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Daniele Trevisanuto is an Associate Professor at the University of Padova, Italy, President of the Veneto Region Italian Society of Neonatology, and Director of the East Veneto Region Neonatal Transport Service. Professor Trevisanuto is vice-director of the Master on “Neonatology and intensive neonatal care” at the University of Padua. From 2012 to 2015, he was the Secretary of the Study Group on Neonatal Resuscitation, Italian Society of Neonatology. He is a Member of the International Liaison Committee on Resuscitation – Neonatal Resuscitation Task Force a member of the European Resuscitation Council, Task Force Neonatal Resuscitation. His research has focused on the following topics: neonatal resuscitation, education, maternal and neonatal care in low-resource countries, neonatal airway management, neonatal transport. He is involved in many international collaborative projects and has been invited as a speaker in about 250 national and international congresses, meetings, and workshops. For a long time, he has been conducting educational and research activities in many middle- and low-research countries (i.e. Mongolia, Vietnam, Myanmar, Sudan, Mozambique, Uganda, Ethiopia). He is the author or co-author of more than 260 peer-reviewed articles (PubMed) and has published chapters in neonatology books. He is the co-inventor of a supraglottic airway device for drug delivery.
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.
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 StyleLaura 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 StyleLaura 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.
Aim The International Liaison Committee on Resuscitation (ILCOR) 2020 Consensus on Science and Treatment Recommendations (CoSTR) for Neonatal Life Support forms the basis for guidelines developed by regional councils such as the American Heart Association (AHA) and the European Resuscitation Council (ERC). We aimed to determine if the updated guidelines are congruent, identify the source of variation, and score their quality. Methods We compared the approach to developing recommendations, final recommendations, and cited evidence in the AHA 2020 and ERC 2021 neonatal resuscitation guidelines. Two investigators scored guideline quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. Results Differences in the recommendations were found between AHA 2020 and ERC 2021 neonatal resuscitation guidelines. The councils gave differing recommendations for practices that had sparse evidence and made recommendations based on expert consensus or observational studies. AGREE II assessment revealed that AHA scored better for the domain ‘rigour of development', but ERC had a higher score for ‘stakeholder involvement'. Both AHA and ERC scored relatively less for ‘applicability'. Conclusion AHA and ERC guidelines are predominantly based on the ILCOR CoSTR. Differences in recommendations between the two were largely related to the evidence gathering process for questions not reviewed by ILCOR, paucity of evidence for some recommendations based on existing regional practices and supported by expert opinion, and different interpretation or application of same evidence. Overall, both guidelines scored well on the AGREE II assessment, but each had domains that could be improved in future editions.
Viraraghavan Vadakkencherry Ramaswamy; Thangaraj Abiramalatha; Gary M. Weiner; Daniele Trevisanuto. A COMPARATIVE EVALUATION AND APPRAISAL OF 2020 AMERICAN HEART ASSOCIATION AND 2021 EUROPEAN RESUSCITATION COUNCIL NEONATAL RESUSCITATION GUIDELINES. Resuscitation 2021, 1 .
AMA StyleViraraghavan Vadakkencherry Ramaswamy, Thangaraj Abiramalatha, Gary M. Weiner, Daniele Trevisanuto. A COMPARATIVE EVALUATION AND APPRAISAL OF 2020 AMERICAN HEART ASSOCIATION AND 2021 EUROPEAN RESUSCITATION COUNCIL NEONATAL RESUSCITATION GUIDELINES. Resuscitation. 2021; ():1.
Chicago/Turabian StyleViraraghavan Vadakkencherry Ramaswamy; Thangaraj Abiramalatha; Gary M. Weiner; Daniele Trevisanuto. 2021. "A COMPARATIVE EVALUATION AND APPRAISAL OF 2020 AMERICAN HEART ASSOCIATION AND 2021 EUROPEAN RESUSCITATION COUNCIL NEONATAL RESUSCITATION GUIDELINES." Resuscitation , no. : 1.
Background Approximately 15% of infants require stimulation in low-resource settings, but data on effectiveness of different stimulation approaches are limited. We aimed to compare two recommended approaches of stimulation (back rubs vs. foot flicks) in reducing the need for face-mask ventilation in newly born infants who were not crying immediately after birth in a low-resource setting. Methods A single center, open-label, randomized, superiority trial was conducted at St. Kizito Hospital in Matany (Uganda) between November 2019 and May 2020. Newly born infants with expected birthweight > 1500 grams who were not crying immediately after birth were randomly assigned to stimulation using back rubs or foot flicks. The primary outcome measure was the success rate of the stimulation, defined as the achievement of an effective crying preventing the need for face-mask ventilation. Results Success of stimulation was achieved in 76/93 neonates (82%) using back rubs and 68/93 neonates (73%) using foot flicks (risk ratio 1.12, 95% confidence interval 0.96–1.31). No procedure-associated complications arose during the study. Time to first cry was not statistically different between the two arms (mean difference −11 seconds, 95% confidence interval −39 to 18). Conclusions In newly born infants who were not crying immediately after birth, this trial did not provide a conclusive message in favor of back rubs or foot flicks. Nonetheless, we could not exclude a possible benefit of back rubs in avoiding the need for positive pressure ventilation and, possibly, further advanced resuscitative maneuvers. Clinical trials registration clinicalTrial.gov: NCT04056091.
Francesco Cavallin; Peter Lochoro; Jerry Ictho; John Bosco Nsubuga; Jesca Ameo; Giovanni Putoto; Daniele Trevisanuto. Back rubs or foot flicks for neonatal stimulation at birth in a low-resource setting: a randomized controlled trial. Resuscitation 2021, 1 .
AMA StyleFrancesco Cavallin, Peter Lochoro, Jerry Ictho, John Bosco Nsubuga, Jesca Ameo, Giovanni Putoto, Daniele Trevisanuto. Back rubs or foot flicks for neonatal stimulation at birth in a low-resource setting: a randomized controlled trial. Resuscitation. 2021; ():1.
Chicago/Turabian StyleFrancesco Cavallin; Peter Lochoro; Jerry Ictho; John Bosco Nsubuga; Jesca Ameo; Giovanni Putoto; Daniele Trevisanuto. 2021. "Back rubs or foot flicks for neonatal stimulation at birth in a low-resource setting: a randomized controlled trial." Resuscitation , no. : 1.
Background To evaluate digital tracheal intubation (DTI) when compared to laryngoscope-assisted TI; finger palpation of endotracheal tube (ETT) tip position when compared to any standard method. Design A systematic review of Medline, Embase, CENTRAL, and CINAHL with synthesis of data using meta-analysis was performed. Main outcome measure The proportion of successful TI and correct ETT tip positioning were the main outcome measures. Results Five studies (one observational study and four RCTs) enrolling 310 neonates were included. 94% (81%–98%) of the DTI were successful on the first attempt (certainty of evidence [CoE]: low). The proportion of successful intubation on the first attempt was higher with DTI when compared to laryngoscope-assisted TI (RR 95% CI: 1.81 [1.18; 2.76]) (CoE: very low). Time to successful TI with DTI was 7.4 (95% CI: 6.3, 8.5) s (CoE: low). Time to successful TI was significantly shorter with DTI when compared to laryngoscope assisted TI (MD [95% CI]: −4.9 [−7.3, −2.4] s) (CoE: very low). There was a trend towards a higher proportion of correct ETT tip positions with finger palpation when compared to weight-based formulae alone (RR 95% CI: 1.12 [0.96; 1.31]) (CoE: very low). Conclusions DTI and finger palpation to ascertain ETT tip position in neonates are promising strategies. Future studies with emphasis on their learning trajectory and generalizability are needed.
Viraraghavan Vadakkencherry Ramaswamy Dm; Thangaraj Abiramalatha Dm; Tapas Bandyopadhyay Dm; Abdul Kareem Pullattayil S Mist; Daniele Trevisanuto. Digital tracheal intubation and finger palpation to confirm endotracheal tube tip position in neonates: A systematic review and meta‐analysis. Pediatric Pulmonology 2021, 1 .
AMA StyleViraraghavan Vadakkencherry Ramaswamy Dm, Thangaraj Abiramalatha Dm, Tapas Bandyopadhyay Dm, Abdul Kareem Pullattayil S Mist, Daniele Trevisanuto. Digital tracheal intubation and finger palpation to confirm endotracheal tube tip position in neonates: A systematic review and meta‐analysis. Pediatric Pulmonology. 2021; ():1.
Chicago/Turabian StyleViraraghavan Vadakkencherry Ramaswamy Dm; Thangaraj Abiramalatha Dm; Tapas Bandyopadhyay Dm; Abdul Kareem Pullattayil S Mist; Daniele Trevisanuto. 2021. "Digital tracheal intubation and finger palpation to confirm endotracheal tube tip position in neonates: A systematic review and meta‐analysis." Pediatric Pulmonology , no. : 1.
One million two hundred thousand neonatal lives are lost each year due to intrapartum-related events; 99% of these deaths occur in low- and lower middle-income countries. Neonates exposed to intrapartum-related events present with failure to breathe at birth. Quick and effective delivery room management of these neonates is critical in the prevention of brain injury. Given the prominent role of lung aeration in the cardiopulmonary transition at birth, the mainstay of neonatal resuscitation is effective ventilation. Basic neonatal resuscitation focuses on simple stimulation, airway positioning and clearing, and bag-mask ventilation. Although principles for basic neonatal resuscitation remain the same for high- and low-resource settings, guidelines may differ based on available human and material resources. Formal training in basic resuscitation reduces intrapartum-related neonatal mortality in low-resource settings. However, there remain opportunities to improve provider performance for increased impact with other strategies such as regular practice and continuous quality improvement.
Jackie Patterson; Krysten North; Eugene Dempsey; Daniel Ishoso; Daniele Trevisanuto; Anne Cc. Lee; Beena D. Kamath-Rayne. Optimizing Initial Neonatal Resuscitation To Reduce Neonatal Encephalopathy Around the World. Seminars in Fetal and Neonatal Medicine 2021, 101262 .
AMA StyleJackie Patterson, Krysten North, Eugene Dempsey, Daniel Ishoso, Daniele Trevisanuto, Anne Cc. Lee, Beena D. Kamath-Rayne. Optimizing Initial Neonatal Resuscitation To Reduce Neonatal Encephalopathy Around the World. Seminars in Fetal and Neonatal Medicine. 2021; ():101262.
Chicago/Turabian StyleJackie Patterson; Krysten North; Eugene Dempsey; Daniel Ishoso; Daniele Trevisanuto; Anne Cc. Lee; Beena D. Kamath-Rayne. 2021. "Optimizing Initial Neonatal Resuscitation To Reduce Neonatal Encephalopathy Around the World." Seminars in Fetal and Neonatal Medicine , no. : 101262.
CONTEXT Positive pressure ventilation (PPV) is the most important intervention during neonatal resuscitation. OBJECTIVE To compare T-piece resuscitators (TPRs), self-inflating bags (SIBs), and flow-inflating bags for newborns receiving PPV during delivery room resuscitation. DATA SOURCES Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, and trial registries (inception to December 2020). STUDY SELECTION Randomized, quasi-randomized, interrupted time series, controlled before-and-after, and cohort studies were included without language restrictions. DATA EXTRACTION Two researchers independently extracted data, assessed the risk of bias, and evaluated the certainty of evidence. The primary outcome was in-hospital mortality. When appropriate, data were pooled by using fixed-effect models. RESULTS Meta-analysis of 4 randomized controlled trials (1247 patients) revealed no significant difference between TPR and SIB for in-hospital mortality (risk ratio 0.74; 95% confidence interval [CI] 0.40 to 1.34). Resuscitation with a TPR resulted in a shorter duration of PPV (mean difference −19.8 seconds; 95% CI −27.7 to −12.0 seconds) and lower risk of bronchopulmonary dysplasia (risk ratio 0.64; 95% CI 0.43 to 0.95; number needed to treat 32). No differences in clinically relevant outcomes were found in 2 randomized controlled trials used to compare SIBs with and without positive end-expiratory pressure valves. No studies used to evaluate flow-inflating bags were found. LIMITATIONS Certainty of evidence was very low or low for most outcomes. CONCLUSIONS Resuscitation with a TPR compared with an SIB reduces the duration of PPV and risk of bronchopulmonary dysplasia. A strong recommendation cannot be made because of the low certainty of evidence. There is insufficient evidence to determine the effectiveness of positive end-expiratory pressure valves when used with SIBs.
Daniele Trevisanuto; Charles Christoph Roehr; Peter G. Davis; Georg M. Schmölzer; Myra Helen Wyckoff; Helen G. Liley; Yacov Rabi; Gary Marshall Weiner. Devices for Administering Ventilation at Birth: A Systematic Review. Pediatrics 2021, 148, 1 .
AMA StyleDaniele Trevisanuto, Charles Christoph Roehr, Peter G. Davis, Georg M. Schmölzer, Myra Helen Wyckoff, Helen G. Liley, Yacov Rabi, Gary Marshall Weiner. Devices for Administering Ventilation at Birth: A Systematic Review. Pediatrics. 2021; 148 (1):1.
Chicago/Turabian StyleDaniele Trevisanuto; Charles Christoph Roehr; Peter G. Davis; Georg M. Schmölzer; Myra Helen Wyckoff; Helen G. Liley; Yacov Rabi; Gary Marshall Weiner. 2021. "Devices for Administering Ventilation at Birth: A Systematic Review." Pediatrics 148, no. 1: 1.
Congenital malformations (CMs) are among the major causes of infant mortality in middle- and low-resource countries. This is the first study describing CMs in neonates admitted to the Neonatal Intensive Care Unit (NICU) of a referral hospital in Mozambique. We included all neonates with CMs admitted to the NICU of Beira Central Hospital from January 2015 to December 2016. CMs were classified according to the International Classification of Disease (ICD-10). All data were retrieved from medical charts. CMs were found in 143/4767 (3%) neonates admitted to the NICU. The most frequent CMs were musculoskeletal (31%), neurological (18%), multiple congenital anomalies (12%), chromosomopathies (11%), cardiovascular (10%), and gastrointestinal (8%). Forty-three patients (30%) underwent corrective surgery. Overall mortality rate was 50%. The prevalence of CMs was 3%, with a mortality rate of 50%. Alongside implementation of antenatal screening programs, improvement on expertise and postnatal care of CMs are warranted.
Elena Cavaliere; Daniele Trevisanuto; Liviana Da Dalt; Giovanni Putoto; Damiano Pizzol; Arlindo Rosario Muhelo; Francesco Cavallin. Congenital malformations in neonates admitted to a neonatal intensive care unit in a low-resource setting. The Journal of Maternal-Fetal & Neonatal Medicine 2021, 1 -5.
AMA StyleElena Cavaliere, Daniele Trevisanuto, Liviana Da Dalt, Giovanni Putoto, Damiano Pizzol, Arlindo Rosario Muhelo, Francesco Cavallin. Congenital malformations in neonates admitted to a neonatal intensive care unit in a low-resource setting. The Journal of Maternal-Fetal & Neonatal Medicine. 2021; ():1-5.
Chicago/Turabian StyleElena Cavaliere; Daniele Trevisanuto; Liviana Da Dalt; Giovanni Putoto; Damiano Pizzol; Arlindo Rosario Muhelo; Francesco Cavallin. 2021. "Congenital malformations in neonates admitted to a neonatal intensive care unit in a low-resource setting." The Journal of Maternal-Fetal & Neonatal Medicine , no. : 1-5.
Meconium aspiration syndrome is a clinical condition characterized by respiratory failure occurring in neonates born through meconium-stained amniotic fluid. Worldwide, the incidence has declined in developed countries thanks to improved obstetric practices and perinatal care while challenges persist in developing countries. Despite the improved survival rate over the last decades, long-term morbidity among survivors remains a major concern. Since the 1960s, relevant changes have occurred in the perinatal and postnatal management of such patients but the most appropriate approach is still a matter of debate. This review offers an updated overview of the epidemiology, etiopathogenesis, diagnosis, management and prognosis of infants with meconium aspiration syndrome.
Chiara Monfredini; Francesco Cavallin; Paolo Villani; Giuseppe Paterlini; Benedetta Allais; Daniele Trevisanuto. Meconium Aspiration Syndrome: A Narrative Review. Children 2021, 8, 230 .
AMA StyleChiara Monfredini, Francesco Cavallin, Paolo Villani, Giuseppe Paterlini, Benedetta Allais, Daniele Trevisanuto. Meconium Aspiration Syndrome: A Narrative Review. Children. 2021; 8 (3):230.
Chicago/Turabian StyleChiara Monfredini; Francesco Cavallin; Paolo Villani; Giuseppe Paterlini; Benedetta Allais; Daniele Trevisanuto. 2021. "Meconium Aspiration Syndrome: A Narrative Review." Children 8, no. 3: 230.
Background The thermal servo-controlled systems are routinely used in neonatal intensive care units (NICUs) to accurately manage patient temperature, but their role during the immediate postnatal phase has not been previously assessed. Objective To compare two modalities of thermal management (with and without the use of a servo-controlled system) immediately after birth. Study design and setting Multicentre, unblinded, randomised trial conducted 15 Italian tertiary hospitals. Participants Infants with estimated birth weight +6 weeks. Intervention Thermal management with or without a thermal servo-controlled system during stabilisation in the delivery room. Primary outcome Proportion of normothermia at NICU admission (axillary temperature 36.5°C–37.5°C). Results At NICU admission, normothermia was achieved in 89/225 neonates (39.6%) with the thermal servo-controlled system and 95/225 neonates (42.2%) without the thermal servo-controlled system (risk ratio 0.94, 95% CI 0.75 to 1.17). Thermal servo-controlled system was associated with increased mild hypothermia (36°C–36.4°C) (risk ratio 1.48, 95% CI 1.09 to 2.01). Conclusions In very low birthweight infants, thermal management with the servo-controlled system conferred no advantage in maintaining normothermia at NICU admission, while it was associated with increased mild hypothermia. Thermal management of preterm infants immediately after birth remains a challenge. Trial registration number NCT03844204
Francesco Cavallin; Nicoletta Doglioni; Alessandra Allodi; Nadia Battajon; Stefania Vedovato; Letizia Capasso; Eloisa Gitto; Nicola Laforgia; Giulia Paviotti; Maria Grazia Capretti; Camilla Gizzi; Paolo Ernesto Villani; Paolo Biban; Simone Pratesi; Gianluca Lista; Fabrizio Ciralli; Massimo Soffiati; Alex Staffler; Eugenio Baraldi; Daniele Trevisanuto. Thermal management with and without servo-controlled system in preterm infants immediately after birth: a multicentre, randomised controlled study. Archives of Disease in Childhood - Fetal and Neonatal Edition 2021, 1 -2020.
AMA StyleFrancesco Cavallin, Nicoletta Doglioni, Alessandra Allodi, Nadia Battajon, Stefania Vedovato, Letizia Capasso, Eloisa Gitto, Nicola Laforgia, Giulia Paviotti, Maria Grazia Capretti, Camilla Gizzi, Paolo Ernesto Villani, Paolo Biban, Simone Pratesi, Gianluca Lista, Fabrizio Ciralli, Massimo Soffiati, Alex Staffler, Eugenio Baraldi, Daniele Trevisanuto. Thermal management with and without servo-controlled system in preterm infants immediately after birth: a multicentre, randomised controlled study. Archives of Disease in Childhood - Fetal and Neonatal Edition. 2021; ():1-2020.
Chicago/Turabian StyleFrancesco Cavallin; Nicoletta Doglioni; Alessandra Allodi; Nadia Battajon; Stefania Vedovato; Letizia Capasso; Eloisa Gitto; Nicola Laforgia; Giulia Paviotti; Maria Grazia Capretti; Camilla Gizzi; Paolo Ernesto Villani; Paolo Biban; Simone Pratesi; Gianluca Lista; Fabrizio Ciralli; Massimo Soffiati; Alex Staffler; Eugenio Baraldi; Daniele Trevisanuto. 2021. "Thermal management with and without servo-controlled system in preterm infants immediately after birth: a multicentre, randomised controlled study." Archives of Disease in Childhood - Fetal and Neonatal Edition , no. : 1-2020.
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.
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 StyleDaniele 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 StyleDaniele 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.
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.
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 StyleAlfonso 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 StyleAlfonso 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.
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.
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 StyleMassimo 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 StyleMassimo 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.
Both neonatal hypothermia and hyperthermia represent important risk factors for neonatal mortality, but information on mortality risk across a full range of neonatal temperatures is lacking in low-resource settings. We evaluated the association between neonatal mortality and a full range of admission temperatures in a low-resource setting. This retrospective observational study was conducted at Beira Central Hospital, Mozambique. The relationship between admission temperature and mortality was evaluated using multivariable analyses with temperature modeled as non-linear term. Among 2098 neonates admitted to the Special Care Unit between January–December 2017, admission temperature was available in 1344 neonates (64%) who were included in the analysis. A non-linear association between mortality rate and temperature was identified. Mortality rate decreased from 84% at 32 °C to 64% at 34.6 °C (− 8% per °C), to 41% at 36 °C (− 16% per °C), to 26% to 36.6 °C (− 25% per °C) and to 22% at 38.3 °C (− 2% per °C), then increased to 40% at 41 °C (+ 7% per °C). Mortality rate was estimated to be at minimum at admission temperature of 37.5 °C. In conclusions, the non-linear relationship highlighted different mortality risks across a full range of neonatal temperatures in a low-resource setting. Admission temperature was not recorded in one third of neonates.
Francesco Cavallin; Serena Calgaro; Valentina Brugnolaro; Olivier Manzungu Wingi; Arlindo Rosario Muhelo; Liviana Da Dalt; Damiano Pizzol; Giovanni Putoto; Daniele Trevisanuto. Non-linear association between admission temperature and neonatal mortality in a low-resource setting. Scientific Reports 2020, 10, 1 -8.
AMA StyleFrancesco Cavallin, Serena Calgaro, Valentina Brugnolaro, Olivier Manzungu Wingi, Arlindo Rosario Muhelo, Liviana Da Dalt, Damiano Pizzol, Giovanni Putoto, Daniele Trevisanuto. Non-linear association between admission temperature and neonatal mortality in a low-resource setting. Scientific Reports. 2020; 10 (1):1-8.
Chicago/Turabian StyleFrancesco Cavallin; Serena Calgaro; Valentina Brugnolaro; Olivier Manzungu Wingi; Arlindo Rosario Muhelo; Liviana Da Dalt; Damiano Pizzol; Giovanni Putoto; Daniele Trevisanuto. 2020. "Non-linear association between admission temperature and neonatal mortality in a low-resource setting." Scientific Reports 10, no. 1: 1-8.
Background Although under-5 mortality has decreased in the last two decades, neonatal mortality remains a global health challenge. Despite achieving notable progress, Ethiopia has still one of the highest neonatal mortality rates worldwide. We aimed to assess the risk factors for mortality among neonates admitted to a special care unit in a referral hospital in rural Ethiopia. Methods This was a retrospective observational study including all 4182 neonates admitted to the special care unit of the St. Luke Wolisso Hospital (Ethiopia) from January 2014 to December 2017. Data were retrieved from hospital charts and entered in an anonymized dataset. A logistic regression model was applied to identify predictors of mortality and effect sizes were expressed as odds ratios with 95% confidence intervals. Results Proportion of deaths was 17% (709/4182 neonates). Neonates referred from other health facilities or home (odds ratio 1.52, 95% confidence interval 1.21 to 1.91), moderate hypothermia at admission (odds ratio 1.53, 95% confidence interval 1.09 to 2.15) and diagnosis of late-onset sepsis (odds ratio 1.63, 95% confidence interval 1.12 to 2.36), low birthweight (odds ratio 2.48, 95% confidence interval 2.00 to 3.09), very low birthweight (odds ratio 11.71, 95% confidence interval 8.63 to 15.94), extremely low birthweight (odds ratio 76.04, 95% confidence interval 28.54 to 263.82), intrapartum-related complications (odds ratio 4.69, 95% confidence interval 3.55 to 6.20), meconium aspiration syndrome (odds ratio 2.34, 95% confidence interval 1.15 to 4.43), respiratory distress (odds ratio 2.25, 95% confidence interval 1.72 to 2.95), other infections (odds ratio 1.92, 95% confidence interval 1.31 to 2.81) or malformations (odds ratio 2.32, 95% confidence interval 1.49 to 3.57) were associated with increased mortality. Being admitted in 2017 vs. 2014 (odds ratio 0.71, 95% confidence interval 0.52 to 0.97), and older age at admission (odds ratio 0.95, 95% confidence interval 0.93 to 0.97) were associated with decreased likelihood of mortality. Conclusions The majority of neonatal deaths was associated with preventable and treatable conditions. Education on neonatal resuscitation and postnatal management, and the introduction of an on-call doctor for high-risk deliveries might have contributed to the reduction in neonatal mortality over time.
Francesco Cavallin; Teresa Bonasia; Desalegn Abebe Yimer; Fabio Manenti; Giovanni Putoto; Daniele Trevisanuto. Risk factors for mortality among neonates admitted to a special care unit in a low-resource setting. BMC Pregnancy and Childbirth 2020, 20, 1 -8.
AMA StyleFrancesco Cavallin, Teresa Bonasia, Desalegn Abebe Yimer, Fabio Manenti, Giovanni Putoto, Daniele Trevisanuto. Risk factors for mortality among neonates admitted to a special care unit in a low-resource setting. BMC Pregnancy and Childbirth. 2020; 20 (1):1-8.
Chicago/Turabian StyleFrancesco Cavallin; Teresa Bonasia; Desalegn Abebe Yimer; Fabio Manenti; Giovanni Putoto; Daniele Trevisanuto. 2020. "Risk factors for mortality among neonates admitted to a special care unit in a low-resource setting." BMC Pregnancy and Childbirth 20, no. 1: 1-8.
Background Thermal control after birth is an essential part of neonatal care. However, the relationship between neonatal temperature at and after admission is unknown. This study aimed to evaluate the change between neonatal temperature at admission and at day 1, and its impact on mortality. Methods Retrospective observational study at the Beira Central Hospital, Mozambique. Axillary temperatures were recorded at admission and at day 1 in 1,226 neonates who were admitted to the Special Care Unit between January 1 and December 31, 2017. The relationship between mortality rate and temperature change was evaluated with a matrix plot and a forest plot (obtained from a logistic regression model as odds ratios with 95% confidence intervals). Results Normothermia was found in 415 neonates (33.8%) at admission and in 638 neonates (52.0%) at day 1. Mortality rate was highest in (i) neonates who remained in severe/moderate hypothermia (74%), (ii) neonates who rewarmed from hypothermia (40–55%), and (iii) neonates who chilled to severe/moderate hypothermia (38–43%). Multivariable analysis confirmed that temperature change from admission to day 1 was an independent predictor of mortality (p < 0.0001). Conclusions In a low-resource setting, one out of three neonates was found hypothermic at day 1 irrespectively of admission temperature. Relevant thermal deviations occurred in a high proportion of newborns with normothermia at admission. Being cold at admission and becoming cold or hyperthermic at day 1 were associated with increased likelihood of mortality. Appropriate actions to prevent both hypothermia and hyperthermia represent both a challenge and a priority during postnatal period.
Francesco Cavallin; Serena Calgaro; Valentina Brugnolaro; Amir Hussein Abubacar Seni; Arlindo Rosario Muhelo; Liviana Da Dalt; Giovanni Putoto; Daniele Trevisanuto. Impact of temperature change from admission to day one on neonatal mortality in a low-resource setting. BMC Pregnancy and Childbirth 2020, 20, 1 -8.
AMA StyleFrancesco Cavallin, Serena Calgaro, Valentina Brugnolaro, Amir Hussein Abubacar Seni, Arlindo Rosario Muhelo, Liviana Da Dalt, Giovanni Putoto, Daniele Trevisanuto. Impact of temperature change from admission to day one on neonatal mortality in a low-resource setting. BMC Pregnancy and Childbirth. 2020; 20 (1):1-8.
Chicago/Turabian StyleFrancesco Cavallin; Serena Calgaro; Valentina Brugnolaro; Amir Hussein Abubacar Seni; Arlindo Rosario Muhelo; Liviana Da Dalt; Giovanni Putoto; Daniele Trevisanuto. 2020. "Impact of temperature change from admission to day one on neonatal mortality in a low-resource setting." BMC Pregnancy and Childbirth 20, no. 1: 1-8.
Objective To summarise currently reported neonatal cases of SARS-CoV-2 infection. Methods A search strategy was designed to retrieve all articles published from 1 December 2019 to 12 May 2020, by combining the terms ‘coronavirus’ OR ‘covid’ OR ‘SARS-CoV-2’) AND (‘neonat*’ OR ‘newborn’) in the following electronic databases: MEDLINE/Pubmed, Scopus, Web of Science, MedRxiv, the Cochrane Database of Systematic Review and the WHO COVID-19 database, with no language restrictions. Quality of studies was evaluated by using a specific tool for assessment of case reports and/or case series. Results Twenty-six observational studies (18 case reports and 8 case series) with 44 newborns with confirmed SARS-CoV-2 infection were included in the final analysis. Studies were mainly from China and Italy. Half of neonates had a documented contact with the infected mother and one out of three infected neonates was admitted from home. Median age at diagnosis was 5 days. One out of four neonates was asymptomatic, and the remaining showed mild symptoms typical of acute respiratory infections and/or gastrointestinal symptoms. The majority of neonates were left in spontaneous breathing (room air) and had good prognosis after a median duration of hospitalisation of 10 days. Conclusions Most neonates with SARS-CoV-2 infection were asymptomatic or presented mild symptoms, generally were left in spontaneous breathing and had a good prognosis after median 10 days of hospitalisation. Large epidemiological and clinical cohort studies, as well as the implementation of collaborative networks, are needed to improve the understanding of the impact of SARS-CoV-2 infection in neonates.
Daniele Trevisanuto; Francesco Cavallin; Maria Elena Cavicchiolo; Martina Borellini; Serena Calgaro; Eugenio Baraldi. Coronavirus infection in neonates: a systematic review. Archives of Disease in Childhood - Fetal and Neonatal Edition 2020, 106, 330 -335.
AMA StyleDaniele Trevisanuto, Francesco Cavallin, Maria Elena Cavicchiolo, Martina Borellini, Serena Calgaro, Eugenio Baraldi. Coronavirus infection in neonates: a systematic review. Archives of Disease in Childhood - Fetal and Neonatal Edition. 2020; 106 (3):330-335.
Chicago/Turabian StyleDaniele Trevisanuto; Francesco Cavallin; Maria Elena Cavicchiolo; Martina Borellini; Serena Calgaro; Eugenio Baraldi. 2020. "Coronavirus infection in neonates: a systematic review." Archives of Disease in Childhood - Fetal and Neonatal Edition 106, no. 3: 330-335.
Tracheal suctioning in non-vigorous newborn delivered through meconium-stained amniotic fluid (MSAF) is supposed to delay initiation of positive pressure ventilation (PPV), but the magnitude of such delay is unknown. To compare the time of PPV initiation when performing immediate laryngoscopy with intubation and suctioning vs. performing immediate PPV without intubation in a manikin model. Randomized controlled crossover (AB/BA) trial comparing PPV initiation with or without endotracheal suctioning in a manikin model of non-vigorous neonates born through MSAF. Participants were 20 neonatologists and 20 pediatric residents trained in advanced airway management. Timing of PPV initiation was longer with vs. without endotracheal suctioning in both pediatric residents (mean difference 13 s, 95% confidence interval 8 to 18 s; p < 0.0001) and neonatologists (mean difference 12 s, 95% confidence interval 8 to 16 s; p < 0.0001). The difference in timing of PPV initiation was similar between pediatric residents and neonatologists (mean difference − 1 s, 95% confidence interval − 7 to 6 s; p = 0.85).Conclusions: Performing immediate laryngoscopy with intubation and suctioning was associated with longer—but not clinically relevant—time of initiation of PPV compared with immediate PPV without intubation in a manikin model. While suggesting negligible delay in starting PPV, further studies in a clinical setting are warranted.Registration: clinicaltrial.gov NCT04076189. What is Known:• Management of the non-vigorous newborn delivered through meconium-stained amniotic fluid remains still controversial.• Tracheal suctioning in non-vigorous newborn delivered through meconium-stained amniotic fluid is supposed to delay initiation of positive pressure ventilation, but the magnitude of such delay is unknown.What is New:• Performing immediate ventilation without intubation was associated with shorter—but not clinically relevant—time of initiation of ventilation compared to immediate laryngoscopy with intubation and suctioning in a manikin model.• Further studies in a clinical setting are warranted.
Francesco Cavallin; Giulia Res; Chiara Monfredini; Nicoletta Doglioni; Paolo Ernesto Villani; Gary Weiner; Daniele Trevisanuto. Time needed to intubate and suction a manikin prior to instituting positive pressure ventilation: a simulation trial. European Journal of Pediatrics 2020, 180, 247 -252.
AMA StyleFrancesco Cavallin, Giulia Res, Chiara Monfredini, Nicoletta Doglioni, Paolo Ernesto Villani, Gary Weiner, Daniele Trevisanuto. Time needed to intubate and suction a manikin prior to instituting positive pressure ventilation: a simulation trial. European Journal of Pediatrics. 2020; 180 (1):247-252.
Chicago/Turabian StyleFrancesco Cavallin; Giulia Res; Chiara Monfredini; Nicoletta Doglioni; Paolo Ernesto Villani; Gary Weiner; Daniele Trevisanuto. 2020. "Time needed to intubate and suction a manikin prior to instituting positive pressure ventilation: a simulation trial." European Journal of Pediatrics 180, no. 1: 247-252.
Aim To evaluate the relationship between clinical assessment of infant colour and oxygen saturation at birth in a low‐resource setting. Methods Classification of infant colour (cyanotic, pink or unclear) by midwives was compared to pulse‐oximeter data at 60‐90‐120‐300 seconds after birth in 60 neonates. Results Overall, oxygen saturation increased over time (P < .0001) and was different according to infant colour (P < .0001). Median oxygen saturation in pink infants was 87% at 60 seconds (n = 1), 90% (IQR 83‐91) at 90 seconds (n = 5), 86% (IQR 81‐94) at 120 seconds (n = 11) and 93% (IQR 90‐96) at 300 seconds (n = 20). Median oxygen saturation in cyanotic infants was 60% (IQR 45‐70) at 60 seconds (n = 52), 64% (IQR 52‐69) at 90 seconds (n = 42), 63% (IQR 56‐68) at 120 seconds (n = 35) and 66% (IQR 62‐74) at 300 seconds (n = 22). Median oxygen saturation in unclear‐coloured infants was 57% (IQR 56‐60) at 60 seconds (n = 7), 78% (IQR 71‐81) at 90 seconds (n = 13), 81% (IQR 79‐88) at 120 seconds (n = 14) and 80% (IQR 76‐84) at 300 seconds (n = 18). The proportion of infants with unclear colour ranged from 12% to 30%. Conclusion The variability of oxygen saturation among pink and cyanotic infants, and the substantial proportion of unclear infant colour, suggest the possible benefit of the availability of pulse oximetry in low‐resource settings.
Francesco Cavallin; Maria Sofia Cori; Senait Negash; Gaetano Azzimonti; Fabio Manenti; Giovanni Putoto; Daniele Trevisanuto. Limited agreement between clinical assessment of infant colour at birth and oxygen saturation in a hospital in Ethiopia. Acta Paediatrica 2020, 110, 68 -71.
AMA StyleFrancesco Cavallin, Maria Sofia Cori, Senait Negash, Gaetano Azzimonti, Fabio Manenti, Giovanni Putoto, Daniele Trevisanuto. Limited agreement between clinical assessment of infant colour at birth and oxygen saturation in a hospital in Ethiopia. Acta Paediatrica. 2020; 110 (1):68-71.
Chicago/Turabian StyleFrancesco Cavallin; Maria Sofia Cori; Senait Negash; Gaetano Azzimonti; Fabio Manenti; Giovanni Putoto; Daniele Trevisanuto. 2020. "Limited agreement between clinical assessment of infant colour at birth and oxygen saturation in a hospital in Ethiopia." Acta Paediatrica 110, no. 1: 68-71.
The coronavirus disease (COVID-19) epidemic started in the Hubei province of China, but is rapidly spreading all over the world. Much of the information and literature have been centered on the adult population while a few reports pertaining to COVID-19 and neonates have been published so far. Actual guidelines are based on expert opinion and show significant differences among the official neonatal societies around the world. Recommendations for the care of neonates born to suspected or confirmed COVD-19 positive mothers in low-resource settings are very limited. This perspective aims to provide practical support for the planning of delivery, resuscitating, stabilizing, and providing postnatal care to an infant born to a mother with suspected or confirmed COVID-19 in low-resource settings where resources for managing emergency situations are limited.
Daniele Trevisanuto; Gary Weiner; SatyaN Lakshminrusimha; Gaetano Azzimonti; John Bosco Nsubuga; Sithembiso Velaphi; Amir Hussein Abubacar Seni; Thorkild Tylleskär; Giovanni Putoto. Management of mothers and neonates in low resources setting during covid-19 pandemia. The Journal of Maternal-Fetal & Neonatal Medicine 2020, 1 -12.
AMA StyleDaniele Trevisanuto, Gary Weiner, SatyaN Lakshminrusimha, Gaetano Azzimonti, John Bosco Nsubuga, Sithembiso Velaphi, Amir Hussein Abubacar Seni, Thorkild Tylleskär, Giovanni Putoto. Management of mothers and neonates in low resources setting during covid-19 pandemia. The Journal of Maternal-Fetal & Neonatal Medicine. 2020; ():1-12.
Chicago/Turabian StyleDaniele Trevisanuto; Gary Weiner; SatyaN Lakshminrusimha; Gaetano Azzimonti; John Bosco Nsubuga; Sithembiso Velaphi; Amir Hussein Abubacar Seni; Thorkild Tylleskär; Giovanni Putoto. 2020. "Management of mothers and neonates in low resources setting during covid-19 pandemia." The Journal of Maternal-Fetal & Neonatal Medicine , no. : 1-12.
Francesco Cavallin; Shaimaa Abuelnoor Ahmed Abdelghany; Serena Calgaro; Amir Hussein Abubacar Seni; Bonifacio Rodriguez Cebola; Giovanni Putoto; Daniele Trevisanuto. Suctioning at birth showed low adherence to official recommendations in a low‐resource setting. Acta Paediatrica 2020, 110, 117 -118.
AMA StyleFrancesco Cavallin, Shaimaa Abuelnoor Ahmed Abdelghany, Serena Calgaro, Amir Hussein Abubacar Seni, Bonifacio Rodriguez Cebola, Giovanni Putoto, Daniele Trevisanuto. Suctioning at birth showed low adherence to official recommendations in a low‐resource setting. Acta Paediatrica. 2020; 110 (1):117-118.
Chicago/Turabian StyleFrancesco Cavallin; Shaimaa Abuelnoor Ahmed Abdelghany; Serena Calgaro; Amir Hussein Abubacar Seni; Bonifacio Rodriguez Cebola; Giovanni Putoto; Daniele Trevisanuto. 2020. "Suctioning at birth showed low adherence to official recommendations in a low‐resource setting." Acta Paediatrica 110, no. 1: 117-118.