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Aim: The first dedicated neonatal continuous positive airway pressure (CPAP) device using variable flow was the Infant Flow. The system was pressure stable with a low resistance to breathing. The aim of this study was to describe the flow and function of the Infant Flow geometry using simulated breathing and computational fluid dynamics. Method: The original Infant Flow geometry was used with simulated term infant breathing at three levels of CPAP. The large eddy simulation methodology was applied in combination with the WALE sub‐grid scale model. Results: The simulation fully resolved the flow phenomena in the Infant Flow geometry. The main flow feature during inspiration was support by gas entrainment and mixing. During expiration, the jet deflected towards the outlet with unstable impingement of the jet at the opposing edge. Conclusion: The proposed mechanism has previously been based on theoretical reasoning, and our results present the first detailed description of the Infant Flow. The pressure stability was based on a jet supporting inspiration by gas entrainment and then being deflected during exhalation. This confirmed previously assumed principles of function and flows within the geometry and provided a base for further developments. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to describe first-year growth among very low birth weight infants and the effect of growth restriction at hospital discharge on first year growth. Method: Anthropometric measures and background information for 118 very low birth weight infants were collected from medical records. Z-scores were calculated based on recent Norwegian growth references. Results: Significant catch-up growth for weight and length was observed during the first year with mean z-score change (SD) of 0.40 (1.05) and 1.01 (1.25) respectively. However, the very low birth weight infants remained lighter and shorter than full-term peers until 12 months corrected age with mean z-score of −0.93 (1.09) and −0.48 (1.06) respectively. Head circumference followed a normal growth pattern after 2 months. Infants discharged from hospital as growth restricted had increased catch-up in weight and length, but remained smaller than infants not subjected to early growth restriction and full-term peers. Multiple regression showed that weight below the 10th percentile at discharge is important for weight and length during the first year of life. Conclusion: Very low birth weight infants showed catch-up growth during the first year, but their weight and length remained less than full-term peers. Growth deficiencies were more pronounced among infants subjected to early growth restriction, despite increased catch-up growth. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether neurodevelopmental outcome or pulmonary morbidity at age two years might be different after early versus late surfactant treatment in intubated preterm infants with severe respiratory distress syndrome (RDS). Methods: In 185 ex-preterm infants of 27–32 completed weeks of gestation, who were enrolled in a controlled trial of early versus late surfactant treatment (31 ± 19 min vs. 202 ± 80 min, respectively), a standardized follow up of medical history, pulmonary morbidity and neurodevelopmental outcome using the Griffiths scales were carried out. Results: Neurobehavioural and motor development was comparable in both groups, as was medical history and actual morbidity. However, in the early treatment group a delay in the subscale ‘personal social’ of the Griffiths test and in one ‘milestone’ of motor development (rolling over from supine to prone) was noticed, and the rate of increased muscular tone was significantly higher. Conclusion: In terms of long-term morbidity or neurological development there is no obvious advantage of an immediate surfactant administration after intubation in preterm infants with RDS. This is in line with our results published earlier on morbidity at discharge, so improvement of gas exchange after intubation can first be awaited before surfactant is indicated. [ABSTRACT FROM AUTHOR]

Aim: To assess survival and neurodevelopmental outcome of extremely preterm infants over a 20-year period at a single tertiary neonatal centre. Methods: All infants between 22 and 25+6 weeks of gestation admitted to a single UK neonatal centre between 1981 and 2000 were enrolled prospectively. Infants in the same gestational age range who were born alive at the hospital but not admitted to the neonatal unit were also identified over the period 1991–2000. All surviving infants received neurological and developmental assessment at a corrected age of 1 year. Results: There was a progressive increase in survival at all gestational ages over the 20-year period. Overall survival rose from 32% to 71% as a proportion of all admissions. The proportion of survivors with adverse neurodevelopmental outcome at 1 year of age showed no consistent change over the same period. Conclusion: In this single centre cohort study, marked improvements in survival over a 20-year period were not accompanied by a significant increase in neurodevelopmental morbidity. [ABSTRACT FROM AUTHOR]