Oxygen Therapy An Issue Of Clinics In Perinatology

In consultation with Consulting Editor, Dr. Lucky Jain, Drs. Maximo Vento and Waldemar Carlo have put together a state-of the-art issue of the Clinics in Perinatology devoted to Perinatal Pharmacology. Clinical review articles are specifically devoted to the following: Monitoring and assessment of oxygenation in infants; Oxygen toxicity in neonates; New methods for non-invasive oxygen administration; Targeting oxygen in preterm and term infants starting at birth; Newborn resuscitation in settings without access to supplemental oxygen; Noninvasive versus invasive ventilatory support; Nasal SIMV versus Nasal CPAP before and after invasive ventilatory support; Is high-flow cannula inferior to CPAP for neonates?; Intermittent hypoxia: Importance; Closed-loop control of inspired oxygen in neonates: Compliance with targets; Meta-analysis oxygenation saturation targeting trials: Do infant subgroups matter?; Targets of oxygen saturation to optimize eye outcomes; Achieved oxygenation saturations and outcome in extremely preterm infants; Pulmonary hypertension in preterm infants; and Current recommendations and practice of oxygen therapy in preterm infants. Readers will come away with the latest information on oxygen therapy as they seek to utilize evidence-based recommendations to improve patient outcomes.

In consultation with Consulting Editor, Dr. Lucky Jain, Drs. Maximo Vento and Waldemar Carlo have put together a state-of the-art issue of the Clinics in Perinatology devoted to Perinatal Pharmacology. Clinical review articles are specifically devoted to the following: Monitoring and assessment of oxygenation in infants; Oxygen toxicity in neonates; New methods for non-invasive oxygen administration; Targeting oxygen in preterm and term infants starting at birth; Newborn resuscitation in settings without access to supplemental oxygen; Noninvasive versus invasive ventilatory support; Nasal SIMV versus Nasal CPAP before and after invasive ventilatory support; Is high-flow cannula inferior to CPAP for neonates?; Intermittent hypoxia: Importance; Closed-loop control of inspired oxygen in neonates: Compliance with targets; Meta-analysis oxygenation saturation targeting trials: Do infant subgroups matter?; Targets of oxygen saturation to optimize eye outcomes; Achieved oxygenation saturations and outcome in extremely preterm infants; Pulmonary hypertension in preterm infants; and Current recommendations and practice of oxygen therapy in preterm infants. Readers will come away with the latest information on oxygen therapy as they seek to utilize evidence-based recommendations to improve patient outcomes.

Preterm birth interrupts the normal developmental progression of most organs, particularly when birth occurs at the lowest level of viability. An immediate task is to successfully transition to a post-natal life without a placental circulation. To do this demands careful management of the cardiorespiratory systems. To best help the fragile preterm infant at this demanding time, care-givers must remember two most pressing goals. These are first to maintain adequacy of gas exchange and delivery, while simultaneously minimizing any secondary injury to the fragile preterm lung. However, after these immediate priorities in the delivery room, the longer term effects of an immature lung development and its associated problems come to the forefront. These problems include the inflammation of perinatal infection, oxygen, and invasive mechanical ventilation. Both the immaturity itself, and secondary lung injury and its inflammation – collectively will often lead to the condition termed bronchopulmonary dysplasia (BPD). Although many of these infants may eventually be discharged to home without a need for oxygen supplementation or pulmonary medications, the long-term impact of interrupted lung development and secondary lung injury remain serious concerns. It is now well recognized that mechanical ventilation is pivotal to developing secondary lung injury and BPD. Consequently, a great deal of time and effort has been put into the development and application of non-invasive ventilator (NIV) approaches to supporting respiratory function in neonates. Since the landmark publication by Gregory and colleagues in 1967, nasal continuous positive airway pressure (nCPAP) has been the most commonly applied approach to NIV. This approach has been supported by the recent generation of randomized controlled trials. However, cumulatively these trials have shown only a small reduction in rates of BPD. Outside of the trial data, despite the wider application of nCPAP, rates of BPD remain relatively unchanged over recent years. This has led to investigations of other NIV approaches including nasal ventilation and high flow nasal cannula therapy. Not only have available modes increased, but so have the interfaces through which these modes may be applied. In the issue of Clinic in Perinatology, readers will find an up-to-date review of non-invasive approaches to supporting preterm respiratory function. This draws on the expertise of leading investigators in the field. This issue reviews the physiologic mechanisms by which the various approaches to NIV may support respiratory function; the evidence base supporting different NIV approaches; and adjunctive aspects of NIV therapy including their use during neonatal transport and the application of other supportive therapies such as inhaled NO.

This issue is a must-read for perinatologists and neonatologists who need current advances in treastment and interventions to improve the viability of the neonate. The Guest Editors have put together a concise monograph on the topic, offering the most current clinica review articles on the following topics: Antenatal corticosteroids: Who should we be treating?; Quality improvement strategies to improve care of women in preterm labor; Delivery at term: when, how, and why?; Detection and prevention of perinatal infection; Current strategies to prevent perinatal HIV transmission; Advances in fetal monitoring and association with outcomes; Relationship between perinatal interventions, the maternal-infant microbiome and neonatal outcomes; Understanding outcomes and counseling families at a periviable gestational age; Therapeutic hypothermia - how can we optimize this therapy to further improve outcomes; Reducing CPAP failure in extremely preterm infants; Optimizing caffeine therapy in preterm infants; Improving uptake of key perinatal interventions using state-wide quality collaboratives; Oxygen therapy in the delivery room: What is the right dose?; and Perinatal white matter injury: prevention and long-term outcomes. Readers will leave with the best evidence they need to improve outcomes.

This issue is a must-read for perinatologists and neonatologists who need current advances in treastment and interventions to improve the viability of the neonate. The Guest Editors have put together a concise monograph on the topic, offering the most current clinica review articles on the following topics: Antenatal corticosteroids: Who should we be treating?; Quality improvement strategies to improve care of women in preterm labor; Delivery at term: when, how, and why?; Detection and prevention of perinatal infection; Current strategies to prevent perinatal HIV transmission; Advances in fetal monitoring and association with outcomes; Relationship between perinatal interventions, the maternal-infant microbiome and neonatal outcomes; Understanding outcomes and couseling families at a periviable gestational age; Therapeutic hypothermia - how can we optimize this therapy to further improve outcomes; Reducing CPAP failure in extremely preterm infants; Optimizing caffeine therapy in preterm infants; Improving uptake of key perinatal interventions using state-wide quality collaboratives; Oxygen therapy in the delivery room: What is the right dose?; and Perinatal white matter injury: prevention and long-term outcomes. Readers will leave with the best evidence they need to improve outcomes.

In this issue of Clinics in Perinatology, Guest Editors Anup Katheria and Lisa Stellwagen bring their considerable expertise to the topic of Care for the Term Newborn. Top experts in the field cover key topics such as delivery room triage and transitions of care; early onset sepsis; congenital infections; postnatal screening & testing; and more. Provides in-depth, clinical reviews on Care for the Term Newborn, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews. Contains 14 relevant, practice-oriented topics including Umbilical Cord Management for vigorous and non-vigorous infants; Fetal Circulation and Critical Congenital Cardiac Disease; Alternative Birth Practices, Refusal, and Therapeutic Hesitancy; Prenatal Substance Exposure; and more.

There is general consensus regarding threshold levels that describe the gray zone on the limits of viability, and gestational age alone should not be used solely in making a decision. This issue will bring light to the latest thoughts and clinical recommendations for delivery during the periviable period. Top thought leaders and clinicians have submitted articles in the following areas: Consequences of Birth at Periviable Gestions on Organ Systems; Medical and Surgical Interventions Before Birth; NICU Care: Nutrition/NEC; Pulmonary Care and Circulatory Support; NICU Stay and Microbiome; and Ethical Considerations and Counseling, to name a few. Readers will come away with the most current content written on this topic and details that can be incorporated into clinical care.

Current Controversies in Neonatology, An Issue of Clinics in Perinatology, E-Book