Expired Tidal Volume Variation in Extremely Low Birth Weight and Very Low Birth Weight Infants on Volume-Targeted Ventilation

2019 ◽  
Vol 207 ◽  
pp. 248-251.e1 ◽  
Author(s):  
Samuel Wong ◽  
Honglang Wang ◽  
Robert Tepper ◽  
Gregory M. Sokol ◽  
Rebecca Rose
Author(s):  
A. V. Migali ◽  
K. A. Kazakova ◽  
Yu. S. Akoyev ◽  
V. M. Studenikin ◽  
M. A. Varichkina ◽  
...  

Innovative technologies in the reanimation and intensive therapy permitted to improve the survival of premature infants, including those with extremely low birth weight infants. There are considered various issues of practical medical care for very-low-birth weight infants in the first three years of life. The special attention is given to patients with bronchopulmonary dysplasia (BPD). There is briefly presented the own authors’ experience of the observation for premature infants in conditions of a multidisciplinary team care approach. There were described such important aspects of the mentioned category of patients as neurodietology/nutritional rehabilitation, compliance with aseptic environmental conditions, the correction of visual and hearing impairment, treatment of neurological deficit, especially neuropharmacology, treatment of paroxysmal disorders and epilepsy.


2020 ◽  
Vol 40 (2) ◽  
pp. 233-236 ◽  
Author(s):  
Kathrin Burgmaier ◽  
Agnes Hackl ◽  
Rasmus Ehren ◽  
Angela Kribs ◽  
Mathias Burgmaier ◽  
...  

The outcome of extremely low-birth-weight (ELBW) and very low-birth-weight (VLBW) infants has substantially improved in recent years. As acute kidney injury is frequent in these infants due to various risk factors, there is an increasing demand for renal replacement therapy in these patients. Data on that topic, however, are scarce. We review the available literature on that topic and report our experience on temporary dialysis in three extremely immature infants (two ELBW and one VLBW) with acute kidney failure. Peritoneal dialysis (PD) was performed for 19, 23, and 44 days until recovery of native renal function. At recent follow-up of 18 and 24 months, two patients are in good clinical condition with chronic kidney disease stages 1 and 4, respectively. One patient deceased at the age of 12 months due to secondary liver failure. The dialysis regimen applied in our study differed significantly from older infants with extremely short dwell times and accordingly high numbers of daily cycles. The use of rigid acute PD catheters was associated with less catheter-related complications (leakage, dislocation, and obstruction) as compared to ascites drainage catheters. In summary, PD was technically feasible and effective also in extremely immature infants, but frequent adjustments of dialysis regimens and high numbers of daily cycles posed immense efforts on both, parents and medical staff.


Author(s):  
Kumar Abdul Rashid ◽  
Reyaz Ahmad Wani ◽  
Shafat Ahmad Tak ◽  
Omar Masood ◽  
Amat U. Samie ◽  
...  

Background: Necrotizing enterocolitis is a life-threatening inflammation of neonatal intestine of multifactorial etiology. In early stages, medical management is considered; while as a transmural disease with pneumatosis or perforation needs surgical attention. Primary peritoneal drainage has evolved as an alternative to classic exploratory laparotomy especially in sick preterm and very low birth weight infants.Methods: In our study, we tried to employ primary peritoneal drainage as an initial intervention in all surgical necrotizing enterocolitis patients and analyzed the results and final outcome in terms of total days in neonatal intensive care unit, total parenteral nutrition days, days to start oral feeds, need for laparotomy, mortality and other complications.Results: Around one-third patients were either very low or extremely low birth weight and 80% patients were preterm. Primary peritoneal drainage was successful without need for laparotomy in around 65% of patients. In the rest 34 patients, 24 were subjected to rescue laparotomy, while 10 could not be stabilized for major surgery. Overall mortality was 29.16%.Conclusions: Early bedside primary peritoneal drainage can be employed in all cases of NEC with perforation with rescue laparotomy to be determined by subsequent monitoring. This strategy seems to be safe and cost-effective in a resource challenged set up and lifesaving in sick and extremely low birth weight infants.


Author(s):  
Helen Trotman ◽  
Maureen Samms-Vaughan ◽  
Charlene Coore-Desai ◽  
Jody-Ann Reece ◽  
Oluwayomi Olugbuyi

Objective The study aimed to determine the outcome of babies born to women ≥40 years in a Jamaican birth cohort. Patients and Methods Maternal demographic data and neonatal data for women ≥40 years who delivered live singleton babies and their younger counterparts aged 20 30 years were extracted from the JA KIDS birth cohort dataset. Outcome measures were preterm birth, low birth weight, very low birth weight, extremely low birth weight, macrosomia, a low 5-minute Apgar score <7, admission to the neonatal unit, and neonatal death. Descriptive analyses were performed; statistical significance was taken at the level p <0.05. Results A total of 5,424 women and their babies were entered into the study, 5,099 (94%) women were aged 20 to 30 years (mean age ± standard deviation [SD]: 24.5 ± 3.2 years) and 325 (6%) were aged ≥40 years (mean age ± SD: 41.5 ± 1.6 years). A greater percentage of preterm babies (18%) were born to women ≥40 years than to their younger counterparts (14%; p = 0.04). There was no difference in the proportion of low birth weight infants, very low birth weight infants, or extremely low birth weight infants born between the two groups (p > 0.05). There was also no significant difference in the proportion of babies who were macrosomic and in those who had a low 5-minute Apgar score <7. There were 866 (16%) neonatal admissions, 67/325 (21%) of these babies were born to women aged ≥40 years and 799/5,099 (16%) were born to their younger counterparts (p = 0.01). The commonest reason for admission was prematurity. While 60 babies died, there was no significant difference between both groups with 56 (1%) born to women 20 to 30 years and 4 (1%) born to women ≥40 years (p = 0.48). Conclusion Adverse outcomes noted for babies born to women ≥40 years were prematurity and the need for neonatal admission. However, no excess mortality was recorded. Key Points


2010 ◽  
Vol 29 (3) ◽  
pp. 153-160 ◽  
Author(s):  
Nichole Miller

The generalized anatomic and physiologic immaturity of preterm infants of very low birth weight (VLBW) (≤1,500 g) and extremely low birth weight (ELBW) (≤1,000 g) places them at high risk for death or associated negative sequelae, including chronic lung disease of infancy (CLDI). The standard treatment for pulmonary immaturity, mechanical ventilation (MV) at birth, can lead to barotrauma, volutrauma, pulmonary edema, infection, and inflammation. To minimize these negative outcomes, multiple treatment strategies have been proposed and evaluated as to their subsequent clinical course. This article compares, contrasts, and integrates the use of MV, nasal continuous positive airway pressure (NCPAP), and surfactant administration to encourage and support consideration of their use in the VLBW and ELBW population. Supporting a reduction of the use of MV in favor of NCPAP is safe and recommended because this practice is likely to decrease the probable sequelae of CLDI while permitting an individualized approach.


2008 ◽  
Vol 27 (2) ◽  
pp. 127-140 ◽  
Author(s):  
Mary Raney ◽  
Ann Donze ◽  
Joan Renaud Smith

FORTY TO 80 PERCENT OF VERY LOW birth weight (VLBW) (infants <1,500 g) and extremely low birth weight (ELBW) (infants <1,000 g) infants will develop hyperglycemia when provided with glucose infusions adequate to meet basal metabolic needs.1,2 Avoiding hyperglycemia while providing adequate nutrition to promote growth and development is a major challenge for health care providers in the NICU. Some health care providers suggest that the judious use of continuous insulin infusion (CII) may provide the opportunity for increasing nutritional support while maintaining euglycemia. A systematic review of the literature is presented to evaluate the evidence supporting this practice.


Sign in / Sign up

Export Citation Format

Share Document