• Airway obstruction and gas leak during mask ventilation of preterm infants in the delivery room.

      Schmölzer, Georg M; Dawson, Jennifer A; Kamlin, C Omar F; O'Donnell, Colm P F; Morley, Colin J; Davis, Peter G; Neonatal Services, The Royal Women’s Hospital, Melbourne, Australia. georg.schmoelzer@me.com (Archives of disease in childhood. Fetal and neonatal edition, 2011-07)
      Preterm infants with inadequate breathing receive positive pressure ventilation (PPV) by mask with variable success. The authors examined recordings of PPV given to preterm infants in the delivery room for prevalence of mask leak and airway obstruction.
    • High flow nasal cannula for respiratory support in preterm infants.

      Wilkinson, Dominic; Andersen, Chad; O'Donnell, Colm Pf; De Paoli, Antonio G; Discipline of Obstetrics and Gynecology, Women's and Children's Hospital, University of Adelaide, 72 King William Road, North Adelaide, SA, Australia, 5006. (The Cochrane database of systematic reviews, 2011)
      High flow nasal cannulae (HFNC) are small, thin, tapered cannulae used to deliver oxygen or blended oxygen and air at flow rates of > 1 L/min. HFNC can be used to provide high concentrations of oxygen and may deliver positive end-expiratory pressure.
    • Oxygenation with T-piece versus self-inflating bag for ventilation of extremely preterm infants at birth: a randomized controlled trial.

      Dawson, Jennifer A; Schmölzer, Georg M; Kamlin, C Omar F; Te Pas, Arjan B; O'Donnell, Colm P F; Donath, Susan M; Davis, Peter G; Morley, Colin J; Newborn Services, The Royal Women's Hospital, Melbourne, Australia. jennifer.dawson@thewomens.org.au (The Journal of pediatrics, 2011-06)
      To investigate whether infants < 29 weeks gestation who receive positive pressure ventilation (PPV) immediately after birth with a T-piece have higher oxygen saturation (SpO₂) measurements at 5 minutes than infants ventilated with a self inflating bag (SIB).
    • A randomised crossover study of low-flow air or oxygen via nasal cannulae to prevent desaturation in preterm infants.

      Hensey, Conor C; Hayden, Eoghan; O'Donnell, Colm Patrick Finbarr; Department of Neonatology, The National Maternity Hospital, Dublin, Ireland. (2013-09)
      To compare the efficacy of low-flow oxygen, low-flow air and sham treatment given via nasal cannulae in preventing desaturation (falls in oxygen saturation (SpO2)) in preterm infants.
    • Resuscitation of preterm infants: delivery room interventions and their effect on outcomes.

      O'Donnell, Colm P F; Schmölzer, Georg M; Department of Neonatology, The National Maternity Hospital, Holles Street, Dublin 2, Ireland. (2012-12)
      Despite advances in neonatal care, the rate of oxygen dependence at 36 weeks' postmenstrual age or bronchopulmonary dysplasia has not fallen. Neonatologists are increasingly careful to apply ventilation strategies that are gentle to the lung in the neonatal intensive care unit. However, there has not been the same emphasis applying gentle ventilation strategies immediately after birth. A lung-protective strategy should start immediately after birth to establish a functional residual capacity, reduce volutrauma and atelectotrauma, facilitate gas exchange, and improve oxygenation during neonatal transition. This article discusses techniques and equipment recommended by international resuscitation guidelines during breathing assistance in the delivery room.
    • Survey of nasal continuous positive airways pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV) use in Irish newborn nurseries.

      Kieran, Emily A; Walsh, Helen; O'Donnell, Colm P F (Archives of disease in childhood. Fetal and neonatal edition, 2011-03)
    • Troponin T, N-terminal pro natriuretic peptide and a patent ductus arteriosus scoring system predict death before discharge or neurodevelopmental outcome at 2 years in preterm infants.

      El-Khuffash, Afif F; Slevin, Marie; McNamara, Patrick J; Molloy, Eleanor J; Department of Neonatology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada. afif_faisal@hotmail.com (Archives of disease in childhood. Fetal and neonatal edition, 2011-03)
      There is little consensus regarding the use of echocardiography in patent ductus arteriosus (PDA) treatment in preterm infants. The use of troponin T (cTnT) and N-terminal Pro-BNP (NTpBNP) in combination with echocardiography assessment may facilitate the development of a superior predictive model.
    • Ultrasonically detectable cerebellar haemorrhage in preterm infants.

      McCarthy, Lisa Kenyon; Donoghue, V; Murphy, J F A; Department of Neonatology, The National Maternity Hospital, Dublin, Ireland. lmccarthy@nmh.ie (2011-07)
      To determine the frequency and pattern of cerebellar haemorrhage (CBH) on routine cranial ultrasound (cUS) imaging in infants of ≤32 weeks gestation, and to investigate how extremely preterm infants with CBH differ from those with severe intraventricular haemorrhage (IVH).
    • Vitamin D nutritional status in preterm infants and response to supplementation.

      McCarthy, Roberta A; McKenna, Malachi J; Oyefeso, Oyinkansola; Uduma, Ogenna; Murray, Barbara F; Brady, Jennifer J; Kilbane, Mark T; Murphy, John F; Twomey, Anne; O' Donnell, Colm P; et al. (2013-07-14)
      Little is known about vitamin D status in preterm infants and their response to supplementation. To investigate this, we assessed serum 25-hydroxyvitamin D (25OHD) levels using RIA in a consecutive sample of stable preterm very low birth weight (VLBW) infants (born ≤ 32 weeks gestation or birth weight ≤ 1·5 kg), and we explored associated factors. Serum 25OHD level was first assessed once infants were tolerating feeds (n 274). If this first 25OHD level was below 50 nmol/l (20 ng/ml), which is the level associated with covering requirements in terms of skeletal health in the majority, then we recommended prolonged augmented vitamin D intake ( ≥ 10 μg (400 IU) daily) from a combination of fortified feeds and vitamin supplements and follow-up re-assessment at approximately 6 weeks corrected age (n 148). The first assessment, conducted at a median for chronological age of 18 (interquartile range (IQR) 11-28) d, found that 78 % had serum 25OHD levels below 50 nmol/l. Multivariable analysis demonstrated that the determinants of serum 25OHD levels were duration of vitamin D supplementation and gestational age at birth (r 2 0·215; P< 0·001). At follow-up, after a median of 104 (IQR 78-127) d, 87 % achieved levels ≥ 50 nmol/l and 8 % had levels >125 nmol/l, a level associated with potential risk of harm. We conclude that low 25OHD levels are an issue for preterm VLBW infants, warranting early nutritional intervention. In infants with serum 25OHD levels < 50 nmol/l, a vitamin D intake of ≥ 10 μg (400 IU) daily achieves target levels in the majority; however, further work is needed to determine the exact dose to safely meet target levels without overcorrection.
    • Warming preterm infants in the delivery room: polyethylene bags, exothermic mattresses or both?

      McCarthy, Lisa K; O'Donnell, Colm P F; The National Maternity Hospital, Dublin 2, Ireland. lisamac79@yahoo.com (2011-12)
      To compare the admission temperature of infants treated with polyethylene bags alone to infants treated with exothermic mattresses in addition to bags in the delivery room.