September 2010

AARC International Respiratory Congress: Lots of Great Presentations for Neonatal-Pediatric RTs
Thanks to the proposals made by many of us in the Neonatal-Pediatric Section, this year’s AARC Congress, Dec. 6–9 in Las Vegas, NV, will be full of great lectures and speakers devoted to our specialty. So if you’ve yet to check out the ADVANCE PROGRAM, click over now and page through the agenda, then register for the meeting today. With 25+ CRCEs, it’s the best educational value you’ll find all year long.

Respiratory Problems Common in Late Preterm Births
Keeping babies in the womb for as long as possible is a good way to ward off respiratory problems, report researchers publishing in the July 28 issue of JAMA. Their study found babies born at 37 weeks were three times more likely to have respiratory distress syndrome than babies born at 39–40 weeks. Other respiratory problems were more common as well. The finding was based on a review of electronic medical records on 233,844 deliveries at 19 hospitals across the U.S. between 2002 and 2008. The investigators note medical experts have suggested the increase seen in late preterm births may be partly due to “convenience” c-sections performed for reasons other than those involving a medical need. Overall, late preterm births accounted for 9% of all deliveries in the study. Thirty-seven percent of these infants required ICU care, compared to just 7% of term infants. READ PRESS RELEASE

MRSA Infections Deadly for CF Patients
Physicians who believe Methicillin-resistant Staphylococcus aureus (MRSA) infections are not as important as other respiratory tract infections in children with cystic fibrosis may have to change their thinking. A new study from Ohio researchers find patients with MRSA bacteria in their respiratory tract have a significantly greater risk of death than those without evidence of MRSA. The research was conducted among 19,833 CF patients between the ages of six and 45. Over the 12 year study, 2537 patients died and 5759 tested positive for respiratory tract MRSA. The mortality rate was 18.3 deaths per 1000 patient-years for patients without MRSA and 27.7 deaths per 1000 patient-years for those with MRSA. After adjustment for various factors associated with severity of illness, the risk of death was approximately 1.3 times greater for CF patients with detectable MRSA. The research was published in the June 16 issue of JAMA. READ PRESS RELEASE

Blood Biomarkers Similar for SIMV, HFOV
Greek researchers who examined the effect of optimized synchronized intermittent mandatory ventilation (SIMV) and high-frequency oscillatory ventilation (HFOV) on circulating Clara cell 16 kD protein (CC16) and interleukin (IL)-6 levels in preterm neonates find similar circulating levels for the two modes. The researchers believe this suggests a “similar alveolar leakage and systemic inflammation with any of the ventilation modes evaluated when their usage is optimized.” The study was carried out in preterm neonates with a gestational age of 30 weeks or less who required mechanical ventilation within the first two hours of life. The study appeared in the July 29 Epub edition of the Journal of Perinatology. READ ABSTRACT

More Research Needed on Flow-Cycled Versus Time-Cycled Synchronized Ventilation for Neonates
Swiss researchers who reviewed the medical literature on the effect of flow-cycled versus time-cycled synchronized ventilation on the risk of bronchopulmonary dysplasia at 36 weeks postmenstrual age in neonates requiring assisted ventilation identified just two small, short-term, randomized, individual crossover trials involving 19 preterm neonates. Since neither reported clinical morbidities or mortality, the authors conclude, “There is insufficient evidence to determine the safety and efficacy of flow-cycled compared to time-cycled synchronized ventilation in neonates.” They call for large randomized clinical trials that also report clinically important outcomes. The report appeared in the July 7 issue of the Cochrane Database of Systematic Reviews. READ ABSTRACT