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Weaning preterm infants from continuous positive airway pressure: evidence for best practice

World Journal of Pediatrics 2015年第3期11卷 212-218页

作者： Hesham Abdel-Hady Basma Shouman nehad nasef Neonatal Intensive Care Unit Mansoura University Children's HospitalMansouraEgypt

Background:Nasal continuous positive airway pressure(NCPAP)is frequently used in preterm ***,there is no consensus on when and how to wean them from *** sources:Based on recent publications,we have reviewed the criteria of readiness-to-wean and factors affecting weaning success.A special focus is placed on the methods of weaning from NCPAP in preterm ***:Practical points of when and how to wean from NCPAP in preterm infants are *** infants are ready to be weaned from NCPAP when they are stable on a low NCPAP pressure with no(or minimal)oxygen *** used to wean from NCPAP include:sudden weaning of NCPAP,gradual decrease of NCPAP pressure,graded-time-off NCPAP(cycling),weaning to high or low flow nasal cannula,and a combination of these *** best strategy for weaning is yet to be ***-off NCPAP increases the duration of NCPAP and length of hospital stay without beneficial effect on success of *** decrease of NCPAP pressure is more physiological and better tolerated than cycling-off ***:Further studies are needed to reach a consensus regarding the optimal timing and the best method for weaning from NCPAP in preterm infants.

关键词： continuous positive airway pressure preterm infant weaning

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Caffeine therapy in preterm infants

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World Journal of Clinical Pediatrics 2015年第4期4卷 81-93页

作者： Hesham Abdel-Hady nehad nasef Abd Elazeez Shabaan Islam Nour Neonatal Intensive Care Unit Mansoura University Children's Hospital

Caffeine is the most commonly used medication for treatment of apnea of prematurity. Its effect has been well established in reducing the frequency of apnea, intermittent hypoxemia, and extubation failure in mechanically ventilated preterm infants. Evidence for additional short-term benefits on reducing the incidence of bronchopulmonary dysplasia and patent ductus arteriosus has also been suggested. Controversies existamong various neonatal intensive care units in terms of drug efficacy compared to other methylxanthines, dosage regimen, time of initiation, duration of therapy, drug safety and value of therapeutic drug monitoring. In the current review, we will summarize the available evidence for the best practice in using caffeine therapy in preterm infants.

关键词： Apnea Caffeine Preterm Methylxanthines

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Acute flaccid paralysis in a patient with sacral dimple

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World Journal of Clinical Pediatrics 2013年第3期2卷 26-30页

作者： Mohammed Mostafa nehad nasef Tarik Barakat Amany K El-Hawary Hesham Abdel-Hady Faculty of Medicine Mansoura University Children’s Hospital Department of Pediatrics Faculty of MedicineUniversity of Mansoura

Sacral dimples are the most common cutaneous anomaly detected during neonatal spinal examination. Congenital dermal sinus tract, a rare type of spinal dysraphism, occurs along the midline neuraxis from occiput down to the sacral region. It is often diagnosed in the presence of a sacral dimple together with skin signs, local infection, meningitis, abscess, or abnormal neurological examination. We report a case of acute flaccid paralysis with sensory level in a 4 mo old female infant with sacral dimple, diagnosed by magnetic resonance imaging to be a paraspinal subdural abscess. Surgical exploration revealed a congenital dermal sinus tract extending from the subdural abscess down to the sacral dimple and open to the exterior with a minute opening.

关键词： Paralysis Paraplegia Spinal dysraphism Spinal cord compression Spinal epidural abscess

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