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UHL Clinical Librarian Service

"bringing you the evidence"

Neonatal Evidence Update

January 2017

NICE  National Institute for Health and Care Excellence

CORTRAK 2 Enteral Access System for placing nasoenteral feeding tubes

End of life care for infants, children and young people with life-limiting conditions: planning and management
New and Updated Cochrane Systematic Reviews

Longchain polyunsaturated fatty acid supplementation in preterm infants
Authors' conclusions: Infants enrolled in the trials were relatively mature and healthy preterm infants. Assessment schedule and methodology, dose and source of supplementation and fatty acid composition of the control formula varied between trials. On pooling of results, no clear long-term benefits or harms were demonstrated for preterm infants receiving LCPUFA-supplemented formula.

Early nasal intermittent positive pressure ventilation (NIPPV) versus early nasal continuous positive airway pressure (NCPAP) for preterm infants
Authors' conclusions: Early NIPPV does appear to be superior to NCPAP alone for decreasing respiratory failure and the need for intubation and endotracheal tube ventilation among preterm infants with respiratory distress syndrome. Additional studies are needed to confirm these results and to assess the safety of NIPPV compared with NCPAP alone in a larger patient population.

Bronchodilators for the prevention and treatment of chronic lung disease in preterm infants
Authors' conclusions: Data are insufficient for reliable assessment of the use of salbutamol for prevention of CLD. One trial of poor quality reported a reduction in the incidence of CLD and shorter duration of supplementary oxygen with prophylactic aminophylline, but these results must be interpreted with caution. Additional clinical trials are necessary to assess the role of bronchodilator agents in prophylaxis or treatment of CLD. Researchers studying the effects of bronchodilators in preterm infants should include relevant clinical outcomes in addition to pulmonary mechanical outcomes. We identified no trials that studied the use of bronchodilator therapy for treatment of CLD.

Nutrient-enriched formula versus standard formula for preterm infants following hospital discharge
Authors' conclusions: Recommendations to prescribe 'postdischarge formula' for preterm infants after hospital discharge are not supported by available evidence. Limited evidence suggests that feeding 'preterm formula' (which is generally available only for in-hospital use) to preterm infants after hospital discharge may increase growth rates up to 18 months post term.

One dose per day compared to multiple doses per day of gentamicin for treatment of suspected or proven sepsis in neonates
Authors' conclusions: There is insufficient evidence from the currently available RCTs to conclude whether a 'once a day' or a 'multiple doses a day' regimen of gentamicin is superior in treating proven neonatal sepsis. However, data suggest that pharmacokinetic properties of a 'once a day' gentamicin regimen are superior to a 'multiple doses a day' regimen in that it achieves higher peak levels while avoiding toxic trough levels. There was no change in nephrotoxicity or auditory toxicity. Based on the assessment of pharmacokinetics, a 'once a day regimen' may be superior in treating sepsis in neonates of more than 32 weeks' gestation.

Heparin for the treatment of thrombosis in neonates
Authors' conclusions: We found no studies that met our inclusion criteria and no evidence from randomized controlled trials to recommend or refute the use of heparin for treatment of neonates with thrombosis.
 

Did you know that you now have free access to Cochrane Clinical Answers?
Cochrane Clinical Answers on Neonatal Care
EBNEO - Evidence Based Neonatology

The 4th international Conference for Evidence-Based Neonatology 10-12 November 2017, in Hyderabad India.
At this Fourth international meeting of our young society, as in prior meetings – we include talks with both neonatal contents and clinical epidemiological methodology. We hope that this meeting will facilitate an international on-going collaboration and interchange. This meeting will be in association with Indian Association of Neonatology.

Detailed conference program and registration will open early 2017. Until then, please sign up for a free membership to ensure you get information through our newsletter when the registration opens.
Dynamed Plus - 

Topic: Zika virus in pregnancy and congenital Zika syndrome
FDA alert to physicians who care for pregnant women that Laboratory Corporation of America (LabCorp) has reported false positive results for commercially available ZIKV Detect IgM Capture ELISA (InBios International, Inc.) (FDA MedWatch 2016 Dec 23)

Birth defects may occur in 6% of pregnancies in women with Zika infection in United States (JAMA 2017 Jan 3)

Peak incidence of congenital microcephaly occurred 24 weeks after peak incidence of symptomatic Zika virus infection in pregnant women during 2016 outbreak in Columbia (MMWR Morb Mortal Wkly Rep 2016 Dec 9 early online)

Topic: Feeding the premature infant
Nutrient-enriched donor milk does not appear to improve neurodevelopmental outcomes at 18 months compared to preterm formula, but may reduce risk of in-hospital necrotizing enterocolitis in very low-birth-weight infants (JAMA 2016 Nov 8)

Topic: Neonatal opioid withdrawal
Review of neonatal abstinence syndrome (N Engl J Med 2016 Dec 22)


UpToDate -  What's new in Neonatology 
Other Sources
 
NIHR Signal report
Supplementary feeding of preterm babies by cup rather than bottle helps breastfeeding success

Patient Information in 10+ languages - Neonatal screening tests 
Public Health England has added ten translated versions of the patient information leaflet Screening tests for you and your baby: babies in special care units. The leaflet originally published in August 2015 explains some important differences in the way that the newborn screening tests are carried out for babies in special care baby units, neonatal intensive care units or paediatric intensive care units.
To access full text you may have to log in to your NHS Athens account (click here to register for free). If full text is not available then please email us to request a copy.

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Table of Contents

Advances in Neonatal Care
Archives of Disease in Childhood - Fetal and Neonatal Edition
Journal of Maternal-Fetal & Neonatal Medicine
Journal of Neonatal Nursing
Journal of Obstetric Gynecologic and Neonatal Nursing
Neonatal Network
Our mailing address is: sarah.sutton@uhl-tr.nhs.uk
 






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