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Manuel Durand - One of the best experts on this subject based on the ideXlab platform.
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respiratory compliance in late preterm infants 340 7 346 7 weeks after Antenatal Steroid therapy
The Journal of Pediatrics, 2018Co-Authors: Mitzi Go, Manuel Durand, Diane Schilling, Thuan Nguyen, Cindy T McevoyAbstract:Objective To compare respiratory compliance in late preterm infants (340/7-346/7 weeks) who received Antenatal Steroids vs matched late preterm infants who did not receive Antenatal Steroids. Study design This was a single-center prospective cohort study. Patients were matched for birth weight, gestational age, race, and sex. Respiratory compliance was the primary outcome measured with the single breath occlusion technique. Results We studied 25 late preterm infants treated with Antenatal Steroids and 25 matched infants who did not receive Antenatal Steroids. The treated infants had a significantly increased respiratory compliance/kg (adjusted 95% CI 0.05, 0.49; P = .016) and fewer required continuous positive airway pressure (P = .007) or >24 hours of supplemental oxygen (P = .046). There was no difference in surfactant therapy. Conclusions Respiratory compliance was significantly increased in this cohort of late preterm infants born at 340/7-346/7 weeks who received Antenatal Steroids compared with matched infants who did not receive Antenatal Steroids. Although not randomized, these data provide physiologic support for the possible beneficial effects of Antenatal Steroids in late preterm infants.
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Respiratory Compliance in Late Preterm Infants (340/7-346/7 Weeks) after Antenatal Steroid Therapy
The Journal of Pediatrics, 2018Co-Authors: Mitzi Go, Manuel Durand, Diane Schilling, Thuan Nguyen, Cindy T McevoyAbstract:Objective To compare respiratory compliance in late preterm infants (340/7-346/7 weeks) who received Antenatal Steroids vs matched late preterm infants who did not receive Antenatal Steroids. Study design This was a single-center prospective cohort study. Patients were matched for birth weight, gestational age, race, and sex. Respiratory compliance was the primary outcome measured with the single breath occlusion technique. Results We studied 25 late preterm infants treated with Antenatal Steroids and 25 matched infants who did not receive Antenatal Steroids. The treated infants had a significantly increased respiratory compliance/kg (adjusted 95% CI 0.05, 0.49; P = .016) and fewer required continuous positive airway pressure (P = .007) or >24 hours of supplemental oxygen (P = .046). There was no difference in surfactant therapy. Conclusions Respiratory compliance was significantly increased in this cohort of late preterm infants born at 340/7-346/7 weeks who received Antenatal Steroids compared with matched infants who did not receive Antenatal Steroids. Although not randomized, these data provide physiologic support for the possible beneficial effects of Antenatal Steroids in late preterm infants.
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decreased respiratory compliance in infants less than or equal to 32 weeks gestation delivered more than 7 days after Antenatal Steroid therapy
Pediatrics, 2008Co-Authors: C Mcevoy, Diane Schilling, Patricia Spitale, Dawn Peters, Jean P Omalley, Manuel DurandAbstract:OBJECTIVES. Our objective was to compare the pulmonary function (respiratory compliance) of infants who were ≤32 weeks9 gestation and delivered >7 days after a single course of Antenatal Steroids versus infants who were delivered 1 to 7 days after a single course of Antenatal Steroids. METHODS. A prospective cohort study of respiratory system compliance was conducted of infants ≤32 weeks9 gestation within 72 hours of life and before surfactant therapy if needed. The study (remote) group was composed of infants who were treated with Antenatal Steroids >7 days before delivery and the comparison group (ideal group) of matched infants who were treated with Antenatal Steroids 1 to 7 days before delivery. Respiratory system compliance was measured with the single-breath occlusion technique. RESULTS. Twenty-eight remotely treated infants and 28 ideally treated infants were studied. The remote group had a significantly lower respiratory system compliance per kilogram and total respiratory system compliance when compared with the ideal Antenatal Steroids group. Within the remote group, infants who received Antenatal Steroids 8 to 14 days (n = 10) before delivery had a significantly higher respiratory system compliance and a trend to less surfactant need (10% vs 33%) as compared with infants who received Antenatal Steroids >14 days (n = 18) before delivery. CONCLUSIONS. Infants who were ≤32 weeks9 gestation and remotely treated with Antenatal Steroids (average 21 days) had a significantly lower respiratory compliance compared with matched infants who were ideally treated with Antenatal Steroids. We speculate that the lower respiratory system compliance may reflect the dissipation of beneficial effects of Antenatal Steroids on pulmonary function when delivery occurs >7 days after therapy and particularly when therapy is >14 days before delivery.
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functional residual capacity and passive compliance measurements after Antenatal Steroid therapy in preterm infants
Pediatric Pulmonology, 2001Co-Authors: C Mcevoy, Susan Bowling, Kathleen Williamson, Marion Stewart, Manuel DurandAbstract:Studies in preterm animal models have shown that Antenatal corticoSteroids enhance lung maturation by improving a variety of physiologic variables, including lung volumes. Changes in lung volume of preterm infants treated with a full course of Antenatal Steroids have not been investigated. We hypothesized that a full course of Antenatal Steroids would significantly increase functional residual capacity (FRC) in treated vs. untreated preterm infants. The objective of our study was to compare FRC and respiratory mechanics in Steroid treated vs. untreated preterm infants. FRC and passive respiratory mechanics were prospectively studied within 36 hr of life in 20 infants (25–34 weeks of gestation) who had received a full course of Antenatal Steroids and in 20 matched untreated preterm infants. FRC was measured with the nitrogen washout method, and respiratory mechanics with the single-breath occlusion technique. Preterm infants who received Steroids (n = 20; mean birth weight = 1,230 g; gestational age = 28.8 weeks) had a significantly higher FRC (29.5 vs. 19.3 mL/kg; P < 0.001) than untreated infants (n = 20; birth weight = 1,202 g; gestational age = 28.5 weeks). Passive respiratory system compliance was also increased in treated vs. untreated infants (P < 0.05). In conclusion, FRC and passive respiratory system compliance were significantly improved in preterm infants (25–34 weeks gestation) treated with a full course of Antenatal Steroids, compared to matched untreated infants. Although this study was not randomized, it confirms that Antenatal Steroids have important effects on pulmonary function that may contribute to a decreased risk of respiratory distress syndrome in treated preterm infants. Pediatr Pulmonol. 2001; 31:425–430. © 2001 Wiley-Liss, Inc.
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Functional residual capacity and passive compliance measurements after Antenatal Steroid therapy in preterm infants
Pediatric Pulmonology, 2001Co-Authors: C Mcevoy, Susan Bowling, Kathleen Williamson, Marion Stewart, Manuel DurandAbstract:Studies in preterm animal models have shown that Antenatal corticoSteroids enhance lung maturation by improving a variety of physiologic variables, including lung volumes. Changes in lung volume of preterm infants treated with a full course of Antenatal Steroids have not been investigated. We hypothesized that a full course of Antenatal Steroids would significantly increase functional residual capacity (FRC) in treated vs. untreated preterm infants. The objective of our study was to compare FRC and respiratory mechanics in Steroid treated vs. untreated preterm infants. FRC and passive respiratory mechanics were prospectively studied within 36 hr of life in 20 infants (25–34 weeks of gestation) who had received a full course of Antenatal Steroids and in 20 matched untreated preterm infants. FRC was measured with the nitrogen washout method, and respiratory mechanics with the single-breath occlusion technique. Preterm infants who received Steroids (n = 20; mean birth weight = 1,230 g; gestational age = 28.8 weeks) had a significantly higher FRC (29.5 vs. 19.3 mL/kg; P
Cindy T Mcevoy - One of the best experts on this subject based on the ideXlab platform.
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respiratory compliance in late preterm infants 340 7 346 7 weeks after Antenatal Steroid therapy
The Journal of Pediatrics, 2018Co-Authors: Mitzi Go, Manuel Durand, Diane Schilling, Thuan Nguyen, Cindy T McevoyAbstract:Objective To compare respiratory compliance in late preterm infants (340/7-346/7 weeks) who received Antenatal Steroids vs matched late preterm infants who did not receive Antenatal Steroids. Study design This was a single-center prospective cohort study. Patients were matched for birth weight, gestational age, race, and sex. Respiratory compliance was the primary outcome measured with the single breath occlusion technique. Results We studied 25 late preterm infants treated with Antenatal Steroids and 25 matched infants who did not receive Antenatal Steroids. The treated infants had a significantly increased respiratory compliance/kg (adjusted 95% CI 0.05, 0.49; P = .016) and fewer required continuous positive airway pressure (P = .007) or >24 hours of supplemental oxygen (P = .046). There was no difference in surfactant therapy. Conclusions Respiratory compliance was significantly increased in this cohort of late preterm infants born at 340/7-346/7 weeks who received Antenatal Steroids compared with matched infants who did not receive Antenatal Steroids. Although not randomized, these data provide physiologic support for the possible beneficial effects of Antenatal Steroids in late preterm infants.
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Respiratory Compliance in Late Preterm Infants (340/7-346/7 Weeks) after Antenatal Steroid Therapy
The Journal of Pediatrics, 2018Co-Authors: Mitzi Go, Manuel Durand, Diane Schilling, Thuan Nguyen, Cindy T McevoyAbstract:Objective To compare respiratory compliance in late preterm infants (340/7-346/7 weeks) who received Antenatal Steroids vs matched late preterm infants who did not receive Antenatal Steroids. Study design This was a single-center prospective cohort study. Patients were matched for birth weight, gestational age, race, and sex. Respiratory compliance was the primary outcome measured with the single breath occlusion technique. Results We studied 25 late preterm infants treated with Antenatal Steroids and 25 matched infants who did not receive Antenatal Steroids. The treated infants had a significantly increased respiratory compliance/kg (adjusted 95% CI 0.05, 0.49; P = .016) and fewer required continuous positive airway pressure (P = .007) or >24 hours of supplemental oxygen (P = .046). There was no difference in surfactant therapy. Conclusions Respiratory compliance was significantly increased in this cohort of late preterm infants born at 340/7-346/7 weeks who received Antenatal Steroids compared with matched infants who did not receive Antenatal Steroids. Although not randomized, these data provide physiologic support for the possible beneficial effects of Antenatal Steroids in late preterm infants.
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The window of improved neonatal respiratory compliance after rescue Antenatal Steroids
Journal of Perinatology, 2018Co-Authors: Brian K. Jordan, Diane Schilling, Cindy T McevoyAbstract:To evaluate whether premature infants delivered ≤7 days after rescue Antenatal Steroid treatment (ideal treatment) have increased passive respiratory compliance compared to those delivered >7 days after treatment (remote treatment). Secondary analysis of a randomized trial of rescue Antenatal Steroids on respiratory compliance. Infants in the treatment group were stratified by the interval between rescue Antenatal Steroids and delivery. We then compared the respiratory compliance in the ideal vs. remote groups. Forty-four women (56 infants) received rescue Antenatal Steroids. Forty-nine infants had evaluable respiratory compliance measurements, with 27 (GA 30.1 weeks, BW 1362 g) “ideally” treated, and 22 (GA 33.8 weeks, BW 2248 g) “remotely” treated. Respiratory compliance was significantly higher for the ideal compared to the remote group (1.32 vs. 1.06 mL/cm H2O/kg; p = 0.037). Infants treated with rescue Antenatal Steroids have a significantly higher respiratory compliance if delivery occurs within 7 days after treatment.
Diane Schilling - One of the best experts on this subject based on the ideXlab platform.
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respiratory compliance in late preterm infants 340 7 346 7 weeks after Antenatal Steroid therapy
The Journal of Pediatrics, 2018Co-Authors: Mitzi Go, Manuel Durand, Diane Schilling, Thuan Nguyen, Cindy T McevoyAbstract:Objective To compare respiratory compliance in late preterm infants (340/7-346/7 weeks) who received Antenatal Steroids vs matched late preterm infants who did not receive Antenatal Steroids. Study design This was a single-center prospective cohort study. Patients were matched for birth weight, gestational age, race, and sex. Respiratory compliance was the primary outcome measured with the single breath occlusion technique. Results We studied 25 late preterm infants treated with Antenatal Steroids and 25 matched infants who did not receive Antenatal Steroids. The treated infants had a significantly increased respiratory compliance/kg (adjusted 95% CI 0.05, 0.49; P = .016) and fewer required continuous positive airway pressure (P = .007) or >24 hours of supplemental oxygen (P = .046). There was no difference in surfactant therapy. Conclusions Respiratory compliance was significantly increased in this cohort of late preterm infants born at 340/7-346/7 weeks who received Antenatal Steroids compared with matched infants who did not receive Antenatal Steroids. Although not randomized, these data provide physiologic support for the possible beneficial effects of Antenatal Steroids in late preterm infants.
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Respiratory Compliance in Late Preterm Infants (340/7-346/7 Weeks) after Antenatal Steroid Therapy
The Journal of Pediatrics, 2018Co-Authors: Mitzi Go, Manuel Durand, Diane Schilling, Thuan Nguyen, Cindy T McevoyAbstract:Objective To compare respiratory compliance in late preterm infants (340/7-346/7 weeks) who received Antenatal Steroids vs matched late preterm infants who did not receive Antenatal Steroids. Study design This was a single-center prospective cohort study. Patients were matched for birth weight, gestational age, race, and sex. Respiratory compliance was the primary outcome measured with the single breath occlusion technique. Results We studied 25 late preterm infants treated with Antenatal Steroids and 25 matched infants who did not receive Antenatal Steroids. The treated infants had a significantly increased respiratory compliance/kg (adjusted 95% CI 0.05, 0.49; P = .016) and fewer required continuous positive airway pressure (P = .007) or >24 hours of supplemental oxygen (P = .046). There was no difference in surfactant therapy. Conclusions Respiratory compliance was significantly increased in this cohort of late preterm infants born at 340/7-346/7 weeks who received Antenatal Steroids compared with matched infants who did not receive Antenatal Steroids. Although not randomized, these data provide physiologic support for the possible beneficial effects of Antenatal Steroids in late preterm infants.
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The window of improved neonatal respiratory compliance after rescue Antenatal Steroids
Journal of Perinatology, 2018Co-Authors: Brian K. Jordan, Diane Schilling, Cindy T McevoyAbstract:To evaluate whether premature infants delivered ≤7 days after rescue Antenatal Steroid treatment (ideal treatment) have increased passive respiratory compliance compared to those delivered >7 days after treatment (remote treatment). Secondary analysis of a randomized trial of rescue Antenatal Steroids on respiratory compliance. Infants in the treatment group were stratified by the interval between rescue Antenatal Steroids and delivery. We then compared the respiratory compliance in the ideal vs. remote groups. Forty-four women (56 infants) received rescue Antenatal Steroids. Forty-nine infants had evaluable respiratory compliance measurements, with 27 (GA 30.1 weeks, BW 1362 g) “ideally” treated, and 22 (GA 33.8 weeks, BW 2248 g) “remotely” treated. Respiratory compliance was significantly higher for the ideal compared to the remote group (1.32 vs. 1.06 mL/cm H2O/kg; p = 0.037). Infants treated with rescue Antenatal Steroids have a significantly higher respiratory compliance if delivery occurs within 7 days after treatment.
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decreased respiratory compliance in infants less than or equal to 32 weeks gestation delivered more than 7 days after Antenatal Steroid therapy
Pediatrics, 2008Co-Authors: C Mcevoy, Diane Schilling, Patricia Spitale, Dawn Peters, Jean P Omalley, Manuel DurandAbstract:OBJECTIVES. Our objective was to compare the pulmonary function (respiratory compliance) of infants who were ≤32 weeks9 gestation and delivered >7 days after a single course of Antenatal Steroids versus infants who were delivered 1 to 7 days after a single course of Antenatal Steroids. METHODS. A prospective cohort study of respiratory system compliance was conducted of infants ≤32 weeks9 gestation within 72 hours of life and before surfactant therapy if needed. The study (remote) group was composed of infants who were treated with Antenatal Steroids >7 days before delivery and the comparison group (ideal group) of matched infants who were treated with Antenatal Steroids 1 to 7 days before delivery. Respiratory system compliance was measured with the single-breath occlusion technique. RESULTS. Twenty-eight remotely treated infants and 28 ideally treated infants were studied. The remote group had a significantly lower respiratory system compliance per kilogram and total respiratory system compliance when compared with the ideal Antenatal Steroids group. Within the remote group, infants who received Antenatal Steroids 8 to 14 days (n = 10) before delivery had a significantly higher respiratory system compliance and a trend to less surfactant need (10% vs 33%) as compared with infants who received Antenatal Steroids >14 days (n = 18) before delivery. CONCLUSIONS. Infants who were ≤32 weeks9 gestation and remotely treated with Antenatal Steroids (average 21 days) had a significantly lower respiratory compliance compared with matched infants who were ideally treated with Antenatal Steroids. We speculate that the lower respiratory system compliance may reflect the dissipation of beneficial effects of Antenatal Steroids on pulmonary function when delivery occurs >7 days after therapy and particularly when therapy is >14 days before delivery.
Gerald F Joseph - One of the best experts on this subject based on the ideXlab platform.
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periviable birth executive summary of a joint workshop by the eunice kennedy shriver national institute of child health and human development society for maternal fetal medicine american academy of pediatrics and american college of obstetricians and
American Journal of Obstetrics and Gynecology, 2014Co-Authors: Tonse N K Raju, Brian M Mercer, David J Burchfield, Gerald F JosephAbstract:This is an executive summary of a workshop on the management and counseling issues of women anticipated to deliver at a periviable gestation (broadly defined as 20 0/7 through 25 6/7 weeks of gestation) and the treatment options for the newborn infant. Upon review of the available literature, the workshop panel noted that the rates of neonatal survival and neurodevelopmental disabilities among the survivors vary greatly across the periviable gestations and are significantly influenced by the obstetric and neonatal management practices (eg, Antenatal Steroid, tocolytic agents, and antibiotic administration; cesarean birth; and local protocols for perinatal care, neonatal resuscitation, and intensive care support). These are, in turn, influenced by the variations in local and regional definitions of limits of viability. Because of the complexities in making difficult management decisions, obstetric and neonatal teams should confer prior to meeting with the family, when feasible. Family counseling should be coordinated with the goal of creating mutual trust, respect, and understanding and should incorporate evidence-based counseling methods. Since clinical circumstances can change rapidly with increasing gestational age, counseling should include discussion of the benefits and risks of various maternal and neonatal interventions at the time of counseling. There should be a plan for follow-up counseling as clinical circumstances evolve. The panel proposed a research agenda and recommended developing educational curricula on the care and counseling of families facing the birth of a periviable infant.
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Periviable birth: executive summary of a Joint Workshop by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Academy of Pediatrics, and American College of Obstetricians
Journal of Perinatology, 2014Co-Authors: Tonse N K Raju, Brian M Mercer, David J Burchfield, Gerald F JosephAbstract:This is an executive summary of a workshop on the management and counseling issues of women anticipated to deliver at a periviable gestation (broadly defined as 20 0/7 through 25 6/7 weeks of gestation), and the treatment options for the newborn. Upon review of the available literature, the workshop panel noted that the rates of neonatal survival and neurodevelopmental disabilities among the survivors vary greatly across the periviable gestations and are significantly influenced by the obstetric and neonatal management practices (for example, Antenatal Steroid, tocolytic agents and antibiotic administration; cesarean birth; and local protocols for perinatal care, neonatal resuscitation and intensive care support). These are, in turn, influenced by the variations in local and regional definitions of limits of viability. Because of the complexities in making difficult management decisions, obstetric and neonatal teams should confer prior to meeting with the family, when feasible. Family counseling should be coordinated with the goal of creating mutual trust, respect and understanding, and should incorporate evidence-based counseling methods. Since clinical circumstances can change rapidly with increasing gestational age, counseling should include discussion of the benefits and risks of various maternal and neonatal interventions at the time of counseling. There should be a plan for follow-up counseling as clinical circumstances evolve. The panel proposed a research agenda and recommended developing educational curricula on the care and counseling of families facing the birth of a periviable infant.
Mitzi Go - One of the best experts on this subject based on the ideXlab platform.
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respiratory compliance in late preterm infants 340 7 346 7 weeks after Antenatal Steroid therapy
The Journal of Pediatrics, 2018Co-Authors: Mitzi Go, Manuel Durand, Diane Schilling, Thuan Nguyen, Cindy T McevoyAbstract:Objective To compare respiratory compliance in late preterm infants (340/7-346/7 weeks) who received Antenatal Steroids vs matched late preterm infants who did not receive Antenatal Steroids. Study design This was a single-center prospective cohort study. Patients were matched for birth weight, gestational age, race, and sex. Respiratory compliance was the primary outcome measured with the single breath occlusion technique. Results We studied 25 late preterm infants treated with Antenatal Steroids and 25 matched infants who did not receive Antenatal Steroids. The treated infants had a significantly increased respiratory compliance/kg (adjusted 95% CI 0.05, 0.49; P = .016) and fewer required continuous positive airway pressure (P = .007) or >24 hours of supplemental oxygen (P = .046). There was no difference in surfactant therapy. Conclusions Respiratory compliance was significantly increased in this cohort of late preterm infants born at 340/7-346/7 weeks who received Antenatal Steroids compared with matched infants who did not receive Antenatal Steroids. Although not randomized, these data provide physiologic support for the possible beneficial effects of Antenatal Steroids in late preterm infants.
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Respiratory Compliance in Late Preterm Infants (340/7-346/7 Weeks) after Antenatal Steroid Therapy
The Journal of Pediatrics, 2018Co-Authors: Mitzi Go, Manuel Durand, Diane Schilling, Thuan Nguyen, Cindy T McevoyAbstract:Objective To compare respiratory compliance in late preterm infants (340/7-346/7 weeks) who received Antenatal Steroids vs matched late preterm infants who did not receive Antenatal Steroids. Study design This was a single-center prospective cohort study. Patients were matched for birth weight, gestational age, race, and sex. Respiratory compliance was the primary outcome measured with the single breath occlusion technique. Results We studied 25 late preterm infants treated with Antenatal Steroids and 25 matched infants who did not receive Antenatal Steroids. The treated infants had a significantly increased respiratory compliance/kg (adjusted 95% CI 0.05, 0.49; P = .016) and fewer required continuous positive airway pressure (P = .007) or >24 hours of supplemental oxygen (P = .046). There was no difference in surfactant therapy. Conclusions Respiratory compliance was significantly increased in this cohort of late preterm infants born at 340/7-346/7 weeks who received Antenatal Steroids compared with matched infants who did not receive Antenatal Steroids. Although not randomized, these data provide physiologic support for the possible beneficial effects of Antenatal Steroids in late preterm infants.