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Vital birth data also fail to capture secondhand exposures which constitute a significant proportion of the population.

Assess the earliest time of LUS to guide surfactant therapy.

In this observational study (ClinicalTrials.gov Identifier NCT04544514), LUS was performed within 30 min and repeated at 1, 2, 4, and 6 h on preterm babies. White lung appearance was defined as type 1 group, whereas prevalence of lines B as type 2 and lines A as type 3. Ultrasound and radiographic findings were also compared to determine surfactant need.

Among 71 patients, 41 received surfactant therapy. In the first evaluation, 37 of them have been defined as type 1, whereas 4 of them have been as type 2 group. Type 3 group did not receive surfactant. Type 1 findings were superior to predict surfactant need and the predictive value was 100% at 2 h.

Even early LUS assessmentat the first 20-30 min was more significant to predict surfactant need than x-ray. Presence of white lung appearance for 2 h indicates an absolute surfactant need.

Even early LUS assessment at the first 20-30 min was more significant to predict surfactant need than x-ray. Presence of white lung appearance for 2 h indicates an absolute surfactant need.

To assess if treating neonatal abstinence syndrome (NAS) with sublingual buprenorphine (SLB) would decrease the mean duration of therapy (DOT) and length of birth hospital stay (LOS).

Conducted at a tertiary hospital with >6000 annual deliveries and a 2% incidence of NAS, a quality improvement study using plan-do-study-act (PDSA) cycles were utilized. Outcomes were measured using statistical process control (SPC) charts.

All NAS patients were treated with SLB, no adverse reactions were reported and the need for an adjunctive agent was static. SPC charts demonstrated decreased variability and special cause variation indicating a reduction in both DOT (from 14.5 to 8.5 days) and LOS (from 18.5 to 13 days).

All NAS patients were treated with SLB, no adverse reactions were reported and the need for an adjunctive agent was static. SPC charts demonstrated decreased variability and special cause variation indicating a reduction in both DOT (from 14.5 to 8.5 days) and LOS (from 18.5 to 13 days).

Estimate the migration of volatile organic compounds (VOCs) which have been identified by the EPA as a public health concern, from the enteral feeding system into human milk.

Unfortified human milk samples were infused through an enteral feeding system with varying duration of infusion, incubator temperature, and pre-infusion tube priming. Purge & Trap analysis and GC/MS were used to identify the VOC profile of milk pre- and post-infusion.

Cyclohexanone and 3,3,5-trimethylcyclohexanone (3,3,5-TMC) accumulated significantly in milk samples post-infusion. Duration of infusion had a significant effect on VOC accumulation (p = 0.001). Accumulation patterns of cyclohexanone and 3,3,5-TMC differed significantly based on milk type (donor vs. mother's own milk).

VOCs, migrate from plastic-based feeding equipment into human milk. Based on these findings, limiting the duration of feeding infusion would reduce VOC exposure derived from enteral feeding in the neonatal intensive care unit.

VOCs, migrate from plastic-based feeding equipment into human milk. Based on these findings, limiting the duration of feeding infusion would reduce VOC exposure derived from enteral feeding in the neonatal intensive care unit.

To evaluate the clinical usefulness of a non-invasive accelerometric device to diagnose GER in preterm babies.

An accelerometer was taped over the sub-xiphoid process in 110 preterm (GA 29.6 ± 3.3 wk) infants (133 studies). Low frequency, sub-audible signals were captured via digital recording (sampling rate 200 Hz), then re-sampled (rate = 60 Hz) to create a spectrogram (focused range 0-30 Hz). Mean amplitude in the focused range was calculated.

Of 85 studies with simultaneous pH-metry and accelerometry, 18 had concurrent positive and 23 had concurrent negative scores, 42 had negative pH scores when accelerometry was positive (≥1 µV), consistent with non-acid reflux. Eleven infants at high risk of aspiration received surgical interventions. All but 1 had negative pH scores while 10/11 had positive accelerometry.

The non-invasiveness of this accelerometric technique allows for GER screening and for repeated testing to assess efficacy of interventions.

The non-invasiveness of this accelerometric technique allows for GER screening and for repeated testing to assess efficacy of interventions.

To characterize pulse oxygen saturation (SpO

) trajectories and respiratory interventions after birth for newborns with cyanotic congenital heart disease (CCHD).

Retrospective single-site study of newborns ≥32 weeks gestation with CCHD single ventricle with critical aortic obstruction (SV-CAO), critical pulmonic obstruction (CPO), transposition of the great arteries (TGA). Minute-to-minute SpO

values and respiratory interventions were summarized and compared.

Two hundred infants were enrolled. SpO

at each minute differed across groups (p < 0.01), with the lowest values in TGA. All interventions were most frequent in TGA (p < 0.01). Continuous positive airway pressure was provided in 22% SV-CAO, 23% CPO, and 66% TGA. Positive pressure ventilation occurred in 7% SV-CAO, 14% CPO, and 33% TGA. Intubation occurred in 4% SV-CAO, 10% CPO, and 53% TGA.

We defined SpO

trajectories and delivery room respiratory interventions for three CCHD phenotypes. These results inform delivery room management of these high-risk populations.

We defined SpO2 trajectories and delivery room respiratory interventions for three CCHD phenotypes. These results inform delivery room management of these high-risk populations.

Determine how neurodevelopmental impairment (NDI) relates to concurrent outcomes for children born extremely preterm.

Retrospective cohort study children born 22 0/7-26 6/7 weeks' gestation at NICHD Neonatal Research Network hospitals. Outcomes were ascertained at 18-22 months' corrected age.

Of 6562 children, 2618 (40%) died and 441 (7%) had no follow-up. Among the remaining 3483 children, 825 (24%), 1576 (45%), 657 (19%), and 425 (12%) had no, potential/mild, moderate, and severe NDI, respectively. Rehospitalization, respiratory medications, surgery, and medical support services were associated with greater NDI severity but affected >10% of children without NDI. Rehospitalization occurred in 40% of children with no NDI (mean (SD) 1.7 (1.3) episodes).

Medical, functional, and social outcomes at 18-22 months' corrected age were associated with NDI; however, many children without NDI were affected. These data should contribute to counseling families and the design of studies for childhood outcomes beyond NDI.

Medical, functional, and social outcomes at 18-22 months' corrected age were associated with NDI; however, many children without NDI were affected. These data should contribute to counseling families and the design of studies for childhood outcomes beyond NDI.

Variation exists in neonatal platelet transfusion practices. Recent studies found potential harm in liberal platelet transfusion practices, supporting the use of lower transfusion thresholds. Our aim was to reduce non-indicated platelet transfusions through implementation of a restrictive platelet transfusion guideline.

Platelet transfusions from January 2017 to December 2019 were classified as indicated or non-indicated using the new guideline. Calcitriol in vitro Interventions included guideline implementation and staff education. Outcomes were evaluated using statistical process control charts. Major bleeding was the balancing measure.

During study, 438 platelet transfusions were administered to 105 neonates. The mean number of non-indicated platelet transfusions/month decreased from 7.3 to 1.6. The rate of non-indicated platelet transfusions per 100 patient admissions decreased from 12.5 to 2.9. Rates of major bleeding remained stable.

Implementation of a restrictive neonatal platelet transfusion guideline significantly reduced potentially harmful platelet transfusions in our NICU without a change in major bleeding.

Implementation of a restrictive neonatal platelet transfusion guideline significantly reduced potentially harmful platelet transfusions in our NICU without a change in major bleeding.

This study evaluates the 24-month follow-up for the NICHD Neonatal Research Network (NRN) Inositol for Retinopathy Trial.

Bayley Scales of Infants Development-III and a standardized neurosensory examination were performed in infants enrolled in the main trial. Moderate/severe NDI was defined as BSID-III Cognitive or Motor composite score <85, moderate or severe cerebral palsy, blindness, or hearing loss that prevents communication despite amplification were assessed.

Primary outcome was determined for 605/638 (95%). The mean gestational age was 25.8 ± 1.3 weeks and mean birthweight was 805 ± 192 g. Treatment group did not affect the risk for the composite outcome of death or survival with moderate/severe NDI (60% vs 56%, p = 0.40).

Treatment group did not affect the risk of death or survival with moderate/severe NDI. Despite early termination, this study represents the largest RCT of extremely preterm infants treated with myo-inositol with neurodevelopmental outcome data.

Treatment group did not affect the risk of death or survival with moderate/severe NDI. Despite early termination, this study represents the largest RCT of extremely preterm infants treated with myo-inositol with neurodevelopmental outcome data.

Despite the established utility of newborn screening tests (NBS), achieving timely specimen transit is a challenge for neonatal intensive care units (NICU).

This project was conducted between September 2017 and July 2020 using the Plan-Do-Study-Act (PDSA) tool. Our primary aim was to increase the percent of NBS samples reaching the state laboratory within 1 day of collection by 20% by April 2020. Process, outcome, and balancing measures were monitored.

Five hundred and eighty-five NBS were collected. There was special cause variation with improvement in the percent of samples received within 1 day of collection from 28 to 77%. Special cause variation was also observed in the process measures without an increase in the percent of unacceptable samples.

Standardizing the NBS collection processes by adopting a sample collection window and same day courier pickup ensures timely specimen transit without adversely affecting the quality of samples collected.

Standardizing the NBS collection processes by adopting a sample collection window and same day courier pickup ensures timely specimen transit without adversely affecting the quality of samples collected.This research study explored changes in family-centered care practices for hospitalized infants and families due to the COVID-19 pandemic. This exploratory descriptive study used a 49-item online survey, distributed to health care professionals working with hospitalized infants and families. The sample consisted of 96 participants from 22 countries. Prior to the COVID-19 pandemic, 87% of units welcomed families and 92% encouraged skin-to-skin care. During the pandemic, family presence was restricted in 83% of units, while participation in infant care was restricted in 32%. Medium-sized (20-40 beds) units applied less restriction than small ( less then 20 beds) units (p = 0.03). Units with single-family rooms that did not restrict parental presence, implemented fewer restrictions regarding parents' active participation in care (p = 0.02). Restrictions to families were not affected by geographic infection rates or developmental care education of health care professionals. Restrictions during the pandemic increased separation between the infant and family.