15 results on '"Eugenia Maranella"'
Search Results
2. Lung recruitment before surfactant administration in extremely preterm neonates with respiratory distress syndrome (IN-REC-SUR-E): a randomised, unblinded, controlled trial
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Alessandra Lio, Roberto Perniola, Vincenzo Salvo, Lucio Giordano, Giuseppe Presta, Francesco Cota, Francesca Paola Fusco, Marcello Vitaliti, Eleonora Balestri, Sandra Di Fabio, Simonetta Costa, Lucia G Tina, Luigi Orfeo, Valeria Fasolato, Alex Staffler, Gaetano Ausanio, Mariarosa Colnaghi, Milena Tana, Luca Massenzi, Maria Luisa Ventura, Virgilio P. Carnielli, Camilla Gizzi, Maria Paola Re, Paolo Tagliabue, Alessandra Grison, Luisa Pieragostini, Chiara Consigli, Isotta Guidotti, Valerio Meli, Vito D'Andrea, Carmine Mattia, Fabio Mosca, Angela Motta, Antonio Del Vecchio, Eloisa Gitto, Anton H. van Kaam, Federica Ferrero, Graeme R. Polglase, Agostina Solinas, Francesca Tormena, Alessandra Casati, Roberto Bottino, Piero Giuseppe Matassa, Carolina Grassia, Stefano Nobile, Lidia Grappone, Mariella Lucente, Giampaolo Garani, Luca Boni, E. Ciarmoli, Claudia Aurilia, Viviana Cardilli, Flavia Petrillo, Carlo Dani, J. Jane Pillow, Federica Pontiggia, Gabriella Nigro, Diego Gazzolo, Filip Cools, Ilaria Stasi, Paola Lago, Lorenzo Quartulli, Giancarlo Gargano, Roberta Pastorino, Cristina Haass, Chiara Tirone, Hubert Messner, Alberto Berardi, Isabella Mondello, Fabrizio Sandri, Vincenzo Rossi, Eugenia Maranella, Vincenzina Roma, Maria Chiara Strozzi, Paolo E Villani, Chiara Poggi, Giovanni Vento, Giovanna Mescoli, Stefania Vedovato, Antonio Scorrano, Laura Ilardi, Valentina Vendettuoli, Caterina Cacace, Stefano Martinelli, Gianfranco Maffei, Mario De Curtis, Pasqua Betta, Kim Maiolo, Clinical sciences, Growth and Development, Neonatology, and ARD - Amsterdam Reproduction and Development more...
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Pulmonary and Respiratory Medicine ,Male ,Critical Care ,medicine.medical_treatment ,surfactant ,law.invention ,lung ,Randomized controlled trial ,law ,Intensive care ,Intensive Care Units, Neonatal ,medicine ,Intubation, Intratracheal ,Humans ,extremely preterm neonates ,Continuous positive airway pressure ,preterm infants ,Pediatrics, Perinatology, and Child Health ,IN-REC-SUR-E ,Mechanical ventilation ,Respiratory Distress Syndrome, Newborn ,Respiratory distress ,business.industry ,Infant, Newborn ,Gestational age ,Pulmonary Surfactants ,Respiration, Artificial ,respiratory distress syndrome ,Treatment Outcome ,Italy ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,Relative risk ,Anesthesia ,Infant, Extremely Premature ,Number needed to treat ,Airway Extubation ,Female ,business - Abstract
Summary Background The importance of lung recruitment before surfactant administration has been shown in animal studies. Well designed trials in preterm infants are absent. We aimed to examine whether the application of a recruitment manoeuvre just before surfactant administration, followed by rapid extubation (intubate-recruit-surfactant-extubate [IN-REC-SUR-E]), decreased the need for mechanical ventilation during the first 72 h of life compared with no recruitment manoeuvre (ie, intubate-surfactant-extubate [IN-SUR-E]). Methods We did a randomised, unblinded, controlled trial in 35 tertiary neonatal intensive care units in Italy. Spontaneously breathing extremely preterm neonates (24 + 0 to 27 + 6 weeks' gestation) reaching failure criteria for continuous positive airway pressure within the first 24 h of life were randomly assigned (1:1) with a minimisation algorithm to IN-REC-SUR-E or IN-SUR-E using an interactive web-based electronic system, stratified by clinical site and gestational age. The primary outcome was the need for mechanical ventilation in the first 72 h of life. Analyses were done in intention-to-treat and per-protocol populations, with a log-binomial regression model correcting for stratification factors to estimate adjusted relative risk (RR). This study is registered with ClinicalTrials.gov , NCT02482766 . Findings Of 556 infants assessed for eligibility, 218 infants were recruited from Nov 12, 2015, to Sept 23, 2018, and included in the intention-to-treat analysis. The requirement for mechanical ventilation during the first 72 h of life was reduced in the IN-REC-SUR-E group (43 [40%] of 107) compared with the IN-SUR-E group (60 [54%] of 111; adjusted RR 0·75, 95% CI 0·57–0·98; p=0·037), with a number needed to treat of 7·2 (95% CI 3·7–135·0). The addition of the recruitment manoeuvre did not adversely affect the safety outcomes of in-hospital mortality (19 [19%] of 101 in the IN-REC-SUR-E group vs 37 [33%] of 111 in the IN-SUR-E group), pneumothorax (four [4%] of 101 vs seven [6%] of 111), or grade 3 or worse intraventricular haemorrhage (12 [12%] of 101 vs 17 [15%] of 111). Interpretation A lung recruitment manoeuvre just before surfactant administration improved the efficacy of surfactant treatment in extremely preterm neonates compared with the standard IN-SUR-E technique, without increasing the risk of adverse neonatal outcomes. The reduced need for mechanical ventilation during the first 72 h of life might facilitate implementation of a non-invasive respiratory support strategy. Funding None. more...
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- 2021
Catalog
3. Seizure burden and neurodevelopmental outcome in newborns with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia: A single center observational study
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Alessia Catalucci, Veronica Pannone, Claudia Basti, Marianna Del Torto, Luisa Di Luca, Cecilia Di Natale, Simona Ciccarelli, Nicola Cimini, Valentina Nardi, Arianna Mareri, Eugenia Maranella, and Sandra Di Fabio more...
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Male ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Encephalopathy ,Status epilepticus ,Electroencephalography ,Single Center ,Severity of Illness Index ,Hypoxic Ischemic Encephalopathy ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Hypothermia, Induced ,Seizures ,medicine ,Humans ,medicine.diagnostic_test ,business.industry ,Infant, Newborn ,Infant ,General Medicine ,Hypothermia ,medicine.disease ,Magnetic Resonance Imaging ,Neurology ,Cohort ,Hypoxia-Ischemia, Brain ,Anticonvulsants ,Female ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
OBJECTIVE To examine the relationship between electrographic seizures and developmental outcome at 18 and 24 months in neonates with moderate and severe hypoxic-ischemic encephalopathy [HIE] treated with therapeutic hypothermia [TH]. STUDY DESIGN 30 term infants with moderate-severe HIE treated with TH were enrolled prospectively from June 2012 to May 2018. All had continuous single channel amplitude integrated EEG (aEEG) monitoring for a minimum of 72 h and brain MR within 4 weeks. The aEEG was classified by severity of background and seizure burden. MR images were graded by the severity of injury. Outcome (defined abnormal in case of death, dyskinetic or spastic quadriplegic cerebral palsy, epilepsy, or Bayley III score < 85 in all three subscales or < 70 in any individual subscale) was assessed at 18 and 24 months. RESULTS Seizures were recorded in 24 out of 30 [80 %] neonates and an abnormal outcome was observed in 7 [23 %] of infants. Patients with poor outcome had a statistically significant correlation with: high seizure burden (p = 0.0004), need for more than one antiepileptic drugs (p = 0.006), a persistent abnormal aEEG trace at 48 h (p = 0.0001) and moderate-severe brain injury at MRI (p = 0.0001). Moreover, infants with status epilepticus or frequent seizures reported a significantly association with abnormal MR imaging and poor outcome than patients with sporadic seizures (p = 0.0009). CONCLUSION The role of seizures in the pathogenesis of brain injury remains controversial. In our cohort the presence of seizures, per se, was not associated with abnormal outcome; however a high seizure burden as well as a persistent abnormal aEEG background pattern and MR lesions resulted significantly associated with poor prognosis. more...
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- 2020
4. Severe neurologic and hepatic toxicity in a newborn prenatally exposed to methamphetamine. A case report
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Valentina Nardi, Arianna Mareri, Alessia Catalucci, Eugenia Maranella, Emanuela Conte, Luisa Di Luca, Cecilia Di Natale, Veronica Pannone, and Sandra Di Fabio
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Male ,Pediatrics ,medicine.medical_specialty ,Methamphetamine ,03 medical and health sciences ,0302 clinical medicine ,Developmental Neuroscience ,Pregnancy ,medicine ,Coagulopathy ,Humans ,Brain Diseases ,medicine.diagnostic_test ,Neonatal encephalopathy ,business.industry ,Infant, Newborn ,Brain ,Magnetic resonance imaging ,General Medicine ,Hypothermia ,medicine.disease ,Term Infant ,Prenatal Injuries ,Pediatrics, Perinatology and Child Health ,Toxicity ,Female ,Phenobarbital ,Neurology (clinical) ,Fresh frozen plasma ,medicine.symptom ,business ,Liver Failure ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Objective In the recent years the increase of methamphetamines (MTA) abusers women has become an emerging problem. Very little data has been published regarding the effects of prenatal MTA exposure. We describe a case of MTA related toxicity in a term newborn which have early onset of neonatal encephalopathy and liver failure. Case report A term infant born to a MTA abuser mother developed seizures and severe neurological symptoms shortly after birth. Methamphetamine was detected both in maternal and in neonatal urine. The laboratoristic tests revealed severe hepatic insufficiency, coagulopathy and thrombocytopenia. Due to neonatal encephalopathy the newborn underwent hypothermia. Phenobarbital, fresh frozen plasma, platelet transfusions and vitamin K were administered. Cranial ultrasonography and magnetic resonance imaging (MRI) showed diffuse white matter damage and two ischemic-hemorrhagic cerebral lesions. Gradually the clinical conditions improved, at 1 month MRI showed a stabilization of cerebral lesions with residual diffuse leukomalacia. Physiotherapy and neurological follow up is ongoing to evaluate the long term effects. Conclusions: although infrequent, MTA-related toxicity should be suspected in infants with neurologic and hepatic symptoms. Further studies are warranted to confirm our findings in order to identify newborns at high risk of acute MTA toxicity in time to provide them the appropriate support. more...
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- 2019
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5. Congenital pulmonary lymphangiectasia in an extremely low birth weight: a case report
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Arianna Mareri, Claudia Basti, Sandra Di Fabio, and Eugenia Maranella
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Embryology ,Pediatrics ,medicine.medical_specialty ,business.industry ,Obstetrics and Gynecology ,medicine.disease ,03 medical and health sciences ,Low birth weight ,0302 clinical medicine ,030228 respiratory system ,Pneumothorax ,Congenital Pulmonary Lymphangiectasia ,030225 pediatrics ,Pediatrics, Perinatology and Child Health ,medicine ,medicine.symptom ,business - Abstract
Objectives Congenital pulmonary lymphangiectasia (CPL) is a rare but fatal disorder of the lung. Case presentation We describe the case of an extremely low birth weight (ELBW) infant who presented with severe respiratory distress and recurrent bilateral pneumothorax. He died on day 17. The post-mortem examination of the lungs showed numerous cystic spaces, ranging from 1 to 2 mm in size, in the visceral pleura, in the thickened interlobular septum and hilum. A diagnosis of primary CPL was made. Conclusions We intend to underline that CPL, albeit rare, must be one of the differential diagnoses in infants with severe neonatal respiratory distress not responding to intensive care. Chronic interstitial lung diseases are a challenging diagnostic clinical problem, which requires a multidisciplinary approach. Histological lung examination may be useful to demonstrate the presence of CPL. more...
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- 2020
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6. Early ultrasonographic follow up in neonatal pneumatocele. Two case reports
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Arianna Mareri, Valentina Nardi, Alessandra Marciano, Eugenia Maranella, Sandra Di Fabio, Marialuisa Tataranno, Luisa Di Luca, and Cecilia Di Natale
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Embryology ,Pediatrics ,medicine.medical_specialty ,Pneumatocele ,business.industry ,Obstetrics and Gynecology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,030225 pediatrics ,Pediatrics, Perinatology and Child Health ,Medicine ,business - Abstract
Pulmonary pneumatocele is a thin-walled, air-filled cyst originating spontaneously within the lungs’ parenchyma, generally after infections or prolonged mechanical respiratory support. The diagnosis of pneumatocele is usually made using both chest X-ray (CXR) and computed tomography (CT) scan. Lung ultrasonography (LUS) is a promising technique used to investigate neonatal pulmonary diseases. We hereby present two cases of pneumatocele in newborns with respiratory distress syndrome (RDS) in which CXR and LUS were used to evaluate pulmonary parenchyma. LUS showed a multilobed cyst with a thin hyperechoic wall and a hypoechoic central area. Repeated LUS demonstrated a progressive reduction of the cyst’s size. After a few weeks, the small lesions were no longer detectable by ultrasound, therefore CXR was used, for follow-up, in the following months, until complete resolution. No data are available in the literature regarding ultrasonographic follow-up of neonatal pneumatocele. A larger number of patients are required to confirm our results and increase the use of LUS in the neonatal intensive care units (NICUs) to reduce neonatal radiations exposure. more...
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- 2018
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7. How to manage fetomaternal hemorrhage? Description of five cases and literature review
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Alessandra Marciano, Luisa Di Luca, Eugenia Maranella, Emanuela Conte, Cecilia Di Natale, Veronica Pannone, and Sandra Di Fabio
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fetomaternal hemorrhage ,neonatal anemia ,newborn ,flow cytometry ,lcsh:R ,lcsh:RJ1-570 ,lcsh:Medicine ,lcsh:Pediatrics ,blood transfusion ,exchange transfusion - Abstract
Fetomaternal hemorrhage (FMH) is a poorly understood condition in which there is a transfer of fetal blood to the maternal circulation. It occurs in approximately 1-3 per 1,000 births. We described five cases with characteristics suggestive of both acute and chronic anemia. When FMH is suspected, maternal blood can be checked for the presence of fetal red blood cells and usually there are three diagnostic modalities: Kleihauer-Betke test, flow cytometry and Rosette test. The clinical manifestations and the prognosis of FMH depend on the gestational age, the volume of the hemorrhage and the rapidity with which it has occurred. Red blood transfusion is recommended, while in case with severe anemia and cardiac failure an exchange transfusion can be considered. The physician’s awareness of the condition, the ability to suspect and diagnose it with appropriate testing have a significant impact on the epidemiology, accurate management and prognosis for the anemic neonates. more...
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- 2017
8. Response to 'Causal connection between methamphetamine and neurotoxicity not established'
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Eugenia Maranella
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Developmental Neuroscience ,Pediatrics, Perinatology and Child Health ,medicine ,Neurotoxicity ,Neurology (clinical) ,General Medicine ,Methamphetamine ,Psychology ,medicine.disease ,Neuroscience ,medicine.drug ,Connection (mathematics) - Published
- 2019
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9. Early predictors of short term neurodevelopmental outcome in asphyxiated cooled infants. A combined brain amplitude integrated electroencephalography and near infrared spectroscopy study
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Francesca Sbravati, Giacomo Faldella, Eugenia Maranella, Silvia Savini, Elena Coccolini, Sara Grandi, Gina Ancora, Ancora G., Maranella E., Grandi S., Sbravati F., Coccolini E., Savini S., and Faldella G. more...
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Encephalopathy ,Hypoxic Ischemic Encephalopathy ,Cerebral palsy ,Developmental Neuroscience ,Hypothermia, Induced ,Brain Cooling ,Humans ,Medicine ,Prospective Studies ,Prospective cohort study ,Asphyxia Neonatorum ,Spectroscopy, Near-Infrared ,business.industry ,Infant, Newborn ,Brain ,Electroencephalography ,General Medicine ,Hypothermia ,Prognosis ,medicine.disease ,Amplitude integrated electroencephalography ,Treatment Outcome ,Tissue oxygenation index ,Cerebral hemodynamics ,Anesthesia ,Hypoxia-Ischemia, Brain ,Pediatrics, Perinatology and Child Health ,Neurology (clinical) ,medicine.symptom ,business - Abstract
Background: Brain Cooling (BC) represents the elective treatment in asphyxiated newborns. Amplitude Integrated Electroencephalography (aEEG) and Near Infrared Spectroscopy (NIRS) monitoring may help to evaluate changes in cerebral electrical activity and cerebral hemodynamics during hypothermia. Objectives: To evaluate the prognostic value of aEEG time course and NIRS data in asphyxiated cooled infants. Methods: Twelve term neonates admitted to our NICU with moderate-severe Hypoxic-Ischemic Encephalopathy (HIE) underwent selective BC. aEEG and NIRS monitoring were started as soon as possible and maintained during the whole hypothermic treatment. Follow-up was scheduled at regular intervals; adverse outcome was defined as death, cerebral palsy (CP) or global quotient more...
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- 2013
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10. Efficacy of a new technique - INtubate-RECruit-SURfactant-Extubate - 'IN-REC-SUR-E' - in preterm neonates with respiratory distress syndrome: study protocol for a randomized controlled trial
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Francesco Torcetta, Maria Lucente, Alessandro Gambacorta, Anton H. van Kaam, Agostina Solinas, Francesca Tormena, Alessandra Grison, J. Jane Pillow, Diego Gazzolo, Fabio Mosca, Giancarlo Gargano, Lorenzo Quartulli, Francesca Paola Fusco, P.G. Matassa, Flavia Petrillo, Carlo Dani, Maria Paola Re, Alessandra Casati, Alessandra Lio, Valentina Vendettuoli, Milena Tana, Carolina Grassia, Maria Luisa Ventura, E. Ciarmoli, Paolo E Villani, Alex Staffler, Gaetano Ausanio, Marcello Vitaliti, Betta Pasqua, Ilaria Stasi, Caterina Cacace, Stefano Nobile, Federica Pontiggia, Lucio Giordano, Chiara Consigli, Antonello Del Vecchio, Claudia Aurilia, Viviana Cardilli, Gabriella Nigro, Chiara Tirone, Eleonora Balestri, Giovanna Mescoli, Luigi Orfeo, Isotta Guidotti, Stefania Vedovato, Antonio Scorrano, Laura Ilardi, Graeme R. Polglase, Alberto Berardi, Giuseppe Presta, Eloisa Gitto, Francesco Giura, Giovanni Vento, Camilla Gizzi, Lidia Grappone, Hubert Messner, Fabrizio Sandri, Enza Roma, Roberta Pastorino, Valerio Meli, Chiara Poggi, Loretta Mattia, Virgilio P. Carnielli, Stefano Martinelli, Gianfranco Maffei, Federica Ferrero, Roberto Perniola, Eugenia Maranella, Sara Dallaglio, Alberto Ricotti, Cinzia Ricci, Francesco Messina, Paolo Tagliabue, Isabella Mondello, Danila D’Onofrio, Filip Cools, Sandra Di Fabio, Roberto Bottino, Luca Boni, Luca Massenzi, Giovanna Montesano, Francesco Cota, Rosario Magaldi, Stefano Visentin, Mariarosa Colnaghi, Giampaolo Garani, Faculty of Medicine and Pharmacy, Clinical sciences, Growth and Development, and Neonatology more...
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Male ,Time Factors ,medicine.medical_treatment ,HFOV ,INSURE ,Lung recruitment ,Preterm infants ,Airway Extubation ,Biological Products ,Caffeine ,Central Nervous System Stimulants ,Citrates ,Continuous Positive Airway Pressure ,Female ,High-Frequency Ventilation ,Humans ,Infant, Newborn ,Intubation, Intratracheal ,Phospholipids ,Pulmonary Surfactants ,Respiratory Distress Syndrome, Newborn ,Treatment Outcome ,Infant, Premature ,Medicine (miscellaneous) ,Pharmacology (medical) ,Study Protocol ,0302 clinical medicine ,Functional residual capacity ,030212 general & internal medicine ,Continuous positive airway pressure ,Respiratory Distress Syndrome ,Respiratory distress ,High-frequency ventilation ,medicine.anatomical_structure ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,Anesthesia ,Breathing ,medicine.medical_specialty ,03 medical and health sciences ,030225 pediatrics ,medicine ,Intensive care medicine ,Premature ,Mechanical ventilation ,Lung ,business.industry ,Infant ,Newborn ,INSURE, Lung recruitment, Preterm infants, Medicine (miscellaneous), Pharmacology (medical) ,Intratracheal ,business ,Intubation - Abstract
Although beneficial in clinical practice, the INtubate-SURfactant-Extubate (IN-SUR-E) method is not successful in all preterm neonates with respiratory distress syndrome, with a reported failure rate ranging from 19 to 69 %. One of the possible mechanisms responsible for the unsuccessful IN-SUR-E method, requiring subsequent re-intubation and mechanical ventilation, is the inability of the preterm lung to achieve and maintain an “optimal” functional residual capacity. The importance of lung recruitment before surfactant administration has been demonstrated in animal studies showing that recruitment leads to a more homogeneous surfactant distribution within the lungs. Therefore, the aim of this study is to compare the application of a recruitment maneuver using the high-frequency oscillatory ventilation (HFOV) modality just before the surfactant administration followed by rapid extubation (INtubate-RECruit-SURfactant-Extubate: IN-REC-SUR-E) with IN-SUR-E alone in spontaneously breathing preterm infants requiring nasal continuous positive airway pressure (nCPAP) as initial respiratory support and reaching pre-defined CPAP failure criteria. In this study, 206 spontaneously breathing infants born at 24+0–27+6 weeks’ gestation and failing nCPAP during the first 24 h of life, will be randomized to receive an HFOV recruitment maneuver (IN-REC-SUR-E) or no recruitment maneuver (IN-SUR-E) just prior to surfactant administration followed by prompt extubation. The primary outcome is the need for mechanical ventilation within the first 3 days of life. Infants in both groups will be considered to have reached the primary outcome when they are not extubated within 30 min after surfactant administration or when they meet the nCPAP failure criteria after extubation. From all available data no definitive evidence exists about a positive effect of recruitment before surfactant instillation, but a rationale exists for testing the following hypothesis: a lung recruitment maneuver performed with a step-by-step Continuous Distending Pressure increase during High-Frequency Oscillatory Ventilation (and not with a sustained inflation) could have a positive effects in terms of improved surfactant distribution and consequent its major efficacy in preterm newborns with respiratory distress syndrome. This represents our challenge. ClinicalTrials.gov identifier: NCT02482766 . Registered on 1 June 2015. more...
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- 2016
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11. Role of bilevel positive airway pressure in the management of preterm newborns who have received surfactant
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Luca Pierantoni, Eugenia Maranella, Giacomo Faldella, Sara Grandi, Mariangela Guglielmi, and Gina Ancora
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Mechanical ventilation ,Artificial ventilation ,Respiratory distress ,business.industry ,medicine.medical_treatment ,Positive pressure ,General Medicine ,medicine.disease ,Respiratory acidosis ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Positive airway pressure ,medicine ,Intubation ,Continuous positive airway pressure ,business - Abstract
Aim: Surfactant given during brief intubation followed by immediate extubation on nasal continuous positive airway pressure [Intubation-Surfactant-Extubation (InSurE) approach] is used to treat respiratory distress syndrome in newborns. Our aim was to evaluate whether bilevel positive airway pressure (BiPAP) after InSurE failure is able to prevent the need for mechanical ventilation (MV). Methods: Chart data of infants with a birth weight 0.4, respiratory acidosis or intractable apnoea within 1 week. After InSurE failure, newborns born before the implementation of BiPAP (historical control group) received MV, whereas those born after BiPAP implementation (BiPAP group) received BiPAP and underwent MV only if failure criteria persisted. The two groups were compared to evaluate whether BiPAP reduced the need for MV in the 7 days after InSurE failure. Results: Six of twenty-two (27%) and 14 of the 38 (37%) infants failed InSurE in the two groups, respectively (p > 0.05). Need for MV was 27% in the historical control group versus 0% in the BiPAP group (risk estimate, 3.38; 95% CI, 2.24, 5.09; p = 0.001). Conclusions: BiPAP reduced the need for MV after InSurE failure. more...
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- 2010
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12. Disseminated, large-sized neonatal pneumatoceles: The wait-and-see strategy
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S. Di Fabio, Eleonora Coclite, Emanuela Conte, Eugenia Maranella, and C. Di Natale
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Pathology ,business.industry ,Escherichia coli pneumonia ,Pulmonary cyst ,medicine.disease_cause ,medicine.disease ,Sepsis ,Staphylococcus aureus ,Internal medicine ,Pediatrics, Perinatology and Child Health ,Parenchyma ,medicine ,Acute pneumonia ,business - Abstract
Summary Pulmonary pneumatoceles are thin-walled, air-filled cysts that develop within the lung parenchyma. Most often, they occur as a sequel of acute pneumonia, commonly caused by Staphylococcus aureus in children. Limited data are available about infective pulmonary cysts in newborns. We report a case of a newborn, who developed multiple pneumatoceles after Escherichia coli pneumonia. Pediatr Pulmonol. 2014; 49:E69–E71. © 2013 Wiley Periodicals, Inc. more...
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- 2013
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13. Effect of posture on brain hemodynamics in preterm newborns not mechanically ventilated
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Arianna Aceti, Luca Pierantoni, Giacomo Faldella, Luigi Corvaglia, Gina Ancora, Eugenia Maranella, Sara Grandi, Ancora G, Maranella E, Aceti A, Pierantoni L, Grandi S, Corvaglia L, and Faldella G.
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Male ,Posture ,Hemodynamics ,Gestational Age ,Patient Positioning ,Cerebral oxygenation ,Humans ,Medicine ,skin and connective tissue diseases ,Head posture ,Spectroscopy, Near-Infrared ,medicine.diagnostic_test ,business.industry ,Infant, Newborn ,Brain ,Echoencephalography ,Respiration, Artificial ,Cerebral blood volume ,Cerebral blood flow ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Female ,sense organs ,business ,Infant, Premature ,Developmental Biology - Abstract
Background: Changes in head posture influence brain hemodynamics. Optimal positioning has been recommended as 1 of 10 potentially better practices to reduce the incidence of brain injury in preterm newborns. Objectives: The aim of this study was to evaluate by near-infrared spectroscopy (NIRS) the effect of different head and body positions and the influence of gestational age (GA) and nasal continuous positive airway pressure on brain hemodynamics in very preterm newborns. Methods: 24 stable preterm newborns were studied by NIRS in 6 different postures including head rotation and head inclination in both supine and prone positions. Changes in normalized tissue hemoglobin index (nTHI) and tissue oxygenation index (TOI) were measured after posture variations. Results: No statistically significant changes in nTHI and in TOI were found in the 6 postures. nTHI variations, expression of cerebral blood volume variations, were influenced by GA. A reduction in nTHI, with a stable TOI, in the less mature infants (with GA ≤26 weeks), occurred on head rotation; nTHI increased again when the head was derotated. Conclusions: Hemodynamic changes after posture variations depend on GA. Head rotation in newborns with GA ≤26 weeks produced a reduction in nTHI with stable TOI. Possible physiopathological mechanisms are discussed. more...
- Published
- 2010
14. Changes in cerebral hemodynamics and amplitude integrated EEG in an asphyxiated newborn during and after cool cap treatment
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Luca Pierantoni, Giacomo Faldella, Eugenia Maranella, Gina Ancora, Chiara Locatelli, Ancora G, Maranella E, Locatelli C, Pierantoni L, and Faldella G
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Magnetic Resonance Spectroscopy ,Encephalopathy ,Hyperemia ,Electroencephalography ,Brain cooling ,Hypoxic Ischemic Encephalopathy ,Body Temperature ,Time ,Disability Evaluation ,Hemoglobins ,Oxygen Consumption ,Developmental Neuroscience ,Hypothermia, Induced ,Predictive Value of Tests ,medicine ,ASPHYXIATED NEWBORN ,Humans ,Monitoring, Physiologic ,Asphyxia Neonatorum ,Epilepsy ,Spectroscopy, Near-Infrared ,medicine.diagnostic_test ,business.industry ,Hemodynamics ,Infant, Newborn ,Brain ,General Medicine ,Oxygenation ,Hypothermia ,medicine.disease ,Cerebral hemodynamics ,Anesthesia ,Cerebrovascular Circulation ,Pediatrics, Perinatology and Child Health ,Hypoxia-Ischemia, Brain ,Neurology (clinical) ,medicine.symptom ,business - Abstract
Amplitude integrated EEG (aEEG) and Near Infrared Spectroscopy (NIRS) were applied in a newborn with a moderate hypoxic–ischemic encephalopathy before, during and after brain cooling. At 2 h of life a selective head cooling with mild systemic hypothermia was started and maintained for 72 h. aEEG background pattern improved from severely abnormal to normal during the first 17 h of life. NIRS revealed a reduction in cerebral blood volume (CBV) during hypothermia that recovered during the rewarming period, whereas brain oxygenation remained stable. As brain cooling is supposed to reduce delayed hyperemia and help to maintain neuronal metabolism following cerebral insults, aEEG and NIRS monitoring may be useful during hypothermic treatment in order to document changes in CBV and brain oxygenation possibly reflecting the efficacy of hypothermia. more...
- Published
- 2009
15. Prognostic Value of Amplitude Integrated Electroencephalography (AEEG) and Near Infrared Spectroscopy (NIRS) in Cooled Infants with Hypoxic-Ischemic Encephalopathy (HIE)
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E. Coccolini, Francesca Sbravati, Eugenia Maranella, Gina Ancora, Sara Grandi, Silvia Savini, and Giacomo Faldella
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Pediatrics ,medicine.medical_specialty ,Pregnancy ,Neurology ,business.industry ,Hypothermia ,medicine.disease ,Hypoxic Ischemic Encephalopathy ,Amplitude integrated electroencephalography ,Cerebral palsy ,Pulmonology ,Anesthesia ,Internal medicine ,Pediatrics, Perinatology and Child Health ,medicine ,Neonatology ,medicine.symptom ,business - Abstract
Background and aims: Brain cooling (BC) represents the elective treatment in asphyctic newborns. aEEG and NIRS monitoring may help to evaluate changes in cerebral electrical activity and cerebral hemodynamics during hypothermia. Aims: To evaluate the prognostic value of aEEG time course and NIRS data in asphyctic cooled infants. Methods: 12 term neonates admitted to our NICU with a moderate-severe HIE underwent selective BC. aEEG and NIRS monitoring were started as soon as possible and maintained during the whole hypothermic treatment. Follow-up was scheduled at regular intervals; adverse outcome was defined as death, cerebral palsy (CP) or global quotient < 88.7 at Griffiths' Scale. Results: 2/12 infants died, 2 developed CP, 1 was normal at 6 months of age and then lost at follow-up and 7 showed a normal outcome at least at 1 year of age. The aEEG background pattern at 24 hours of life was abnormal in 10 newborns; only 4 of them developed an adverse outcome, whereas the 2 infants with a normal aEEG developed normally. In infants with adverse outcome NIRS showed a higher Tissue Oxygenation Index (TOI) compared with those with normal outcome (80.0±10.5% vs 66.9±7.0%, p=0.057; 79.7±9.4% vs 67.1±7.9%, p=0.034; 80.2±8.8% vs 71.6±5.9%, p=0.069 at 6, 12 and 24 hours of life, respectively). Conclusions: The aEEG background pattern at 24 hours of life loses its positive predictive value after BC implementation; TOI could be useful to early predict non responder infants that may benefit from other innovative therapies. more...
- Published
- 2011
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