The UK screening and treatment of retinopathy of prematurity (ROP) updated 2022 guidelines were developed by a multidisciplinary guideline development group from the Royal College of Paediatrics and Child Health and the Royal College of Ophthalmologists, following the standards of the National Institute for Health and Care Excellence. They were published on the websites of the Royal College of Paediatrics and Child Health and the Royal College of Ophthalmologists in March 2022, and formally published in Early Human Development in March 2023. The guidelines provide evidence-based recommendations for the screening and treatment of ROP. The most significant change in the 2022 updated version compared to the previous guidelines is the lowering of the gestational age screening criterion to below 31 weeks. The treatment section covers treatment indications, timing, methods, and follow-up visits of ROP. This article interprets the guidelines and compares them with ROP guidelines/consensus in China, providing a reference for domestic peers.
英国早产儿视网膜病变的筛查和治疗指南2022更新版由英国皇家儿科与儿童健康学院和皇家眼科学院的多学科指南制订小组按照英国国家卫生与临床优化研究所标准制订，于2022年3月发表在英国皇家儿科与儿童健康学院网站和皇家眼科学院网站，2023年3月在Early Human Development杂志正式发表。该指南对早产儿视网膜病变的筛查及治疗进行了循证推荐和建议。与更新前的指南相比，2022更新版最重要的变化是将胎龄筛查标准降至31周以下；治疗部分涵盖了早产儿视网膜病变的治疗适应证、时间、方法及随诊。该文对该指南进行解读并与国内早产儿视网膜病变指南/共识进行比较，为国内同行提供参考和借鉴。.

OBJECTIVE: This study examines the hypothesis that infant-driven oral feeding leads to earlier achievement of oral feeding and reduces the length of hospital stay compared with provider-driven oral feeding in premature infants METHODS: We used a retrospective chart review to compare 2 groups of premature infants born at ≤35 weeks of gestation. The control group (CG) received the Provider-Driven Oral Feeding model and the intervention group (IG) received the Infant-Driven Oral Feeding model. Postmenstrual age (PMA) upon achieving full oral feeding, PMA at first oral feeding, discharge weight, and length of hospital stay were compared between the groups.
RESULTS: There are 208 infants in CG and 170 infants in IG. Infants in IG were born, on average, at a lower gestational age and birth weight than infants in CG. The median PMA at full oral feeding of 35 2/7 weeks (interquartile range [IQR], 34 2/7-36 2/7) for IG is significantly lower than the median of 35 5/7 weeks (IQR, 35-36 5/7) for CG, P-value < 0.001. Median PMA at first oral feeding is 34 1/7 weeks for both groups. Median PMA at discharge was 36 6/7 weeks for both groups. Median discharge weights of 2509 g (IQR, 2175-2964) for IG and 2459 g (IQR, 2204-2762) for CG are not statistically different.
CONCLUSIONS: Implementation of the Infant-Driven Feeding guideline led to earlier achievement of full oral feeding by 3 days on average while maintaining the same discharge weight but did not lead to earlier hospital discharge.

Transfusion of red blood cells, platelets, and fresh frozen plasma in neonatal patients has not been well characterized in the literature, with guidelines varying greatly between institutions. However, anemia and thrombocytopenia are highly prevalent, especially in preterm neonates. When transfusing a neonatal patient, clinicians must take into consideration physiologic differences, gestational and postnatal age, congenital disorders, and maternal factors while weighing the risks and benefits of transfusion. This review of existing literature summarizes current evidence-based neonatal transfusion guidelines and highlights areas of current ongoing research and those in need of future studies.

Electroencephalography (EEG) of neonatal patients is amongst the most valuable diagnostic and prognostic tool. EEG recordings, acquired at the bedside of infants, evaluate brain function and the maturation of premature and extremely premature infants. Strict conditions of acquisition and interpretation must be respected to guarantee the quality of the EEG and ensure its safety for fragile children. This article provides guidance for EEG acquisition including: (1) the required equipment and devices, (2) the modalities of installation and asepsis precautions, and (3) the digital signal acquisition parameters to use during the recording. The fundamental role of a well-trained technician in supervising the EEG recording is emphasized. In parallel to the acquisition recommendations, we present a guideline for EEG interpretation and reporting. The successive steps of EEG interpretation, from reading the EEG to writing the report, are described. The complexity of the EEG signal in neonates makes artefact detection difficult. Thus, we provide an overview of certain characteristic artefacts and detail the methods for eliminating them.

This study presented the guidelines for the prevention and management of procedural pain management in Japan and investigated the impact of these guidelines on Japanese neonatal intensive care units (NICUs). The aim of this study was to investigate whether the published national guidelines influenced organizational factors that could lead to improved pain management and, if so, whether the number of units that perform pain assessments, the administration of local guidelines and collaboration among health care professionals had improved in the 5-year period from 2012 to 2017.
An anonymous questionnaire was sent to 106 Level 3 NICUs across Japan.
The response rate was 78% (81 units). In almost all cases, the implementation of organizational factors had increased. Forty-seven units (47%) reported that health care professionals collaborated in pain management, compared with 11 units (17.7%) in 2012. In addition, compliance with the guidelines for pain assessment improved over the 5-year period. Twenty-four units (30%) reported that they used a structured scale for pain measurement, compared with nine units (15%) in 2012.
The current study suggested that the national guidelines published in 2014 influenced the organizational factors that could lead to improved pain management in Japanese NICUs. The number of units that used a structured scale for pain measurement, the development of local guidelines, and collaboration among health care professionals increased over the 5-year period from 2012 to 2017.

OBJECTIVE: The objective of this systematic review and analysis was to answer the following question: What are the optimal treatment strategies for posthemorrhagic hydrocephalus (PHH) in premature infants?
METHODS: Both the US National Library of Medicine and the Cochrane Database of Systematic Reviews were queried using MeSH headings and key words relevant to PHH. Two hundred thirteen abstracts were reviewed, after which 98 full-text publications that met inclusion criteria that had been determined a priori were selected and reviewed.
RESULTS: Following a review process and an evidentiary analysis, 68 full-text articles were accepted for the evidentiary table and 30 publications were rejected. The evidentiary table was assembled linking recommendations to strength of evidence (Classes I-III).
CONCLUSIONS: There are 7 recommendations for the management of PHH in infants. Three recommendations reached Level I strength, which represents the highest degree of clinical certainty. There were two Level II and two Level III recommendations for the management of PHH. Recommendation Concerning Surgical Temporizing Measures: I. Ventricular access devices (VADs), external ventricular drains (EVDs), ventriculosubgaleal (VSG) shunts, or lumbar punctures (LPs) are treatment options in the management of PHH. Clinical judgment is required.
METHODS: Level II, moderate degree of clinical certainty. Recommendation Concerning Surgical Temporizing Measures: II. The evidence demonstrates that VSG shunts reduce the need for daily CSF aspiration compared with VADs.
METHODS: Level II, moderate degree of clinical certainty. Recommendation Concerning Routine Use of Serial Lumbar Puncture: The routine use of serial lumbar puncture is not recommended to reduce the need for shunt placement or to avoid the progression of hydrocephalus in premature infants.
METHODS: Level I, high clinical certainty. Recommendation Concerning Nonsurgical Temporizing Agents: I. Intraventricular thrombolytic agents including tissue plasminogen activator (tPA), urokinase, or streptokinase are not recommended as methods to reduce the need for shunt placement in premature infants with PHH.
METHODS: Level I, high clinical certainty. Recommendation Concerning Nonsurgical Temporizing Agents. II. Acetazolamide and furosemide are not recommended as methods to reduce the need for shunt placement in premature infants with PHH.
METHODS: Level I, high clinical certainty. Recommendation Concerning Timing of Shunt Placement: There is insufficient evidence to recommend a specific weight or CSF parameter to direct the timing of shunt placement in premature infants with PHH. Clinical judgment is required.
METHODS: Level III, unclear clinical certainty. Recommendation Concerning Endoscopic Third Ventriculostomy: There is insufficient evidence to recommend the use of endoscopic third ventriculostomy (ETV) in premature infants with posthemorrhagic hydrocephalus.
METHODS: Level III, unclear clinical certainty.

There are special challenges in implementing parenteral nutrition (PN) in paediatric patients, which arises from the wide range of patients, ranging from extremely premature infants up to teenagers weighing up to and over 100 kg, and their varying substrate requirements. Age and maturity-related changes of the metabolism and fluid and nutrient requirements must be taken into consideration along with the clinical situation during which PN is applied. The indication, the procedure as well as the intake of fluid and substrates are very different to that known in PN-practice in adult patients, e.g. the fluid, nutrient and energy needs of premature infants and newborns per kg body weight are markedly higher than of older paediatric and adult patients. Premature infants <35 weeks of pregnancy and most sick term infants usually require full or partial PN. In neonates the actual amount of PN administered must be calculated (not estimated). Enteral nutrition should be gradually introduced and should replace PN as quickly as possible in order to minimise any side-effects from exposure to PN. Inadequate substrate intake in early infancy can cause long-term detrimental effects in terms of metabolic programming of the risk of illness in later life. If energy and nutrient demands in children and adolescents cannot be met through enteral nutrition, partial or total PN should be considered within 7 days or less depending on the nutritional state and clinical conditions.