February 2012
Notes from the Section
- The Winter edition of our Section Bulletin is
ONLINE
now, so click over to read great articles on a
new volunteer opportunity in Haiti and the role
of the respiratory therapist as an airway clearance
specialist. We also have a profile of our 2011
Specialty Practitioner of the Year.
- Neonatal-Pediatric Section members can earn
one free CRCE credit with an archived webcast
available to Section members only. Go to the Neonatal
SECTION
EDUCATION PAGE to register.
- Accessing our section discussion list on AARConnect
has just gotten a lot easier. Go HERE
for instructions on downloading our mobile app
on your Blackberries, Androids, and iPhones.
- AARC Executive Director Sam Giordano, MBA, RRT,
FAARC, will retire in June and the search is on
for his replacement. If you are interested in
applying for the position, CHECK
OUT the application requirements.
Chronic Conditions Increase RSV Risk
Danish investigators analyzed data on 391,983 children in several national databases, including a respiratory syncytial virus (RSV) database, to determine whether chronic conditions other than prematurity, heart disease, and Down syndrome affect the risk for and severity of hospitalization for RSV. Results revealed several new risk factors for RSV hospitalization, including malformations, interstitial lung disease, neuromuscular disease, liver disease, chromosomal abnormalities, congenital immunodeficiencies, and inborn errors of metabolism. In many of these chronic conditions, length of hospital stay for RSV was increased. The authors conclude, “Chronic disease per se is an important risk factor for RSV hospitalization.” The study was published ahead of print by Clinical Infectious Diseases on Jan. 12. READ ABSTRACT
Hydrocortisone Safely Facilitates Extubation
A new study out of The Netherlands finds hydrocortisone treatment to facilitate extubation in the preterm neonate has positive short term pulmonary effects and does not lead to cerebral palsy. The research was conducted among 55 preterm infants who received hydrocortisone at a median postnatal age of 14 days. Treatment significantly reduced FiO2 from a median of 0.39 to 0.30, mean airway pressure from a median of 10.0 cmH2O to 7.6 cmH2O, and PaCO2 from a median of 53.5 mmHg to 47 mmHg. All patients were successfully extubated. Eleven of 52 patients, or 21.1%, had chronic lung disease at 36 weeks but none had developed cerebral palsy at a 24 month follow up. The study was published ahead of print in the International Journal of Pediatrics on Dec. 20. READ ABSTRACT
Risk Factors for ROP
Oxygen administration is a known risk factor for retinopathy of prematurity (ROP), but other factors come into play as well, report researchers publishing ahead of print in the Journal of Maternal-Fetal & Neonatal Medicine on Jan. 26. They analyzed the records of 93 very low birth weight neonates with stage 3 or greater ROP, looking at perinatal ROP risk factors in those with stage 3 ROP that did and did not require surgery. Among the results:
- In the first two weeks and in the whole first month of life length of oxygen administration was an independent risk factor for treatment-requiring ROP.
- In the first month of life sepsis was also identified as an independent risk factor for surgical ROP.
- Sepsis and Candida pneumonia from birth to ROP diagnosis, and prolonged mechanical ventilation from diagnosis to prethreshold ROP, were associated with treatment-requiring ROP.
- Blood transfusions were the only risk factor for treatment-requiring ROP identified in all the periods analyzed.
The authors conclude, “Beside scrupulous oxygen administration monitoring and prevention of infections, blood transfusions are of primary importance in the development of treatment-requiring ROP.” READ ABSTRACT
Factors Help Identify Readiness to Discontinue Supplemental Oxygen
Connecticut Children’s Medical Center investigators have identified several factors associated with readiness to discontinue supplemental oxygen in very low birth weight infants with bronchopulmonary dysplasia who are approaching discharge from the NICU. The study involved 233 infants who were on nasal cannula supplemental oxygen. Infants were more likely to pass a challenge with room air at rest, during activity, and during feeding if they had gained more weight in the week prior to the challenge. Infants who passed gained 12.4 ± 5 g/kg/d vs. 11.2 ± 5.3 g/kg/d in infants who did not pass. Infants with increasing capillary pco 2, cannula flow rate, and pulmonary acuity score were less likely to pass the challenge, as were those with a history of patent ductus arteriosus (PDA). The authors conclude, “Weight, pco 2, cannula flow rate, pulmonary acuity score, and history of PDA ligation identify infants with BPD ready to maintain saturation and gain weight without supplemental oxygen.” The study was published ahead of print by the American Journal of Perinatology on Nov. 30. READ ABSTRACT
