Drude Merete Fugelseth

• BJARKØ, LISA; Fugelseth, Drude Merete; Haugen, Guttorm Nils & Nestaas, Eirik (2024). Early postnatal transitional circulation in fetal growth restricted neonates. Early Human Development. ISSN 0378-3782. 201. doi: 10.1016/j.earlhumdev.2024.106170. Full text in Research Archive
• Dhariwal, Achal; Rajar, Polona; Silva, Gabriela Salvadori Da; Åmdal, Heidi Aarø; Berild, Dag & Saugstad, Ola Didrik [Show all 11 contributors for this article] (2024). Prolonged hospitalization signature and early antibiotic effects on the nasopharyngeal resistome in preterm infants. Nature Communications. 15(1). doi: 10.1038/s41467-024-50433-7. Full text in Research Archive Show summary

  Respiratory pathogens, commonly colonizing nasopharynx, are among the leading causes of death due to antimicrobial resistance. Yet, antibiotic resistance determinants within nasopharyngeal microbial communities remain poorly understood. In this prospective cohort study, we investigate the nasopharynx resistome development in preterm infants, assess early antibiotic impact on its trajectory, and explore its association with clinical covariates using shotgun metagenomics. Our findings reveal widespread nasopharyngeal carriage of antibiotic resistance genes (ARGs) with resistomes undergoing transient changes, including increased ARG diversity, abundance, and composition alterations due to early antibiotic exposure. ARGs associated with the critical nosocomial pathogen Serratia marcescens persist up to 8–10 months of age, representing a long-lasting hospitalization signature. The nasopharyngeal resistome strongly correlates with microbiome composition, with inter-individual differences and postnatal age explaining most of the variation. Our report on the collateral effects of antibiotics and prolonged hospitalization underscores the urgency of further studies focused on this relatively unexplored reservoir of pathogens and ARGs.

• Wendel, Kristina; Aas, Marlen Fossan; Gunnarsdottir, Gunnþórunn; Rossholt, Madelaine; Bratlie, Marianne & Nordvik, Tone [Show all 12 contributors for this article] (2023). Effect of arachidonic and docosahexaenoic acid supplementation on respiratory outcomes and neonatal morbidities in preterm infants. Clinical Nutrition. ISSN 0261-5614. 42(1), p. 22–28. doi: 10.1016/j.clnu.2022.11.012. Full text in Research Archive Show summary

  Background & aims Studies have suggested that supplementation with docosahexaenoic acid (DHA) to preterm infants might be associated with an increased risk of bronchopulmonary dysplasia (BPD). Our aim was to investigate the effect of enteral supplementation with arachidonic acid (ARA) and DHA on short-term respiratory outcomes and neonatal morbidities in very preterm infants. Methods This is a secondary analysis of data from the ImNuT (Immature, Nutrition Therapy) study, a randomized double blind clinical trial. Infants with gestational age less than 29 weeks were randomized to receive a daily enteral supplement with ARA 100 mg/kg and DHA 50 mg/kg (intervention) or medium chain triglycerides (MCT) oil (control), from second day of life to 36 weeks postmenstrual age. Study outcomes included duration of respiratory support, incidence of BPD and other major morbidities associated with preterm birth. Results 120 infants with mean (SD) gestational age 26.4 (1.7) weeks were randomized and allocated to either the intervention or control group. Supplementation with ARA and DHA led to a significant reduction in number of days with respiratory support (mean (95% CI) 63.4 (56.6–71.3) vs 80.6 (72.4–88.8); p = 0.03) and a lower oxygen demand (FiO2) (mean (95% CI) 0.26 (0.25–0.28) vs 0.29 (0.27–0.30); p = 0.03) compared to control treatment. There were no clinically important differences in incidence of BPD and other major morbidities between the treatment groups. Conclusions Supplementation with ARA and DHA to preterm infants was safe and might have a beneficial effect on respiratory outcomes.

• Rossholt, Madelaine; Bratlie, Marianne; Wendel, Kristina; Aas, Marlen Fossan; Gunnarsdottir, Gunnþórunn & Fugelseth, Drude [Show all 11 contributors for this article] (2023). Effect of arachidonic and docosahexaenoic acid supplementation on quality of growth in preterm infants: A secondary analysis of a randomized controlled trial. Clinical Nutrition. ISSN 0261-5614. 42(12), p. 2311–2319. doi: 10.1016/j.clnu.2023.10.005. Full text in Research Archive Show summary

  Background & aims A balanced supply of arachidonic acid (ARA) and docosahexaenoic acid (DHA) may be crucial for quality of growth in preterm infants. This secondary analysis of a randomized controlled trial aimed to determine the effect of enhanced ARA and DHA supplementation on growth and body composition in infants born before 29 weeks of gestation. Furthermore, we aimed to study associations between human milk feeding, growth patterns and body composition. Methods The ImNuT-trial randomized 121 infants to receive a daily supplement with medium chain triglycerides (control) or 100 mg/kg ARA and 50 mg/kg DHA (ARA:DHA group) from the second day of life until 36 weeks postmenstrual age. Growth and body composition were evaluated up to 3 months corrected age. Results The ARA:DHA group showed better linear growth from birth to term equivalent age compared to the control group; mean difference in z score change from birth for length was 0.74 ([95% CI, 0.17–1.3]; p = 0.010). There were no differences in growth and body composition outcomes at 3 months corrected age between the groups. An increase in z score for weight after 36 weeks postmenstrual age and breastfeeding at 3 months corrected age were the strongest positive predictors of fat mass% at 3 months corrected age (both, p < 0.001). Conclusion Early enhanced supplementation of ARA and DHA may be beneficial with respect to somatic growth in very preterm infants.

• Wendel, Kristina; Gunnarsdottir, Gunnþórunn; Aas, Marlen Fossan; Westvik, Asbjørn; Pripp, Are Hugo & Fugelseth, Drude [Show all 8 contributors for this article] (2023). Essential Fatty Acid Supplementation and Early Inflammation in Preterm Infants: Secondary Analysis of a Randomized Clinical Trial. Neonatology. ISSN 1661-7800. 120(4), p. 465–472. doi: 10.1159/000530129. Full text in Research Archive Show summary

  Introduction: Postnatal inflammation is associated with increased mortality and adverse outcomes in preterm infants. The essential fatty acids arachidonic acid (ARA) and docosahexaenoic acid (DHA) are precursors of lipid mediators with a key role in resolving inflammation. Our aim was to investigate the effect of ARA and DHA supplementation on systemic inflammation in very preterm infants and to identify clinical factors associated with early inflammation. Methods: Secondary analysis of data from a randomized clinical trial (ImNuT study). Infants with gestational age (GA) less than 29 weeks were randomized to receive a daily enteral supplement with ARA 100 mg/kg and DHA 50 mg/kg (ARA:DHA group) or MCT oil (control group) from the second day of life to 36 weeks postmenstrual age. ARA, DHA, and four proinflammatory cytokines (IL-1β, IL-6, IL-8, and TNF-α) were analyzed in repeated dried blood samples from birth to day 28 and the area under the curve (AUC) for each variable was calculated. Results: The intention to treat population included 120 infants with mean (SD) GA 26.4 (1.7). The ARA:DHA group had significantly lower IL-6 levels from day 3 to day 28 compared to the control group, mean difference AUC log10 (95% CI): 0.16 (0.03–0.30) pg/mL, p = 0.018. There was no correlation between ARA or DHA blood concentrations and cytokine levels. Having a low gestational age was independently associated with increased levels of all cytokines during the first 4 weeks of life. Conclusions: Enhanced supplementation with ARA and DHA may modulate inflammation in very preterm infants.

• Wendel, Kristina; Rossholt, Madelaine Eloranta; Gunnarsdottir, Gunnþórunn; Aas, Marlen Fossan; Westvik, Asbjørn & Pripp, Are Hugo [Show all 10 contributors for this article] (2023). Lung function in preterm infants at 3 months corrected age after neonatal LC-PUFA supplementation. Pediatric Pulmonology. ISSN 8755-6863. 59(2), p. 389–398. doi: 10.1002/ppul.26760. Full text in Research Archive Show summary

  Abstract Objective To test the hypothesis that long‐chain polyunsaturated fatty acid (LC‐PUFA) supplementation improves lung function at 3 months corrected age (CA) compared with standard treatment in very preterm infants. We also aimed to investigate the association between bronchopulmonary dysplasia (BPD), longitudinal growth, and lung function at 3 months CA. Methods A secondary analysis from the ImNuT trial, in which 121 infants with gestational age &lt;29 weeks were randomized to a daily supplement with arachidonic acid (ARA) and docosahexaenoic acid (DHA) (ARA:DHA group) or MCT‐oil (control group) from birth up to 36 weeks postmenstrual age (PMA). Lung function was assessed at 3 months CA by tidal flow volume loops and the outcomes were the ratio of time to peak tidal expiratory flow to expiratory time ( t PTEF / t E ) and tidal volume ( V T ) per body weight (mL/kg). Results Thirty‐nine infants in the ARA:DHA group versus 51 in the control group had a successful lung function test. There was no mean difference (MD) in t PTEF / t E ratio (MD: 0.01, 95% confidence interval [CI]: −0.04 to 0.05; p  = .77) or V T (MD: 0.09 mL/kg, 95% CI: –0.79 to 0.62; p  = .81) between the study groups. The multivariable regression model showed that BPD was associated with t PTEF / t E ratio ≤ 0.25 ( p  = .03) and that an increase in z score for length after 36 weeks PMA correlated positively with V T (mL/kg) ( p  = .03). Conclusion Neonatal LC‐PUFA supplementation did not improve lung function at 3 months CA in very preterm infants. BPD was independently associated with reduced lung function, while improved linear growth correlated with higher tidal volumes.

• Nestaas, Eirik; BJARKØ, LISA; Kiserud, Torvid; Haugen, Guttorm Nils & Fugelseth, Drude (2023). Heart function by M-mode and tissue Doppler in the early neonatal period in neonates with fetal growth restriction. Early Human Development. ISSN 0378-3782. 183. doi: 10.1016/j.earlhumdev.2023.105809. Full text in Research Archive Show summary

  Background: Fetal growth restricted (FGR) neonates have increased risk of circulatory compromise due to failure of normal transition of circulation after birth. Aim: Echocardiographic assessment of heart function in FGR neonates first three days after birth. Study design: Prospective observational study. Subjects: FGR- and non-FGR neonates. Outcome measures: M-mode excursions and pulsed-wave tissue Doppler velocities normalised for heart size and E/e′ of the atrioventricular plane day one, two and three after birth. Results: Compared with controls (non-FGR of comparable gestational age, n = 41), late-FGR (gestational age ≥ 32 weeks, n = 21) exhibited higher septal excursion (15.9 (0.6) vs. 14.0 (0.4) %, p = 0.021) (mean (SEM)) and left E/e′ (17.3 (1.9) vs.11.5 (1.3), p = 0.019). Relative to day three, indexes on day one were higher for left excursion (21 (6) % higher on day one, p = 0.002), right excursion (12 (5) %, p = 0.025), left e′ (15 (7) %, p = 0.049), right a′ (18 (6) %, p = 0.001), left E/e′ (25 (10) %, p = 0.015) and right E/e′ (17 (7) %, p = 0.013), whereas no index changed from day two to day three. Late-FGR had no impact on changes from day one and two to day three. No measurements differed between early-FGR (n = 7) and late-FGR. Conclusions: FGR impacted neonatal heart function the early transitional days after birth. Late-FGR hearts had increased septal contraction and reduced left diastolic function compared with controls. The dynamic changes in heart function between first three days were most evident in lateral walls, with similar pattern in late-FGR and non-FGR. Early-FGR and late-FGR exhibited similar heart function.

• Rossholt, Madelaine; Bratlie, Marianne; Wendel, Kristina; Aas, Marlen Fossan; Gunnarsdottir, Gunnþórunn & Fugelseth, Drude [Show all 10 contributors for this article] (2023). A standardized feeding protocol ensured recommended nutrient intakes and prevented growth faltering in preterm infants < 29 weeks gestation. Clinical Nutrition ESPEN. ISSN 2405-4577. 53, p. 251–259. doi: 10.1016/j.clnesp.2022.12.024. Full text in Research Archive Show summary

  Background & aims Nutrition is a cornerstone of postnatal care to prevent compromised growth and support short- and long-term health outcomes in preterm infants. We aimed to evaluate nutritional intakes and growth among infants <29 weeks gestation after implementation of a standardized feeding protocol. Methods This is an observational cohort secondary analysis of data from the ImNuT study (Immature, Nutrition Therapy, NCT03555019). To reduce variations in nutritional practice and ensure accommodation to current guidelines, we developed a standardized feeding protocol. Detailed information on actual nutritional intakes, growth and biochemistry was prospectively collected and assessed from birth to 36 weeks postmenstrual age (PMA). Results Median (range) gestational age and birth weight were 26+6 (22+6-28+6) weeks and 798 (444–1485) g. Energy and macronutrient intakes progressively increased from birth through transition to exclusive enteral feeds. Parenteral nutrition was weaned at median (IQR) day 11 (9, 14) when nutritional requirements were met by exclusively enteral feeds. Infants exhibited a median (IQR) weight loss of 7.8% (5.7, 11.6) and regained birth weight by day 8 (7, 11). Average velocity in weight, length and head circumference from birth to 36 weeks PMA were in accordance with target growth rates; median (IQR) 15.8 (14.7, 17.7) g/kg/d, 1.1 (0.98, 1.3) cm/week and 0.82 (0.83, 0.89) cm/week. At 36 weeks PMA, only 3% of infants exhibited moderate growth faltering (decline in weigh-for-age z score >1.2 from birth), and none severe. Conclusions In infants <29 weeks gestation, the standardized feeding protocol was well tolerated. Nutrient intakes and growth were close to recommendations.

• Rossholt, Madelaine; Wendel, Kristina; Bratlie, Marianne; Aas, Marlen Fossan; Gunnarsdottir, Gunnþórunn & Fugelseth, Drude [Show all 11 contributors for this article] (2023). Vitamin A Status in Preterm Infants Is Associated with Inflammation and Dexamethasone Exposure. Nutrients. 15(2). doi: 10.3390/nu15020441. Full text in Research Archive Show summary

  Vitamin A has a key role in lung development and its deficiency is associated with an increased risk of bronchopulmonary dysplasia. This secondary cohort analysis of the ImNuT trial (Immature, Nutrition Therapy NCT03555019) aimed to (1) explore vitamin A status in preterm infants &lt;29 weeks gestation and (2) assess the influence of inflammation and postnatal dexamethasone exposure on vitamin A concentrations in blood. We report detailed information on vitamin A biochemistry, vitamin A intake, markers of inflammation and dexamethasone exposure. After four weeks of age, infants exposed to dexamethasone (n = 39) showed higher vitamin A concentrations compared to unexposed infants (n = 41); median (IQR) retinol was 1.0 (0.74, 1.5) vs. 0.56 (0.41, 0.74) µmol/L, p &lt; 0.001. Pretreatment retinol concentrations were lower in the dexamethasone group compared to non-exposed infants (p &lt; 0.001); 88% vs. 60% of the infants were considered deficient in vitamin A (retinol &lt; 0.7 µmol/L) at one week of age. Small size for gestational age, mechanical ventilation and elevated levels of interleukin-6 were factors negatively associated with first-week retinol concentrations. In conclusion, preterm infants &lt;29 weeks gestation are at risk of vitamin A deficiency despite intakes that accommodate current recommendations. The presence of inflammation and dexamethasone exposure should be considered when interpreting vitamin A status.

• Rajar, Polona; Dhariwal, Achal; Silva, Gabriela Salvadori Da; Junges, Roger; Åmdal, Heidi Aarø & Berild, Dag [Show all 12 contributors for this article] (2022). Microbial DNA extraction of high-host content and low biomass samples: Optimized protocol for nasopharynx metagenomic studies. Frontiers in Microbiology. 13, p. 1–15. doi: 10.3389/fmicb.2022.1038120. Full text in Research Archive Show summary

  Introduction Low microbial biomass and high human DNA content in nasopharyngeal aspirate samples hinder comprehensive characterization of microbiota and resistome. We obtained samples from premature infants, a group with increased risk of developing respiratory disorders and infections, and consequently frequent exposure to antibiotics. Our aim was to devise an optimal protocol for handling nasopharyngeal aspirate samples from premature infants, focusing on host DNA depletion and microbiome and resistome characterization. Methods Three depletion and three DNA extraction protocols were compared, using RT-PCR and whole metagenome sequencing to determine the efficiency of human DNA removal, taxonomic profiling and assignment of antibiotic resistance genes. Protocols were tested using mock communities, as well as pooled and individual patient samples. Results The only extraction protocol to retrieve the expected DNA yield from mock community samples was based on a lytic method to improve Gram positive recovery (MasterPure™). Host DNA content in non-depleted aliquots from pooled patient samples was 99%. Only samples depleted with MolYsis™ showed satisfactory, but varied reduction in host DNA content, in both pooled and individual patient samples, allowing for microbiome and resistome characterisation (host DNA content from 15% to 98%). Other depletion protocols either retrieved too low total DNA yields, preventing further analysis, or failed to reduce host DNA content. By using Mol_MasterPure protocol on aliquots from pooled patient samples, we increased the number of bacterial reads by 7.6 to 1,725.8-fold compared to non-depleted reference samples. PCR results were indicative of achieved microbial enrichment. Individual patient samples processed with Mol_MasterPure protocol varied greatly in total DNA yield, host DNA content (from 40% to 98%), species and antibiotic resistance gene richness. Discussion Despite high human DNA and low microbial biomass content in nasopharynx aspirates of preterm infants, we were able to reduce host DNA content to levels compatible with downstream shotgun metagenomic analysis, including bacterial species identification and coverage of antibiotic resistance genes. Whole metagenomic sequencing of microbes colonizing the nasopharynx may contribute to explaining the possible role of airway microbiota in respiratory conditions and reveal carriage of antibiotic resistance genes.

• Bjarkø, Lisa; Fugelseth, Drude; Harsem, Nina Kittelsen; Kiserud, Torvid; Haugen, Guttorm Nils & Nestaas, Eirik (2022). Cardiac morphology in neonates with fetal growth restriction. Journal of Perinatology. ISSN 0743-8346. 43. doi: 10.1038/s41372-022-01538-8. Full text in Research Archive Show summary

  Objective: Assess effects of fetal growth restriction (FGR) on cardiac modelling in premature and term neonates. Study design: Prospective echocardiographic study of a cohort of FGR neonates (n = 21) and controls (n = 41) with normal prenatal growth and circulation. Results: Unadjusted for gestational age, birth weight, sex, and twin/singleton, Late-FGR neonates had smaller hearts than controls, with globular left ventricles and symmetrical right ventricles. Adjusted estimates showed smaller left ventricles and similarly sized right ventricles, with symmetrical left and right ventricles. Early-FGR (compared with Late-FGR) had smaller hearts and globular left ventricles in unadjusted estimates, but after adjustment, sizes and shapes were similar. Conclusion: FGR had significant impact on cardiac modelling, seen in both statistical models unadjusted and adjusted for gestational age, birth weight, sex, and twin/singleton. The adjustments, however, refined the results and revealed more specific effects of FGR, thus underscoring the importance of statistical adjustments in such studies.

• Brigtsen, Anne Karin; Jacobsen, Anne Flem; Dedi, Lumnije; Melby, Kjetil K.; Nygaard, Cathrine Skorpen & Fugelseth, Drude [Show all 7 contributors for this article] (2022). Group B Streptococcus colonization at delivery is associated with maternal peripartum infection. PLOS ONE. 17(4). doi: 10.1371/journal.pone.0264309. Full text in Research Archive Show summary

  Background Group B Streptococcus (GBS) is a major cause of serious neonatal infection but its role in maternal morbidity has received little investigation. The aim of this study was to determine whether GBS colonization at delivery is associated with increased risk of maternal peripartum infection. Methods In this prospective cohort study, 1746 unselected women had a vaginal-rectal culture taken at the onset of labor. Diagnosis of maternal peripartum infection was based on a combination of two or more signs or symptoms including fever, breast pain, severe wound or pelvic pain, purulent discharge and abnormal laboratory tests including C-reactive protein and white blood cell count occurring from labor until 2 weeks postpartum. The main outcome measure was the proportion of women with maternal peripartum infection according to GBS colonization status. Results A total of 25.9% (452/1746) women were colonized with GBS. The rate of peripartum infection was almost twice as high in colonized women (49/452 [10.8%]) vs. non-colonized women (81/1294 [6.3%]); OR 1.82 [1.26–2.64], p = 0.002). This association was confirmed in a multivariable model (OR 1.99 [1.35–2.95], p = 0.001). Women diagnosed with peripartum infection had a significantly longer hospital stay compared to women without peripartum infection (4 days (median) vs. 3 days, p < 0.001). Length of hospital stay did not differ between colonized and non-colonized women. Serotype IV GBS was more frequent in colonized women with peripartum infection than in women without peripartum infection (29.3% vs. 12.5%, p = 0.003). Conclusions GBS colonization at delivery is associated with increased risk of peripartum infection. Whether this increase is due directly to invasion by GBS or whether GBS colonization is associated with a more general vulnerability to infection remains to be determined.

• Kynø, Nina M; Fugelseth, Drude; Knudsen, Lina Merete Mæland & Tandberg, Bente Silnes (2021). Starting parenting in isolation a qualitative user-initiated study of parents’ experiences with hospitalization in Neonatal Intensive Care units during the COVID-19 pandemic. PLOS ONE. 16(10), p. 1–17. doi: 10.1371/journal.pone.0258358. Full text in Research Archive Show summary

  Background Worldwide, strict infection control measures including visitation regulations were implemented due to the COVID-19 pandemic at Neonatal Intensive Care Units (NICUs). These regulations gave restricted access for parents to their hospitalized infants. The consequence was limited ability to involve in the care of their infants. At Oslo University Hospital entry to NICU was denied to all except healthy mothers in March 2020. The absolute access ban for fathers lasted for 10 weeks. The aim of this study was to explore parental experiences with an infant hospitalized in the NICU during this absolute visitation ban period. Methods We invited post discharge all parents of surviving infants that had been hospitalized for at least 14 days to participate. They were interviewed during autumn 2020 using an explorative semi-structured interview approach. Data were analyzed via inductive thematic analysis. Results Nine mothers and four fathers participated. The COVID-19 regulations strongly impacted the parent’s experiences of their stay. The fathers’ limited access felt life-impacting. Parents struggled to become a family and raised their voices to be heard. Not being able to experience parenthood together led to emotional loneliness. The fathers struggled to learn how to care for their infant. The regulations might lead to a postponed attachment. On the other hand, of positive aspect the parents got some quietness. Being hospitalized during this first wave was experienced as exceptional and made parents seeking alliances by other parents. Social media was used to keep in contact with the outside world. Conclusions The regulations had strong negative impact on parental experiences during the NICU hospitalization. The restriction to fathers’ access to the NICU acted as a significant obstacle to early infant-father bonding and led to loneliness and isolation by the mothers. Thus, these COVID-19 measures might have had adverse consequences for families.

• Wendel, Kristina; Pfeiffer, Helle Cecilie; Fugelseth, Drude; Nestaas, Eirik; Domellöf, Magnus & Skålhegg, Bjørn Steen [Show all 42 contributors for this article] (2021). Effects of nutrition therapy on growth, inflammation and metabolism in immature infants: a study protocol of a double-blind randomized controlled trial (ImNuT). BMC Pediatrics. 21. doi: 10.1186/s12887-020-02425-x. Full text in Research Archive Show summary

  Background: Current nutritional management of infants born very preterm results in significant deficiency of the essential fatty acids (FAs) arachidonic acid (ARA) and docosahexaenoic acid (DHA). The impact of this deficit on brain maturation and inflammation mediated neonatal morbidities are unknown. The aim of this study is to determine whether early supply of ARA and DHA improves brain maturation and neonatal outcomes in infants born before 29 weeks of gestation. Methods: Infants born at Oslo University Hospital are eligible to participate in this double-blind randomized controlled trial. Study participants are randomized to receive an enteral FA supplement of either 0.4 ml/kg MCT-oil™ (medium chain triglycerides) or 0.4 ml/kg Formulaid™ (100 mg/kg of ARA and 50 mg/kg of DHA). The FA supplement is given from the second day of life to 36 weeks' postmenstrual age (PMA). The primary outcome is brain maturation assessed by Magnetic Resonance Imaging (MRI) at term equivalent age. Secondary outcomes include quality of growth, incidence of neonatal morbidities, cardiovascular health and neuro-development. Target sample size is 120 infants (60 per group), this will provide 80% power to detect a 0.04 difference in mean diffusivity (MD, mm2/sec) in major white matter tracts on MRI. Discussion: Supplementation of ARA and DHA has the potential to improve brain maturation and reduce inflammation related diseases. This study is expected to provide valuable information for future nutritional guidelines for preterm infants. Trial registration: Clinicaltrials.gov ID: NCT03555019 . Registered 4 October 2018- Retrospectively registered.

• Kynø, Nina Margrethe; Fugelseth, Drude Merete & Hanssen, Ingrid (2020). When a common language is missing: Nurse–mother communication in the NICU. A qualitative study. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 29(13-14), p. 2221–2230. doi: 10.1111/jocn.15212. Full text in Research Archive Show summary

  Aims and objectives To explore how communication in neonatal intensive care units (NICUs) between immigrant mothers and nurses take place without having a common language, and how these mothers experience their NICU stay. Background Admission of infants to NICU affects both parents and infants. Immigrant mothers constitute a vulnerable hospital population in need of culturally, linguistically and individually tailored information. Design and methods The study had a qualitative design reported according to the COREQ criteria. Eight mothers who spoke neither Scandinavian nor English went through individual semi‐structured interviews. Six mother–nurse interactions were observed, and eight nurses' experiences were explored through focus‐group interviews. All interviews were audio recorded and transcribed verbatim. The analysis was thematic and hermeneutic in character. Results Interpreters were present during the consultations with the physicians, but rarely during the daily nurse‐mother interactions. Nurses focused on daily routines, infant care guidance and mother–infant attachment. The mothers learned through demonstrations and hands‐on guidance. Language barriers made it difficult to assess the mothers' understanding, but the mothers expressed that they felt adequately included in the care of their infant and well informed and guided. Even so, both mothers and nurses expressed desire to use interpreters more regularly. The pictorial communication boards available lacked important vocabulary needed in neonatal nursing contexts and their use furthermore interrupted the mother–nurse conversation. Conclusion Body language, simple words, guesswork, trial and error characterised the nurse–mother interaction. The nurses adopted various communication strategies to help the mothers understand and give them a voice. Competent interpreters were used during meetings with physicians, but not during daily bedside guidance and information giving by nurses. Relevance to clinical practice Knowledge of immigrant mothers' and nurses' communication strategies and how both parties think, feel and act to overcome communication problem is necessary to improve clinical practice and reduce communication barriers.

• Nestaas, Eirik; Fugelseth, Drude & Eriksen, Beate Horsberg (2018). Assessment of Systemic Blood Flow and Myocardial Function in the Neonatal Period Using Ultrasound. In Polin, Richard A. (Eds.), Hemodynamics and Cardiology. Elsevier. ISSN 9780323533669. Full text in Research Archive
• Heier, Martin; Nygaard, Cathrine Skorpen; Brunborg, Cathrine; Seljeflot, Ingebjørg; MARGEIRSDOTTIR, HANNA DIS & Hanssen, Kristian Folkvord [Show all 8 contributors for this article] (2018). Preserved endothelial function in young adults with type 1 diabetes. PLOS ONE. 13:e0206523(10), p. 1–8. doi: 10.1371/journal.pone.0206523. Full text in Research Archive Show summary

  Background and aim Endothelial dysfunction is involved in the pathogenesis of atherosclerosis and is typically present in older adults with type 1 diabetes (T1D). In young adults, we aimed to assess the impact of T1D on endothelial function as detected by digital peripheral arterial tonometry (PAT) and its relationship with cardiovascular risk factors and long term glycemic control. Materials and methods Reactive hyperemia index (RHI) as a measure of endothelial function was assessed by PAT in 46 T1D patients and 32 healthy controls. All were participants in the "Atherosclerosis and Childhood Diabetes" study, with baseline values registered five years previously. Annual measurements of HbA1c for assessment of glycemic burden were provided by the Norwegian Childhood Diabetes Registry. Results The diabetes patients had a mean age of 20.8 years, a median duration of diabetes of 10.0 years and a mean HbA1c of 8.7%. RHI was not significantly decreased in the diabetes group, mean 2.00 (SD = 0.59) vs. 2.21 (SD = 0.56), p = .116. There was no gender difference or any associations with traditional risk factors. Furthermore, there was no significant association between RHI and either HbA1c or long term glycemic burden. Conclusions RHI as a measure of endothelial function was preserved in young adults with T1D compared with healthy controls.

• Skranes, Janne Helen; Løhaugen, Gro; Schumacher, Eva Margrethe; Osredkar, Damjan; Server, Andrés & Cowan, Frances Mary [Show all 9 contributors for this article] (2017). Amplitude-Integrated Electroencephalography Improves the Identification of Infants with Encephalopathy for Therapeutic Hypothermia and Predicts Neurodevelopmental Outcomes at 2 Years of Age. Journal of Pediatrics. ISSN 0022-3476. 187, p. 34–42. doi: 10.1016/j.jpeds.2017.04.041. Full text in Research Archive
• Brunvand, Leif; Heier, Martin; Brunborg, Cathrine; Hanssen, Kristian Folkvord; Fugelseth, Drude & STENSÆTH, KNUT HAAKON [Show all 8 contributors for this article] (2017). Advanced glycation end products in children with type 1 diabetes and early reduced diastolic heart function. BMC Cardiovascular Disorders. 17(133). doi: 10.1186/s12872-017-0551-0. Full text in Research Archive Show summary

  Background Reduced diastolic function is an early sign of diabetes cardiomyopathy in adults and is associated with elevated levels of HbA1c and advanced glycation end products (AGEs). Objective To assess the associations between early reduced diastolic function and elevated levels of HbA1c and AGEs in children and adolescents with type 1 diabetes (T1D). Methods One hundred fourty six T1D patients (age 8–18 years) without known diabetic complications were examined with tissue Doppler imaging and stratified into two groups according to diastolic function. A clinical examination and ultrasound of the common carotid arteries were performed. Methylglyoxal-derived hydroimidazolone-1 (MG-H1) was measured by immunoassay. Results At inclusion, 36 (25%) participants were stratified into a low diastolic function group (E’/A’-ratio < 2.0). Compared to the rest of the T1D children, these participants had higher body mass index (BMI), 22.8 (SD = 4.0) vs. 20.1 (SD = 3.4) kg/m2, p < 0.001, higher systolic blood pressure 104.2 (SD = 8.7) vs. 99.7 (SD = 9.3) mmHg, p = 0.010, and higher diastolic blood pressure, 63.6 (SD = 8.3) vs. 59.9 (SD = 7.9) mmHg, p = 0.016. The distensibility coefficient was lower, 0.035 (SD = 0.010) vs. 0.042 (SD = 0.02) kPa−1, p = 0.013, Young’s modulus higher, 429 (SD = 106) vs. 365 (SD = 143), p = 0.009, and MG-H1 higher, 163.9 (SD = 39.2) vs. 150.3 (SD = 33.4) U/ml, p = 0.046. There was no difference in carotid intima-media thickness between the groups. There were no associations between reduced diastolic function and years from diagnosis, HBA1c, mean HBA1c, CRP or calculated glycemic burden. Logistic regression analysis showed that BMI was an independent risk factor for E’/A’-ratio as well as a non-significant, but relatively large effect size for MG-H1, indicating a possible role for AGEs. Conclusions Early signs of reduced diastolic function in children and adolescents with T1D had higher BMI, but not higher HbA1c. They also had elevated serum levels of the advanced glycation end product MG-H1, higher blood pressure and increased stiffness of the common carotid artery, but these associations did not reach statistical significance when tested in a logistic regression model.

• Brunvand, Leif; Fugelseth, Drude; STENSÆTH, KNUT-HAAKON; Dahl-Jørgensen, Knut & MARGEIRSDOTTIR, HANNA DIS (2016). Early reduced myocardial diastolic function in children and adolescents with type 1 diabetes mellitus a population-based study. BMC Cardiovascular Disorders. 16(103). doi: 10.1186/s12872-016-0288-1. Full text in Research Archive Show summary

  Background Reduced diastolic myocardial function is an early sign of diabetic cardiomyopathy. The aim of this study was to test the hypothesis that children and adolescents with type 1 diabetes mellitus (T1D), but without other known complications, have early reduced diastolic myocardial function diagnosed with echocardiographic color tissue Doppler imaging (cTDI). Methods cTDI examination was carried out in 173 T1D patients and 62 age-matched controls. The T1D-patients were 8–18 years old with (mean (SD)) diabetes duration of 5.6 (3.4) years and HbA1c of 8.4 (1.3). All were treated with either insulin pumps or 4–6 daily insulin injections. cTDI early (E’) and late (A’) peak diastolic velocities and systolic peak velocity were measured from the lateral, septal, anterior and posterior mitral annulus and from the lateral tricuspidal annulus. Results Myocardial diastolic function was reduced in the T1D-patients with higher peak A’-velocity and lower E’/A’-ratio in all registrations. Overall mean (SD) mitral E’/A’-ratio was 2.3 (0.5) in T1D and 2.7 (0.6) in the controls (p < 0001). The overall mitral E’/A’-ratio was negative associated with blood pressure (BP) and body mass index (BMI). Stratifying all participants into three groups according to BMI (<25, 25–75, >75 centile, respectively), the T1D had lower E’/A’-values in all stratified groups, except for in the highest BMI-group where both T1D and controls had the lowest E’/A’-ratio. Systolic function did not differ in any of the measurements. There were no associations with sex, diabetes duration, carotid artery intima-media-thickness, vessel elasticity or HbA1c. Conclusion Diabetic children and adolescents using modern intensive insulin treatment had echocardiographic signs of reduced diastolic myocardial function despite short duration of disease. The reduced function was associated with higher BP and higher BMI.

• Fredly, Siv; Nygaard, Cathrine Skorpen; Skranes, Janne Helen; Stiris, Tom & Fugelseth, Drude (2016). Cooling effect on skin microcirculation in asphyxiated newborn infants with increased C-reactive protein. Neonatology. ISSN 1661-7800. 110(4), p. 270–276. doi: 10.1159/000446763. Full text in Research Archive
• Nestaas, Eirik; Støylen, Asbjørn & Fugelseth, Drude (2016). Speckle tracking using gray-scale information from tissue Doppler recordings versus regular gray-scale recordings in term neonates. Ultrasound in Medicine and Biology. ISSN 0301-5629. 42(11), p. 2599–2605. doi: 10.1016/j.ultrasmedbio.2016.06.003. Full text in Research Archive
• Fredly, Siv; Fugelseth, Drude; Nygaard, Cathrine Skorpen; Salerud, Gøran; Stiris, Tom & Kvernebo, Knut (2016). Noninvasive assessments of oxygen delivery from the microcirculation to skin in hypothermia-treated asphyxiated newborn infants. Pediatric Research. ISSN 0031-3998. 79, p. 902–906. doi: 10.1038/pr.2016.16. Full text in Research Archive
• Brigtsen, Anne Karin; Dedi, Lumnije; Melby, Kjetil K.; Holberg-Petersen, Mona; Radtke, Andreas & Lyng, Randi Valsø [Show all 10 contributors for this article] (2015). Comparison of PCR and serotyping of Group B Streptococcus in pregnant women: The Oslo GBS-study. Journal of Microbiological Methods. ISSN 0167-7012. 108, p. 31–35. doi: 10.1016/j.mimet.2014.11.001. Full text in Research Archive
• Brigtsen, Anne Karin; Jacobsen, Anne Flem; Dedi, Lumnije; Melby, Kjetil K.; Fugelseth, Drude & Whitelaw, Andrew (2015). Maternal colonization with Group B streptococcus is associated with an increased rate of infants transferred to the neonatal intensive care unit. Neonatology. ISSN 1661-7800. 108, p. 157–163. doi: 10.1159/000434716. Full text in Research Archive
• Helmer, Caroline; Skranes, Janne Helen; Liestøl, Knut & Fugelseth, Drude (2015). Using adrenaline during neonatal resuscitation may have an impact on serum cardiac troponin-T levels. Acta Paediatrica. ISSN 0803-5253. 104(9), p. e378–e383. doi: 10.1111/apa.13055. Full text in Research Archive
• Fredly, Siv; Fugelseth, Drude; Wester, Torjus; Häggblad, Erik & Kvernebo, Knut (2015). Skin microcirculation in healthy term newborn infants-assessment of morphology, perfusion and oxygenation. Clinical Hemorheology and Microcirculation. ISSN 1386-0291. 59(4), p. 309–322. doi: 10.3233/CH-131764. Full text in Research Archive
• Skranes, Janne Helen; Cowan, Frances; Stiris, Tom; Fugelseth, Drude; Thoresen, Marianne & SERVER, ANDRES (2015). Brain imaging in cooled encephalopathic neonates does not differ between four and 11 days after birth. Acta Paediatrica. ISSN 0803-5253. 104(8), p. 752–758. doi: 10.1111/apa.13016. Full text in Research Archive
• Nestaas, Eirik; Skranes, Janne Helen; Støylen, Asbjørn; Brunvand, Leif & Fugelseth, Drude (2014). The myocardial function during and after whole-body therapeutic hypothermia for hypoxic–ischemic encephalopathy, a cohort study. Early Human Development. ISSN 0378-3782. 90(5), p. 247–252. doi: 10.1016/j.earlhumdev.2014.01.014. Full text in Research Archive
• Nestaas, Eirik; Fugelseth, Drude & Støylen, Asbjørn (2014). Automated, Objective and Expert-Independent Assessment of the Analyzability of Strain and Strain Rate in Tissue Doppler Images in Term Neonates by Analysis of Beat-to-Beat Variation. Ultrasound in Medicine and Biology. ISSN 0301-5629. 40(3), p. 637–642. doi: 10.1016/j.ultrasmedbio.2013.10.026. Full text in Research Archive
• Skranes, Janne Helen; Elstad, Maja; Thoresen, Marianne; Cowan, Frances; Stiris, Tom & Fugelseth, Drude (2014). Hypothermia Makes Cerebral Resistance Index a Poor Prognostic Tool in Encephalopathic Newborns. Neonatology. ISSN 1661-7800. 106(1), p. 17–23. doi: 10.1159/000358229. Full text in Research Archive
• Lee, Anja; Nestaas, Eirik; Liestøl, Knut; Brunvand, Leif; Lindemann, Rolf & Fugelseth, Drude (2014). Tissue Doppler imaging in very preterm infants during the first 24 h of life: an observational study. Archives of Disease in Childhood: Fetal and Neonatal Edition. ISSN 1359-2998. 99(1), p. F64–F69. doi: 10.1136/archdischild-2013-304197. Full text in Research Archive
• Eriksen, Beate Horsberg; Nestaas, Eirik; Hole, Torstein; Liestøl, Knut; Støylen, Asbjørn & Fugelseth, Drude (2014). Myocardial function in term and preterm infants. Influence of heart size, gestational age and postnatal maturation. Early Human Development. ISSN 0378-3782. 90(7), p. 359–364. doi: 10.1016/j.earlhumdev.2014.04.010. Full text in Research Archive Show summary

  Background Sparse knowledge exists on the differences in cardiac function between term and preterm infants. This study examines the impact of heart size, gestational age and postnatal maturation on myocardial function. Aim To assess and compare serial echocardiographic indices of myocardial function in term and moderately preterm infants. Methods Longitudinal, prospective, observational echocardiographic cohort study of 45 healthy term infants examined at day three and at 12–20 weeks postnatal age and 53 moderately preterm infants (gestational age 31–35 weeks) examined at day three and at term equivalent (4–10 weeks postnatal age). Outcomes Primary: Systolic mitral and tricuspid annular plane excursions and annular peak systolic pulsed wave tissue Doppler (pwTDI) velocities. Secondary: Indices normalized for heart size. Results On day three, all indices were higher in the term than in the preterm infants whereas normalized systolic pwTDI velocities were lower in the term infants and normalized excursions showed no difference. All indices increased with advanced postnatal age. The indices in term infants on day three were lower than in preterm infants at term equivalent, with and without normalization. After postnatal maturation in both groups, all indices were higher in the term group (except left pwTDI), whereas normalized indices showed no consistent pattern. Conclusions Myocardial function indices increased with gestational age at birth and more profoundly with postnatal maturation. Serial examinations of non-normalized and normalized myocardial function indices showed no sustained differences between the preterm and the term infants. Normalization by heart size may be of value when assessing myocardial function in infants.

• Eriksen, Beate Horsberg; Nestaas, Eirik; Hole, Torstein; Liestøl, Knut; Støylen, Asbjørn & Fugelseth, Drude (2013). Longitudinal assessment of atrioventricular annulus excursion by grey-scale m-mode and colour tissue Doppler imaging in premature infants. Early Human Development. ISSN 0378-3782. 89(12), p. 977–982. doi: 10.1016/j.earlhumdev.2013.09.006. Full text in Research Archive
• Eriksen, Beate Horsberg; Husebekk, Anne; Fugelseth, Drude; Salberg, Karen Reistad & Lindemann, Rolf (2013). Et nyfødt barn med petekkier. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 133(7), p. 761–764. doi: 10.4045/tidsskr.12.1009. Full text in Research Archive
• Eriksen, Beate Horsberg; Nestaas, Eirik; Hole, Torstein; Liestøl, Knut; Støylen, Asbjørn & Fugelseth, Drude (2013). Myocardial function in premature infants: a longitudinal observational study. BMJ Open. 3(3). doi: 10.1136/bmjopen-2012-002441. Full text in Research Archive Show summary

  Objectives: Gestational and chronological age may have an impact on myocardial function. We studied the longitudinal changes of the atrioventricular tissue Doppler velocities in premature infants through the neonatal transitional period and at expected term and explored the reproducibility of the measurements. Design: Prospective, observational and longitudinal cohort study. Setting: Two-centre study, from a secondary and a tertiary neonatal intensive care unit. Participants: 55 infants (29 males) with gestational age 31–35 weeks and birth weight 1127–2836 grams. Primary and secondary outcome measures: Pulsed-wave atrioventricular left, septum and right ventricular annulus tissue Doppler systolic (S′), early diastolic (E′) and late diastolic (A′) velocities measured by repeated echocardiographic examinations days 1, 2 and 3 and at expected term. Results: All velocities increased significantly from the neonatal period to expected term (p<0.001). We found a significant correlation between gestational age and right-sided S′, E′ and A′ on day 1 (Pearson correlation 0.32–0.46, p<0.05), for S′ in all three walls and septal E′ and A′ on day 2 (Pearson correlation 0.27–0.49, p<0.05). There was a moderate linear correlation between left ventricle end-diastolic length and septal and right S′ at term and for septal E′ and A′ at day 1 (Pearson correlation 0.30–0.56, p<0.05). We found no correlation between heart rate and tissue Doppler velocities when controlling for the effect of fusion. Continuous positive airway pressure showed moderate effect where as persistence of the ductus arteriosus showed no effect on the tissue Doppler velocities. The E′/A′ relationship was consistently reversed throughout the study with frequently fused diastolic tissue velocity signals. Conclusions: Pulsed-wave atrioventricular annulus tissue Doppler velocities were related to gestational age, postnatal age and ventricular size. Right ventricle velocities showed more pronounced increase with postnatal maturation than left ventricle velocities. The degree of E′/A′ fusion influenced the diastolic tissue Doppler velocities and should be reported if present.

• Henrichsen, Thore Andre; Lindenskov, Paal Helge H.; Shaffer, Thomas H.; Løkke, Ruth J.; Fugelseth, Drude & Lindemann, Rolf (2012). Perfluorodecalin lavage of a longstanding lung atelectasis in a child with spinal muscle atrophy. Pediatric Pulmonology. ISSN 8755-6863. 47(4), p. 415–419. doi: 10.1002/ppul.21565. Full text in Research Archive
• Nestaas, Eirik; Støylen, Asbjørn & Fugelseth, Drude (2012). Myocardial performance assessment in neonates by one-segment strain and strain rate analysis by tissue Doppler - a quality improvement cohort study. BMJ Open. 2(4). doi: 10.1136/bmjopen-2012-001636. Full text in Research Archive Show summary

  Objectives: To investigate one-segment strain and strain rate indices as measures of myocardial performance in asphyxiated term neonates. Design: Quality improvement cohort study. Setting: Newborns admitted to a neonatal intensive care unit at a Norwegian University Hospital for perinatal asphyxia and non-asphyxiated newborn recruited from the maternity ward at the same hospital. Participants: Twenty asphyxiated and 48 non-asphyxiated term neonates. Primary outcome measure: Strain and strain rate indices and repeatability measures. One-segment longitudinal strain and strain rate by tissue Doppler were assessed on days 1, 2 and 3 of life in nine heart walls. Repeatability was compared against measurements from two-segment analyses previously performed in the same images. Results: The 95% limits of agreement were significantly better for the one-segment than two-segment repeatability analyses, the inter-rater peak systolic strain (PSS) was (−3.1, 3.3) vs (−11.4, 18.3)%, the inter-rater peak systolic strain rate (PSSR) was (−0.38, 0.40) vs (−0.79, 1.15)/s, the intra-rater PSS was (−2.5, 2.6) vs (−8.0, 9.8)% and the intra-rater PSSR was (−0.23, 0.25) vs (−0.75, 0.80)/s (p<0.05). The myocardial performance was lower in the asphyxiated neonates (indices closer to zero) than in the non-asphyxiated neonates, PSS was −17.8 (0.6) (mean (SEM)) vs −21.2 (0.3)%, PSSR −1.43 (0.08) vs −1.61 (0.03)/s, early diastolic strain rate 1.72 (0.11) vs 2.00 (0.11)/s and strain rate during the atrial systole 1.92 (0.17) vs 2.27 (0.10)/s (p<0.05), despite no difference in fractional shortening (29.0 (0.5) vs 29.1 (1.0)%) (p>0.05). Conclusions: One-segment strain and strain rate assessed the reduced myocardial performance in asphyxiated neonates with significantly improved reproducibility as compared with two-segment analysis and was therefore more feasible than two-segment analyses for assessment of myocardial performance after perinatal asphyxia.

• Fugelseth, Drude; RAMSTAD, HEIDI; Kvehaugen, Anne Stine; Nestaas, Eirik; Støylen, Asbjørn & Staff, Anne Cathrine (2011). Myocardial function in offspring 5-8 years after pregnancy complicated by preeclampsia. Early Human Development. ISSN 0378-3782. 87(8), p. 531–535. doi: 10.1016/j.earlhumdev.2011.04.006. Full text in Research Archive
• Kvehaugen, Anne Stine; Dechend, R; Ramstad, HB; Troisi, R; Fugelseth, Drude & Staff, Anne Cathrine (2011). Endothelial Function and Circulating Biomarkers Are Disturbed in Women and Children After Preeclampsia. Hypertension. ISSN 0194-911X. 58(1), p. 63–69. doi: 10.1161/HYPERTENSIONAHA.111.172387. Full text in Research Archive
• Nestaas, Eirik; Støylen, Asbjørn; Brunvand, Leif & Fugelseth, Drude (2011). Longitudinal strain and strain rate by tissue Doppler are more sensitive indices than fractional shortening for assessing the reduced myocardial function in asphyxiated neonates. Cardiology in the Young. ISSN 1047-9511. 21(1), p. 1–7. doi: 10.1017/S1047951109991314. Full text in Research Archive
• Lee, Anja; Liestøl, Knut; Nestaas, Eirik; Brunvand, Leif; Lindemann, Rolf & Fugelseth, Drude (2010). Superior vena cava flow: feasibility and reliability of the off-line analyses. Archives of Disease in Childhood: Fetal and Neonatal Edition. ISSN 1359-2998. 95(2), p. F121–F125. doi: 10.1136/adc.2009.176883. Full text in Research Archive
• Fredly, Siv; Aksnes, Gunnar; Viddal, Kai O; Lindemann, Rolf & Fugelseth, Drude (2009). The outcome in newborns with congenital diaphragmatic hernia in a Norwegian region. Acta Paediatrica. ISSN 0803-5253. 98(1), p. 107–111. doi: 10.1111/j.1651-2227.2008.01024.x. Full text in Research Archive
• Lee, Anja; Liestøl, Knut; Nestaas, Eirik; Brunvand, Leif; Lindemann, Rolf & Fugelseth, Drude (2009). Superior vena cava flow - feasibility and reliability of the off-line analyses. Archives of Disease in Childhood: Fetal and Neonatal Edition. ISSN 1359-2998. doi: 10.1136/adc.2009.176883. Full text in Research Archive
• Bakkeheim, E; Bergerud, U. E.; Schmidt-Melbye, AC; Akkok, CA; Liestøl, Knut & Fugelseth, Drude [Show all 7 contributors for this article] (2009). Maternal IgG anti-A and anti-B titres predict outcome in ABO-incompatibility in the neonate. Acta Paediatrica. ISSN 0803-5253. 98(12), p. 1896–1901. doi: 10.1111/j.1651-2227.2009.01478.x. Full text in Research Archive
• Nestaas, E; Stoylen, A; Støylen, Asbjørn; Brunvand, L & Fugelseth, D (2009). Tissue Doppler Derived Longitudinal Strain and Strain Rate During the First 3 Days of Life in Healthy Term Neonates. Pediatric Research. ISSN 0031-3998. 65(3), p. 357–362. Full text in Research Archive
• Nestaas, Eirik; Støylen, Asbjørn & Fugelseth, Drude (2008). Optimal types of probe, and tissue Doppler frame rates, for use during tissue Doppler recording and off-line analysis of strain and strain rate in neonates at term. Cardiology in the Young. ISSN 1047-9511. 18(5), p. 502–511. doi: 10.1017/S1047951108002655. Full text in Research Archive
• Lindemann, Rolf; Myhre, Mia Cathrine; Bakken, Mari; Rustad, Cecilie; Fugelseth, Drude & Woldseth, Berit (2008). Et nyfødt barn med hyperventilasjon. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 128(13-14), p. 1535–1536. Full text in Research Archive
• Nestaas, Eirik; Støylen, Asbjørn; Sandvik, Leif; Brunvand, Leif & Fugelseth, Drude (2007). FEASIBILITY AND RELIABILITY OF STRAIN AND STRAIN RATE MEASUREMENT IN NEONATES BY OPTIMIZING THE ANALYSIS PARAMETERS SETTINGS. Ultrasound in Medicine and Biology. ISSN 0301-5629. 33(2), p. 270–278. Full text in Research Archive
• Nestaas, Eirik; Støylen, Asbjørn; Sandvik, Leiv; Brunvand, Leif & Fugelseth, Drude (2007). Feasibility and reliability of strain and strain rate measurement in neonates by optimizing the analysis parameters settings. Ultrasound in Medicine and Biology. ISSN 0301-5629. 33(2), p. 270–278. doi: 10.1016/j.ultrasmedbio.2006.08.006. Full text in Research Archive
• Lindemann, Rolf; Rajka, Thomas; Henrichsen, Thore Andre; Vinorum, Ole Georg; Lange, Charlotte De & Erichsen, Aage [Show all 7 contributors for this article] (2007). Bronchioalveolar lavage with perfluorochemical liquid during conventional ventilation. Pediatric Critical Care Medicine. ISSN 1529-7535. 8. doi: 10.1097/01.PCC.0000282757.25347.6C. Full text in Research Archive
• Børke, Wenche Bakken; Edvardsen, Thor; Fugelseth, Drude Merete; Lenes, K; Ihlen, Halfdan & Saugstad, Ola Didrik [Show all 7 contributors for this article] (2006). Reduced left ventricular function in hypoxemic newborn pigs: a strain Doppler echocardiographic study. Pediatric Research. ISSN 0031-3998. 59(5), p. 630–635. Full text in Research Archive
• Fugelseth, Drude Merete; Børke, Wenche Bakken; Lenes, K; Matthews, Iren; Saugstad, Ola Didrik & Thaulow, Erik (2005). Restoration of cardiopulmonary function with 21% versus 100% oxygen after hypoxaemia in newborn pigs. Archives of Disease in Childhood: Fetal and Neonatal Edition. ISSN 1359-2998. 90, p. 229–234. Full text in Research Archive Show summary

  Objective: To assess the consequences of hypoxaemia and resuscitation with room air versus 100% O2 on cardiac troponin I (cTnI), cardiac output (CO), and pulmonary artery pressure (PAP) in newborn pigs. Design: Twenty anaesthetised pigs (12�36 hours; 1.7�2.7 kg) were subjected to hypoxaemia by ventilation with 8% O2. When mean arterial blood pressure fell to 15 mm Hg, or arterial base excess was �20 mmol/l, resuscitation was performed with 21% (n = 10) or 100% (n = 10) O2 for 30 minutes, then ventilation with 21% O2 for 120 minutes. Blood was analysed for cTnI. Ultrasound examinations of CO and PAP (estimated from tricuspid regurgitation velocity (TR-Vmax)) were performed at baseline, during hypoxia, and at the start of and during reoxygenation. Results: cTnI increased from baseline to the end point (p<0.001), confirming a serious myocardial injury, with no differences between the 21% and 100% O2 group (p = 0.12). TR-Vmax increased during the insult and returned towards baseline values during reoxygenation, with no differences between the groups (p = 0.11) or between cTnI concentrations (p = 0.31). An inverse relation was found between increasing age and TR-Vmax during hypoxaemia (p = 0.034). CO per kg body weight increased during the early phase of hypoxaemia (p<0.001), then decreased. Changes in CO per kg were mainly due to changes in heart rate, with no differences between the groups during reoxygenation (p = 0.298). Conclusion: Hypoxaemia affects the myocardium and PAP. During this limited period of observation, reoxygenation with 100% O2 showed no benefits compared with 21% O2 in normalising myocardial function and PAP. The important issue may be resuscitation and reoxygenation without hyperoxygenation

• Fugelseth, Drude; Satas, Saulius; Steen, PA & Thoresen, Marianne (2003). Cardiac output, pulmonary artery pressure, and patent ductus arteriosus during therapeutic cooling after global hypoxia-ischaemia. Archives of Disease in Childhood: Fetal and Neonatal Edition. ISSN 1359-2998. 88(3), p. F223–F228. Full text in Research Archive

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• Nestaas, Eirik; BJARKØ, LISA; Kiserud, Torvid; Haugen, Guttorm Nils & Fugelseth, Drude (2024). Corrigendum to “Heart function by M-mode and tissue Doppler in the early neonatal period in neonates with fetal growth restriction”, [Early Hum. Dev. 183 (2023) 105809] (Early Human Development (2023) 183, (S0378378223001056), (10.1016/j.earlhumdev.2023.105809)). Early Human Development. ISSN 0378-3782. doi: 10.1016/j.earlhumdev.2024.106032. Full text in Research Archive
• BJARKØ, LISA; Fugelseth, Drude; Harsem, Nina Kittelsen; Kiserud, Torvid; Haugen, Guttorm Nils & Nestaas, Eirik (2024). Correction to: Cardiac morphology in neonates with fetal growth restriction (Journal of Perinatology, (2023), 43, 2, (187-195), 10.1038/s41372-022-01538-8). Journal of Perinatology. ISSN 0743-8346. doi: 10.1038/s41372-024-02104-0. Full text in Research Archive
• Rajar, Polona; Dhariwal, Achal; Salvadori, Gabriela; Junges, Roger; Åmdal, Heidi Aarø & Berild, Dag [Show all 12 contributors for this article] (2022). Microbial DNA extraction of high-host content and low biomass samples: optimized protocol for nasopharynx metagenomic studies. Full text in Research Archive Show summary

  Low microbial biomass and high human DNA content in nasopharyngeal aspirate samples hinder comprehensive characterization of microbiota and resistome. We obtained samples from premature infants, a group with increased risk of developing respiratory disorders and infections, and consequently frequent exposure to antibiotics. Our aim was to devise an optimal protocol for handling nasopharyngeal aspirates from premature infants, focusing on host DNA depletion and microbiome and resistome characterization. Three depletion and three DNA extraction protocols were compared, using RT-PCR and whole metagenome sequencing to determine the efficiency of human DNA removal, taxonomic profiling and assignment of antibiotic resistance genes. Protocols were tested using mock communities, as well as pooled and individual patient samples. The only extraction protocol to retrieve the expected DNA yield from mock community samples was based on a lytic method to improve Gram positive recovery (MasterPure™). Only samples depleted with MolYsis™ showed satisfactory, but varied reduction in host DNA content, in both pooled and individual patient samples, allowing for microbiome and resistome characterisation (host DNA content from 15% to 98%). PCR results were indicative of achieved microbial enrichment. Despite high human DNA and low microbial biomass content in nasopharynx aspirates of preterm infants, we were able to reduce host DNA content to levels compatible with downstream shotgun metagenomic analysis, including bacterial species identification and coverage of antibiotic resistance genes. Whole metagenomic sequencing of microbes colonizing the nasopharynx may contribute to explaining the possible role of airway microbiota in respiratory conditions and reveal carriage of antibiotic resistance genes.

• Brigtsen, Anne Karin; Jacobsen, Anne Flem; Dedi, Lumnije; Melby, Kjetil K.; Espeland, Cathrine Nygaard & Fugelseth, Drude [Show all 7 contributors for this article] (2019). Maternal peripartum infection in women colonized with group B Streptococcus at delivery: a prospective cohort study. Full text in Research Archive
• Kynø, Nina Margrethe; Fugelseth, Drude & Hanssen, Ingrid (2018). Når felles språk med helsepersonell mangler; mødres opplevelser på nyfødtintensiv avdeling. Full text in Research Archive
• Fugelseth, Drude (2017). Measuring superior vena cava flow as part of echocardiography examinations performed by neonatologists. Acta Paediatrica. ISSN 0803-5253. 106(1), p. 5–6. doi: 10.1111/apa.13604. Full text in Research Archive
• Wood, Thomas Ragnar; Skranes, Janne Helen; Falck, Mari; Lohaugen, GC; Stiris, Tom & Loberg, EM [Show all 8 contributors for this article] (2016). Core Temperature After Neonatal Hypoxia-Ischaemia Predicts Long-term Cerebral Injury. Full text in Research Archive
• Skranes, Janne Helen; Cowan, Frances; Stiris, Tom; Fugelseth, Drude; Thoresen, Marianne & SERVER, ANDRES (2014). Cerebral MRI on Days 4 and 11 in Encephalopathic Neonates Treated With Hypothermia. Full text in Research Archive
• Skranes, Janne Helen; Thoresen, Marianne; Stiris, Tom; Cowan, Frances; Server, Andres Alonso & Fugelseth, Drude [Show all 7 contributors for this article] (2013). Changes in Cerebral Resistance Index (RI) after rewarming from day three of cooling predicts good but not poor outcome in infants undergoing therapeutic hypothermia. Full text in Research Archive
• Fugelseth, Drude & Kutzsche, Stefan (2013). Ensuring safe neonatal care for newborn babies. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 133(3), p. 270–271. doi: 10.4045/tidsskr.12.1222. Full text in Research Archive
• Brigtsen, Anne Karin; Dedi, Lumnije; Melby, Kjetil K.; Fugelseth, Drude; Flem-Jacobsen, Anne & Lindemann, Rolf (2012). High Prevalence of Group B Streptococcus Serotype IX in the Norwegian Population. Full text in Research Archive
• Eriksen, Beate Horsberg; Nestaas, Eirik & Fugelseth, Drude (2012). Functional echocardiography and cerebral blood doppler velocity measurements: Repeated examinations for clinical assessment in moderately preterm infants. Journal of Maternal-Fetal & Neonatal Medicine. ISSN 1476-7058. 25. doi: 10.3109/14767058.2012.667977. Full text in Research Archive
• Bakkeheim, Egil; Bergerud, U. E.; Schmidt-Melbye, Anne-Christine; Akkok, CA; Liestøl, Knut & Fugelseth, Drude [Show all 7 contributors for this article] (2010). Maternal IgG Anti-A and Anti-B Titres Predict Outcome in ABO-Incompatibility in the Neonate EDITORIAL COMMENT. Obstetrical and Gynecological Survey. ISSN 0029-7828. 65(3), p. 160–162. Full text in Research Archive
• Fugelseth, Drude Merete; Børke, Wenche Bakken; Lenes, Kjetil; Matthews, Iren; Saugstad, Ola Didrik & Thaulow, Erik (2004). Reversal of pulmonary hypertension and restoration of cardiac output in hypoxemic newborn pigs. Full text in Research Archive
• Nestaas, Eirik & Fugelseth, Drude (2010). Longitudinal strain and strain rate by tissue Doppler in term neonates. Universitetet i Oslo. ISSN 9788280725912. Full text in Research Archive

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