Do early MRI signals predict lesion size in a neonatal stroke rat model?

SUMMARY: In this study, we compared lesion size by using VADC and VT2 at 0, 2, 5, 24, and 48 hours and histologic lesions at 48 hours in a P7 rat stroke model. The best correlation between VHISTO and VADC was at H0, and between VHISTO and VT2, at H2-H5. Early MR imaging signals allowed excluding "no-lesion" and "no-reflow" animals to help standardize this neonatal stroke model and predict lesion size.

[Influence of hospital location on short-term fate of premature infants born at 34 weeks of gestation]. / Influence du lieu d'hospitalisation sur le devenir à court terme des prématurés nés à 34 semaines d'aménorrhée.

In France, new care units have emerged in maternity wards for the treatment of moderate prematurity, called mother-child units (MCU). We compared the length of hospitalization between the MCUs and the neonatal units (NNUs) for premature infants born at 34 weeks of amenorrhea at Grenoble university hospital. This was a retrospective, single-center study, including 99 premature infants born from 34 of amenorrhea to 34 weeks+6 days between 2004 and 2009. Were included all premature 34-week infants hospitalized in the NNU or the MCU excluding those with respiratory distress, birth defects, and including infants whose birth weight was less than 1500g admitted to the neonatal intensive care unit or transferred secondarily to the MCU. The characteristics of both groups were similar apart from a lower birth weight in the NNU group (1892 vs. 2182g) and gestational age less than in the NNU group (34.1 vs. 34.3 SA). Our primary outcome, length of hospital stay, was significantly shorter in the MCU (15.4 vs. 20.7 days in the NNU, P<0.01) as well as the duration of nasogastric tube feeding (2.8 vs. 9.1 days, P<0.01). This difference remained after adjustment for birth weight and gestational age. Our retrospective study shows that the length of hospitalization of premature infants born at 34 weeks gestation and hospitalized in our center is significantly shorter when they are admitted to the MCU rather than neonatology. For this reason, this mode of hospitalization in maternity MCUs can be recommended.

[Newborn infants supported by extracorporeal membrane oxygenation: survival and clinical outcome]. / Survie et devenir clinique des nouveau-nés mis en assistance respiratoire extracorporelle.

OBJECTIVES: To assess the prognosis of newborn infants with refractory hypoxemia who required extracorporeal membrane oxygenation (ECMO). METHODS: Eighty-nine newborn infants treated by ECMO during more than 24 hours over a 8-year period (1996-2003) were included in this observational cohort study with a 9-month and 24-month evaluation. RESULTS: Respiratory failure mainly resulted from meconium aspiration syndrome (MAS, 43%), congenital diaphragmatic hernia (CDH, 15%) and sepsis (15%). Overall survival at hospital discharge was 67%. Infants with MAS had the best survival rate (82%) and those with CDH had the worst (46%). Of the remaining 60 survivors, 53% remained oxygen dependent at 28 days and 33% at 45 days. At the age of 2 years, only 1 infant remained oxygen dependent (but did not required oxygen at 3 years) and only 3 infants had significant neurodevelopmental problems. CDH group was associated with a prolonged duration in supplementary oxygen (P<0.001) and a prolonged duration for tube feeding (P=0.01) as compared with other diagnoses. Regarding neurologic outcome, CDH infants had the poorer neurological acquisition rate at 9 months but a very good evolution by the time of the 24-month evaluation. CONCLUSIONS: Morbidity in ECMO survivors is low considering the severity of illness in the newborn period, mainly related to pulmonary and feeding dysfunctions during the first months, in particular for the CDH group. Outcome at the age of 2 years of CDH infants is most often favourable regarding growth and neurodevelopmental evolution.