The impact of surgery on infants born at extremely low birth weight

Background: Disentangling renal adverse drug reactions from confounders remains a major challenge to assess causality and severity in neonates, with additional limitations related to the available tools (modified Kidney Disease Improving Global Outcome, or Division of Microbiology and Infectious Diseases pediatric toxicity table). Vancomycin and amikacin are nephrotoxic while still often prescribed in neonates. We selected these compounds to assess their impact on creatinine dynamics as a sensitive tool to detect a renal impairment signal. Methods: A recently developed dynamical model that characterized serum creatinine concentrations of 217 extremely low birth weight (<1000 g, ELBW) neonates (4036 observations) was enhanced with data on vancomycin and/or amikacin exposure to identify a potential effect of antibiotic exposure by nonlinear mixed-effects modelling. Results: Seventy-seven percent of ELBW patients were exposed to either vancomycin or amikacin. Antibiotic exposure resulted in a modest increase in serum creatinine and a transient decrease in creatinine clearance. The serum creatinine increase was dependent on gestational age, illustrated by a decrease with 56% in difference in serum creatinine between a 24 or 32-week old neonate, when exposed in the 3rd week after birth. Conclusions: A previously described model was used to explore and quantify the impact of amikacin or vancomycin exposure on creatinine dynamics. Such tools serve to explore minor changes, or compare minor differences between treatment modalities.

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The Impact of Fluid Therapy Strategies on Nonoliguric Hyperkalemia in Extremely Low Birth Weight Infants

Neonatal Medicine ◽

10.5385/nm.2014.21.1.28 ◽

2014 ◽

Vol 21 (1) ◽

pp. 28

Author(s):

Min Young Kim ◽

Eun Jae Chang ◽

Young Hye Kim ◽

Woo Jung Jang ◽

Hye Jung Cho ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Fluid Therapy ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infants ◽

Therapy Strategies ◽

The Impact

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Late-Onset Sepsis as a Risk Factor for Bronchopulmonary Dysplasia in Extremely Low Birth Weight Infants: A Nationwide Cohort Study

Scientific Reports ◽

10.1038/s41598-019-51617-8 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 5

Author(s):

Euiseok Jung ◽

Byong Sop Lee

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Birth Weight ◽

Low Birth Weight ◽

Bronchopulmonary Dysplasia ◽

Late Onset ◽

Extremely Low Birth Weight ◽

Late Onset Sepsis ◽

The Impact ◽

Multiple Episodes

Abstract This study aimed to determine the effect of late-onset sepsis (LOS) on the development of bronchopulmonary dysplasia (BPD) in extremely low birth weight (ELBW) infants. A prospective cohort study was performed using data collected from 64 centres registered in the Korean national registry. LOS was defined as a positive blood culture and antibiotics treatment after 72 hours of life and prior to 36 weeks postmenstrual age (PMA). Data on the causative organisms were collected and analysed for respiratory outcomes. Among the 1,434 ELBW infants who survived to 36 weeks PMA, 481 (34%) developed LOS caused by bacteria (n = 405), fungi (n = 28), or both (n = 48). The incidence of BPD was significantly associated with LOS in both the entire cohort and the propensity score-matched cohort. Two or more LOS episodes were a risk factor for BPD. The impact of multiple episodes of LOS on BPD was prominent in infants who received mechanical ventilation for two weeks or less. The estimated odds ratios for BPD and severe BPD were greater with fungal LOS than with bacterial LOS. In conclusion, LOS, particularly complicated by multiple episodes and/or fungi, was a risk factor for BPD in ELBW infants.

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Growth, Feeding Tolerance and Metabolism in Extreme Preterm Infants under an Exclusive Human Milk Diet

Nutrients ◽

10.3390/nu11071443 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1443 ◽

Cited By ~ 1

Author(s):

Eibensteiner ◽

Auer-Hackenberg ◽

Jilma ◽

Thanhaeuser ◽

Wald ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Growth Parameters ◽

Extremely Low Birth Weight ◽

Multicenter Cohort Study ◽

Protein Sources ◽

The Impact ◽

Feeding Tolerance

Background: For preterm infants, human milk (HM) has to be fortified to cover their enhanced nutritional requirements and establish adequate growth. Most HM fortifiers are based on bovine protein sources (BMF). An HM fortifier based on human protein sources (HMF) has become available in the last few years. The aim of this study is to investigate the impact of an HMF versus BMF on growth in extremely low birth weight (ELBW, <1000 g) infants. Methods: This was a retrospective, controlled, multicenter cohort study in infants with a birthweight below 1000 g. The HMF group received an exclusive HM diet up to 32+0 weeks of gestation and was changed to BMF afterwards. The BMF group received HM+BMF from fortifier introduction up to 37+0 weeks. Results: 192 extremely low birth weight (ELBW)-infants were included (HMF n = 96, BMF n = 96) in the study. After the introduction of fortification, growth velocity up to 32+0 weeks was significantly lower in the HMF group (16.5 g/kg/day) in comparison to the BMF group (18.9 g/kg/day, p = 0.009) whereas all other growth parameters did not differ from birth up to 37+0 weeks. Necrotizing enterocolitis (NEC) incidence was 10% in the HMF and 8% in the BMF group. Conclusion: Results from this study do not support the superiority of HFM over BMF in ELBW infants.

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The Impact of Extremely Low Birth Weight on the Families of School-Aged Children

PEDIATRICS ◽

10.1542/peds.2005-2118 ◽

2006 ◽

Vol 117 (6) ◽

pp. 2006-2013 ◽

Cited By ~ 38

Author(s):

D. Drotar

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Extremely Low Birth Weight ◽

School Aged Children ◽

The Impact

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The impact of instrumental dead-space in volume-targeted ventilation of the extremely low birth weight (ELBW) infant

Pediatric Pulmonology ◽

10.1002/ppul.20954 ◽

2009 ◽

Vol 44 (2) ◽

pp. 128-133 ◽

Cited By ~ 35

Author(s):

Sepideh Nassabeh-Montazami ◽

Kabir M. Abubakar ◽

Martin Keszler

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Dead Space ◽

Extremely Low Birth Weight ◽

The Impact

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The Administration of Probiotics in Extremely Low-Birth-Weight Infants and the Incidence of Necrotizing Enterocolitis and Mortality: A Systematic Review

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i48b33269 ◽

2021 ◽

pp. 121-131

Author(s):

Mohammed Khalid Harasani ◽

Sarah Abdulrahman Almosaiteer ◽

Faisal Saleh Aloraini ◽

Saleh Khalid Aldakhil ◽

Jamilah Sulaiman Alsaiari ◽

...

Keyword(s):

Systematic Review ◽

Birth Weight ◽

Low Birth Weight ◽

Randomized Controlled Trials ◽

Necrotizing Enterocolitis ◽

Extremely Low Birth Weight ◽

Controlled Trials ◽

Low Birth Weight Infants ◽

Randomized Controlled ◽

The Impact

Encouraging findings were previously demonstrated in a previous meta-analysis that analyzed the results of randomized controlled trials (RCTs) that investigated the potential favorable effects of probiotics administration in preterm infants to prevent necrotizing enterocolitis (NEC) and feeding intolerance. This evidence has only been linked to low birth-weight infants (<1000 g), while evidence regarding the impact of administration of these modalities for Extremely Low-Birth-Weight Infants (ELBW) infants is still controversial among the different studies in the literature. A systematic review was conducted to retrieve all the relevant randomized controlled trials in the literature that investigated the impact of probiotics administration on the different outcomes in ELBW infants, including the incidence of mortality and NEC. A thorough search was then conducted through the different databases to find the relevant articles.A total of 11 RCTs were included in the present systematic review. All articles were published between 2007 and 2021, with a total of 3225 ELBW infants were included in both the intervention and control groups across the different included trials. Our results indicate that the administration of these modalities does not have a significant impact on these outcomes. However, it has been reported that they enhance the growth rate, especially head growth circumference, which has been reported to be superior to the placebo effect. Further investigations for ELBW should be encouraged to furtherly validate these modalities, although no adverse events have been reported for their administration among trials in the current systematic review.

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