,Neonatal Sepsis ,Infant, Premature - Abstract
The clinical manifestation of Escherichia coli could vary from asymptomatic bacteraemia to systemic bloodstream infection and meningitis. We describe an unusual course of E. coli infection in twins, emphasising commencement of appropriate antimicrobial therapy. A set of male dichorionic diamniotic twins were delivered at 34 weeks of gestation by caesarian section. Pregnancy was complicated by diabetes, pre-eclampsia and cholestasis. Antenatal ultrasounds noted a congenital pulmonary airway malformation in twin A. Following delivery, twin A developed respiratory distress, but twin B was asymptomatic. Partial septic work-up at admission in the neonatal intensve care unit was done. Twin A’s blood culture grew E. coli, while twin B’s blood culture was negative. Twin A was treated with 7 days of intravenous antibiotics. At 11 days of age, twin B acutely developed a scrotal swelling. On suspicion of testicular torsion, he was taken for urgent surgery, which revealed a scrotal abscess positive for E. coli. The scrotum was irrigated and successfully treated with 4 weeks of antibiotics. Both twins were doing well at 3 months of follow-up.
- Published
- 2021
13. Maternal age and long-term neurodevelopmental outcomes of preterm infants 29 weeks gestational age
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Rebecca Sherlock, Jill G. Zwicker, Prakesh S. Shah, Julia DiLabio, Vibhuti Shah, and Sibasis Daspal
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Adult ,Complete data ,medicine.medical_specialty ,Canada ,Gestational Age ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,Age groups ,030225 pediatrics ,medicine ,Humans ,030212 general & internal medicine ,Retrospective Studies ,Obstetrics ,business.industry ,Incidence (epidemiology) ,Confounding ,Infant, Newborn ,Obstetrics and Gynecology ,Gestational age ,Infant ,Retrospective cohort study ,medicine.disease ,Bronchopulmonary dysplasia ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,business ,Infant, Premature ,Maternal Age - Abstract
The objective of this study is to assess the impact of maternal age on neurodevelopmental (ND) outcomes of infants
- Published
- 2020
14. Neonatal Outcomes in Very Preterm Infants With Severe Congenital Heart Defects : An International Cohort Study
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Mikael Norman, Stellan Håkansson, Satoshi Kusuda, Maximo Vento, Liisa Lehtonen, Brian Reichman, Brian A. Darlow, Mark Adams, Dirk Bassler, Tetsuya Isayama, Franca Rusconi, Shoo Lee, Kei Lui, Junmin Yang, Prakesh S. Shah, Peter Marshall, Peter Schmidt, Anjali Dhawan, Paul Craven, Koert de Waal, Karen Simmer, Andy Gill, Jane Pillow, Jacqueline Stack, Pita Birch, Lucy Cooke, Dan Casalaz, Jim Holberton, Alice Stewart, Lyn Downe, Michael Stewart, Barbara Bajuk, Andrew Berry, Rod Hunt, Charles Kilburn, Tony De Paoli, Srinivas Bolisetty, Mary Paradisis, Ingrid Rieger, Pieter Koorts, Carl Kuschel, Lex Doyle, Andrew Numa, Hazel Carlisle, Nadia Badawi, Alison Loughran‐Fowlds, Guan Koh, Jonathan Davis, Melissa Luig, Chad Andersen, Georgina Chambers, Nicola Austin, Adrienne Lynn, Brian Darlow, Liza Edmonds, Lindsay Mildenhall, Mariam Buksh, Malcolm Battin, Jutta van den Boom, David Bourchier, Vaughan Richardson, Fiona Dineen, Victor Samuel Rajadurai, Simon Lam, Genevieve Fung, Adele Harrison, Anne Synnes, Joseph Ting, Zenon Cieslak, Rebecca Sherlock, Wendy Yee, Khalid Aziz, Jennifer Toye, Carlos Fajardo, Zarin Kalapesi, Koravangattu Sankaran, Sibasis Daspal, Mary Seshia, Ruben Alvaro, Amit Mukerji, Orlando Da Silva, Chuks Nwaesei, Kyong‐Soon Lee, Michael Dunn, Brigitte Lemyre, Kimberly Dow, Ermelinda Pelausa, Keith Barrington, Christine Drolet, Bruno Piedboeuf, Martine Claveau, Marc Beltempo, Valerie Bertelle, Edith Masse, Roderick Canning, Hala Makary, Cecil Ojah, Luis Monterrosa, Akhil Deshpandey, Jehier Afifi, Andrzej Kajetanowicz, Shoo K. Lee, Sture Andersson, Outi Tammela, Ulla Sankilampi, Timo Saarela, Eli Heymann, Shmuel Zangen, Tatyana Smolkin, Francis Mimouni, David Bader, Avi Rothschild, Zipora Strauss, Clari Felszer, Hussam Omari, Smadar Even Tov‐Friedman, Benjamin Bar‐Oz, Michael Feldman, Nizar Saad, Orna Flidel‐Rimon, Meir Weisbrod, Daniel Lubin, Ita Litmanovitz, Amir Kugelman, Eric Shinwell, Gil Klinger, Yousif Nijim, Alona Bin‐Nun, Agneta Golan, Dror Mandel, Vered Fleisher‐Sheffer, David Kohelet, Lev Bakhrakh, Satoshi Hattori, Masaru Shirai, Toru Ishioka, Toshihiko Mori, Takasuke Amizuka, Toru Huchimukai, Hiroshi Yoshida, Ayako Sasaki, Junichi Shimizu, Toshihiko Nakamura, Mami Maruyama, Hiroshi Matsumoto, Shinichi Hosokawa, Atsuko Taki, Machiko Nakagawa, Kyone Ko, Azusa Uozumi, Setsuko Nakata, Akira Shimazaki, Tatsuya Yoda, Osamu Numata, Hiroaki Imamura, Azusa Kobayashi, Shuko Tokuriki, Yasushi Uchida, Takahiro Arai, Mitsuhiro Ito, Kuniko Ieda, Toshiyuki Ono, Masashi Hayashi, Kanemasa Maki, MieToru Yamakawa, Masahiko Kawai, Noriko Fujii, Kozue Shiomi, Koji Nozaki, Hiroshi Wada, Taho Kim, Yasuyuki Tokunaga, Akihiro Takatera, Toshio Oshima, Hiroshi Sumida, Yae Michinomae, Yoshio Kusumoto, Seiji Yoshimoto, Takeshi Morisawa, Tamaki Ohashi, Yukihiro Takahashi, Moriharu Sugimoto, Noriaki Ono, Shinichiro Miyagawa, Takahiko Saijo, Takashi Yamagami, Kosuke Koyano, Shoko Kobayashi, Takeshi Kanda, Yoshihiro Sakemi, Mikio Aoki, Koichi Iida, Mitsushi Goshi, Yuko Maruyama, Alejandro Avila‐Alvarez, José Luis Fernandez‐Trisac, Mª Luz Couce Pico, María José Fernández Seara, Andrés Martínez Gutiérrez, Carolina Vizcaíno, Miriam Salvador Iglesias, Honorio Sánchez Zaplana, Belén Fernández Colomer, José Enrique García López, Rafael García Mozo, M. Teresa González Martínez, Mª Dolores Muro Sebastián, Marta Balart Carbonell, Joan Badia Barnusell, Mònica Domingo Puiggròs, Corporacio Parc Taulí, Josep Figueras Aloy, Francesc Botet Mussons, Israel Anquela Sanz, Gemma Ginovart Galiana, H. De La Santa, W. Coroleu, Martin Iriondo, Laura Castells Vilella, Roser Porta, Xavier Demestre, Silvia Martínez Nadal, Cristina de Frutos Martínez, María Jesús López Cuesta, Dolores Esquivel Mora, Joaquín Ortiz Tardío, Isabel Benavente, Almudena Alonso, Ramón Aguilera Olmos, Miguel A. García Cabezas, Mª Dolores Martínez Jiménez, Mª Pilar Jaraba Caballero, Mª Dolores Ordoñez Díaz, Alberto Trujillo Fagundo, Lluis Mayol Canals, Fermín García‐Muñoz Rodrigo, Lourdes Urquía Martí, María Fernanda Moreno Galdo, José Antonio Hurtado Suazo, Eduardo Narbona López, José Uberos Fernández, Miguel A. Cortajarena Altuna, Oihana Muga Zuriarrain, David Mora Navarro, María Teresa Domínguez, Mª Yolanda Ruiz del Prado, Inés Esteban Díez, María Teresa Palau Benavides, Santiago Lapeña, Teresa Prada, Eduard Soler Mir, Araceli Corredera Sánchez, Enrique Criado Vega, Náyade del Prado, Cristina Fernández, Lucía Cabanillas Vilaplana, Irene Cuadrado Pérez, Luisa López Gómez, Laura Domingo Comeche, Isabel Llana Martín, Carmen González Armengod, Carmen Muñoz Labián, Mª José Santos Muñoz, Dorotea Blanco Bravo, Vicente Pérez, Mª Dolores Elorza Fernández, Celia Díaz González, Susana Ares Segura, Manuela López Azorín, Ana Belén Jimenez MD, Tomás Sánchez‐Tamayo, Elías Tapia Moreno, María González, José Enrique Sánchez Martínez, José María Lloreda García, Concepción Goñi Orayen, Javier Vilas González, María Suárez Albo, Eva González Colmenero, Elena Pilar Gutiérrez González, Beatriz Vacas del Arco, Josefina Márquez Fernández, Laura Acosta Gordillo, Mercedes Granero Asensio, Carmen Macías Díaz, Mar Albújar, Pedro Fuster Jorge, Sabina Romero, Mónica Rivero Falero, Ana Belén Escobar Izquierdo, Javier Estañ Capell, Mª Isabel Izquierdo Macián, Mª Mar Montejo Vicente, Raquel Izquierdo Caballero, Mª Mercedes Martínez, Aintzane Euba, Amaya Rodríguez Serna, Juan María López de Heredia Goya, Alberto Pérez Legorburu, Ana Gutiérrez Amorós, Víctor Manuel Marugán Isabel, Natalio Hernández González, Segundo Rite Gracia, Mª Purificación Ventura Faci, Mª Pilar Samper Villagrasa, Jiri Kofron, Katarina Strand Brodd, Andreas Odlind, Lars Alberg, Sofia Arwehed, Ola Hafström, Anna Kasemo, Karin Nederman, Lars Åhman, Fredrik Ingemarsson, Henrik Petersson, Pernilla Thurn, Eva Albinsson, Bo Selander, Thomas Abrahamsson, Ingela Heimdahl, Kristbjorg Sveinsdottir, Erik Wejryd, Anna Hedlund, Maria Katarina Söderberg, Lars Navér, Thomas Brune, Jens Bäckström, Johan Robinson, Aijaz Farooqi, Erik Normann, Magnus Fredriksson, Anders Palm, Urban Rosenqvist, Bengt Walde, Cecilia Hagman, Andreas Ohlin, Rein Florell, Agneta Smedsaas‐Löfvenberg, Philipp Meyer, Rachel Kusche, Sven Schulzke, Mathias Nelle, Bendicht Wagner, Thomas Riedel, Grégoire Kaczala, Riccardo E. Pfister, Jean‐François Tolsa, Matthias Roth, Martin Stocker, Bernhard Laubscher, Andreas Malzacher, John P. Micallef, Lukas Hegi, Romaine Arlettaz, Vera Bernet, Carlo Dani, Patrizio Fiorini, Paolo Ghirri, Barbara Tomasini, Tampere University, Department of Paediatrics, and Clinical Medicine
- Subjects
Heart Defects, Congenital ,Male ,Pediatrics ,medicine.medical_specialty ,Epidemiology ,Birth weight ,Gestational Age ,Infant, Premature, Diseases ,030204 cardiovascular system & hematology ,3121 Internal medicine ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Developmental biology ,Infant Mortality ,cardiac malformation ,Medicine ,Humans ,Hospital Mortality ,Original Research ,business.industry ,Mortality rate ,Congenital Heart Disease ,Infant, Newborn ,Gestational age ,Pediatrik ,preterm birth ,Infant ,Retinopathy of prematurity ,Odds ratio ,medicine.disease ,mortality ,Bronchopulmonary dysplasia ,newborn infant ,Infant, Extremely Premature ,Necrotizing enterocolitis ,Female ,Mortality/Survival ,Cardiology and Cardiovascular Medicine ,business ,Cohort study - Abstract
Background Very preterm infants are at high risk of death or severe morbidity. The objective was to determine the significance of severe congenital heart defects ( CHDs ) for these risks. Methods and Results This cohort study included infants from 10 countries born from 2007–2015 at 24 to 31 weeks’ gestation with birth weights CHDs were defined by International Classification of Diseases, Ninth Revision ( ICD‐9 ) and Tenth ( ICD‐10 ) codes and categorized as those compromising systemic output, causing sustained cyanosis, or resulting in congestive heart failure. The primary outcome was in‐hospital mortality. Secondary outcomes were neonatal brain injury, necrotizing enterocolitis, bronchopulmonary dysplasia, and retinopathy of prematurity. Adjusted and propensity score–matched odds ratios ( ORs ) were calculated. Analyses were stratified by type of CHD , gestational age, and network. A total of 609 (0.77%) infants had severe CHD and 76 371 without any malformation served as controls. The mean gestational age and birth weight were 27.8 weeks and 1018 g, respectively. The mortality rate was 18.6% in infants with CHD and 8.9% in controls (propensity score–matched OR , 2.30; 95% CI , 1.61–3.27). Severe CHD was not associated with neonatal brain injury, necrotizing enterocolitis, or retinopathy of prematurity, whereas the OR for bronchopulmonary dysplasia increased. Mortality was higher in all types, with the highest propensity score–matched OR (4.96; 95% CI, 2.11–11.7) for CHD causing congestive heart failure. While mortality did not differ between groups at OR for mortality in infants with CHD increased to 10.9 (95% CI, 5.76–20.70) at 31 weeks’ gestational age. Rates of CHD and mortality differed significantly between networks. Conclusions Severe CHD is associated with significantly increased mortality in very preterm infants.
- Published
- 2020
15. Rare cause of emergency in the first week of life: congenital hepatoblastoma (case report)
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Gregory Hansen, Laurence Givelichian, Veronica Mugarab-Samedi, Gloria Ha Young Yoo, Grant G. Miller, Sibasis Daspal, and Kaarthigeyan Kalaniti
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Chemotherapy ,Hepatoblastoma ,Pediatrics ,medicine.medical_specialty ,Lung ,business.industry ,medicine.medical_treatment ,Case Report ,030204 cardiovascular system & hematology ,medicine.disease ,Malignancy ,Microbiology ,03 medical and health sciences ,0302 clinical medicine ,Infectious Diseases ,medicine.anatomical_structure ,Term Infant ,Acute abdomen ,medicine ,Sick Newborn ,Parasitology ,030212 general & internal medicine ,Presentation (obstetrics) ,medicine.symptom ,business - Abstract
During the first week of life, a sudden deterioration in a newborn commonly includes investigations to rule out infections, lung pathologies, cardiac lesions, neurological insults, metabolic disorders or gastrointestinal emergencies. It is unusual, however, to consider malignancy as the primary causative factor. In this case report, we describe a rare and unusual presentation of congenital hepatoblastoma, its complications and management in a neonate with multi-organ dysfunction. A term infant presented with sudden deterioration, hemodynamic instability and an acute abdomen on his 4th day of life. Surgical exploration revealed a ruptured neoplasm that pathology diagnosed as a congenital hepatoblastoma. After the patient was stabilized, chemotherapy was initiated. At present, the patient is 8 months old and under continuous follow-up of oncology service. This case highlights the importance of considering rare diagnoses including congenital malignancy when investigating and managing a sick newborn with multi-organ dysfunction.
- Published
- 2020
16. Costs of Neonatal Intensive Care for Canadian Infants with Preterm Birth
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Juan D. Rios, Prakesh S. Shah, Marc Beltempo, Deepak Louis, Amit Mukerji, Shahirose Premji, Vibhuti Shah, Shoo K. Lee, Petros Pechlivanoglou, Haim Abenhaim, Jehier Afifi, Ruben Alvaro, James Andrews, Anthony Armson, Francois Audibert, Khalid Aziz, Marilyn Ballantyne, Jon Barrett, Anick Berard, Valerie Bertelle, Lucie Blais, Alan Bocking, Jaya Bodani, Jason Burrows, Kimberly Butt, Roderick Canning, George Carson, Nils Chaillet, Sue Chandra, Paige Church, Zenon Cieslak, Joan Crane, Dianne Creighton, Orlando Da Silva, Thierry Daboval, Leanne Dahlgren, Sibasis Daspal, Cecilia de Cabo, Akhil Deshpandey, Kimberly Dow, Christine Drolet, Michael Dunn, null Salhab el Helou, Darine El-Chaar, Walid El-Naggar, Carlos Fajardo, Robert Gagnon, Rob Gratton, Victor Han, Adele Harrison, Shabih Hasan, Michael Helewa, Matthew Hicks, K.S. Joseph, Andrzej Kajetanowicz, Zarin Kalapesi, May Khairy, Thierry Lacaze-Masmonteil, Kyong-Soon Lee, Brigitte Lemyre, Abhay Lodha, Thuy Mai Luu, Linh Ly, Annette Majnemer, Hala Makary, Isabelle Marc, Edith Masse, Sarah D. McDonald, Doug McMillan, Nir Melamed, Amy Metcalfe, Diane Moddemann, Luis Monterrosa, Michelle Morais, William Mundle, Lynn Murphy, Kellie Murphy, Anne-Monique Nuyt, Chuks Nwaesei, Karel O’Brien, Martin Offringa, Cecil Ojah, Annie Ouellet, Jean-Charles Pasquier, Ermelinda Pelausa, Bruno Piedboeuf, Elodie Portales-Casamar, Pramod Puligandla, Eleanor Pullenayegum, Amber Reichert, Kate Robson, Carol Schneider, Mary Seshia, Rebecca Sherlock, Sandesh Shivananda, Nalini Singhal, Erik Skarsgard, Amanda Skoll, Graeme Smith, Anne Synnes, Katherine Thériault, Joseph Ting, Suzanne Tough, Jennifer Toye, Jagdeep Ubhi, Michael Vincer, Wendy Whittle, Hilary Whyte, Doug Wilson, Stephen Wood, Philip Ye, Wendy Yee, Jill Zwicker, null Jaideep Kanungo, Ayman Abou Mehrem, Koravangattu Sankaran, Mohammad Adie, Faiza Khurshid, Keith Barrington, Anie Lapoint, Guillaume Ethier, Martine Claveau, and Julie Emberley
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Male ,medicine.medical_specialty ,Canada ,Neonatal intensive care unit ,Birth weight ,Gestational Age ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Intensive care ,Intensive Care Units, Neonatal ,Medicine ,Birth Weight ,Humans ,030212 general & internal medicine ,Activity-based costing ,Unit cost ,health care economics and organizations ,Health economics ,business.industry ,Infant, Newborn ,Gestational age ,Length of Stay ,3. Good health ,Hospitalization ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Cohort ,Intensive Care, Neonatal ,Female ,business ,Algorithms ,Infant, Premature - Abstract
To develop and validate an itemized costing algorithm for in-patient neonatal intensive care unit (NICU) costs for infants born prematurely that can be used for quality improvement and health economic analyses.We sourced patient resource use data from the Canadian Neonatal Network database, with records from infants admitted to 30 tertiary NICUs in Canada. We sourced unit cost inputs from Ontario hospitals, schedules of benefits, and administrative sources. Costing estimates were generated by matching patient resource use data to the appropriate unit costs. All cost estimates were in 2017 Canadian dollars and assigned from the perspective of a provincial public payer. Results were validated using previous estimates of inpatient NICU costs and hospital case-cost estimates.We assigned costs to 27 742 infants born prematurely admitted from 2015 to 2017. Mean (SD) gestational age and birth weight of the cohort were 31.8 (3.5) weeks and 1843 (739) g, respectively. The median (IQR) cost of hospitalization before NICU discharge was estimated as $20 184 ($9739-51 314) for all infants; $11 810 ($6410-19 800) for infants born at gestational age of 33-36 weeks; $30 572 ($16 597-$51 857) at gestational age of 29-32 weeks; and $100 440 ($56 858-$159 3867) at gestational age of29 weeks. Cost estimates correlated with length of stay (r = 0.97) and gestational age (r = -0.65). The estimates were consistent with provincial resource estimates and previous estimates from Canada.NICU costs for infants with preterm birth increase as gestation decreases and length of stay increases. Our cost estimates are easily accessible, transparent, and congruent with previous cost estimates.
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- 2020
17. Lung Ultrasound as a Predictor of the Extubation Readiness in Preterm Infants
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Kaarthigeyan Kalaniti, Sibasis Daspal, Levesque, Felix, and Samedi, Veronica
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- 2020
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18. INTESTINAL DYSMOTILITY MIMICKING HIRSCHSPRUNG DISEASE IN EXTREMELY PRETERM INFANT
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Lautermilch, Janell, Samedi, Veronica, Kaarthigeyan Kalaniti, and Sibasis Daspal
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- 2020
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19. Is Video Laryngoscopy the Optimal Tool for Successful Intubation in a Neonatal Simulation Setting? A Single-Center Experience
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Sibasis Daspal, John Shatzer, and Iram Musharaf
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medicine.medical_specialty ,Resuscitation ,medicine.medical_treatment ,Laryngoscopy ,Single Center ,lcsh:Gynecology and obstetrics ,intubation ,neonatal ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,030225 pediatrics ,Health care ,medicine ,Intubation ,Neonatology ,direct laryngoscopy ,lcsh:RG1-991 ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,030208 emergency & critical care medicine ,simulation ,Crossover study ,video laryngoscopy ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Original Article ,business - Abstract
Background Endotracheal intubation is a skill required for resuscitation. Due to various reasons, intubation opportunities are decreasing for health care providers. Objective To compare the success rate of video laryngoscopy (VL) and direct laryngoscopy (DL) for interprofessional neonatal intubation skills in a simulated setting. Methods This was a prospective nonrandomized simulation crossover trial. Twenty-six participants were divided into three groups based on their frequency of intubation. Group 1 included pediatric residents; group 2 respiratory therapists and transport nurses; and group 3 neonatal nurse practitioners and physicians working in neonatology. We compared intubation success rate, intubation time, and laryngoscope preference. Results Success rates were 100% for both DL and VL in groups 1 and 2, and 88.9% for DL and 100% for VL in group 3. Median intubation times for DL and VL were 22 seconds (interquartile range [IQR] 14.3–22.8 seconds) and 12.5 seconds (IQR 10.3–38.8 seconds) in group 1 (p = 0.779); 17 seconds (IQR 8–21 seconds) and 12 seconds (IQR 9–16.5 seconds) in group 2 (p = 0.476); and 11 seconds (IQR 7.5–15.5 seconds) and 15 seconds (IQR 11.5–36 seconds) in group 3 (p = 0.024). Conclusion We conclude that novice providers tend to perform better with VL, while more experienced providers perform better with DL. In this era of decreased clinical training opportunities, VL may serve as a useful tool to teach residents and other novice health care providers.
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- 2020
20. Bedside Lung Ultrasound as a Predictor of the Extubation Readiness in Preterm Infants
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Kaarthigeyan Kalaniti, Veronica Mugarab Samedi, and Sibasis Daspal
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education.field_of_study ,Extubation failure ,medicine.diagnostic_test ,business.industry ,Population ,Atelectasis ,respiratory system ,medicine.disease ,Lung ultrasound ,Anesthesia ,Clinical information ,Pediatrics, Perinatology and Child Health ,medicine ,Arterial blood ,Lung volumes ,Chest radiograph ,education ,business - Abstract
An accurate assessment of extubation readiness in preterm infants is very important as this population is prone to the re-intubation. Current criteria for extubation are based on clinical evaluation, chest radiograph findings, amount of ventilatory support and arterial blood gas (ABG) parameters. Several studies have shown that a low lung volume and/or features of atelectasis extubation could predict extubation failure. Lung ultrasound (LUS) provides with opportunity to detect both alveolar (consolidation) and interstitial lungs diseases at the bed-side. These data combined with clinical information could be used for the …
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- 2020
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21. Use of Telehealth during COVID-19 Pandemic in Expanding Access to Neonatal Follow-Up Clinics
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Samedi, Veronica, Sibasis Daspal, Kaarthigeyan Kalaniti, Riehl, Adeline, Wonko, Neil, Britz, Erin, VanDusen, Anissa, Moody, Rae, and Britz, Jana
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- 2020
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22. LINEAR GROWTH AND MINERAL ACCRETION IN EXCLUSIVELY HUMAN MILK FED EXTREMELY LOW BIRTH WEIGHT NEWBORNS (ID 460)
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Samedi, Veronica, Kaarthigeyan Kalaniti, Bingham, William T, and Sibasis Daspal
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- 2020
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23. Rates and Determinants of Mother’s Own Milk Feeding in Infants Born Very Preterm
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Dinesh Dharel, Nalini Singhal, Christel Wood, Zenon Cieslak, Fabiana Bacchini, Prakesh S. Shah, Xiang Y. Ye, Belal Alshaikh, Haim Abenhaim, Jehier Afifi, Ruben Alvaro, James Andrews, Anthony Armson, Francois Audibert, Khalid Aziz, Marilyn Ballantyne, Jon Barrett, Marc Beltempo, Anick Berard, Valerie Bertelle, Lucie Blais, Alan Bocking, Jaya Bodani, Jason Burrows, Kimberly Butt, Roderick Canning, George Carson, Nils Chaillet, Sue Chandra, Paige Church, Kevin Coughlin, Joan Crane, Dianne Creighton, Orlando Da Silva, Thierry Daboval, Leanne Dahlgren, Sibasis Daspal, Cecilia de Cabo, Akhil Deshpandey, Kimberly Dow, Christine Drolet, Michael Dunn, Salhab el Helou, Darine El-Chaar, Walid El-Naggar, Carlos Fajardo, Jonathan Foster, Robert Gagnon, Rob Gratton, Victor Han, Adele Harrison, Shabih Hasan, Michael Helewa, Matthew Hicks, K.S. Joseph, Andrzej Kajetanowicz, Zarin Kalapesi, May Khairy, Thierry Lacaze-Masmonteil, Kyong-Soon Lee, Brigitte Lemyre, Abhay Lodha, Deepak Louis, Thuy Mai Luu, Linh Ly, Annette Majnemer, Hala Makary, Isabelle Marc, Edith Masse, Sarah D. McDonald, Doug McMillan, Nir Melamed, Amy Metcalfe, Diane Moddemann, Luis Monterrosa, Michelle Morais, Amit Mukerji, William Mundle, Lynn Murphy, Kellie Murphy, Anne-Monique Nuyt, Chuks Nwaesei, Karel O’Brien, Martin Offringa, Cecil Ojah, Annie Ouellet, Jean-Charles Pasquier, Petros Pechlivanoglou, Ermelinda Pelausa, Bruno Piedboeuf, Elodie Portales-Casamar, Shahirose Premji, Pramod Puligandla, Eleanor Pullenayegum, Amber Reichert, Carol Schneider, Mary Seshia, Vibhuti Shah, Rebecca Sherlock, Sandesh Shivananda, Erik Skarsgard, Amanda Skoll, Graeme Smith, Anne Synnes, Katherine Thériault, Joseph Ting, Suzanne Tough, Jennifer Toye, Jagdeep Ubhi, Michael Vincer, Wendy Whittle, Hilary Whyte, Doug Wilson, Stephen Wood, Philip Ye, Wendy Yee, and Jill Zwicker
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Adult ,Canada ,medicine.medical_specialty ,Canadian Neonatal Network ,Population ,Mothers ,Gestational Age ,formula feeding ,Breast milk ,Pediatrics ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Formula feeding ,Intensive Care Units, Neonatal ,030225 pediatrics ,medicine ,Hospital discharge ,Humans ,030212 general & internal medicine ,education ,education.field_of_study ,premature infant [breast milk feeding] ,Milk, Human ,Obstetrics ,business.industry ,Infant, Newborn ,Gestational age ,Infant Formula ,Patient Discharge ,Bottle Feeding ,Very preterm ,Breast Feeding ,Logistic Models ,Infant, Extremely Premature ,Pediatrics, Perinatology and Child Health ,Cohort ,Female ,business ,Cohort study - Abstract
To examine rates and determinants of mother's own milk (MOM) feeding at hospital discharge in a cohort of infants born very preterm within the Canadian Neonatal Network (CNN).This was a population-based cohort study of infants born at33 weeks of gestation and admitted to neonatal intensive care units (NICUs) participating in the CNN between January 1, 2015, and December 31, 2018. We examined the rates and determinants of MOM use at discharge home among the participating NICUs. We used multivariable logistic regression analysis to identify independent determinants of MOM feeding.Among the 6404 infants born very preterm and discharged home during the study period, 4457 (70%) received MOM or MOM supplemented with formula. Rates of MOM feeding at discharge varied from 49% to 87% across NICUs. Determinants associated with MOM feeding at discharge were gestational age 29-32 weeks compared with26 weeks (aOR 1.56, 95% CI 1.25-1.93), primipara mothers (aOR 2.12, 95% CI 1.86-2.42), maternal diabetes (aOR 0.79, 95% CI 0.66-0.93), and maternal smoking (aOR 0.27, 95% CI 0.19-0.38). Receipt of MOM by day 3 of age was the major predictor of breast milk feeding at discharge (aOR 3.61, 95% CI 3.17-4.12).Approximately two-thirds of infants born very preterm received MOM at hospital discharge, and rates varied across NICUs. Supporting mothers to provide breast milk in the first 3 days after birth may be associated with improved MOM feeding rates at discharge.
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- 2021
24. Mode of delivery and neonatal outcomes in extremely preterm Vertex/nonVertex twins
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Liran Hiersch, Prakesh S. Shah, Faiza Khurshid, Edith Masse, Kellie Murphy, Sarah D. McDonald, George Carson, Jon Barrett, Nir Melamed, Joseph Ting, Zenon Cieslak, Rebecca Sherlock, Ayman Abou Mehrem, Jennifer Toye, Carlos Fajardo, Zarin Kalapesi, Jaya Bodani, Koravangattu Sankaran, Sibasis Daspal, Mary Seshia, Deepak Louis, Ruben Alvaro, Amit Mukerji, Orlando Da Silva, Mohammad Adie, Kyong-Soon Lee, Michael Dunn, Brigitte Lemyre, Ermelinda Pelausa, Keith Barrington, Anie Lapoint, Guillaume Ethier, Christine Drolet, Bruno Piedboeuf, Martine Claveau, Marc Beltempo, Valerie Bertelle, Roderick Canning, Hala Makary, Cecil Ojah, Luis Monterrosa, Julie Emberley, Jehier Afifi, Andrzej Kajetanowicz, Shoo K. Lee, Haim Abenhaim, James Andrews, Anthony Armson, Francois Audibert, Khalid Aziz, Marilyn Ballantyne, Anick Berard, Lucie Blais, Alan Bocking, Jason Burrows, Kimberly Butt, Nils Chaillet, Sue Chandra, Paige Church, Kevin Coughlin, Joan Crane, Dianne Creighton, Thierry Daboval, Leanne Dahlgren, Cecilia de Cabo, Akhil Deshpandey, Kimberly Dow, Salhab el Helou, Darine El-Chaar, Walid El-Naggar, Jonathan Foster, Robert Gagnon, Rob Gratton, Victor Han, Adele Harrison, Shabih Hasan, Michael Helewa, Matthew Hicks, K.S. Joseph, Thierry Lacaze-Masmonteil, Abhay Lodha, Thuy Mai Luu, Linh Ly, Annette Majnemer, Isabelle Marc, Doug McMillan, Amy Metcalfe, Diane Moddemann, Michelle Morais, William Mundle, Lynn Murphy, Anne-Monique Nuyt, Chuks Nwaesei, Karel O’Brien, Martin Offringa, Annie Ouellet, Jean-Charles Pasquier, Petros Pechlivanoglou, Elodie Portales-Casamar, Shahirose Premji, Pramod Puligandla, Eleanor Pullenayegum, Amber Reichert, Kate Robson, Carol Schneider, Vibhuti Shah, Sandesh Shivananda, Nalini Singhal, Erik Skarsgard, Amanda Skoll, Graeme Smith, Anne Synnes, Katherine Thériault, Suzanne Tough, Jagdeep Ubhi, Michael Vincer, Wendy Whittle, Hilary Whyte, Doug Wilson, Stephen Wood, Philip Ye, Wendy Yee, and Jill Zwicker
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Adult ,Male ,medicine.medical_specialty ,Birth trauma ,Infant, Premature, Diseases ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Intensive care ,Birth Injuries ,Diseases in Twins ,medicine ,Humans ,030212 general & internal medicine ,Breech Presentation ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,Cesarean Section ,Obstetrics ,Vaginal delivery ,business.industry ,Infant, Newborn ,Obstetrics and Gynecology ,Retrospective cohort study ,Delivery, Obstetric ,medicine.disease ,Trial of Labor ,3. Good health ,Treatment Outcome ,Case-Control Studies ,Infant, Extremely Premature ,Relative risk ,Pregnancy, Twin ,Premature Birth ,Gestation ,Female ,Vertex Presentation ,Presentation (obstetrics) ,business - Abstract
Background One of the controversies in the management of twin gestations relates to mode of delivery, especially when the second twin is in a nonvertex presentation (Vertex/nonVertex pairs) and birth is imminent at extremely low gestation. Objective We hypothesized that, for Vertex/nonVertex twins born before 28 weeks’ gestation, cesarean delivery would be associated with a lower risk of adverse neonatal outcomes than trial of vaginal delivery. Our aim was to test this hypothesis by comparing the neonatal outcomes of Vertex/nonVertex twins born before 28 weeks’ gestation by mode of delivery using a large national cohort. Study Design This work is a retrospective cohort study of all twin infants born at 240/7 to 276/7 weeks’ gestation and admitted to level III neonatal intensive care units participating in the Canadian Neonatal Network (2010–2017). Exposure is defined a trial of vaginal delivery for Vertex/nonVertex twins. Nonexposed (control) groups are defined as cases where both twins were delivered by cesarean delivery, either in vertex or nonvertex presentation (control group 1) or owing to the nonvertex presentation of the first twin (control group 2). Outcome measures are defined as a composite of neonatal death, severe neurologic injury, or birth trauma. Results A total of 1082 twin infants (541 twin pairs) met the inclusion criteria: 220 Vertex/nonVertex pairs, of which 112 had a trial of vaginal delivery (study group) and 108 had cesarean delivery for both twins (control group 1); 170 pairs with the first twin in nonvertex presentation, all of which were born by cesarean delivery (control group 2); and 151 pairs with both twins in vertex presentation (vertex or nonvertex). In the study group, the rate of urgent cesarean delivery for the second twin was 30%. The rate of the primary outcome in the study group was 42%, which was not significantly different compared with control group 1 (37%; adjusted relative risk, 0.93; 95% confidence interval, 0.71–1.22) or control group 2 (34%; adjusted relative risk, 1.20; 95% confidence interval, 0.92–1.58). The findings remained similar when outcomes were analyzed separately for the first and second twins. Conclusion For preterm Vertex/nonVertex twins born at
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- 2021
25. 32 Web-based Camera (NICView) as a sense of proximity tool: a Quality-Improvement initiative for parents of neonates admitted in the NICU
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Sibasis Daspal, William Bingham, Kaarthigeyan Kalaniti, Adel Riehl, and Veronica Mugarab-Samedi
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Quality management ,Nursing ,business.industry ,Pediatrics, Perinatology and Child Health ,Web application ,Sense (electronics) ,Abstract / Résumés ,business ,Psychology - Abstract
Background Family-centered care (FCC) is an important approach and a vital component in healthcare. However, implementation of FCC model in a clinical setting presents a challenge. Effective parent-health care provider relationships are very essential in NICU especially when treatment is complex during the management of critically-ill neonates. Web-based camera (WBC) systems have been used in a few NICUs in the USA and the UK, allowing virtual visitation of the family members. However, to the best of our knowledge, there is no center in Canada that has utilized this WBC (NICView ®) service. NICView® is a WBC mounted to the baby’s bed, which is streaming ‘live’ video around-the-clock to parents and families. We report the perception of parents and their satisfaction after using NICView® facility in our NICU. Objectives Our goal was to see if the WBC system reduced the anxiety and stress level in parents by exploring NICView ® as a tool to enhance FCC model. This study was designed to explore the perception of parents and their satisfaction levels during their newborns stay within our NICU. Design/Methods A prospective, questionnaire-based study conducted over 6-month period. Determinants that may facilitate or disrupt the use of a commercially-available camera device were identified. After signing an informed consent form, the parents utilized the camera service continuously throughout the newborn stay within the NICU, except during the times of procedures, feedings and routine baby care. Demographic information of parents was collected in the questionnaire, along with along satisfaction questions. Parents filled out the questionnaires after 1-week of utilization of the camera or sooner if the baby was getting discharged. Results 94 respondents completed the questionnaire. Parental perception was consistent with earlier studies. Almost all parents used the service on a regular basis, twenty NICView cameras had more than 7000 logins by respondents during study period. Family members residing out of Saskatoon or out-of-SK and in some instances out-of-Canada used it the most, especially working fathers or distant grandparents. Seventy-five percent of the respondents were mothers. Almost 89% of parents reported having the WBC system helped reduce their anxiety and stress levels. All parents (100%) recommended this WBC system to other parents and strongly agreed that NICView was easy to use. Nearly 98% of parents agreed that they felt very connected with their baby using the WBC system. Frequently reported comments were on the positioning of camera like incorrect camera placement that did not offer a good view of the baby, the need to call nurses sometimes to turn on or adjust the camera after care, using the chat option to adjust the camera position when moved away. After we saw these frequent comments, we had to reiterate to bed-side nurses to re-position the camera if moved away and reminded parents to make use of the NICView® 24-hr customer support service available offered by the company. Conclusion
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- 2020
26. Neonates with a 10-min Apgar score of zero: Outcomes by gestational age
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You Jia Zhong, Martine Claveau, Eugene W. Yoon, Khalid Aziz, Nalini Singhal, Prakesh S. Shah, Pia Wintermark, Jaideep Kanungo, Joseph Ting, Zenon Cieslak, Rebecca Sherlock, Wendy Yee, Jennifer Toye, Carlos Fajardo, Zarin Kalapesi, Koravangattu Sankaran, Sibasis Daspal, Mary Seshia, Ruben Alvaro, Amit Mukerji, Orlando Da Silva, Chuks Nwaesei, Kyong-Soon Lee, Michael Dunn, Brigitte Lemyre, Kimberly Dow, Ermelinda Pelausa, Keith Barrington, Christine Drolet, Bruno Piedboeuf, Marc Beltempo, Valerie Bertelle, Roderick Canning, Hala Makary, Cecil Ojah, Luis Monterrosa, Julie Emberley, Jehier Afifi, Andrzej Kajetanowicz, and Shoo K. Lee
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Male ,medicine.medical_specialty ,Resuscitation ,Canada ,Gestational Age ,Infant, Premature, Diseases ,030204 cardiovascular system & hematology ,Emergency Nursing ,03 medical and health sciences ,0302 clinical medicine ,Matched cohort ,Hypothermia, Induced ,Intensive Care Units, Neonatal ,Heart rate ,Infant Mortality ,Medicine ,Humans ,Retrospective Studies ,business.industry ,Obstetrics ,Infant, Newborn ,Gestational age ,Infant ,030208 emergency & critical care medicine ,Prognosis ,3. Good health ,Survival Rate ,Emergency Medicine ,Apgar Score ,Apgar score ,Female ,Cardiology and Cardiovascular Medicine ,business ,Neonatal resuscitation ,Follow-Up Studies - Abstract
Background The current resuscitation guidelines for neonates recommend considering stopping resuscitation efforts if the heart rate remains undetectable after 10 min of adequate resuscitation. However, this recommendation does not take into account the gestational age (GA) of the neonates. We determined the outcomes of neonates with a 10-min Apgar score of zero (Apgar10 = 0) with respect to their GA. Methods In a retrospective matched cohort study, we studied neonates admitted to the Canadian Neonatal Network NICUs between 2010 and 2016 with an Apgar10 = 0. The neonates were divided into 3 subgroups according to their GA: (1) ≥36 weeks’, (2) 320/7–356/7 weeks’, and (3) Results 177 neonates had Apgar10 = 0. Survival to discharge was significantly different between GA groups [≥36 weeks’ 61% vs. 320/7–356/7 weeks’ 58% vs. Conclusion Neonates with Apgar10 = 0 had different outcomes depending on their GA. Less than half of neonates born at
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- 2019
27. 'Web-based Camera (NICView) as a Sense of Proximity Tool: a Quality-Improvement Initiative for Parents of Neonates Admitted in the NICU'
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Kaarthigeyan Kalaniti, Sibasis Daspal, Samedi, Veronica, A. Riehl, and Bingham, William T
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- 2019
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28. Exclusively Human Milk-Based Nutrition for Extremely Preterm Newborns - A single center experience
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Samedi, Veronica, Bingham, William T., Wonko, Neil, H. Ludwig-Auser, Kaarthigeyan Kalaniti, and Sibasis Daspal
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- 2019
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29. Admission Laboratory Testing on Umbilical Cord Blood Helps to Prevent Early Anemia in NICU Patients(Study Protocol)
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Samedi, Veronica, Wonko, Neil, Bingham, William T., Kaarthigeyan Kalaniti, Sibasis Daspal, and Mense-Dietrich, Natasha
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- 2019
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30. The value of different radiological modalities in the assessment of spontaneous pneumomediastinum
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Kaarthigeyan Kalaniti, Singh, Poonam, Wonko, Neil, Sibasis Daspal, and Samedi, Veronica
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- 2019
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31. EXOGENOUS SURFACTANT DISTRIBUTION IN PREMATURE INFANTS WITH RESPIRATORY DISTRESS SYNDROME: SYSTEMATIC REVIEW AND ROLE OF LUNG ULTRASOUND
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Kaarthigeyan Kalaniti, Sibasis Daspal, Levesque, Felix, Samedi, Veronica, and Mugarab-Samedi, Nargiz
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- 2019
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32. Optic Nerve Sheath Diameter for Preterm Infants: A Pilot Study
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Sarah Ardell, Gregory Hansen, Tanya Holt, and Sibasis Daspal
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Male ,medicine.medical_specialty ,Optic nerve sheath ,Neonatal intensive care unit ,Intracranial Pressure ,Concordance ,Pilot Projects ,03 medical and health sciences ,Superior eyelid ,0302 clinical medicine ,030225 pediatrics ,Intensive Care Units, Neonatal ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Monitoring, Physiologic ,Ultrasonography ,business.industry ,Infant, Newborn ,Gestational age ,Reproducibility of Results ,Optic Nerve ,Organ Size ,ROC Curve ,Pediatrics, Perinatology and Child Health ,Linear Models ,Multiple linear regression analysis ,Female ,Radiology ,Intracranial Hypertension ,business ,Infant, Premature ,Developmental Biology - Abstract
Objective: In preterm infants, early diagnosis and management of a raised intracranial pressure (ICP) may be important to improve neurodevelopmental outcomes. While invasive ICP monitoring is not recommended, ultrasonography of the optic nerve sheath diameter (ONSD) could provide a noninvasive alternative to evaluate ICP. The objective of this pilot study was to document ranges of ONSD in preterm infants. Methods: This prospective cohort pilot evaluated preterm infants who were admitted to the neonatal intensive care unit without suspected raised ICP. Three images per eye were obtained from a 20–5 MHz linear array ultrasound transducer placed on the patient’s superior eyelid. The OSND was measured 3 mm behind the globe. A second ultrasonographer duplicated half of the scans. Multiple linear regression analysis was conducted for both right and left ONSD with corrected gestational age, weight, and head circumference as predictors. Lin’s concordance assessed interrater reliability. Results: In 12 preterm infants 114 scans were performed on both eyes. The median age was 33 weeks (corrected gestational age) with a range of 29–36 weeks. Corrected gestational age was the strongest predictor for ONSD, and preliminary measurements at each gestational age were established. Interrater reliability demonstrated substantial agreement (Qc = 0.97). Conclusion: In preterm infants, ONSD strongly correlates with corrected gestational age. These data should be validated with other imaging modalities before abnormal ranges can be considered.
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- 2018
33. Outcomes of singleton small for gestational age preterm infants exposed to maternal hypertension: a retrospective cohort study
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Sibasis Daspal, Wendy Yee, Prakesh S. Shah, Ermelinda Pelausa, Elhaytham Omar Sanad Elsayed, Kamran Yusuf, and Rody Canning
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Male ,medicine.medical_specialty ,Canada ,Population ,Pregnancy Complications, Cardiovascular ,Mothers ,Gestational Age ,Infant, Premature, Diseases ,Infant, Newborn, Diseases ,03 medical and health sciences ,0302 clinical medicine ,Pre-Eclampsia ,Pregnancy ,030225 pediatrics ,Intensive care ,Intensive Care Units, Neonatal ,Infant Mortality ,medicine ,Odds Ratio ,Humans ,education ,Ductus Arteriosus, Patent ,Retrospective Studies ,education.field_of_study ,business.industry ,Obstetrics ,Infant, Newborn ,Gestational age ,Infant ,Retinopathy of prematurity ,Hypertension, Pregnancy-Induced ,medicine.disease ,Treatment Outcome ,Bronchopulmonary dysplasia ,Infant, Extremely Premature ,Pediatrics, Perinatology and Child Health ,Necrotizing enterocolitis ,Infant, Small for Gestational Age ,Multivariate Analysis ,Intensive Care, Neonatal ,Small for gestational age ,Female ,business ,030217 neurology & neurosurgery ,Infant, Premature - Abstract
BACKGROUND Hypertensive disorders of pregnancy (HDP) are a major cause of small for gestational age (SGA). Preterm SGA infants have higher rates of adverse outcomes than appropriate for gestational age infants. However, the outcomes are not well established in the setting of HDP. METHODS Retrospective population-based study using the Canadian Neonatal Network database from January 1, 2010 to December 31, 2016 of SGA infants
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- 2018
34. Screening for Retinopathy of Prematurity Through Utilization a Pediatric Retinal Camera at Jim Pattison Children’s Hospital: A Vision for Improved Care
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Shehla Rubab, Sibasis Daspal, Malshi Karunatilake, and Veronica Mugarab Samedi
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congenital, hereditary, and neonatal diseases and abnormalities ,Pediatrics ,medicine.medical_specialty ,genetic structures ,Birth weight ,Early detection ,RJ1-570 ,chemistry.chemical_compound ,Disease severity ,digital retinal imaging ,Medicine ,business.industry ,screening ,Incidence (epidemiology) ,Gestational age ,Retinal ,Retinopathy of prematurity ,medicine.disease ,eye diseases ,chemistry ,Perspective ,Pediatrics, Perinatology and Child Health ,Retinal imaging ,Retinopathy of prematuirty ,sense organs ,business - Abstract
Retinopathy of Prematurity (ROP) is a vascular proliferative disorder of preterm infants, with increased disease severity and incidence occurring with lower gestational age and birth weight. An alternate approach to ROP screening with wide-field digital retinal imaging helps with the early detection of ROP, especially during the pandemic.
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- 2021
35. NeonatalEscherichia coliinfection in twins: clinical spectrum and management dilemma
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Sibasis Daspal, Veronica Mugarab Samedi, Dylan Ehman, and Kaarthigeyan Kalaniti
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medicine.medical_specialty ,Pregnancy ,medicine.diagnostic_test ,Respiratory distress ,Obstetrics ,business.industry ,Congenital pulmonary airway malformation ,General Medicine ,medicine.disease ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030225 pediatrics ,Scrotum ,medicine ,Blood culture ,030212 general & internal medicine ,medicine.symptom ,business ,Meningitis ,Escherichia coli infection - Abstract
The clinical manifestation ofEscherichia colicould vary from asymptomatic bacteraemia to systemic bloodstream infection and meningitis. We describe an unusual course ofE. coliinfection in twins, emphasising commencement of appropriate antimicrobial therapy. A set of male dichorionic diamniotic twins were delivered at 34 weeks of gestation by caesarian section. Pregnancy was complicated by diabetes, pre-eclampsia and cholestasis. Antenatal ultrasounds noted a congenital pulmonary airway malformation in twin A. Following delivery, twin A developed respiratory distress, but twin B was asymptomatic. Partial septic work-up at admission in the neonatal intensve care unit was done. Twin A’s blood culture grewE. coli, while twin B’s blood culture was negative. Twin A was treated with 7 days of intravenous antibiotics. At 11 days of age, twin B acutely developed a scrotal swelling. On suspicion of testicular torsion, he was taken for urgent surgery, which revealed a scrotal abscess positive forE. coli. The scrotum was irrigated and successfully treated with 4 weeks of antibiotics. Both twins were doing well at 3 months of follow-up.
- Published
- 2021
36. Actuarial Survival Based on Gestational Age in Days at Birth for Infants Born at <26 Weeks of Gestation
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Prakesh S. Shah, Sanaya Rau, Eugene W. Yoon, Ruben Alvaro, Orlando da Silva, Hala Makary, Martine Claveau, Shoo K. Lee, Jaideep Kanungo, Joseph Ting, Zenon Cieslak, Rebecca Sherlock, Ayman Abou Mehrem, Jennifer Toye, Khalid Aziz, Carlos Fajardo, Zarin Kalapesi, Jaya Bodani, Koravangattu Sankaran, Sibasis Daspal, Mary Seshia, Deepak Louis, Amit Mukerji, Orlando Da Silva, Mohammad Adie, Kyong-Soon Lee, Michael Dunn, Brigitte Lemyre, Faiza Khurshid, Ermelinda Pelausa, Keith Barrington, Anie Lapoint, Guillaume Ethier, Christine Drolet, Bruno Piedboeuf, Marc Beltempo, Valerie Bertelle, Edith Masse, Roderick Canning, Cecil Ojah, Luis Monterrosa, Julie Emberley, Jehier Afifi, and Andrzej Kajetanowicz
- Subjects
Male ,Canada ,medicine.medical_specialty ,Day of life ,Gestational Age ,Infant, Premature, Diseases ,Actuarial survival ,Tertiary Care Centers ,03 medical and health sciences ,Patient Admission ,0302 clinical medicine ,Intensive Care Units, Neonatal ,030225 pediatrics ,Intensive care ,Infant Mortality ,Birth Weight ,Humans ,Medicine ,030212 general & internal medicine ,Retrospective Studies ,business.industry ,Obstetrics ,Last menstrual period ,Infant, Newborn ,Infant ,Gestational age ,Retrospective cohort study ,Antenatal ultrasound ,3. Good health ,Infant, Extremely Premature ,Pediatrics, Perinatology and Child Health ,Intensive Care, Neonatal ,Gestation ,Female ,business ,Infant, Premature - Abstract
Objective To provide comprehensive, contemporary information on the actuarial survival of infants born at 22-25 weeks of gestation in Canada. Study design In a retrospective cohort study, we included data from preterm infants of 22-25 weeks of gestation admitted to neonatal intensive care units participating in the Canadian Neonatal Network between 2010 and 2017. Infants with major congenital anomalies were excluded. We calculated gestational age using in vitro fertilization date, antenatal ultrasound dating, last menstrual period, obstetrical estimate, or neonatal estimate (in that order). Infants were followed until either discharge or death. Each day of gestational age was considered a category except for births at 22 weeks, where the first 4 days were grouped into one category and the last 3 days were grouped into another category. For each day of life, an actuarial survival rate was obtained by calculating how many infants survived to discharge out of those who had survived up to that day. Results Of 4335 included infants, 85, 679, 1504, and 2067 were born at 22, 23, 24, and 25 weeks of gestation, respectively. Survival increased from 32% at 22 weeks to 83% at 254−6/7 weeks. Graphs of actuarial survival developed for the first 6 weeks after birth in male and female children indicated a steep increase in survival during the first 7-10 days postnatally. Conclusions Survival increased steadily with postnatal survival and was dependent on gestational age in days and sex of the child.
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- 2020
37. Neonatal Intensive Care Unit-Level Patent Ductus Arteriosus Treatment Rates and Outcomes in Infants Born Extremely Preterm
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Mikael Norman, Anne Synnes, Toshihiko Mori, Mitsuhiro Ito, David Kohelet, Hiroshi Matsumoto, Luis Monterrosa, Philipp Meyer, Akhil Deshpandey, Pernilla Thurn, Hiroaki Imamura, Edith Masse, Yuko Maruyama, Toru Ishioka, Satoshi Hattori, Ola Hafström, Wendy Yee, Koravangattu Sankaran, Rachel Kusche, Jehier Afifi, Zipora Strauss, Shmuel Zangen, Takeshi Kanda, Mie Toru Yamakawa, Takashi Yamagami, Sven M. Schulzke, Daniel Lubin, Gil Klinger, Mark Raymond Adams, Maria Katarina Söderberg, Fredrik Ingemarsson, Jennifer Toye, Yukihiro Takahashi, Junichi Shimizu, Michael Feldman, Vera Bernet, Marc Beltempo, Adele Harrison, Joseph Ting, Takeshi Morisawa, Kimberly Dow, Atsuko Taki, Meir Weisbrod, Prakesh S. Shah, Keith J. Barrington, Brian Reichman, Ulla Sankilampi, Benjamin Bar-Oz, Mary Seshia, John P. Micallef, Lev Bakhrakh, Hussam Omari, Liisa Lehtonen, Amit Mukerji, Kozue Shiomi, Bernhard Laubscher, Mikio Aoki, Hiroshi Wada, Cecil Ojah, Dror Mandel, Martin Stocker, Ingela Heimdahl, Toshio Oshima, Bo Selander, Rebecca Sherlock, Yousif Nijim, Ita Litmanovitz, Yoshihiro Sakemi, Yoshio Kusumoto, Henrik Petersson, Alona Bin-Nun, Christine Drolet, Shoko Kobayashi, Shinichiro Miyagawa, Kyong-Soon Lee, Urban Rosenqvist, Takasuke Amizuka, Jean-François Tolsa, Hiroshi Yoshida, Martine Claveau, Andreas Malzacher, Akihiro Takatera, Hiroshi Sumida, Agneta Golan, Jens Bäckström, Thomas Riedel, Rein Florell, Masahiko Kawai, Thomas Brune, Osamu Numata, Lars Åhman, Stellan Håkansson, Outi Tammela, Thomas Abrahamsson, Brigitte Lemyre, Michael Dunn, Clari Felszer, Shuko Tokuriki, Valerie Bertelle, Cecilia Hagman, Takahiko Saijo, Eli Heymann, Akira Shimazaki, Andreas Odlind, Sibasis Daspal, Kosuke Koyano, Roderick Canning, Kjell Helenius, Machiko Nakagawa, Yasushi Uchida, Tamaki Ohashi, Kanemasa Maki, Carlos Fajardo, Orlando da Silva, Matthias Roth, Romaine Arlettaz, Yasuyuki Tokunaga, Toshihiko Nakamura, Azusa Uozumi, Azusa Kobayashi, Avi Rothschild, Karin Nederman, Chuks Nwaesei, Anna Hedlund, Setsuko Nakata, Andreas Ohlin, Katarina Strand Brodd, Erik Normann, Amir Kugelman, Bengt Walde, Dirk Bassler, Tatyana Smolkin, Bruno Piedboeuf, Ermelinda Pelausa, Shoo K. Lee, Noriko Fujii, Orna Flidel-Rimon, Hala Makary, Jiri Kofron, Aijaz Farooqi, Taho Kim, Lars Navér, Khalid Aziz, Toru Huchimukai, Vered Fleisher-Sheffer, Tatsuya Yoda, Agneta Smedsaas Löfvenberg, Tetsuya Isayama, Noriaki Ono, Eva Albinsson, Ruben Alvaro, Kristbjorg Sveinsdottir, Anna Kasemo, Grégoire Kaczala, Junmin Yang, Kyone Ko, Zenon Cieslak, Timo Saarela, Sofia Arwehed, Bendicht Peter Wagner, Mami Maruyama, Eric S. Shinwell, Lars Alberg, Mitsushi Goshi, Zarin Kalapesi, Amish Jain, Moriharu Sugimoto, Mathias Nelle, Koji Nozaki, Kuniko Ieda, Shinichi Hosokawa, Smadar Even Tov-Friedman, Masashi Hayashi, Magnus Fredriksson, Lukas Hegi, Nizar Saad, Seiji Yoshimoto, Francis B. Mimouni, David Bader, Yae Michinomae, Johan Robinson, Erik Wejryd, Toshiyuki Ono, Sture Andersson, Satoshi Kusuda, Ayako Sasaki, Takahiro Arai, Koichi Iida, Masaru Shirai, Andrzej Kajetanowicz, Riccardo Pfister, Anders Palm, and Pfister, Riccardo
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Male ,Pediatrics ,Neonatal intensive care unit ,health care facilities, manpower, and services ,Indomethacin ,Anti-Inflammatory Agents ,Ibuprofen ,Ibuprofen/therapeutic use ,Cohort Studies ,0302 clinical medicine ,Japan ,Periventricular/epidemiology ,Neonatal ,Ductus arteriosus ,030212 general & internal medicine ,Israel ,Ductus Arteriosus, Patent ,ddc:618 ,Anti-Inflammatory Agents, Non-Steroidal ,Composite outcomes ,3. Good health ,Japan/epidemiology ,Europe ,Intensive Care Units ,medicine.anatomical_structure ,Echocardiography ,Infant, Extremely Premature ,Cohort ,cardiovascular system ,Necrotizing/epidemiology ,Gestation ,Female ,Cohort study ,Adult ,Non-Steroidal/therapeutic use ,Canada ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Leukomalacia, Periventricular ,Birth weight ,education ,Canada/epidemiology ,Extremely Premature ,Europe/epidemiology ,03 medical and health sciences ,Indomethacin/therapeutic use ,Enterocolitis, Necrotizing ,Intensive Care Units, Neonatal ,030225 pediatrics ,medicine ,Humans ,cardiovascular diseases ,Israel/epidemiology ,Cerebral Intraventricular Hemorrhage ,Retrospective Studies ,Cerebral Intraventricular Hemorrhage/epidemiology ,Cardiovascular Surgical Procedures/statistics & numerical data ,Enterocolitis ,business.industry ,Cardiovascular Surgical Procedures ,Extremely preterm ,Infant, Newborn ,Infant ,Ductus Arteriosus ,Newborn ,Pediatrics, Perinatology and Child Health ,Linear Models ,Patent/diagnostic imaging/epidemiology/therapy ,business ,Leukomalacia - Abstract
To assess associations between neonatal intensive care unit (NICU)-level patent ductus arteriosus (PDA) treatment rates (pharmacologic or surgical) and neonatal outcomes.This cohort study included infants born at 24-28 weeks of gestation and birth weight1500 g in 2007-2015 in NICUs caring for ≥100 eligible infants in 6 countries. The ratio of observed/expected (O/E) PDA treatment rates was derived for each NICU by estimating the expected rate using a logistic regression model adjusted for potential confounders and network. The primary composite outcome was death or severe neurologic injury (grades III-IV intraventricular hemorrhage or periventricular leukomalacia). The associations between the NICU-level O/E PDA treatment ratio and neonatal outcomes were assessed using linear regression analyses including a quadratic effect (a square term) of the O/E PDA treatment ratio.From 139 NICUs, 39 096 infants were included. The overall PDA treatment rate was 45% in the cohort (13%-77% by NICU) and the O/E PDA treatment ratio ranged from 0.30 to 2.14. The relationship between the O/E PDA treatment ratio and primary composite outcome was U-shaped, with the nadir at a ratio of 1.13 and a significant quadratic effect (P.001). U-shaped relationships were also identified with death, severe neurologic injury, and necrotizing enterocolitis.Both low and high PDA treatment rates were associated with death or severe neurologic injury, whereas a moderate approach was associated with optimal outcomes.
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- 2020
38. Extensive cardiopulmonary resuscitation of preterm neonates at birth and mortality and developmental outcomes
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Nicole Fischer, Amuchou Soraisham, Prakesh S. Shah, Anne Synnes, Yacov Rabi, Nalini Singhal, Joseph Y. Ting, Dianne Creighton, Deborah Dewey, Marilyn Ballantyne, Abhay Lodha, Prakesh S Shah, Jaideep Kanungo, Joseph Ting, Wendy Yee, Jennifer Toye, Carlos Fajardo, Zarin Kalapesi, Koravangattu Sankaran, Sibasis Daspal, Mary Seshia, Ruben Alvaro, Amit Mukerji, Orlando Da Silva, Chuks Nwaesei, Kyong-Soon Lee, Michael Dunn, Brigitte Lemyre, Kimberly Dow, Ermelinda Pelausa, Anie Lapoint, Christine Drolet, Bruno Piedboeuf, Martine Claveau, Marc Beltempo, Valerie Bertelle, Edith Masse, Roderick Canning, Hala Makary, Cecil Ojah, Luis Monterrosa, Julie Emberley, Jehier Afifi, Andrzej Kajetanowicz, Shoo K Lee, null Canadian Neonatal Follow-Up Network (CNFUN) Investigators, Thevanisha Pillay, Reg Sauvé, Leonora Hendson, Amber Reichert, Jaya Bodani, Diane Moddemann, Thierry Daboval, David Lee, Kevin Coughlin, Linh Ly, Edmond Kelly, Saroj Saigal, Paige Church, Patricia Riley, Thuy Mai Luu, Francine Lefebvre, Charlotte Demers, Sylvie Bélanger, Michael Vincer, and Phil Murphy
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Male ,Pediatrics ,medicine.medical_specialty ,Canada ,medicine.medical_treatment ,education ,Motor Disorders ,Gestational Age ,030204 cardiovascular system & hematology ,Emergency Nursing ,Odds ,03 medical and health sciences ,0302 clinical medicine ,Corrected Age ,Infant Mortality ,medicine ,Humans ,Cardiopulmonary resuscitation ,Retrospective Studies ,business.industry ,Delivery room ,Infant, Newborn ,Gestational age ,Infant ,030208 emergency & critical care medicine ,Odds ratio ,Cardiopulmonary Resuscitation ,3. Good health ,Neurodevelopmental Disorders ,Infant, Extremely Premature ,Emergency Medicine ,Premature Birth ,Female ,Outcome data ,Cardiology and Cardiovascular Medicine ,business ,Neonatal resuscitation ,Infant, Premature ,Follow-Up Studies - Abstract
To compare mortality and neurodevelopmental outcomes of extremely low gestational age neonates who received delivery room extensive cardiopulmonary resuscitation (DR-CPR) to those who did not require DR-CPR.Preterm neonates born at29 weeks' gestational age between January 2010 and September 2011 and assessed at Canadian Neonatal Follow-Up Network centers were studied. Neonates who received DR-CPR were compared to those who did not require DR-CPR using univariate and multivariable analyses. The primary outcome was a composite of mortality or any neurodevelopmental impairment at 18 to 24 months corrected age defined as the presence of any one or more of the following: cerebral palsy; Bayley-III cognitive, language, or motor composite scores85 on any one of the components; sensorineural/mixed hearing loss or unilateral or bilateral visual impairment. Secondary outcomes were the individual components of the composite outcomes.Of the 2760 neonates born, 173 were excluded and remaining 2587 eligible neonates were included in our study. Of these 2068 had outcome data (80%) of whom 190 (9.2%) received DR-CPR. DR-CPR was independently associated with mortality or neurodevelopmental impairment (adjusted odds ratio [aOR] 1.76; 95% CI 1.21-2.55) and mortality alone (aOR1.94; 95% CI 1.33-2.83). DR-CPR was also associated with increased odds of motor impairment (aOR 2.03; 95% CI 1.28-3.23).In extremely low gestational age neonates, DR-CPR was associated with higher odds of the composite outcome of mortality or neurodevelopmental impairment, mortality alone, and lower motor scores at 18 to 24 months' corrected age.
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- 2018
39. Central Line-Associated Blood Stream Infections and Non-Central Line-Associated Blood Stream Infections Surveillance in Canadian Tertiary Care Neonatal Intensive Care Units
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Kyong-Soon Lee, Marc Beltempo, Julie Emberley, Keith J. Barrington, Joseph Ting, Michael Dunn, Sibasis Daspal, Kimberly Dow, Jehier Afifi, Cecil Ojah, Rebecca Sherlock, Jaideep Kanungo, Bruno Piedboeuf, Shoo K. Lee, Andrzej Kajetanowicz, Zenon Cieslak, Hala Makary, Prakesh S. Shah, Roderick Canning, Chuks Nwaesei, Orlando da Silva, Amit Mukerji, Christine Drolet, Zarin Kalapesi, Ruben Alvaro, Brigitte Lemyre, Jennifer Toye, Koravangattu Sankaran, Carlos Fajardo, Ermelinda Pelausa, Luis Monterrosa, Wendy Yee, Amy R. Zipursky, Martine Claveau, Valerie Bertelle, Anie Lapoint, Mary Seshia, Eugene W. Yoon, and Edith Masse
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Male ,medicine.medical_specialty ,Canada ,Catheterization, Central Venous ,Neonatal intensive care unit ,Bacteremia ,Gestational Age ,Gram-Positive Bacteria ,Tertiary care ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Intensive care ,Intensive Care Units, Neonatal ,Sepsis ,Gram-Negative Bacteria ,medicine ,Central Venous Catheters ,Humans ,Meningitis ,030212 general & internal medicine ,Retrospective Studies ,Central line ,Cross Infection ,business.industry ,Tertiary Healthcare ,Incidence (epidemiology) ,Infant, Newborn ,Retrospective cohort study ,Infections surveillance ,3. Good health ,Catheter-Related Infections ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Regression Analysis ,Female ,business ,Blood stream - Abstract
To determine if the reported reduction in hospital-acquired infections is due to reduced central line-associated blood stream infections (CLABSI) or non-CLABSIs.A retrospective cohort study design was used to describe the change in organism pattern and incidence of hospital-acquired infections (CLABSIs and non-CLABSIs) in neonates33 weeks of gestation admitted to tertiary neonatal intensive care units in the Canadian Neonatal Network between January 1, 2010, and December 31, 2016. Hospital-acquired infection was diagnosed when a pathogenic organism was isolated from blood or cerebrospinal fluid in a neonate with suspected sepsis. CLABSI was diagnosed when a central venous catheter was present at the time or removed in the 2 days before a hospital-acquired infection diagnosis. Cochran-Armitage and Mann-Kendall trend tests and linear regression models were used for statistical analyses.Of 28 144 eligible neonates from 30 Canadian Neonatal Network neonatal intensive care units, 3306 (11.7%) developed hospital-acquired infections. There was a significant decrease in the rate of hospital-acquired infections (14.2% in 2010 and 9.2% in 2016; P .01), and the rate of both CLABSIs and non-CLABSIs (P .01) over the study period concomitant with a significant decrease in the duration of central line use (P = .01). The rates of meningitis also decreased during the study period (1.2% in 2010 and 0.9% in 2016; P .01). Infections owing to gram-positive cocci significantly decreased, but infections owing to gram-negative organisms remained unchanged.Although there was a significant decrease in CLABSIs and non-CLABSIs, hospital-acquired infections in preterm neonates remained high. Infections owing to gram-negative organisms remained unchanged and are a target for future preventative efforts.
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- 2018
40. Predictors of Severe Neurologic Injury on Ultrasound Scan of the Head and Risk Factor-based Screening for Infants Born Preterm
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Michael Narvey, Bruno Piedboeuf, Shoo K. Lee, Eugene H. Ng, Andrzej Kajetanowicz, Kyong-Soon Lee, Mireille Guillot, Luis Monterrosa, Edith Masse, Hala Makary, Wissam Shalish, Mary Seshia, Chuks Nwaesei, Martine Claveau, Prakesh S. Shah, Anie Lapoint, Ermelinda Pelausa, Carlos Fajardo, Marc Beltempo, Jennifer Toye, Kimberly Dow, Rebecca Sherlock, Orlando da Silva, Jaideep Kanungo, Valerie Bertelle, Andrea Martel-Bucci, Joseph Ting, Jehier Afifi, Cecil Ojah, Wendy Yee, Pia Wintermark, Roderick Canning, Keith J. Barrington, Michael Dunn, Sibasis Daspal, Ruben Alvaro, Zenon Cieslak, Brigitte Lemyre, Zarin Kalapesi, Amit Mukerji, Koravangattu Sankaran, Christine Drolet, and Julie Emberley
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Leukomalacia, Periventricular ,Birth weight ,Ultrasound scan ,Clinical Decision-Making ,Infant, Premature, Diseases ,Risk Assessment ,Sensitivity and Specificity ,Severity of Illness Index ,03 medical and health sciences ,Neonatal Screening ,0302 clinical medicine ,Risk Factors ,Clinical Decision Rules ,030225 pediatrics ,Odds Ratio ,medicine ,Humans ,030212 general & internal medicine ,Risk factor ,Cerebral Intraventricular Hemorrhage ,Retrospective Studies ,Ultrasonography ,Periventricular leukomalacia ,business.industry ,Infant, Newborn ,Gestational age ,Retrospective cohort study ,medicine.disease ,3. Good health ,Logistic Models ,Intraventricular hemorrhage ,Pediatrics, Perinatology and Child Health ,Gestation ,Female ,business ,Head - Abstract
To identify risk factors for severe neurologic injury (intraventricular hemorrhage grade 3 or greater and/or periventricular leukomalacia) diagnosed by ultrasound scan of the head among infants born at 30This was a retrospective cohort study of infants born at 30The rate of severe neurologic injury was 3.1% among infants screened (285/9221). Significant risk factors included singleton birth (aOR 1.96, 95% CI 1.35-2.85), 5-minute Apgar7 (aOR 1.81, 95% CI 1.30-2.50), mechanical ventilation on day 1 (aOR 2.65, 95% CI 1.88-3.71), and treatment with vasopressors on day 1 (aOR 3.23, 95% CI 2.19-4.75). Risk categories were low (no risk factor, 1.2%, 25/2137), moderate (singleton with no other risk factor: 1.8%, 68/3678), and high (≥1 risk factor among 5-minute Apgar7, receipt of vasopressors or mechanical ventilation on day 1: 5.6%, 192/3408). Screening moderate- to high-risk infants identified 91% (260/285) of infants with severe neurologic injury and would require screening fewer infants (1647 infants per year) than screening all infants33 weeks of gestation (2064 infants screened per year, 93% [265/285] of cases identified).Risk factor-based ultrasound scan of the head screening among infants born at 30-32 weeks of gestation could help optimize resources better than gestational age based screening.
- Published
- 2019
41. Tactile Stimulation During Newborn Resuscitation: The Good, the Bad, and the Ugly
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Sibasis Daspal, Anil Chacko, and Kaarthigeyan Kalaniti
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Resuscitation ,medicine.medical_specialty ,Sensory stimulation therapy ,business.industry ,lcsh:R ,MEDLINE ,lcsh:Medicine ,030208 emergency & critical care medicine ,General Medicine ,030204 cardiovascular system & hematology ,Newborn ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Medicine ,Clinical Note ,business - Published
- 2018
42. LUNG ULTRASONOGRAPHY AS A BEDSIDE TOOL TO ASSESS EXOGENOUS SURFACTANT DISTRIBUTION
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Kaarthigeyan Kalaniti, Sibasis Daspal, Levesque, Felix, Imran, Ahmad, and Samedi, Veronica
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- 2018
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43. Revisiting the Definition of Bronchopulmonary Dysplasia: Effect of Changing Panoply of Respiratory Support for Preterm Neonates
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Tetsuya Isayama, Junmin Yang, Prakesh S. Shah, David S. C. Lee, Michael Dunn, Sibasis Daspal, and Shoo K. Lee
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Male ,Pediatrics ,medicine.medical_specialty ,Canada ,medicine.medical_treatment ,Cohort Studies ,Positive-Pressure Respiration ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Oxygen therapy ,Intensive care ,Intensive Care Units, Neonatal ,Medicine ,Humans ,030212 general & internal medicine ,Bronchopulmonary Dysplasia ,Retrospective Studies ,business.industry ,Area under the curve ,Postmenstrual Age ,Infant, Newborn ,Oxygen Inhalation Therapy ,Gestational age ,Infant ,Retrospective cohort study ,Odds ratio ,medicine.disease ,Bronchopulmonary dysplasia ,Area Under Curve ,Pediatrics, Perinatology and Child Health ,Female ,business ,Infant, Premature - Abstract
Importance Several definitions of bronchopulmonary dysplasia are clinically used; however, their validity remains uncertain considering ongoing changes in the panoply of respiratory support treatment strategies used within neonatal units. Objective To identify the optimal definition of bronchopulmonary dysplasia that best predicts respiratory and neurodevelopmental outcomes in preterm infants. Design, Setting, and Participants Retrospective cohort study at tertiary neonatal intensive care units. Preterm infants born at less than 29 weeks’ gestation between 2010 and 2011 who were admitted to neonatal intensive care units participating in the Canadian Neonatal Network and completed follow-up assessments in a Canadian Neonatal Follow-Up Network clinic at 18 to 21 months. Exposures Various traditional bronchopulmonary dysplasia criteria based on respiratory status at different postmenstrual ages. Main Outcomes and Measures Serious respiratory morbidity, neurosensory impairment at 18 to 21 months of age, and a composite outcome of respiratory or neurosensory morbidity or death after discharge. Adjusted odds ratios (AORs) and 95% CIs were calculated. Results Of 1914 eligible survivors, 1503 were assessed (mean gestational age was 26.3 weeks; 68% were white, 9% were black, and 23% were other race/ethnicity), 88 had serious respiratory morbidity, 257 infants had neurosensory impairment, and 12 infants died after discharge. Definitions using oxygen requirement alone as the criterion at various postmenstrual ages were less predictive compared with those using the criterion of oxygen/respiratory support (RS) (receiving supplemental oxygen and/or positive-pressure RS); among those, oxygen/RS at 36 weeks had the highest AOR and area under the curve (AUC) for all outcomes. Further analyses of oxygen/RS at each week between 34 and 44 weeks’ postmenstrual age indicated that the predictive ability for serious respiratory morbidity increased from 34 weeks (AOR, 1.8; 95% CI, 0.9-3.4, AUC, 0.721) to 40 weeks (AOR, 6.1; 95% CI, 3.4-11.0; AUC, 0.799). For serious neurosensory impairment, the AOR and AUC at 40 weeks’ PMA (AOR, 1.5, 95% CI, 1.0-2.1; AUC, 0.740) were only marginally below their peak values at 37 weeks’ PMA (AOR, 1.8; 95% CI, 1.3-2.6; AUC, 0.743). Conclusions and Relevance Defining bronchopulmonary dysplasia by the use of oxygen alone is inadequate because oxygen/RS is a better indicator of chronic respiratory insufficiency. In particular, oxygen/RS at 40 weeks’ PMA was identified as the best predictor for serious respiratory morbidity, while it also displayed a good ability to predict neurosensory morbidity at 18 to 21 months.
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- 2017
44. Severe Neurodevelopmental Impairment in Neonates Born Preterm: Impact of Varying Definitions in a Canadian Cohort
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Matthew D. Haslam, Sarka Lisonkova, Dianne Creighton, Paige Church, Junmin Yang, Prakesh S. Shah, K.S. Joseph, Anne Synnes, Adele Harrison, Joseph Ting, Zenon Cieslak, Rebecca Sherlock, Wendy Yee, Carlos Fajardo, Khalid Aziz, Jennifer Toye, Zarin Kalapesi, Koravangattu Sankaran, Sibasis Daspal, Molly Seshia, Ruben Alvaro, Amit Mukerji, Orlando Da Silva, Chuks Nwaesei, Kyong-Soon Lee, Michael Dunn, Brigitte Lemyre, Kimberly Dow, Ermelinda Pelausa, Lajos Kovacs, Keith Barrington, Christine Drolet, Bruno Piedboeuf, S. Patricia Riley, Martine Claveau, Daniel Faucher, Valerie Bertelle, Edith Masse, Roderick Canning, Hala Makary, Cecil Ojah, Luis Monterrosa, Wayne Andrews, Akhil Deshpandey, Doug McMillan, Jehier Afifi, Andrzej Kajetanowicz, Shoo K. Lee, Thevanisha Pillay, Reg Sauvé, Leonora Hendson, Amber Reichert, Jaya Bodani, Diane Moddemann, Chukwuma Nwaesei, Thierry Daboval, David Lee, Linh Ly, Edmond Kelly, Salhab el Helou, Francine Lefebvre, Charlotte Demers, Sylvie Bélanger, Michael Vincer, and Phil Murphy
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Male ,Canada ,medicine.medical_specialty ,Pediatrics ,Neonatal intensive care unit ,Gestational Age ,Infant, Premature, Diseases ,macromolecular substances ,Rate ratio ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Risk Factors ,Intensive Care Units, Neonatal ,030225 pediatrics ,medicine ,Humans ,030212 general & internal medicine ,Neonatology ,business.industry ,Incidence ,Incidence (epidemiology) ,Infant, Newborn ,Infant ,Gestational age ,medicine.disease ,3. Good health ,nervous system ,Bronchopulmonary dysplasia ,Neurodevelopmental Disorders ,Pediatrics, Perinatology and Child Health ,Cohort ,Female ,business ,Infant, Premature ,Follow-Up Studies ,Cohort study - Abstract
Objective To assess the impact of variations in the definition of severe neurodevelopmental impairment (NDI) on the incidence of severe NDI and the association with risk factors using the Canadian Neonatal Follow-Up Network cohort. Study design Literature review of severe NDI definitions and application of these definitions were performed in this database cohort study. Infants born at 23-28 completed weeks of gestation between 2009 and 2011 (n = 2187) admitted to a Canadian Neonatal Network neonatal intensive care unit and assessed at 21 months' corrected age were included. The incidence of severe NDI, aORs, and 95% CIs were calculated to express the relationship between risk factors and severe NDI using the definitions with the highest and the lowest incidence rates of severe NDI. Results The incidence of severe NDI ranged from 3.5% to 14.9% (highest vs lowest rate ratio 4.29; 95% CI 3.37-5.47). The associations between risk factors and severe NDI varied depending on the definition used. Maternal ethnicity, employment status, antenatal corticosteroid treatment, and gestational age were not associated consistently with severe NDI. Although maternal substance use, sex, score of neonatal acute physiology >20, late-onset sepsis, bronchopulmonary dysplasia, and brain injury were consistently associated with severe NDI irrespective of definition, the strength of the associations varied. Conclusions The definition of severe NDI significantly influences the incidence and the associations between risk factors and severe NDI. A standardized definition would facilitate site comparisons and scientific communication.
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- 2018
45. Neurodevelopmental Outcomes of Infants Born at <29 Weeks of Gestation Admitted to Canadian Neonatal Intensive Care Units Based on Location of Birth
- Author
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Reem Amer, Diane Moddemann, Mary Seshia, Ruben Alvaro, Anne Synnes, Kyong-Soon Lee, Shoo K. Lee, Prakesh S. Shah, Adele Harrison, Joseph Ting, Zenon Cieslak, Rebecca Sherlock, Wendy Yee, Khalid Aziz, Jennifer Toye, Carlos Fajardo, Zarin Kalapesi, Koravangattu Sankaran, Sibasis Daspal, Amit Mukerji, Orlando Da, Chuks Nwaesei, Michael Dunn, Brigitte Lemyre, Kimberly Dow, Ermelinda Pelausa, Keith Barrington, Christine Drolet, Bruno Piedboeuf, Martine Claveau, Daniel Faucher, Valerie Bertelle, Edith Masse, Roderick Canning, Hala Makary, Cecil Ojah, Luis Monterrosa, Akhil Deshpandey, Jehier Afifi, Andrzej Kajetanowicz, Thevanisha Pillay, Reg Sauvé, Leonora Hendson, Amber Reichert, Jaya Bodani, Cecilia deCabo, Thierry Daboval, David Lee, Linh Ly, Edmond Kelly, Salhab el Helou, Paige Church, Marc Beltempo, Francine Levebrve, Charlotte Demers, Sylvie Bélanger, Michael Vincer, and Phil Murphy
- Subjects
Male ,Risk ,Canada ,Pediatrics ,medicine.medical_specialty ,Databases, Factual ,Adverse outcomes ,Birth weight ,Diagnostic Techniques, Neurological ,Gestational Age ,Infant, Premature, Diseases ,Nervous System ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Intensive Care Units, Neonatal ,030225 pediatrics ,Intensive care ,Infant Mortality ,medicine ,College education ,Birth Weight ,Humans ,030212 general & internal medicine ,Retrospective Studies ,Tertiary Healthcare ,business.industry ,Cerebral Palsy ,Data Collection ,Infant, Newborn ,Composite outcomes ,Infant ,medicine.disease ,3. Good health ,Perinatal Care ,Infant, Extremely Premature ,Pediatrics, Perinatology and Child Health ,Apgar Score ,Gestation ,Small for gestational age ,Female ,business ,Infant, Premature - Abstract
To compare mortality and neurodevelopmental outcomes of outborn and inborn preterm infants born at29 weeks of gestation admitted to Canadian neonatal intensive care units (NICUs).Data were obtained from the Canadian Neonatal Network and Canadian Neonatal Follow-up Network databases for infants born at29 weeks of gestation admitted to NICUs from April 2009 to September 2011. Rates of death, severe neurodevelopmental impairment (NDI), and overall NDI were compared between outborn and inborn infants at 18-21 months of age, corrected for prematurity.Of 2951 eligible infants, 473 (16%) were outborn. Mean birth weight (940 ± 278 g vs 897 + 237 g), rates of treatment with antenatal steroids (53.9% vs 92.9%), birth weight small for gestational age (5.3% vs 9.4%), and maternal college education (43.7% vs 53.9%) differed between outborn and inborn infants, respectively (all P values.01). The median Score for Neonatal Acute Physiology-II (P = .01) and Apgar score at 5 minutes (P .01) were higher in inborn infants. Severe brain injury was more common among outborn infants (25.3% vs 14.7%, P .01). Outborn infants had higher odds of death or severe NDI (aOR 1.7, 95% CI 1.3-2.2), death or overall NDI (aOR 1.6, 95% CI 1.2-2.2), death (aOR 2.1, 95% CI 1.5-3.0), and cerebral palsy (aOR 1.9, 95% CI 1.1-3.3).The composite outcomes of death or neurodevelopmental impairment were significantly higher in outborn compared with inborn infants admitted to Canadian NICUs. Adverse outcomes were mainly attributed to increased mortality and cerebral palsy in outborn neonates.
- Published
- 2018
46. The role of antenatal corticosteroids in twin pregnancies complicated by preterm birth
- Author
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Daniel Faucher, Michael Dunn, Edith Masse, Ermelinda Pelausa, Sibasis Daspal, Anne Synnes, Zarin Kalapesi, Andrzej Kajetanowicz, Luis Monterrosa, Jennifer Toye, Sandesh Shivananda, Kyong-Soon Lee, Hala Makary, Mary Seshia, Joseph Ting, Zenon Cieslak, Jyotsna Shah, Christine Drolet, Kimberly Dow, Brigitte Lemyre, Keith J. Barrington, Adele Harrison, Carlos Fajardo, Rebecca Sherlock, Koravangattu Sankaran, Orlando da Silva, Valerie Bertelle, Prakesh S. Shah, Jehier Afifi, Cecil Ojah, Roderick Canning, Bruno Piedboeuf, Shoo K. Lee, Nir Melamed, Ruben Alvaro, Chuks Nwaesei, Eugene W. Yoon, Khalid Aziz, Akhil Deshpandey, Wendy Yee, Martine Claveau, and Kellie E. Murphy
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Twins ,Gestational Age ,Odds ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Adrenal Cortex Hormones ,Enterocolitis, Necrotizing ,Pregnancy ,030225 pediatrics ,Infant Mortality ,Diseases in Twins ,Odds Ratio ,medicine ,Birth Weight ,Humans ,Retinopathy of Prematurity ,Bronchopulmonary Dysplasia ,Retrospective Studies ,Respiratory Distress Syndrome, Newborn ,030219 obstetrics & reproductive medicine ,business.industry ,Infant, Newborn ,Infant ,Obstetrics and Gynecology ,Gestational age ,Prenatal Care ,Retinopathy of prematurity ,Retrospective cohort study ,Odds ratio ,medicine.disease ,Confidence interval ,Treatment Outcome ,Bronchopulmonary dysplasia ,Pregnancy, Twin ,Premature Birth ,Small for gestational age ,Female ,Morbidity ,business ,Infant, Premature - Abstract
Background Data regarding the effects of antenatal corticosteroids in twin pregnancies are limited because of the insufficient number of women with twins enrolled in randomized controlled trials on antenatal corticosteroids. Furthermore, the interpretation of available data is limited by the fact that the interval from the administration of antenatal corticosteroids to delivery is greater than 7 days in a large proportion of twins, a factor that has been shown to affect the efficacy of antenatal corticosteroids and has not been controlled for in previous studies. Objective The objective of the study was to compare neonatal mortality and morbidity in preterm twins receiving a complete course of antenatal corticosteroids 1–7 days before birth to those who did not receive antenatal corticosteroids and to compare these outcome effects with those observed in singletons. Study Design We performed a retrospective cohort study using data collected on singleton and twin neonates born between 24 0/7 and 33 6/7 weeks' gestational age and were admitted to tertiary neonatal units in Canada between 2010 and 2014. A comparison of neonatal outcomes between twin neonates who received a complete course of antenatal corticosteroids 1–7 days before birth (n = 1758) and those who did not receive antenatal corticosteroids (n = 758) and between singleton neonates who received a complete course of antenatal corticosteroids 1–7 days before birth (n = 4638) and those did not receive antenatal corticosteroids (n = 2312) was conducted after adjusting for gestational age, sex, hypertension, outborn status, small for gestational age, parity, and cesarean birth. Adjusted odds ratios and 95% confidence intervals for various neonatal outcomes were calculated. Results Administration of a complete course of antenatal corticosteroids within 1–7 days before birth in both twins and singletons was associated with similar reduced odds of neonatal death (for twins adjusted odds ratio 0.42 [95% confidence interval, 0.24–0.76] and for singletons adjusted odds ratios, 0.38 [95% confidence interval, 0.28–0.50]; P = .7 for comparison of twins vs singletons), mechanical ventilation (for twins adjusted odds ratio, 0.47 [95% confidence interval, 0.35–0.63] and for singletons adjusted odds ratio, 0.47 [95% confidence interval, 0.41–0.55]; P = .9), respiratory distress syndrome (for twins adjusted odds ratio, 0.53 [95% confidence interval, 0.40–0.69], and for singletons adjusted odds ratio, 0.54 [95% confidence interval, 0.47–0.62]; P = .9) and severe neurological injury (for twins adjusted odds ratio, 0.50 [95% confidence interval, 0.30–0.83] and for singletons adjusted odds ratio, 0.45 [95% confidence interval, 0.34–0.59]; P = .7). Administration of a complete course of antenatal corticosteroids was not associated with a reduced odds of bronchopulmonary dysplasia, severe retinopathy of prematurity, or necrotizing enterocolitis in both twins and singletons. Conclusion Administration of a complete course of antenatal corticosteroids 1–7 days before birth in twin pregnancies is associated with a clinically significant decrease in neonatal mortality, short-term respiratory morbidity, and severe neurological injury that is similar in magnitude to that observed among singletons.
- Published
- 2016
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