Munmun Rawat
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View article: Dextrose with Insulin During Neonatal Resuscitation for Prolonged Asphyxia in a Near-Term Ovine Model: A Proof-of-Concept Study
Dextrose with Insulin During Neonatal Resuscitation for Prolonged Asphyxia in a Near-Term Ovine Model: A Proof-of-Concept Study Open
Background: Neonatal myocytes rely predominantly on glycolytic metabolism for survival during hypoxic conditions. During asphyxia, metabolic pathway dysregulation impairs cardiac myocyte contractility. Co-administration of dextrose and ins…
View article: Optimal Duration of Umbilical Cord Clamping with Ventilation in a Preterm Asphyxiated Ovine Model
Optimal Duration of Umbilical Cord Clamping with Ventilation in a Preterm Asphyxiated Ovine Model Open
Background: There is inadequate evidence to support recommendations for the delayed clamping of umbilical cords in preterm neonates who are born non-vigorous. Objective: In a preterm bradycardic ovine model, our objective was to compare th…
View article: Neonatal resuscitation for bradycardia (HR < 60 bpm)—an alternate approach using an ovine model
Neonatal resuscitation for bradycardia (HR < 60 bpm)—an alternate approach using an ovine model Open
Background The International Liaison Committee on Resuscitation recommends initiating chest compressions (CC) in newborns when heart rate (HR) is <60 beats per minute (bpm) after 30 s of effective positive pressure ventilation (PPV). Metho…
View article: The Utility of Umbilical Cord Pulse Oximetry—A Translational Study with Four Minutes of Deferred Cord Clamping Using an Asphyxiated Preterm Ovine Model
The Utility of Umbilical Cord Pulse Oximetry—A Translational Study with Four Minutes of Deferred Cord Clamping Using an Asphyxiated Preterm Ovine Model Open
Background: Expert guidelines recommend using pulse oximetry (PO) in the delivery room to monitor oxygen saturation (SpO2) and heart rate (HR). Umbilical cord pulse oximetry (UCP) is a novel concept that, despite being postductal, could pr…
View article: Impact of Change in Neonatal Resuscitation Program Guidelines for Infants Born Through Meconium-Stained Amniotic Fluid
Impact of Change in Neonatal Resuscitation Program Guidelines for Infants Born Through Meconium-Stained Amniotic Fluid Open
Background: In 2016, the neonatal resuscitation program (NRP) changed its recommendation to perform endotracheal suctioning in non-vigorous neonates born through meconium-stained amniotic fluid (MSAF). The objective of this study is to com…
View article: Impact of Change in Neonatal Resuscitation Program Guidelines for Infants Born Through Meconium-Stained Amniotic Fluid
Impact of Change in Neonatal Resuscitation Program Guidelines for Infants Born Through Meconium-Stained Amniotic Fluid Open
Background: In 2016, the neonatal resuscitation program (NRP) withdrew its recommendation to perform endotracheal suctioning in non-vigorous neonates born through meconium-stained amniotic fluid (MSAF). The objective of this study is to co…
View article: Efficacy of laryngeal mask epinephrine in neonatal resuscitation; an ovine study
Efficacy of laryngeal mask epinephrine in neonatal resuscitation; an ovine study Open
Background The efficacy of Laryngeal Mask Airway (LMA) epinephrine during neonatal resuscitation has not been studied. We hypothesize that LMA epinephrine is as effective as endotracheal tube (ETT) epinephrine. Methods Sixteen fetal lambs …
View article: Femoral Occlusion during Neonatal Cardiopulmonary Resuscitation Improves Outcomes in an Ovine Model of Perinatal Cardiac Arrest
Femoral Occlusion during Neonatal Cardiopulmonary Resuscitation Improves Outcomes in an Ovine Model of Perinatal Cardiac Arrest Open
Background: The goal of chest compressions during neonatal resuscitation is to increase cerebral and coronary blood flow leading to the return of spontaneous circulation (ROSC). During chest compressions, bilateral femoral occlusion may in…
View article: Masked Randomized Trial of Epinephrine versus Vasopressin in an Ovine Model of Perinatal Cardiac Arrest
Masked Randomized Trial of Epinephrine versus Vasopressin in an Ovine Model of Perinatal Cardiac Arrest Open
Background: Current neonatal resuscitation guidelines recommend the use of epinephrine for bradycardia/arrest not responding to ventilation and chest compressions. Vasopressin is a systemic vasoconstrictor and is more effective than epinep…
View article: Less Invasive Surfactant Administration: A Viewpoint
Less Invasive Surfactant Administration: A Viewpoint Open
The standard of care in treating respiratory distress syndrome in preterm infants is respiratory support with nasal continuous positive airway pressure or a combination of continuous positive airway pressure and exogenous surfactant replac…
View article: Initial Use of 100% but Not 60% or 30% Oxygen Achieved a Target Heart Rate of 100 bpm and Preductal Saturations of 80% Faster in a Bradycardic Preterm Model
Initial Use of 100% but Not 60% or 30% Oxygen Achieved a Target Heart Rate of 100 bpm and Preductal Saturations of 80% Faster in a Bradycardic Preterm Model Open
Background: Currently, 21–30% supplemental oxygen is recommended during resuscitation of preterm neonates. Recent studies have shown that 58% of infants < 32 week gestation age are born with a heart rate (HR) < 100 bpm. Prolonged bradycard…
View article: Severe Neonatal Opioid Withdrawal Requiring Pharmacotherapy: Impact of Region of Residence
Severe Neonatal Opioid Withdrawal Requiring Pharmacotherapy: Impact of Region of Residence Open
Objectives Our objective was to evaluate the trend and to assess the impact of maternal region of residence in Western New York (WNY), on severe neonatal opioid withdrawal syndrome (NOWS). Study Design Term infants' born at gestational age…
View article: Laryngeal Masks in Neonatal Resuscitation—A Narrative Review of Updates 2022
Laryngeal Masks in Neonatal Resuscitation—A Narrative Review of Updates 2022 Open
Positive pressure ventilation (PPV) is crucial to neonatal cardiopulmonary resuscitation because respiratory failure precedes cardiac failure in newborns affected by perinatal asphyxia. Prolonged ineffective PPV could lead to a need for ad…
View article: Optimal oxygen use in neonatal advanced cardiopulmonary resuscitation—a literature review
Optimal oxygen use in neonatal advanced cardiopulmonary resuscitation—a literature review Open
Clinical research is needed to arrive at the best strategy for assessment of oxygenation and choice of FiO2 during neonatal CPR that lead to improved survival and outcomes. In this article, we have reviewed the literature on evidence behin…
View article: Effect of a Larger Flush Volume on Bioavailability and Efficacy of Umbilical Venous Epinephrine during Neonatal Resuscitation in Ovine Asphyxial Arrest
Effect of a Larger Flush Volume on Bioavailability and Efficacy of Umbilical Venous Epinephrine during Neonatal Resuscitation in Ovine Asphyxial Arrest Open
The 7th edition of the Textbook of Neonatal Resuscitation recommends administration of epinephrine via an umbilical venous catheter (UVC) inserted 2–4 cm below the skin, followed by a 0.5-mL to 1-mL flush for severe bradycardia despite eff…
View article: Sustained Inflation Reduces Pulmonary Blood Flow during Resuscitation with an Intact Cord
Sustained Inflation Reduces Pulmonary Blood Flow during Resuscitation with an Intact Cord Open
The optimal timing of cord clamping in asphyxia is not known. Our aims were to determine the effect of ventilation (sustained inflation–SI vs. positive pressure ventilation–V) with early (ECC) or delayed cord clamping (DCC) in asphyxiated …
View article: Resuscitation with an Intact Cord Enhances Pulmonary Vasodilation and Ventilation with Reduction in Systemic Oxygen Exposure and Oxygen Load in an Asphyxiated Preterm Ovine Model
Resuscitation with an Intact Cord Enhances Pulmonary Vasodilation and Ventilation with Reduction in Systemic Oxygen Exposure and Oxygen Load in an Asphyxiated Preterm Ovine Model Open
(1) Background: Optimal initial oxygen (O2) concentration in preterm neonates is controversial. Our objectives were to compare the effect of delayed cord clamping with ventilation (DCCV) to early cord clamping followed by ventilation (ECCV…
View article: Randomised trial of epinephrine dose and flush volume in term newborn lambs
Randomised trial of epinephrine dose and flush volume in term newborn lambs Open
Objectives Neonatal resuscitation guidelines recommend 0.5–1 mL saline flush following 0.01–0.03 mg/kg of epinephrine via low umbilical venous catheter for persistent bradycardia despite effective positive pressure ventilation (PPV) and ch…
View article: Proficiency of Laryngeal Mask Airway Insertion Skill in NRP Certified Providers
Proficiency of Laryngeal Mask Airway Insertion Skill in NRP Certified Providers Open
Objective In 2015, Neonatal Resuscitation Program (NRP) recommended laryngeal mask airway (LMA) as an alternative to the endotracheal tube (ETT) in situations where the provider is “unable to intubate and unable to ventilate.” LMA insertio…
View article: How Do We Monitor Oxygenation during the Management of PPHN? Alveolar, Arterial, Mixed Venous Oxygen Tension or Peripheral Saturation?
How Do We Monitor Oxygenation during the Management of PPHN? Alveolar, Arterial, Mixed Venous Oxygen Tension or Peripheral Saturation? Open
Oxygen is a pulmonary vasodilator and plays an important role in mediating circulatory transition from fetal to postnatal period. Oxygen tension (PO2) in the alveolus (PAO2) and pulmonary artery (PaO2) are the main factors that influence h…
View article: How Do We Monitor Oxygenation During The Management of PPHN? Alveolar, Arterial or Mixed Oxygen Tension or Peripheral Saturation?
How Do We Monitor Oxygenation During The Management of PPHN? Alveolar, Arterial or Mixed Oxygen Tension or Peripheral Saturation? Open
Oxygen is a pulmonary vasodilator and plays an important role in mediating circulatory transition from fetal and postnatal period. Alveolar oxygen tension (PAO2) and pulmonary arterial PO2 are the main factors that influence hypoxic pulmon…
View article: Optimal Oxygen Targets in Term Lambs with Meconium Aspiration Syndrome and Pulmonary Hypertension
Optimal Oxygen Targets in Term Lambs with Meconium Aspiration Syndrome and Pulmonary Hypertension Open
Optimal oxygen saturation as measured by pulse oximetry (SpO2) in neonatal lung injury, such as meconium aspiration syndrome (MAS) and persistent pulmonary hypertension of newborn (PPHN), is not known. Our goal was to determine the SpO2 ra…
View article: COVID-19 in Newborns and Infants—Low Risk of Severe Disease: Silver Lining or Dark Cloud?
COVID-19 in Newborns and Infants—Low Risk of Severe Disease: Silver Lining or Dark Cloud? Open
One hundred years after the 1918 influenza pandemic, we now face another pandemic with the severe acute respiratory syndrome–novel coronavirus-2 (SARS-CoV-2). There is considerable variability in the incidence of infection and severe disea…
View article: Perinatal Hypophosphatasia in a Premature Infant
Perinatal Hypophosphatasia in a Premature Infant Open
A premature male infant was delivered at 32 weeks' gestation due to category-2 fetal tracing after preterm labor. The physical exam showed shortened and bowed long bones, with calvarium felt in small area of the head. Serum alkaline phosph…
View article: Oxygenation and Hemodynamics during Chest Compressions in a Lamb Model of Perinatal Asphyxia Induced Cardiac Arrest
Oxygenation and Hemodynamics during Chest Compressions in a Lamb Model of Perinatal Asphyxia Induced Cardiac Arrest Open
The current guidelines recommend the use of 100% O2 during resuscitation of a neonate requiring chest compressions (CC). Studies comparing 21% and 100% O2 during CC were conducted in postnatal models and have not shown a difference in inci…