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Eugenio Baraldi
Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padua, Via Giustiniani, 3, 35128 Padua, Italy

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Journal article
Published: 30 August 2021 in Children
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The current SARS-CoV-2 disease (COVID-19) pandemic is a sudden major stressor superimposed on pre-existing high distress in parents of infants admitted to the neonatal intensive care unit (NICU). This study aimed to investigate the psychological wellbeing of NICU parents during the COVID-19 pandemic. Forty-four parents of 25 inpatients of the Padua University Hospital NICU were included from June 2020 to February 2021. At 7–14 days postpartum parents completed the Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), Parental Stressor Scale: NICU (PSS:NICU) and an ad-hoc questionnaire measuring parental COVID-19 related stress. About one third of parents reported extreme/high stress and a relevant negative impact on parenthood experience. Less time (82%) and less physical contact (73%) with infants due to COVID-19 preventive measures were the most frequent negative factors. Higher COVID-19 related parental stress was positively associated with anxiety, depression, NICU parental stress, stress related to NICU environment, and parental role alterations. Depression symptoms, stress related to infant condition and parental role alterations were higher in mothers. The pandemic affected parental emotional and relational wellbeing directly through additional stress due to COVID-19 concerns and indirectly through the impact of restrictions on the experience of becoming parents.

ACS Style

Laura Polloni; Francesco Cavallin; Elisabetta Lolli; Rossana Schiavo; Martina Bua; Biancarosa Volpe; Marta Meneghelli; Eugenio Baraldi; Daniele Trevisanuto. Psychological Wellbeing of Parents with Infants Admitted to the Neonatal Intensive Care Unit during SARS-CoV-2 Pandemic. Children 2021, 8, 755 .

AMA Style

Laura Polloni, Francesco Cavallin, Elisabetta Lolli, Rossana Schiavo, Martina Bua, Biancarosa Volpe, Marta Meneghelli, Eugenio Baraldi, Daniele Trevisanuto. Psychological Wellbeing of Parents with Infants Admitted to the Neonatal Intensive Care Unit during SARS-CoV-2 Pandemic. Children. 2021; 8 (9):755.

Chicago/Turabian Style

Laura Polloni; Francesco Cavallin; Elisabetta Lolli; Rossana Schiavo; Martina Bua; Biancarosa Volpe; Marta Meneghelli; Eugenio Baraldi; Daniele Trevisanuto. 2021. "Psychological Wellbeing of Parents with Infants Admitted to the Neonatal Intensive Care Unit during SARS-CoV-2 Pandemic." Children 8, no. 9: 755.

Journal article
Published: 25 June 2021 in Pediatric Pulmonology
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Background Among infants needing urgent transfer after birth, very preterm infants are a high-risk sub-group requiring special attention. This study aimed to assess trends in early respiratory management in a large series of very preterm infants undergoing postnatal transfer. Methods Trends in patient characteristics and early respiratory management were assessed in 798 very preterm infants who were transferred by the Eastern Veneto Neonatal Emergency Transport Service in 2000–2019. Trends were analyzed using joinpoint regression analysis and summarized as annual percentage changes (APCs). Results Proportion of neonates with birth weight less than 1 kg decreased from 33% to 16% (APC −3.82%). Use of nasal-continuous-positive-airway pressure increased (at call: APC 15.39%; during transfer: APC 15.60%), while use of self-inflating bag (at call: APC −12.09%), oxygen therapy (at call: APC −13.00%; during transfer: APC −23.77%) and mechanical ventilation (at call: APC −2.71%; during transfer: APC −2.99%) decreased. Use of oxygen concentrations at 21% increased (at call: APC 6.26%; during transfer: APC 7.14%), while oxygen concentrations above 40% decreased (at call: APC −5.73%; at transfer APC −8.89%). Surfactant administration at call increased (APC 3%–10%), while surfactant administration when arriving at referring hospital remained around 7-11% (APC 2.55%). Conclusion Relevant trends toward “gentle” approaches in early respiratory management of very preterm infants undergoing postnatal transfer occurred during the last twenty years. In addition, the proportion of transferred extremely low birth weight infants halved. Clinicians and stakeholders should consider such information when allocating assets to both hospitals and transfer services and planning regional perinatal programs.

ACS Style

Francesco Cavallin Msc; Nicoletta Doglioni; Laura Brombin; Elisabetta Lolli Rd; Cristina Loddo; Maria Elena Cavicchiolo; Veronica Mardegan; Mariella Magarotto; Nicoletta Mainini; Daniel Nardo; Rebecca Luisa Peloso; Daniele Piva; Elena Priante; Enrico Valerio; Eugenio Baraldi; Daniele Trevisanuto. Trends in respiratory management of transferred very preterm infants in the last two decades. Pediatric Pulmonology 2021, 1 .

AMA Style

Francesco Cavallin Msc, Nicoletta Doglioni, Laura Brombin, Elisabetta Lolli Rd, Cristina Loddo, Maria Elena Cavicchiolo, Veronica Mardegan, Mariella Magarotto, Nicoletta Mainini, Daniel Nardo, Rebecca Luisa Peloso, Daniele Piva, Elena Priante, Enrico Valerio, Eugenio Baraldi, Daniele Trevisanuto. Trends in respiratory management of transferred very preterm infants in the last two decades. Pediatric Pulmonology. 2021; ():1.

Chicago/Turabian Style

Francesco Cavallin Msc; Nicoletta Doglioni; Laura Brombin; Elisabetta Lolli Rd; Cristina Loddo; Maria Elena Cavicchiolo; Veronica Mardegan; Mariella Magarotto; Nicoletta Mainini; Daniel Nardo; Rebecca Luisa Peloso; Daniele Piva; Elena Priante; Enrico Valerio; Eugenio Baraldi; Daniele Trevisanuto. 2021. "Trends in respiratory management of transferred very preterm infants in the last two decades." Pediatric Pulmonology , no. : 1.

Diagnostic testing
Published: 10 May 2021 in Pediatric Pulmonology
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Introduction Pediatric flexible laryngotracheal bronchoscopy (FB) is an integral part of diagnostics and treatment at tertiary pediatric respiratory centers. Aim FBs performed between 2013 and 2018 at our Pediatric Allergy and Respiratory Medicine Unit of the Department of Women's and Children's Health at Padua University were examined in terms of the indications, findings and adverse events. Materials and methods The electronic medical records of pediatric patients who underwent FB at least once between 1 January 2013 and 31 December 2018 were considered. Patients' clinical data, indications for FB, anatomical findings, information deriving from bronchoalveolar lavage (BAL) and bronchial brushing, and possible adverse events were analyzed. Results There were 447 pediatric FBs performed in 428 patients (aged from 1 month to 18 years) for diagnostic purposes (92.4%), to clear secretions (3.6%) or to monitor a known condition (4.0%). The main indications were recurrent lower respiratory tract infections (LRTI, 32.2%) and chronic wet cough (9.4%). Lower airway malacia was the most common abnormal finding in these two groups (36.1% and 28.6%, respectively). BAL bacterial culture was positive in 55 children (39.6%) with recurrent LRTI and in 25 (59.5%) with chronic wet cough, being Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis the microorganisms most commonly isolated. FB proved a safe procedure and was well tolerated. Conclusions Pediatric FB is an essential tool at our tertiary pediatric respiratory center. It helps establish the anatomical conditions underlying several chronic respiratory conditions and any correlated microbiological findings, with a significant impact on further patient management.

ACS Style

Valentina Agnese Ferraro; Eugenio Baraldi; Diana Stabinger; Andrea Zamunaro; Stefania Zanconato; Silvia Carraro. Pediatric flexible bronchoscopy: A single‐center report. Pediatric Pulmonology 2021, 56, 2634 -2641.

AMA Style

Valentina Agnese Ferraro, Eugenio Baraldi, Diana Stabinger, Andrea Zamunaro, Stefania Zanconato, Silvia Carraro. Pediatric flexible bronchoscopy: A single‐center report. Pediatric Pulmonology. 2021; 56 (8):2634-2641.

Chicago/Turabian Style

Valentina Agnese Ferraro; Eugenio Baraldi; Diana Stabinger; Andrea Zamunaro; Stefania Zanconato; Silvia Carraro. 2021. "Pediatric flexible bronchoscopy: A single‐center report." Pediatric Pulmonology 56, no. 8: 2634-2641.

Journal article
Published: 04 May 2021 in Pediatric Pulmonology
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Objectives To compare the efficacy of intra‐tracheal (IT) surfactant/budesonide (SB) with that of surfactant alone (S) in reducing the rate of bronchopulmonary dysplasia (BPD) at 36 weeks post‐menstrual age (PMA), we included extremely preterm very low birth weight (VLBW) infants with severe respiratory distress syndrome (RDS) in our tertiary neonatal level of care unit (Padua, Italy). Study Design A retrospective chart review of two cohorts of extremely preterm VLBW neonates (<28+0 gestation weeks, birth weight [BW] < 1500 g) born in two consequent epochs (2017–2018/2018–2019) were compared. The SB group received surfactant (200 mg/kg 1st dose) and budesonide (0.25 mg/kg), while the S group received surfactant alone. Results Among 68 neonates with RDS Grades III–IV, FiO2 ≥ 0.3 within 12 h of life, 18 were included in each group after matching for perinatal, clinical, and laboratory characteristics. IT SB did not affect the rate of BPD (Vermont Oxford Network, Jensen's, and National Institute of Child Health and Human Development BPD Workshop 2018 definitions), death, BPD, or death at 36 weeks PMA. Hypotension requiring inotropic support within the first 5 days was lower in those receiving the combined treatment (p = .03). The SB group had fewer admissions to pediatric ward due to respiratory causes up to 12 months of corrected age (p = .03). Conclusion The preliminary results of this retrospective study suggest that in extremely preterm VLBW infants, IT SB for severe RDS did not affect the incidence of BPD, death, and BPD or death at 36 weeks PMA, compared to surfactant alone. The combined therapy proved to be safe in this population. Further studies are warranted to explore the role of early IT steroids on respiratory morbidity in preterm infants.

ACS Style

Laura Moschino; Daniel Nardo; Luca Bonadies; Matteo Stocchero; Giulia Res; Elena Priante; Sabrina Salvadori; Eugenio Baraldi. Intra‐tracheal surfactant/budesonide versus surfactant alone: Comparison of two consecutive cohorts of extremely preterm infants. Pediatric Pulmonology 2021, 56, 2114 -2124.

AMA Style

Laura Moschino, Daniel Nardo, Luca Bonadies, Matteo Stocchero, Giulia Res, Elena Priante, Sabrina Salvadori, Eugenio Baraldi. Intra‐tracheal surfactant/budesonide versus surfactant alone: Comparison of two consecutive cohorts of extremely preterm infants. Pediatric Pulmonology. 2021; 56 (7):2114-2124.

Chicago/Turabian Style

Laura Moschino; Daniel Nardo; Luca Bonadies; Matteo Stocchero; Giulia Res; Elena Priante; Sabrina Salvadori; Eugenio Baraldi. 2021. "Intra‐tracheal surfactant/budesonide versus surfactant alone: Comparison of two consecutive cohorts of extremely preterm infants." Pediatric Pulmonology 56, no. 7: 2114-2124.

Review article
Published: 07 April 2021 in Pediatric Research
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The aim of this review was threefold: (a) to retrieve all SARS-CoV-2 evidences published by Italian neonatologists working in maternity centers and NICUs during the pandemic; (b) to summarize current evidence for the management of term and preterm infants with a SARS-CoV-2-related illness; and (c) to provide an update for dealing with the second wave of COVID-19 and discuss open questions. A review was conducted using MEDLINE/PubMed and the national COVID-19 registry of the Italian Society of Neonatology including citations from December 1, 2019 to October 28, 2020. Sixty-three articles were included. Collected data were divided into the following topics: (a) antenatal management, (b) management in delivery room, (c) postnatal management, (d) mother–baby dyad and breastfeeding management, (e) neonatal emergency transport system reorganization, (f) parents’ management and perspective during SARS-CoV-2 pandemic, and (g) future perspective. Evidences have evolved over the pandemic period and the current review can be useful in the management of the mother–neonate dyad during SARS-CoV-2 future waves. Italian neonatologists have played an active role in producing official guidelines and reporting data that have contributed to improve the care of neonates. A joint European action plan is mandatory to face COVID-19 in neonates with more awareness.

ACS Style

Maria Elena Cavicchiolo; Daniele Trevisanuto; Elena Priante; Laura Moschino; Fabio Mosca; Eugenio Baraldi. Italian neonatologists and SARS-CoV-2: lessons learned to face coming new waves. Pediatric Research 2021, 1 -9.

AMA Style

Maria Elena Cavicchiolo, Daniele Trevisanuto, Elena Priante, Laura Moschino, Fabio Mosca, Eugenio Baraldi. Italian neonatologists and SARS-CoV-2: lessons learned to face coming new waves. Pediatric Research. 2021; ():1-9.

Chicago/Turabian Style

Maria Elena Cavicchiolo; Daniele Trevisanuto; Elena Priante; Laura Moschino; Fabio Mosca; Eugenio Baraldi. 2021. "Italian neonatologists and SARS-CoV-2: lessons learned to face coming new waves." Pediatric Research , no. : 1-9.

Original article
Published: 17 March 2021 in Pediatric Pulmonology
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Bronchopulmonary dysplasia (BPD) still carries a heavy burden of morbidity and mortality in survivors of extreme prematurity. The disease is characterized by simplification of the alveolar structure, involving a smaller number of enlarged alveoli due to decreased septation and a dysmorphic pulmonary microvessel growth. These changes lead to persistent abnormalities mainly affecting the smaller airways, lung parenchyma and pulmonary vasculature, that can be assessed with lung function tests and imaging techniques. Several longitudinal lung function studies have demonstrated that most preterm‐born subjects with BPD embark on a low lung function trajectory, never achieving their full airway growth potential. They are consequently at higher risk of developing a chronic obstructive pulmonary disease(COPD)‐like phenotype later in life. Studies based on computer tomography and magnetic resonance imaging, have also shown that in these patients there is a persistence of lung abnormalities like emphysematous areas, bronchial wall thickening, interstitial opacities and mosaic lung attenuation also in adult age. This review aims to outline the current knowledge on pulmonary and vascular growth in survivors of BPD and the evidence of their lung function and imaging up to adulthood. This article is protected by copyright. All rights reserved.

ACS Style

Laura Moschino; Luca Bonadies; Eugenio Baraldi. Lung growth and pulmonary function after prematurity and bronchopulmonary dysplasia. Pediatric Pulmonology 2021, 1 .

AMA Style

Laura Moschino, Luca Bonadies, Eugenio Baraldi. Lung growth and pulmonary function after prematurity and bronchopulmonary dysplasia. Pediatric Pulmonology. 2021; ():1.

Chicago/Turabian Style

Laura Moschino; Luca Bonadies; Eugenio Baraldi. 2021. "Lung growth and pulmonary function after prematurity and bronchopulmonary dysplasia." Pediatric Pulmonology , no. : 1.

Journal article
Published: 18 February 2021 in Metabolites
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Sepsis is a major concern in neonatology, but there are no reliable biomarkers for its early diagnosis. The aim of the study was to compare the metabolic profiles of plasma and urine samples collected at birth from preterm neonates with and without earlyonset sepsis (EOS) to identify metabolic perturbations that might orient the search for new early biomarkers. All preterm newborns admitted to the neonatal intensive care unit were eligible for this proof-of-concept, prospective case-control study. Infants were enrolled as “cases” if they developed EOS, and as “controls”if they did not. Plasma samples collected at birth and urine samples collected within 24 h of birth underwent untargeted and targeted metabolomic analysis using mass spectrometry coupled with ultra-performance liquid chromatography. Univariate and multivariate statistical analyses were applied. Of 123 eligible newborns, 15 developed EOS. These 15 newborns matched controls for gestational age and weight. Metabolomic analysis revealed evident clustering of the cases versus controls, with the glutathione and tryptophan metabolic pathways markedly disrupted in the former. In conclusion, neonates with EOS had a metabolic profile at birth that clearly distinguished them from those without sepsis, and metabolites of glutathione and tryptophan pathways are promising as new biomarkers of neonatal sepsis.

ACS Style

Veronica Mardegan; Giuseppe Giordano; Matteo Stocchero; Paola Pirillo; Gabriele Poloniato; Enrica Donadel; Sabrina Salvadori; Carlo Giaquinto; Elena Priante; Eugenio Baraldi. Untargeted and Targeted Metabolomic Profiling of Preterm Newborns with EarlyOnset Sepsis: A Case-Control Study. Metabolites 2021, 11, 115 .

AMA Style

Veronica Mardegan, Giuseppe Giordano, Matteo Stocchero, Paola Pirillo, Gabriele Poloniato, Enrica Donadel, Sabrina Salvadori, Carlo Giaquinto, Elena Priante, Eugenio Baraldi. Untargeted and Targeted Metabolomic Profiling of Preterm Newborns with EarlyOnset Sepsis: A Case-Control Study. Metabolites. 2021; 11 (2):115.

Chicago/Turabian Style

Veronica Mardegan; Giuseppe Giordano; Matteo Stocchero; Paola Pirillo; Gabriele Poloniato; Enrica Donadel; Sabrina Salvadori; Carlo Giaquinto; Elena Priante; Eugenio Baraldi. 2021. "Untargeted and Targeted Metabolomic Profiling of Preterm Newborns with EarlyOnset Sepsis: A Case-Control Study." Metabolites 11, no. 2: 115.

Review
Published: 24 January 2021 in Nutrients
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Necrotizing enterocolitis (NEC), the first cause of short bowel syndrome (SBS) in the neonate, is a serious neonatal gastrointestinal disease with an incidence of up to 11% in preterm newborns less than 1500 g of birth weight. The rate of severe NEC requiring surgery remains high, and it is estimated between 20–50%. Newborns who develop SBS need prolonged parenteral nutrition (PN), experience nutrient deficiency, failure to thrive and are at risk of neurodevelopmental impairment. Prevention of NEC is therefore mandatory to avoid SBS and its associated morbidities. In this regard, nutritional practices seem to play a key role in early life. Individualized medical and surgical therapies, as well as intestinal rehabilitation programs, are fundamental in the achievement of enteral autonomy in infants with acquired SBS. In this descriptive review, we describe the most recent evidence on nutritional practices to prevent NEC, the available tools to early detect it, the surgical management to limit bowel resection and the best nutrition to sustain growth and intestinal function.

ACS Style

Laura Moschino; Miriam Duci; Francesco Fascetti Leon; Luca Bonadies; Elena Priante; Eugenio Baraldi; Giovanna Verlato. Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection. Nutrients 2021, 13, 340 .

AMA Style

Laura Moschino, Miriam Duci, Francesco Fascetti Leon, Luca Bonadies, Elena Priante, Eugenio Baraldi, Giovanna Verlato. Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection. Nutrients. 2021; 13 (2):340.

Chicago/Turabian Style

Laura Moschino; Miriam Duci; Francesco Fascetti Leon; Luca Bonadies; Elena Priante; Eugenio Baraldi; Giovanna Verlato. 2021. "Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection." Nutrients 13, no. 2: 340.

Short communication
Published: 07 January 2021 in European Journal of Pediatrics
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In the aftermath of the SARS-CoV-2 pandemic, we revised the cost-effectiveness of the exploited interventions in neonatal intensive care unit, to redefine future strategies for hospital management. Costs were revised with respect to the lockdown R0 or under different R0 scenarios to estimate the cost-effectiveness of the screening program adopted. Weekly nasopharyngeal swabs for parents, neonates, and personnel were the major cost during the pandemic, although they effectively reduced the number of cases in our unit. Conclusion: Parents and healthcare personnel testing appears to be an effective strategy due to the high number of contact they have within the hospital environment and outside, able to minimize the cases within our unit.

ACS Style

Alfonso Galderisi; Elisabetta Lolli; Maria Elena Cavicchiolo; Luca Bonadies; Daniele Trevisanuto; Eugenio Baraldi. The aftermath of SARS-CoV-2 in NICU: saving or checking accounts? Projected cost-effectiveness analysis. European Journal of Pediatrics 2021, 180, 1631 -1635.

AMA Style

Alfonso Galderisi, Elisabetta Lolli, Maria Elena Cavicchiolo, Luca Bonadies, Daniele Trevisanuto, Eugenio Baraldi. The aftermath of SARS-CoV-2 in NICU: saving or checking accounts? Projected cost-effectiveness analysis. European Journal of Pediatrics. 2021; 180 (5):1631-1635.

Chicago/Turabian Style

Alfonso Galderisi; Elisabetta Lolli; Maria Elena Cavicchiolo; Luca Bonadies; Daniele Trevisanuto; Eugenio Baraldi. 2021. "The aftermath of SARS-CoV-2 in NICU: saving or checking accounts? Projected cost-effectiveness analysis." European Journal of Pediatrics 180, no. 5: 1631-1635.

Original article
Published: 07 January 2021 in European Journal of Nuclear Medicine and Molecular Imaging
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Although maternal antenatal transfer is the preferred option, some infants inevitably need urgent transport to a tertiary neonatal care facility after birth. This study aimed to investigate trends over time in patient characteristics and respiratory management in a large series of neonatal emergency transfers, in order to provide health caregivers an up-to-date profile of such patients and their therapeutic needs. Trends in patient characteristics and respiratory management were evaluated in 3337 transfers by the Eastern Veneto Neonatal Emergency Transport Service in 2000–2019. Joinpoint regression analysis was performed to evaluate trends and to estimate annual percentage changes (APCs). Proportions of preterm neonates increased (APC2000–2012 2.25%), then decreased (APC2012–2019 − 6.04%). Transfers at birth increased (APC2000–2013 2.69%), then decreased (APC2013–2019 − 5.76%). Proportion of neonates with cardiac and surgical diseases declined (APCs2000–2019 − 6.82% and − 3.32%), while proportion of neonates with neurologic diseases increased (APC2000–2019 8.62%). Use of nasal-continuous-positive-airway-pressure (APC2000–2019 9.72%) and high-flow-nasal-cannula (APC2007–2019 58.51%) at call, and nasal-continuous-positive-airway-pressure (APC2000–2019 13.87%) and nasal-intermittent-mandatory-ventilation (APC2000–2019 32.46%) during transfer increased. Mechanical ventilation during transfer decreased (APC2014–2019 − 10.77%). Use of oxygen concentrations at 21% increased at call and during transfer (APCs 2000–2019 2.24% and 2.44%), while oxygen concentrations above 40% decreased at call and during transfer (APCs 2000–2019 − 3.93% and − 5.12%). Conclusion: Our findings revealed a shift toward a more “gentle” approach and the reduced use of oxygen in respiratory management. Equipment and team expertise should meet the requirements of such changing patients and their therapeutic needs.

ACS Style

Daniele Trevisanuto; on behalf of the Servizio Trasporto Emergenza Neonatale STEN Group; Francesco Cavallin; Cristina Loddo; Laura Brombin; Elisabetta Lolli; Nicoletta Doglioni; Eugenio Baraldi. Trends in neonatal emergency transport in the last two decades. European Journal of Nuclear Medicine and Molecular Imaging 2021, 180, 635 -641.

AMA Style

Daniele Trevisanuto, on behalf of the Servizio Trasporto Emergenza Neonatale STEN Group, Francesco Cavallin, Cristina Loddo, Laura Brombin, Elisabetta Lolli, Nicoletta Doglioni, Eugenio Baraldi. Trends in neonatal emergency transport in the last two decades. European Journal of Nuclear Medicine and Molecular Imaging. 2021; 180 (2):635-641.

Chicago/Turabian Style

Daniele Trevisanuto; on behalf of the Servizio Trasporto Emergenza Neonatale STEN Group; Francesco Cavallin; Cristina Loddo; Laura Brombin; Elisabetta Lolli; Nicoletta Doglioni; Eugenio Baraldi. 2021. "Trends in neonatal emergency transport in the last two decades." European Journal of Nuclear Medicine and Molecular Imaging 180, no. 2: 635-641.

Journal article
Published: 05 January 2021 in Children
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Background: Extracorporeal membrane oxygenation (ECMO) implantation for neonates with severe cardiorespiratory life-threatening conditions is highly effective. However, since ECMO is a high-risk and complex therapy, this treatment is usually performed in centers with proven expertise. Methods: A retrospective review of neonates, from January 2014 to January 2020, presenting with life-threatening conditions and treated by means of Hub and Spoke (HandS) ECMO in peripheral (spoke) hospitals. Data were retrieved from our internal ECMO registry. Protocols and checklists were revised and shared with all spoke hospitals located in North-Eastern Italy. Results: Eleven neonates receiving maximal respiratory and cardiovascular support at a spoke hospital underwent HandS ECMO management. All but three patients were affected by life-threatening meconium aspiration syndrome (MAS). The median ECMO support duration and hospitalization were four (range 2–32) and 30 days (range 8–50), respectively. All but two patients (with congenital diaphragmatic hernia), were weaned off ECMO and discharged home. At a mean follow up of 33.7 ± 29.2 months, all survivors were alive and well, without medications, and normal somatic growth. All but one had normal neuropsychological development. Conclusion: HandS ECMO model for neonates with life-threatening conditions is effective and successful. A specialized multidisciplinary team and close cooperation between Hub and Spoke centers are essential for success.

ACS Style

Massimo Padalino; Nicoletta Doglioni; Daniel Nardo; Eugenio Baraldi; Vladimiro Vida; Daniele Trevisanuto. The “Hub and Spoke” (HandS) ECMO for “Resuscitating” Neonates with Respiratory Life-Threatening Conditions. Children 2021, 8, 24 .

AMA Style

Massimo Padalino, Nicoletta Doglioni, Daniel Nardo, Eugenio Baraldi, Vladimiro Vida, Daniele Trevisanuto. The “Hub and Spoke” (HandS) ECMO for “Resuscitating” Neonates with Respiratory Life-Threatening Conditions. Children. 2021; 8 (1):24.

Chicago/Turabian Style

Massimo Padalino; Nicoletta Doglioni; Daniel Nardo; Eugenio Baraldi; Vladimiro Vida; Daniele Trevisanuto. 2021. "The “Hub and Spoke” (HandS) ECMO for “Resuscitating” Neonates with Respiratory Life-Threatening Conditions." Children 8, no. 1: 24.

Letters to the editor
Published: 24 November 2020 in Pediatric Pulmonology
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ACS Style

Luca Bonadies; Daniele Donà; Eugenio Baraldi. Lung ultrasound is used in neonatology for diagnostics, monitoring and prognostics, but also for prevention. Pediatric Pulmonology 2020, 56, 333 -334.

AMA Style

Luca Bonadies, Daniele Donà, Eugenio Baraldi. Lung ultrasound is used in neonatology for diagnostics, monitoring and prognostics, but also for prevention. Pediatric Pulmonology. 2020; 56 (2):333-334.

Chicago/Turabian Style

Luca Bonadies; Daniele Donà; Eugenio Baraldi. 2020. "Lung ultrasound is used in neonatology for diagnostics, monitoring and prognostics, but also for prevention." Pediatric Pulmonology 56, no. 2: 333-334.

Supplement article
Published: 24 November 2020 in Pediatric Allergy and Immunology
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E‐cigarettes (e‐cigs) have been initially proposed as an aid to smoke cessation in adults, whereas they turned into a paradoxical preferential gateway to tobacco and nicotine initiation for adolescents naïve to tobacco. More than 25% of US school‐age students is an e‐cigs user with a steep rise over the past years. A marketing strategy on media and social network targeting youths, in the absence of rules to protect the pediatric users, resulted in an unprecedented trend up in tobacco consumption among adolescents and gave rise to a new generation of nicotine‐addicted teenagers. Flavored e‐cigs liquids and aerosols contain airway irritants and toxicants, that, in turn, produced an increase in asthma prevalence and its exacerbations among adolescents. In addition, since August 2019 an outbreak of e‐cigarette, or vaping, product use‐associated lung injury (EVALI) has been described. In view of this, e‐cigs must no longer be considered harmless, especially in adolescents never used a tobacco product before. This is a call‐for‐action to establish effective rules and campaigns targeting youths aimed to limit their access to e‐cigs, thereby preserving the potential benefit in quitting tobacco addiction described in adults. Behavioral and educational actions, out of the conventional primary care setting, have been described as a model for a youth‐centered campaign. We call for stricter regulations on e‐cigs products, with respect to their marketing to the youngest ones, along with public health and primary care interventions that could curb the spread of this “vaping” epidemic.

ACS Style

Alfonso Galderisi; Valentina Agnese Ferraro; Marta Caserotti; Luca Quareni; Giorgio Perilongo; Eugenio Baraldi. Protecting youth from the vaping epidemic. Pediatric Allergy and Immunology 2020, 31, 66 -68.

AMA Style

Alfonso Galderisi, Valentina Agnese Ferraro, Marta Caserotti, Luca Quareni, Giorgio Perilongo, Eugenio Baraldi. Protecting youth from the vaping epidemic. Pediatric Allergy and Immunology. 2020; 31 (S26):66-68.

Chicago/Turabian Style

Alfonso Galderisi; Valentina Agnese Ferraro; Marta Caserotti; Luca Quareni; Giorgio Perilongo; Eugenio Baraldi. 2020. "Protecting youth from the vaping epidemic." Pediatric Allergy and Immunology 31, no. S26: 66-68.

Journal article
Published: 29 September 2020 in Metabolites
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Background: “breathomics” enables indirect analysis of metabolic patterns underlying a respiratory disease. In this study, we analyze exhaled breath condensate (EBC) in asthmatic children before (T0) and after (T1) a three-week course of inhaled beclomethasone dipropionate (BDP). Methods: we recruited steroid-naive asthmatic children for whom inhaled steroids were indicated and healthy children, evaluating asthma control, spirometry and EBC (in asthmatics at T0 and T1). A liquid-chromatography–mass-spectrometry untargeted analysis was applied to EBC and a mass spectrometry-based target analysis to urine samples. Results: metabolomic analysis discriminated asthmatic (n = 26) from healthy children (n = 16) at T0 and T1, discovering 108 and 65 features relevant for the discrimination, respectively. Searching metabolomics databases, seven putative biomarkers with a plausible role in asthma biochemical–metabolic processes were found. After BDP treatment, asthmatic children, in the face of an improved asthma control (p < 0.001) and lung function (p = 0.01), showed neither changes in EBC metabolomic profile nor in urinary endogenous steroid profile. Conclusions: “breathomics” can discriminate asthmatic from healthy children, with prostaglandin, fatty acid and glycerophospholipid as putative markers. The three-week course of BDP—in spite of a significant clinical improvement—was not associated with changes in EBC metabolic arrangement and urinary steroid profile.

ACS Style

Valentina Agnese Ferraro; Silvia Carraro; Paola Pirillo; Antonina Gucciardi; Gabriele Poloniato; Matteo Stocchero; Giuseppe Giordano; Stefania Zanconato; Eugenio Baraldi. Breathomics in Asthmatic Children Treated with Inhaled Corticosteroids. Metabolites 2020, 10, 390 .

AMA Style

Valentina Agnese Ferraro, Silvia Carraro, Paola Pirillo, Antonina Gucciardi, Gabriele Poloniato, Matteo Stocchero, Giuseppe Giordano, Stefania Zanconato, Eugenio Baraldi. Breathomics in Asthmatic Children Treated with Inhaled Corticosteroids. Metabolites. 2020; 10 (10):390.

Chicago/Turabian Style

Valentina Agnese Ferraro; Silvia Carraro; Paola Pirillo; Antonina Gucciardi; Gabriele Poloniato; Matteo Stocchero; Giuseppe Giordano; Stefania Zanconato; Eugenio Baraldi. 2020. "Breathomics in Asthmatic Children Treated with Inhaled Corticosteroids." Metabolites 10, no. 10: 390.

Communication
Published: 01 September 2020 in Healthcare
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Since February 2020, Italy has been faced with the dramatic spread of novel Coronavirus SARS-CoV-2. This impetuous pandemic infection forced many hospitals to reorganize their healthcare systems. Predicting a rapid spread of the SARS-CoV-2 virus within our region, the Department for Women’s and Children’s Health promptly decided (i) to revise the distribution of the clinical areas in order to create both designated COVID-19 and COVID-19-free areas with their own access, (ii) to reinforce infection prevention control (IPC) measures for all healthcare workers and administrative staff and (iii) to adopt the new “double-gate approach”: a phone call pre-triage and nasopharyngeal swab for SARS-CoV-2 detection before the admission of all patients and caregivers. Between 21 February 2020 till 04 May 2020, only seven physicians, two nurses and two of the administrative staff resulted positive, all during the first week of March. No other cases of intra-department infection were documented among the healthcare workers since all the preventive procedures described above were implemented. It is predicted that similar situations can happen again in the future, and thus, it is necessary to be more prepared to deal with them than we were at the beginning of this COVID-19 pandemic.

ACS Style

Daniele Donà; Carlo Giaquinto; Eugenio Baraldi; Alessandra Biffi; Piergiorgio Gamba; Anna Saieva; Luca Antoniello; Paola Costenaro; Susanna Masiero; Laura Sainati; Liviana Da Dalt; Giorgio Perilongo. COVID-19 Pandemic: Perspective of an Italian Tertiary Care Pediatric Center. Healthcare 2020, 8, 311 .

AMA Style

Daniele Donà, Carlo Giaquinto, Eugenio Baraldi, Alessandra Biffi, Piergiorgio Gamba, Anna Saieva, Luca Antoniello, Paola Costenaro, Susanna Masiero, Laura Sainati, Liviana Da Dalt, Giorgio Perilongo. COVID-19 Pandemic: Perspective of an Italian Tertiary Care Pediatric Center. Healthcare. 2020; 8 (3):311.

Chicago/Turabian Style

Daniele Donà; Carlo Giaquinto; Eugenio Baraldi; Alessandra Biffi; Piergiorgio Gamba; Anna Saieva; Luca Antoniello; Paola Costenaro; Susanna Masiero; Laura Sainati; Liviana Da Dalt; Giorgio Perilongo. 2020. "COVID-19 Pandemic: Perspective of an Italian Tertiary Care Pediatric Center." Healthcare 8, no. 3: 311.

Encyclopedia
Published: 31 August 2020 in Reference Module in Biomedical Sciences
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Emerging evidence has radically challenged the concept of a single natural history for childhood and adulthood chronic lung diseases, such as asthma and chronic obstructive pulmonary disease. In fact, a growing body of studies suggests a multifactorial origin of these conditions stemming in early-life, even in the womb. Being born preterm, especially at the smallest gestational ages, impairs normal lung morphogenesis resulting in a decreased surface area for gas exchange, reduced branching and distribution of the vasculature. Likewise, other antenatal insults, such as chorioamnionitis, maternal smoking, and nutrients deficiency, can alter the physiologic lung development. Taken together, these intra-uterine factors can interact and shape the future individual lung function until adult life.

ACS Style

Laura Moschino; Eugenio Baraldi. Prematurity and Intrauterine Insults. Reference Module in Biomedical Sciences 2020, 1 .

AMA Style

Laura Moschino, Eugenio Baraldi. Prematurity and Intrauterine Insults. Reference Module in Biomedical Sciences. 2020; ():1.

Chicago/Turabian Style

Laura Moschino; Eugenio Baraldi. 2020. "Prematurity and Intrauterine Insults." Reference Module in Biomedical Sciences , no. : 1.

Review article
Published: 09 August 2020 in American Journal of Perinatology
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There is growing evidence in medical literature to support an association between early-life respiratory syncytial virus lower respiratory tract-lower respiratory tract infection (RSV-LRTI) and recurrent wheezing/asthma-like symptoms. It has been estimated that children with a history of RSV-LRTI have a 2- to 12-fold higher risk of developing asthma. The connection between RSV infection and a developmental trajectory of reduced lung function remains throughout adolescence and early adulthood, suggesting a possible role for RSV even in the inception of chronic obstructive pulmonary disease. That is why the postnatal period appears to offer a specific window of opportunity for early intervention to prevent chronic obstructive lung diseases. The mechanisms by which RSV contributes to the onset of wheezing/asthma and lung function impairment are not fully understood but appear to relate to injury caused directly by the virus and/or to pre-existing predisposing factors. While awaiting a deeper understanding of the association between RSV and chronic lung diseases, the crucial role of pediatricians and physicians is to develop strategies to prevent RSV infections to try and protect children's lifelong respiratory health. Key Points

ACS Style

Eugenio Baraldi; Luca Bonadies; Paolo Manzoni. Evidence on the Link between Respiratory Syncytial Virus Infection in Early Life and Chronic Obstructive Lung Diseases. American Journal of Perinatology 2020, 37, S26 -S30.

AMA Style

Eugenio Baraldi, Luca Bonadies, Paolo Manzoni. Evidence on the Link between Respiratory Syncytial Virus Infection in Early Life and Chronic Obstructive Lung Diseases. American Journal of Perinatology. 2020; 37 (S 02):S26-S30.

Chicago/Turabian Style

Eugenio Baraldi; Luca Bonadies; Paolo Manzoni. 2020. "Evidence on the Link between Respiratory Syncytial Virus Infection in Early Life and Chronic Obstructive Lung Diseases." American Journal of Perinatology 37, no. S 02: S26-S30.

Original article
Published: 07 August 2020 in European Journal of Pediatrics
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Since February 21, 2020, SARS-CoV-2 has spread exponentially worldwide. Neonatal patients needing intensive care are considered a vulnerable population. To report the results of a policy based on multi-timepoint surveillance for SARS-CoV-2 of all neonates admitted to the neonatal intensive care unit (NICU), their parents, and all healthcare providers in a part of Italy with a high prevalence of the infection. Observational study conducted from 21 February to 21 April 2020. Intervention consisted of (a) parental triage on arrival at the neonatal ward; (b) universal testing with nasopharyngeal swabs and blood testing for SARS-CoV-2 IgM and IgG antibodies; (c) use of continuous personal protective equipment at the NICU by parents and staff. A total of 6726 triage procedures were performed on 114 parents, and 954 nasopharyngeal swabs were collected from 226 individuals. Five (2.2%) asymptomatic individuals (2 parents and 3 healthcare providers) tested positive on nasopharyngeal swabs and were kept isolated for 14 days. Of 75 admitted newborn, no one tested positive on nasopharyngeal swabs or antibody tests. Three parents presented with fever or flu-like symptoms at triage; they tested negative on swabs. Conclusion: With universal screening of neonates, parents, and staff, there were no cases of SARS-CoV-2 infection among the neonates admitted to a NICU in an area with a high incidence of SARS-CoV-2. Our experience could be usefully compared with other strategies with a view to developing future evidence-based guidelines for managing high-risk neonates in case of new epidemics.

ACS Style

Maria Elena Cavicchiolo; Daniele Trevisanuto; Elisabetta Lolli; Veronica Mardegan; Anna Maria Saieva; Elisa Franchin; Mario Plebani; Daniele Donato; Eugenio Baraldi. Universal screening of high-risk neonates, parents, and staff at a neonatal intensive care unit during the SARS-CoV-2 pandemic. European Journal of Pediatrics 2020, 179, 1949 -1955.

AMA Style

Maria Elena Cavicchiolo, Daniele Trevisanuto, Elisabetta Lolli, Veronica Mardegan, Anna Maria Saieva, Elisa Franchin, Mario Plebani, Daniele Donato, Eugenio Baraldi. Universal screening of high-risk neonates, parents, and staff at a neonatal intensive care unit during the SARS-CoV-2 pandemic. European Journal of Pediatrics. 2020; 179 (12):1949-1955.

Chicago/Turabian Style

Maria Elena Cavicchiolo; Daniele Trevisanuto; Elisabetta Lolli; Veronica Mardegan; Anna Maria Saieva; Elisa Franchin; Mario Plebani; Daniele Donato; Eugenio Baraldi. 2020. "Universal screening of high-risk neonates, parents, and staff at a neonatal intensive care unit during the SARS-CoV-2 pandemic." European Journal of Pediatrics 179, no. 12: 1949-1955.

A different view
Published: 21 July 2020 in Acta Paediatrica
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Bronchopulmonary dysplasia (BPD) is an independent risk factor for respiratory syncytial virus (RSV) hospitalisation in children who have not received prophylaxis. It is associated with an RSV hospitalisation rate of 12%‐21%, which is up to 10 times higher than term‐born infants and other high‐risk groups without comorbidities, even up to three years of age.1 A meta‐analysis has confirmed that hospitalised children with BPD experience significant morbidity compared to non BPD subjects including a median hospital length of stay of 7.2 days versus 2.5 days. They also need higher intensive care admissions, with an odds ratio (OR) of 2.9 and 95% confidence interval (CI) of 2.3‐3.5 (p < 0.001), have a greater need for mechanical ventilation (OR 8.2, 95% CI, 7.6‐8.9, p < 0.001) and experience a higher case‐fatality (OR 12.8, 95% CI 9.4‐17.3, p< 0.001).2 In 2012, expenditure for children hospitalised with RSV and BPD, in the USA, was 1.7‐fold higher than children hospitalised with congenital heart disease and airway anomalies.

ACS Style

Bosco Paes; Eugenio Baraldi; Brigitte Fauroux; Xavier Carbonell‐Estrany. Exploring respiratory syncytial virus prophylaxis for children with all grades of bronchopulmonary dysplasia. Acta Paediatrica 2020, 110, 25 -27.

AMA Style

Bosco Paes, Eugenio Baraldi, Brigitte Fauroux, Xavier Carbonell‐Estrany. Exploring respiratory syncytial virus prophylaxis for children with all grades of bronchopulmonary dysplasia. Acta Paediatrica. 2020; 110 (1):25-27.

Chicago/Turabian Style

Bosco Paes; Eugenio Baraldi; Brigitte Fauroux; Xavier Carbonell‐Estrany. 2020. "Exploring respiratory syncytial virus prophylaxis for children with all grades of bronchopulmonary dysplasia." Acta Paediatrica 110, no. 1: 25-27.

Correspondence
Published: 29 May 2020 in Allergy
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Sara Manti; Amelia Licari; Salvatore Leonardi; Gian Luigi Marseglia; Eugenio Baraldi. Reply to correspondence: “Bronchiolitis needs a revisit: Distinguishing between virus entities and their treatments”. Allergy 2020, 75, 1531 -1532.

AMA Style

Sara Manti, Amelia Licari, Salvatore Leonardi, Gian Luigi Marseglia, Eugenio Baraldi. Reply to correspondence: “Bronchiolitis needs a revisit: Distinguishing between virus entities and their treatments”. Allergy. 2020; 75 (6):1531-1532.

Chicago/Turabian Style

Sara Manti; Amelia Licari; Salvatore Leonardi; Gian Luigi Marseglia; Eugenio Baraldi. 2020. "Reply to correspondence: “Bronchiolitis needs a revisit: Distinguishing between virus entities and their treatments”." Allergy 75, no. 6: 1531-1532.