Nov. 30, 2016
Volume VII | Issue No. 48


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Perioperative risk factors for impaired neurodevelopment after cardiac surgery in early infancy
A prospective 2 year longitudinal study of 153 full-term infants undergoing cardiac surgery for congenital heart disease before 2 months of age indicates that 87% survive with 9% of survivors having severe cognitive, language and/or motor impairments (primarily language). Risk factors include single ventricle physiology with obstruction to the pulmonary circulation, repeat cardiac surgery, reduced gestational age, elevated postoperative serum lactate or s100 calcium-binding protein B (s100 B is expressed by astrocytes and is involved in a number of cellular processes).

Youth mental health and replacing sedentary video games (SVG's) and active outdoor play (AOP) with active video games (AVG's)
It appears that replacing one hour of sedentary video play with either one hour active video or outdoor play enhances emotional, prosocial and life satisfaction. One hour active outdoor play (vs. active or sedentary video gaming) has the best mental health outcomes.

Delivery room management and outcomes of extremely preterm (22-27 weeks gestation) infants born with Apgar scores of 0  
A study of 2,173 infants classified as stillborn with a 1-minute Apgar of 0 and resuscitated, indicates 0.6% (13) are admitted to a NICU and 11 survive to hospital discharge. No infant survives without resuscitation or if their heart beat is not regained by five minutes.

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Delayed cord clamping (DCC)/milking (UCM); iron stores and one year physical growth outcomes
 
"Physiological studies in term infants have shown that a transfer from the placenta of approximately 80ml of blood occurs by one minute after birth". This additional supply of extra iron may help to prevent iron deficiency during the first year of life (with additional potential benefits e.g. a 50% reduction in intraventricular hemorrhages in the preterm infant). Umbilical cord milking in the term and preterm infant may also increase mean hemoglobin and ferritin blood levels.

A follow-up study of a control trial where full term infants were randomized to DCC (60-90 secs) or UCM and hemoglobin and ferritin levels measured with growth parameters assessed at 1 year indicates no differences between them for hemoglobin/ferritin blood levels and 1 year growth measurements.

Association of bystander cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest and overall neurological outcomes

From an analysis of data from the Cardiac Arrest Registry to Enhance Survival on bystandard CPR, it appears that only in 46.5% of 3,900 instances is bystander CPR (both conventional and compression only) provided. Overall, with conventional CPR survival and good neurological outcomes occurs in 11.3% and 9.1% respectively. Compression only CPR in children <18 years of age appears to offer no benefits.

Exercise-induced inspiratory symptoms (EIIS) in school children

EIIS or strider has multiple causes but frequently occurs in physically active and healthy young people. Continuous
Causes of Stridor in Children
Causes of Stridor in Children
laryngoscopy during maximal treadmill exercise (CLE-test) visualizes the larynx using a flexible laryngoscope during exercise.

A post-test questionnaire study of 60 children (mean age 14 years) with EIIS following the CLE test indicates that continuous laryngoscopy is feasible; 35% have exercise induced laryngeal obstruction (many may have supraglottic obstruction. Ed) and in some children asthma medication may be discontinued.
 
Pediatric Pulmonology
Video Feature
Your brain on video games | Daphne Bavelier
Your brain on video games
Yoga therapy for pain-related Functional Gastrointestinal Disorders (AP-FGID) in children

A study of 69 children (8-18 years of age) with pain-related functional gastrointestinal disorders evaluated and compared abdominal pain and quality of life following 10 weeks of yoga therapy with standard medical care at 12 months post-treatment.

One year following a 10 week course of yoga therapy in children with pain related gastrointestinal disorders improves pain frequency and intensity (vs. standard care) and decreases school absences.


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