A5068291584- Mechanical Circulatory Support Devices
- Neonatal Respiratory Health Research
- Neonatal and fetal brain pathology
- Congenital Heart Disease Studies
- Neonatal Health and Biochemistry
- Metabolism and Genetic Disorders
- Cardiac Structural Anomalies and Repair
- Central Venous Catheters and Hemodialysis
- Antibiotics Pharmacokinetics and Efficacy
- Cardiac Arrest and Resuscitation
- Cardiac pacing and defibrillation studies
- Cystic Fibrosis Research Advances
- Mitochondrial Function and Pathology
- Anesthesia and Neurotoxicity Research
- Pulmonary Hypertension Research and Treatments
- Immune Response and Inflammation
- Neonatal and Maternal Infections
- Infective Endocarditis Diagnosis and Management
- Extracellular vesicles in disease
- COVID-19 Impact on Reproduction
- Thermal Regulation in Medicine
- Palliative Care and End-of-Life Issues
- Teratomas and Epidermoid Cysts
- Long-Term Effects of COVID-19
- Infant Nutrition and Health
St. Christopher's Hospital for Children
2014-2025
Drexel University
2014-2025
Children's Hospital of Philadelphia
2014
Neuronal exosomes purified from peripheral blood samples have been proposed as diagnostic tool in the setting of acute brain injury but never tested clinically. We hypothesized that exosome protein biomarkers would change over time following hypoxic and predict response to therapy.Synaptopodin (SYNPO), an actin-associated present postsynaptic spines, was evaluated a potential biomarker well as: synaptophysin, neuron-specific enolase, mitochondrial cytochrome c oxidase. A secondary analysis...
Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is associated with fewer neurological complications and decreased mortality compared to veno-arterial (VA) ECMO in neonatal respiratory failure. The Crescent right atrial (RA) cannula the only dual-lumen for VV designed have tip atrium. purpose of this study describe experience early use RA cannula. We performed a retrospective cohort 58 neonates infants cannulated from September 2021 through August 2023 at 15 institutions...
Study Objective To describe the population pharmacokinetics and pharmacodynamic target attainment of ampicillin in neonates with hypoxic-ischemic encephalopathy (HIE) undergoing controlled hypothermia (CH). Design Prospective, open-label pharmacokinetic study. Setting A 189-bed, freestanding children's tertiary care teaching hospital. Patients Thirteen (three females 10 males) HIE receiving CH 100 mg/kg/dose intravenously every 8 hours who were admitted to neonatal intensive unit between May...
Treatment of neonates with persistent pulmonary hypertension newborn includes optimization ventilatory support, use vasodilators, and/or inotropic support. If refractory to this management, some may require extracorporeal membrane oxygenation. We describe a case series 10 treated vasopressin in single tertiary center. Mean initiation time was at 30 h life dose ranging from 85 milliunits/kg/h. Oxygenation index decreased after 12 exposure (25 11) and mean arterial pressure improved 1 (45 58...
Objective This study aims to test whether implementing a guideline for nonemergent intubation improves the rate of premedication intubations in an academic level IV neonatal intensive care unit (NICU). We further sought hypothesis that neonates who receive have decreased pain scores at time intubation, fewer attempts, and no associated adverse events. Study Design was prospective observational with ongoing audit feedback as well statistical process control analysis. Data collection began on...
Naphthalene poisoning due to exposure mothballs is a common cause of toxicity in children worldwide. known hemolytic anemia, methemoglobinemia, and hepatic renal injury. Neonates are more susceptible the effects oxidative stress from naphthalene because their low glutathione stores immaturity enzymes. However, there no reported cases chronic fetal during pregnancy. We report novel case naphthalene-containing that occurred second trimester through third Our patient presented with...
Objective Identify population pharmacokinetics and pharmacodynamic target attainment of gentamicin in neonates with hypoxic‐ischemic encephalopathy ( HIE ) undergoing controlled hypothermia CH ). Design Prospective open‐label pharmacokinetic study. Gentamicin concentrations were modeled dosing regimens simulated for a 5000‐patient neonatal receiving using PM etrics, nonparametric, pharmacometric modeling, simulation package R. Setting A 189‐bed children's tertiary care teaching hospital....
Recent data describe an increasing use of extracorporeal membrane oxygenation (ECMO) in neonates with various clinical conditions besides primary respiratory or cardiac diagnoses. Infants underlying genetic disorders characterized by cardiopulmonary failure pose unique management challenges. When pathognomonic dysmorphic features for common diagnoses are not present, the prognosis is uncertain at best when determining ECMO candidacy. Lengthy turnaround times testing often delay definitive...
Over the wire removal of an ECMO cannula and exchange for another or catheter vascular closure device is desirable in certain circumstances.We describe a novel technique this.
The study aims to describe our experience with the implementation of phenobarbital as a primary sedation strategy during neonatal extracorporeal membrane oxygenation (ECMO).
Objective This study aimed to compare magnetic resonance imaging (MRI) severity scores and in-hospital outcomes among neonates with perinatal hypoxic–ischemic encephalopathy (HIE) without exposure sedation–analgesia (SA) during therapeutic hypothermia (TH). Study Design A single-center, retrospective cohort of HIE undergoing TH between January 2010 December 2020. Demographics, clinical characteristics, MRI scores, were compared patients SA those use. Results Of the 131 neonates, 55 (42%) did...
Advances in neonatal care for hypoxic respiratory failure, with high-frequency ventilation and inhaled nitric oxide, have led to a decreased need extracorporeal membrane oxygenation (ECMO). However, neonates resistant such therapies are more complex at higher risk of mortality. One population includes those ischemic encephalopathy (HIE) undergoing controlled hypothermia (CH). We present challenging case full-term neonate inotrope-resistant Escherichia coli septic shock, profound...
Since the initial deployment of neonatal extracorporeal membrane oxygenation (ECMO) for respiratory failure, use ECMO in this population has diversified. We present a term female infant with carbamoyl phosphate synthetase 1 and partial N-acetylglutamate synthase deficiencies who developed severe hyperammonemia refractory to medical management requiring venoarterial ECMO-driven continuous veno-venous hemodiafiltration ammonia detoxification. This case report illustrates subpopulation where...
Pulmonary hemorrhage (PH) is an infrequent and potentially fatal event in term neonates. Reports of successful management PH on extracorporeal membrane oxygenation (ECMO) are limited, given the accentuated risk mortality imposed by use heparin to prevent thrombosis ECMO. We present a case neonate with hypoxic ischemic encephalopathy undergoing controlled hypothermia who developed respiratory failure, hemodynamic instability, Enterobacter cloacae pneumonia sepsis complicated severe required...
Separately, refractory septic shock and purpura fulminans have very poor outcomes. The ethics involved in offering extracorporeal membrane oxygenation to high-risk patients is complex. We report a novel case of requiring veno-arterial continuous renal replacement therapy due Streptococcus pyogenes bacteremia with highlight the ethical challenges patient such likelihood survival.
Safety and efficacy data on controlled hypothermia (CH) for neonates with moderate to severe hypoxic ischemic encephalopathy has been extrapolated a subgroup of these patients who also require extracorporeal membrane oxygenation refractory persistent pulmonary hypertension the newborn (PPHN). However, safety concomitant use CH (ECMO) are lacking.
A full term boy is delivered vaginally at 38 weeks’ gestation to a 35-year-old gravida 4, para 2 woman with unremarkable prenatal laboratory findings including negative group B Streptococcus findings. The maternal history significant for early neonatal death of male infant from unknown cause 7 years earlier. Pregnancy and delivery are uncomplicated. neonate has birthweight 2,800 g, appropriate gestational age, Apgar scores 8 9 1 5 minutes, respectively. He initially feeding well in the...
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic, while known for lung disease of several types and multisystem failure (called COVID-19), usually has a mild or asymptomatic course in children youth. There is paucity data defining the risk factors pediatric patients how they interact with SARS-CoV-2 infection. A 15-year-old female, MyD88 immunodeficiency suspected COVID-19 exposure, presented to emergency department fever, subsequently tested positive SARS-CoV-2. …
Background: The landscape of ECMO for respiratory failure has changed over the past years, primarily because unavailable equipment. OriGen catheters were recalled in 2019 compelling centers to opt veno-arterial (VA) given technical complexity and reported complications Avalon bicaval catheter placement. We describe our experience with percutaneous veno-venous (VV) cannulation short-term neonatal outcomes institution. Methods: Retrospective cohort review VV patients from 2023 a level IV...
Introduction: Initiation of pediatric extracorporeal membrane oxygenation (ECMO) is often complicated by systemic inflammatory response syndrome (SIRS). Blood products utilized in circuit prime may augment the induced ECMO initiation. We hypothesize that donor blood contain proteins which are activated on exposure to circuit. Materials and Methods: Single-center prospective study an ex-vivo model utilizing reconstituted or whole blood. Samples were collected stored at regular intervals...