• IEIE Transactions on Smart Processing and Computing
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• 제5권2호
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• pp.107-116
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• 2016

Premature babies of less than 37 weeks gestation might require oxygen therapy as an integral part of treatment and respiratory support. Because of their under-developed lungs, these so-called "preemies" might contract respiratory distress syndrome (RDS). To treat RDS, neonatal oxygen therapy is administered, where controlled oxygen gas is measured as a fraction of inspired oxygen ($FiO_2$). However, exposure to high oxygen content during long treatment could cause oxygen intoxication, which might cause permanent blindness due to retinopathy of prematurity (ROP), whereas insufficient oxygen exposure could cause severe hypoxia. A doctor would use oxygen saturation ($SpO_2$) data and prescribe a dose of $FiO_2$ to maintain $SpO_2$ within a suitable range. One objective is to maintain $SpO_2$ within the acceptable range using $FiO_2$ that is as low as possible. Adjustment of $FiO_2$ would normally be done by nurses every 15 to 30 minutes, which might not be safe in many situations. An error in $FiO_2$ adjustment during a manual procedure could be as large as +/- 2.5%. This paper presents a system that can determine an $FiO_2$ value suitable to the current $SpO_2$ and that automatically adjusts $FiO_2$ with an error clearance of +/- 0.25%.

• Neonatal Medicine
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• 제16권2호
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• pp.101-109
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• 2009

Pulmonary surfactant (PS) therapy in premature infants has a remarkable impact on improving survival and outcomes in neonatal respiratory distress syndrome (RDS). Early PS therapy involves instillation of PS upon delivery of very premature infants or if there is evidence of RDS, such as an increased requirement of oxygen 2 hours after birth, especially in infants <30 weeks gestation. Early PS treatment in very premature infants results in a significant reduction in the severity of RDS, mortality, and incidence of pneumothorax, pulmonary interstitial emphysema, and bronchopulmonary dysplasia in comparison with late PS treatment. According to European and American consensus guidelines on the management of neonatal RDS, early PS instillation should be considered for infants <30 weeks gestation, infants with a birth weight <1,250 g, or if the mother has not received antepartum corticosteroids. We suggest that the Korean health insurance policy on RDS be modified so that PS can be used for better clinical outcomes of very premature infants.

• Journal of Chest Surgery
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• 제28권12호
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• pp.1132-1138
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• 1995

From 1991 to 1994, we experienced 24 cases of neonatal pneumothorax who were admitted to the Neonatal Intensive Care Unit[NICU , Chosun University Hospital. The Following results were obtained.1 The incidence of neonatal pneumothorax was 0.70%, and there were 8 spontaneous pneumothoraces and 16 secondary pneumothoraces. 2 The clinical manifestation of neonatal pneumothorax was as followed. Male infant was dominant[M:F=2:1 , the onset was within 24 hours in the majority[83% , and the right side[62% was more frequent than the left side. The gestation duration and birth weight show no correlation with underlying neonatal pneumothorax. The pulmonary diseases were meconium aspiration syndrome and hyaline membrane disease, and the incidence of those was 58%. Meconium aspiration syndrome occurred earlier than hyaline membrane disease. Symptoms and signs were tachypnea[46% , cyanosis[21% , irritability[13% , chest retraction[8% and apnea[8% .3 The treatments performed were oxygen therapy[17% , thoracentesis[4% and closed thoracostomy with underwater seal drainage[79% . The Mean duration of air leakage was 11.7 hours, and the mean drainage time was 4.35$\pm$1.3day. 4 The overall hospital mortality was 33%, and the rate of complication was 46%. The complications were metabolic acidosis, atelectasis, pleural effusion, pulmonary hemorrhage and pneumonia. We concluded that the prognosis was related to the underlying pulmonary disease.

• Neonatal Medicine
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• 제28권1호
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• pp.1-6
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• 2021

Persistent pulmonary hypertension of the newborn (PPHN) is a consequence of the failure of a decrease in the elevated pulmonary vascular resistance after birth. Pulmonary vasodilators, including inhaled nitric oxide (iNO), have been the mainstream of targeted therapy for PPHN, but no drugs have been proven to be effective in preterm infants with PPHN. The fetus remains hemodynamically stable despite lower arterial oxygen tension and pulmonary blood flow as compared to full-term newborns. This adaptation is due to the lower oxygen requirement and high oxygen-carrying capacity of fetal circulation. The immature lungs of preterm infants are more vulnerable to reactive oxygen species, and the response of pulmonary vascular dilatation to blood oxygen tension is blunted in preterm infants. Recently, iNO has been reported to be effective in a selected group of preterm infants, such as those with prolonged preterm rupture of membrane-oligohydramnios-pulmonary hypoplasia sequence. PPHN in preterm infants, along with maximum supportive treatment based on fetal physiology and meticulous assessment of cardiovascular function, is in dire need of new treatment guidelines, including optimal dosing strategies for pulmonary vasodilators.

• Neonatal Medicine
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• 제25권2호
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• pp.66-71
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• 2018

Purpose: Respiratory morbidity is the most common problem among neonates admitted to neonatal intensive care units. Therefore, the aim of this study was to make a differential diagnosis between transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), and pneumonia through comparison of clinical features and test results. Methods: This retrospective study was conducted in 86 infants with TTN, RDS, or pneumonia. These were infants who had respiratory distress, were born after ${\geq}34$ weeks of gestation, and transferred to the neonatal intensive care unit of Kosin University Gospel Hospital between June 1, 2011 and June 30, 2016. Results: The numbers (percentage) of infants with TTN, RDS, and pneumonia were 51 (59.3%), 20 (23.3%), and 15 (17.4%), respectively. Late-preterm and early-term newborns accounted for 65.1% of the infants. Tachypnea was observed in 74.4% of the neonates. The median age at admission was 4 hours (0 to 116) after birth. The infants with RDS had significantly lower birth weights, pH levels, base excess and oxygen saturation levels at admission, longer duration of total ventilator therapy, and hospital stay than those in the other two groups. The infants with pneumonia showed significantly high initial high-sensitivity C-reactive protein levels and significant chest radiographic findings. Conclusion: Early differential diagnosis for TTN, RDS, and pneumonia is challenging because they show similar respiratory symptoms at an early stage. Clinical features and test results can be used to determine the etiology of respiratory distress and early antibiotic treatment.

• Neonatal Medicine
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• 제25권4호
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• pp.144-152
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• 2018

Purpose: The aim of this study was to investigate the clinical characteristics of Respiratory syncytial virus (RSV) infection during the neonatal period to provide information that is useful in clinical practice and suggest extension of the palivizumab administration. Methods: Neonates admitted to the National Health Insurance Service Ilsan Hospital neonatal intensive care unit due to respiratory symptoms and for whom multiplex reverse transcription-polymerase chain reaction and multiplex real time-polymerase chain reaction tests were performed between October 2011 and May 2016 were included in this study. Medical records were retrospectively reviewed, and data was collected for 156 neonates. Results: Among the 156 neonates, RSV was detected in 114 (73.1%), non-RSV in 25 (16%), and no virus in 17 (10.9%). The majority were full term infants (92.4%) and peak incidence of RSV infection was in January. Post-natal care center infection was more common in the RSV group (46.6%) than that in the other virus groups (24%, P=0.0243). Clinical symptoms were severe in the RSV group in contrast to that in the non-RSV or others groups. The RSV group frequently needed oxygen therapy (P=0.0001) and the duration of hospital stays were longer (P=0.0001). Conclusion: RSV is a significant cause of respiratory infection in neonates and the severity is higher in contrast to that with other viral causes of infection. Infants in post-natal care centers have a high-risk of developing RSV infections; therefore, palivizumab administration may be considered in this group to prevent hospitalization and reduce the duration of hospital stay.

• International Journal of Molecular Medicine
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• 제44권5호
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• pp.1641-1652
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• 2019

Conditioned media from various sources comprise numerous growth factors and cytokines and are known to promote the regeneration of damaged tissues. Among these, natural killer cell conditioned medium (NK-CdM) has been shown to stimulate collagen synthesis and the migration of fibroblasts during the wound healing process. With a long-term aim of developing a treatment for skin photoaging, the ability of NK-CdM to prevent ultraviolet-B (UV-B) damage was assessed in neonatal human dermal fibroblasts (NHDFs) and an in vitro reconstructed skin model. The factors present in NK-CdM were profiled using an antibody array analysis. Protein and mRNA levels in UV-B exposed NHDFs treated with NK-CdM were measured by western blotting and quantitative reverse transcription-PCR, respectively. The total antioxidant capacity of NK-CdM was determined to assess its ability to suppress reactive oxygen species. The anti-photoaging effect of NK-CdM was also assessed in a 3D reconstituted human full skin model. NK-CdM induced proliferation of UV-B-treated NHDFs, increased procollagen expression, and decreased matrix metalloproteinase (MMP)-1 expression. NK-CdM also exhibited a potent antioxidant activity as measured by the total antioxidant capacity. NK-CdM inhibited UV-B-induced collagen degradation by inactivating MAPK signaling. NK-CdM also elicited potential anti-wrinkle effects by inhibiting the UV-B-induced increase in MMP-1 expression levels in a 3D reconstituted human full skin model. Taken together, the suppression of both UV-B-induced MMP-1 expression and JNK activation by NK-CdM suggests NK-CdM as a possible candidate anti-skin aging agent.

• Neonatal Medicine
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• 제18권2호
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• pp.189-196
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• 2011

목적: 최근 폐표면활성제는 태변흡인증후군 환자에서 호흡곤란을 호전시키기 위한 치료 중 하나로 사용되고 있다. 본 연구에서는 태변흡인증후군에서 폐표면활성제가 치료결과로서 호흡기지표에 미치는 영향을 살펴보았다. 방법: MEDLINE, EMBASE, CENTRAL 등의 주요 데이터베이스 및 초록 등을 검색하여 2011년 6월까지 보고된 관련 무작위 배정연구를 선별하였다. OI 또는 a/A $PO_2$와 같은 호흡기 지표를 포함한 자료를 추출하여 폐표면활성제 보충요법과 폐표면활성제 세정요법 각각에 대해 메타분석을 수행하였다. 비뚤림 위험 및 임상적, 통계적 이질성을 평가하였다. 결과: 두 건의 폐표면활성제 보충요법 연구와 두 건의 폐표면 활성제 세정요법 연구가 분석에 포함되었다. 폐표면활성제 보충요법의 경우 OI에서는 두 연구 결과 사이의 이질성이 큰 반면, a/A $PO_2$에서는 보충요법 후 시간이 경과할 수록 군 간의 차이가 유의하게 나타났다(12시간째 WMD 0.08, 95% CI 0.04, 0.12; 24시간째 WMD 0.17, 95% CI 0.06, 0.28). 폐표면활성제 세정요법의 경우 통합하여 분석하였을 때 치료군이 대조군에 비해 임상 경과가 좋은 경향을 보였으나 통계적인 유의성은 확보하지는 못하였다. 결론: 태변흡인증후군에서 폐표면활성제 사용은 임상경과를 호전시키는 것으로 보인다. 기존의 연구수가 제한되어 있고 대상환자의 중증도 및 폐표면활성제 투여방법 또한 서로 다르므로 추가적인 연구를 통한 보충적인 근거가 도움이 될 것이다.

• Neonatal Medicine
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• 제15권2호
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• pp.142-151
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• 2008

목 적 : 신생아 호흡 곤란 증후군의 치료에 우리나라에서 널리 사용되고 있는 국내 제제인 Newfactan$^{(R)}$은 Surfacten$^{(R)}$과의 비교연구는 있었지만 다른 제제와의 비교연구는 그 동안 이루어지지 않았다. 이에 본 연구는 유럽에서 널리 사용되고 있는 돼지 폐에서 추출된 modified natural surfactants인 Curosurf$^{(R)}$와 Newfactan$^{(R)}$과의 치료효과를 비교하고자 본 연구를 실시 하게 되었다. 방 법 : 2004년 4월부터 2006년 12월까지 신생아 중환자실에 신생아 호흡 곤란 증후군으로 진단되어 폐 표면 활성제를 투여받았고 출생체중이 2,500 g 이하이면서 재태연령이 35주 이하인 신생아 중 주요 선천성 기형과 태변흡입 증후군이 있었던 경우를 제외한 65명을 대상으로 하였고 이들을 Curosurf$^{(R)}$를 투여 받은 군 31명과 Newfactan $^{(R)}$을 투여 받은 군 34명으로 나누어 두 제제를 사용한 환아들의 임상적 특성과 초기 투여 반응, 합병증을 의무기록을 토대로 분석하여 비교하였다. 결 과 : Curosurf$^{(R)}$ 투여군과 Newfactan$^{(R)}$ 투여군 사이에 출생체중, 재태 기간, 산모의 병력상 특징에서 두 군간에 차이는 없었고, 폐 표면활성제 투여 후의 호흡지표의 변화에서 두 군 모두 투여 2시간 후부터 의미 있는 호흡지표의 개선을 보였으나 두 군간에는 차이가 없었고, 폐 표면활성제를 재투여한 빈도와 입원기간 중에 사망률도 두 군 사이에 차이가 없었다. 장기 치료효과인 인공호흡기 사용기간, 산소 투여기간, 퇴원당시의 나이를 비교해 봤을 때 산소 투여기간이 Newfactan$^{(R)}$ 투여군에서 31.3${\pm}$21.2일, Curosurf$^{(R)}$ 투여군에서 24.6${\pm}$26.2일로 Newfactan$^{(R)}$ 투여군에서 산소 투여기간이 더 길었지만 통계적으로 유의하지는 않았다. 기흉, 폐출혈, 동맥관 개존, 뇌실내 출혈 등의 급성기 합병증은 두 군간에 차이가 없었으며, 기관지 폐 형성이상의 빈도는 Newfactan$^{(R)}$ 투여군이 35.5%, Curosurf$^{(R)}$ 투여군이 26.9%로 Newfactan $^{(R)}$ 투여군에서 약간 더 높은 경향을 나타내었지만 통계적으로 의미있는 차이는 아니었다. 미숙아 망막증, 뇌실주위 연화증, 괴사성 장염등의 장기 합병증의 발생에서도 두 군 사이에 의미있는 차이는 없었다. 결 론 : Newfactan$^{(R)}$ 과 Curosurf$^{(R)}$ 두 제제의 투여 후의 초기 치료반응 및 장기 투여효과, 급만성 합병증의 발생빈도에 있어서 유의한 차이를 보이지 않았다.

• Child Health Nursing Research
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• 제11권4호
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• pp.390-395
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• 2005

Purpose: To investigate the effects of a warm water-filled bag on body temperature, Oxygen demand, respiratory rate and blood sugar in high risk neonates. Method: The infants were assigned to two groups, 16 in the experimental and 20 in the control group. Infants in the experimental group was received $40{\~}42^{\circ}C$ warm water-filled bag therapy for 2 hours under radiant warmers. Infants in the control group were placed under the same kind of radiant warmers but without the warm water-filled bag. The following were measured every 30 minutes: rectal temperature, $O_2$ demand ($FiO_2$), and respiratory rate. Blood sugar was measured hourly. Result: Body temperatures increased significantly in the experimental group (P=0.0138), and there was a difference according to time (P=0.0001). Significant difference were found between the two groups fur $FiO_2$ (P=0.0180). There was no difference in respiratory rates between the two groups and rates according to time for the experimental group were also not significant (P=0.3569). No significant difference between two groups was found for blood sugar (P=0.2152), but there was a significant difference according to the times (P=0.0001). Conclusion: This results of this study indicate that a warm-filled bag is an effective means of resorting body temperature and reducing $O_2$ demand in high risk neonates.