Accuracy of the Apple Watch single-lead ECG recordings in pre-term neonates

2021 ◽  
pp. 1-5
Author(s):  
Christian Paech ◽  
Maria Kobel ◽  
Anna Michaelis ◽  
Roman Antonin Gebauer ◽  
Philipp Kalden ◽  
...  
Keyword(s):  
University Hospital ◽  
Preterm Neonates ◽  
Excellent Correlation ◽  
Term Neonates ◽  
Paediatric Cardiologist ◽  
Remote Areas ◽  
Neonatal Icu ◽  
Gestational Week ◽  
Widespread Availability ◽  
Cardiac Specialist

Abstract Introduction: Telemedicine gained an increasing use throughout the last years. Lifestyle tools like the Apple watch seem to have an increasing spread even in remote areas and underdeveloped regions. The increasing availability of these tools offers the chance to use the health care functions of these devices to improve provision of professional medical care. First data on the use of the Apple Watch as a remote monitoring device in children have been reported, showing good acceptability and usability of the Apple Watch for symptom monitoring in children. This study aimed to evaluate the accuracy of the Apple Watch iECG in comparison to a standard 12-lead ECG in pre-term babies. Methods: In this prospective, single-arm study, consecutive preterm neonates hospitalised in Leipzig University Hospital neonatal ICU were eligible. A 12-lead ECG and an iECG using Apple Watch 4 were performed. iECG and 12-lead ECG measurements were performed by a paediatric cardiologist. Cardiac rhythm was classified and amplitudes and timing intervals were analysed for comparability. Results: Fifty preterm neonates, gestational week (23–36 weeks), and body weight (0.65–3.09 kg) were enrolled. Overall good quality and excellent correlation of the Apple Watch generated iECG in comparison to the standard 12-lead ECG could be demonstrated (p < 0.001). When interpreted by a paediatric cardiologist, a correct rhythm classification could be done in 100% of cases. Conclusion: The Apple Watch iECG seems to be a valuable tool to record an ECG comparable to lead I of the standard 12-lead ECG even in pre-term neonates. With a widespread availability and excellent connectivity, the Apple Watch iECG function may provide practitioners with a tool to send an iECG for interpretation to a paediatric cardiac specialist.

scholarly journals Serum Calcium Levels in Preterm and Term Neonates on Phototherapy

2014 ◽  
Vol 34 (1) ◽  
pp. 24-28 ◽  
Author(s):  
S Arora ◽  
GS Narang ◽  
G Singh
Keyword(s):  
Serum Calcium ◽  
Magnesium Deficiency ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Term Neonates ◽  
Neonatal Icu ◽  
Appropriate For Gestational Age ◽  
Preterm Group ◽  
Double Surface

Introduction: In addition to known causes of hypocalcemia like, prematurity, Intrauterine growth retardation (IUGR), asphyxia, sepsis, infants of diabetic mothers (IDM), high phosphate formula, Magnesium deficiency, effect of phototherapy on serum calcium levels has caught attention of researchers from time to time. The objectives of this study were to evaluate serum calcium levels in relation to duration of phototherapy, single surface Vs double surface phototherapy in term and preterm neonates. Materials and Methods: This study was done in a neonatal ICU of a tertiary care hospital. Hundred preterm and term neonates > 72 hrs of age with weight appropriate for gestational age were selected. Serum calcium levels were measured at the onset and after 24 hrs and 48 hrs of phototherapy and results were analyzed in both the groups. Results: Hypocalcemia was more frequently observed in term group as compared to preterm group. Hypocalcemia occurred more frequently after 48 hrs of continuous phototherapy in both groups. Hypocalcemia was more common under DSPT as compared to SSPT in both groups. Conclusion: Hypocalcemia is a significant problem in neonates subjected to phototherapy. DOI: http://dx.doi.org/10.3126/jnps.v34i1.9165 J Nepal Paediatr Soc 2014;34(1):24-28

Epidemiological, Clinical and Evolutive Aspects of Preterm Neonates at the University Hospital of Angondje – Gabon

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Steeve MINTO'O ◽  
Eliane KUISSI KAMGAING ◽  
Julienne Isabelle MINKO ◽  
Raïssa KOUMBA MANIAGA ◽  
Jean KOKO
Keyword(s):  
University Hospital ◽  
Preterm Neonates ◽  
The University

scholarly journals Short Term Outcomes of Neonates Born after Prolonged Premature Rupture of Membranes < 34 Weeks Gestation

2019 ◽  
Vol 4 (2) ◽  
pp. 83
Author(s):  
Isam Bsisu ◽  
Alaa Aldalaeen ◽  
Rawan Elrajabi ◽  
Ala AlZaatreh ◽  
Rama Jadallah ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Preterm Births ◽  
University Hospital ◽  
High Rate ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Gestational Week ◽  
The Mean

<p><strong><em>Background:</em></strong><em> Preterm premature rupture of membranes (PPROM) is responsible for one?third of all preterm births worldwide. This aim of this study was to investigate the outcome of neonates born after prolonged PPROM with gestational age below 34 weeks. </em></p><p><strong><em>Materials and methods:</em></strong><em> This retrospective study included 65 patients who were born to mothers with Prolonged PPROM &lt;34 weeks gestation between January 2011 and December 2015 and admitted to the neonatal intensive care unit (NICU) at Jordan University Hospital. </em></p><p><strong><em>Results: </em></strong><em>The mean gestational age of included patients was (31.9 ± 2.5 weeks), mean birth weight was (1840 ± 583 g) and 43 (66.2%) were males. The mortality rate in those infants was 12.3 %. Gestational age, birth weight, and Apgar score were significantly lower among mortality cases compared to surviving cases (P &lt; 0.05). </em></p><p><strong><em>Conclusion:</em></strong><em> Prolonged PPROM before the 34<sup>th</sup> gestational week is associated with high rate of morbidity and mortality, for which early identification of risk factors for developing PPROM can help in reducing the risk for preterm labors and subsequent burden on healthcare system.</em></p>

scholarly journals Association Between Platelet-to-Lymphocyte Ratio and Preterm Necrotizing Enterocolitis

2021 ◽  
Vol 9 ◽  
Author(s):  
Juan Zheng ◽  
Hua Wang
Keyword(s):  
Necrotizing Enterocolitis ◽  
Very Low Birth Weight ◽  
University Hospital ◽  
Preterm Neonates ◽  
Control Group ◽  
Platelet To Lymphocyte Ratio ◽  
Retrospective Case ◽  
Low Birth Weight Infants ◽  
Intestinal Necrosis ◽  
Lymphocyte Ratio

Introduction: Necrotizing enterocolitis (NEC) is a fatal condition for very-low-birth-weight infants. Necrotizing enterocolitis is a multi-factor phenomenon that results in intestinal mucosal damage and leads to intestinal necrosis. However, sensitive laboratory indicators for NEC are lacking, making early diagnosis difficult. This study aimed to explore the relationship between the platelet-to-lymphocyte ratio (PLR) and NEC in preterm neonates to enable an earlier diagnosis of the condition.Methods: This was a retrospective case–control study of preterm neonates diagnosed with NEC between January 2018 and December 2019 in the West China Second University Hospital. Controls were selected from preterm neonatal intensive care unit (NICU) graduates, and they were matched for gestation and year of birth to the preterms diagnosed without NEC. In total, 93 and 107 infants were included in the NEC and control groups, respectively. Empowerstats analysis was used to identify the association between PLR and preterm NEC.Results: The NEC group had significantly higher PLR levels than the control group. PLR &gt; 100 within 1 week before NEC diagnosis was a risk factor for NEC. There was a positive connection between PLR and preterm NEC. A PLR of &gt;100 was determined as the optimal cutoff for predicting preterm NEC, with patients with PLR &gt;100 having a higher risk of NEC [odds ratio (OR): 18.82 (95% confidence interval (CI): 2.93–120.98), p = 0.002].Conclusions: A PLR of &gt;100 within 1 week after clinical abnormalities is associated with a high risk of NEC in preterm neonates.

Polymorphonuclear Leukocyte Function in the Preterm Neonate: Effect of Chronologic Age

PEDIATRICS ◽  
1991 ◽  
Vol 87 (5) ◽  
pp. 675-679
Author(s):  
Shaista S. Usmani ◽  
Jerrold S. Schlessel ◽  
Concepcion G. Sia ◽  
Shahid Kamran ◽  
Shahnaz D. Orner
Keyword(s):  
Gestational Age ◽  
Polymorphonuclear Leukocyte ◽  
Preterm Neonate ◽  
Preterm Neonates ◽  
Term Neonates ◽  
Leukocyte Function ◽  
Pmn Functions ◽  
Gestational Age At Birth ◽  
Normal Adults ◽  
Age At Birth

In this study, effect of chronologic age on polymorphonuclear leukocyte (PMN) chemiluminescence and random and chemotactic motility was evaluated in 38 stable preterm neonates of less than 32 weeks' gestation during the first month of life. Chemiluminescence and random and chemotactic motility of PMNs from preterm neonates were first evaluated at mean postnatal age of 9.8 days and then weekly for an ensuing 21-day period. For comparison, one blood sample was obtained for PMN functions from 14 healthy term neonates younger than 72 hours of age and seven normal adults. On day 1 PMN chemiluminescence and random and chemotactic motility values in preterm neonates were significantly lower (P &lt; .001) compared with those in term neonates and PMN function values of term neonates were significantly lower (P &lt; .001) than those of adults. Although initial PMN chemiluminescence and random and chemotactic motility values in preterm neonates were depressed, subsequent values on days 7, 14, and 21 increased significantly (P &lt; .002). On day 21 (mean postnatal age of 30.8 days) no differences existed in chemiluminescent activity and random motility between preterm and term neonates; chemotactic motility in preterm neonates, however, remained impaired. Mean cumulative age (gestational age at birth plus postnatal age) of preterm neonates on day 21 of study was 32.5 weeks, suggesting that chronologic age has more effect on maturational changes in PMN functions than gestational age.

"COMPARATIVE STUDY OF EARLY NEONATAL MORBIDITIES OF LATE PRETERM AND TERM NEONATES"

2021 ◽  
pp. 23-25
Author(s):  
Jatin Manocha ◽  
Kusum Mahajan ◽  
Anuj Kumar
Keyword(s):  
Preterm Infants ◽  
Prospective Observational Study ◽  
Neonatal Period ◽  
Newborn Infants ◽  
Late Preterm ◽  
Preterm Neonates ◽  
Feeding Problems ◽  
Term Neonates ◽  
Late Preterm Infants ◽  
Study Results

Background- Newborn infants are unique in their physiology and the health problems that they experience. Neonatal period is dened from birth to under four weeks of age. Late preterm infants may physiologically and physically appear like infants born at term, but most late preterm infants may undergo complications like respiratory distress, apnea, hypothermia, feeding problems, hypoglycemia, hyperbilirubinemia, sepsis, and mortality. AIM-To compare the clinical prole of late preterm neonates with term neonates. MATERIALAND METHODS: This prospective observational study was carried out in neonatal division of department of pediatrics MMIMSR, Mullana. Eligible neonates delivered at MMIMSR, Mullana born from 34 weeks up to 42 weeks gestation were included. All infants enrolled in the study was followed daily till rst 7 days of life for any morbidity by clinical evaluation and review of hospital records.104 preterms included in the study and 226 term neonates were included in the study. Results- Preterms born via LSCS and NVD were(58%vs.42%).Morbidities in late preterms were Hypoglycemia (21.2% vs. 9.3%), Hypothermia (15.4%vs5.7%), hypocalcaemia (38.4% vs. 5.3%), neonatal hyperbilirubinemia(67.3% vs. 30.5%), feeding difculties(44.2% vs. 14.6%), sepsis(40.4% vs. 19.5%), respiratory support(53% vs. 47%)

scholarly journals Short-Term Neurodevelopmental Outcome in Term Neonates Treated with Phenobarbital versus Levetiracetam: A Single-Center Experience

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Raffaele Falsaperla ◽  
Laura Mauceri ◽  
Piero Pavone ◽  
Massimo Barbagallo ◽  
Giovanna Vitaliti ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Neurodevelopmental Outcome ◽  
University Hospital ◽  
Neonatal Seizures ◽  
First Line ◽  
Short Term ◽  
Term Neonates ◽  
Single Center Experience ◽  
Randomized Controlled Studies ◽  
Antiepileptic Medication

Background. Phenobarbital (PB) has been traditionally used as the first-line treatment for neonatal seizures. More recently, levetiracetam (LEV) has been increasingly used as a promising newer antiepileptic medication for treatment of seizures in neonates. Objectives. The aim of our study was to compare the effect of PB vs. LEV on short-term neurodevelopmental outcome in infants treated for neonatal seizures. Method. This randomized, one-blind prospective study was conducted on term neonates admitted to the Neonatal Intensive Care Unit of S. Bambino Hospital, University Hospital “Policlinico-Vittorio Emanuele,” Catania, Italy, from February 2016 to February 2018. Thirty term neonates with seizures were randomized to receive PB or LEV; the Hammersmith Neonatal Neurological Examination (HNNE) was used at baseline (T0) and again one month after the initial treatment (T1). Results. We found a significantly positive HNNE score for the developmental outcomes, specifically tone and posture, in neonates treated with LEV. There was no significant improvement in the HNNE score at T1 in the neonates treated with PB. Conclusion. This study suggests a positive effect of levetiracetam on tone and posture in term newborns treated for neonatal seizures. If future randomized-controlled studies also show better efficacy of LEV in the treatment of neonatal seizures, LEV might potentially be considered as the first-line anticonvulsant in this age group.

scholarly journals Production of granulocyte colony-stimulating factor in vitro by monocytes from preterm and term neonates [see comments]

Blood ◽  
1993 ◽  
Vol 82 (8) ◽  
pp. 2478-2484 ◽  
Author(s):  
KR Schibler ◽  
KW Liechty ◽  
WL White ◽  
RD Christensen
Keyword(s):  
Newborn Infants ◽  
Preterm Neonates ◽  
Granulocyte Colony Stimulating Factor ◽  
Serum Concentrations ◽  
Colony Stimulating Factor ◽  
Term Infants ◽  
Term Neonates ◽  
And Function ◽  
Stimulating Factor

Abstract We postulated that defective generation of granulocyte colony- stimulating factor (G-CSF) by cells of newborn infants might underlie their deficiencies in upregulating neutrophil production and function during bacterial infection. To test this, we isolated monocytes from the blood of preterm neonates, term neonates, and adults and, after stimulation with various concentrations of interleukin-1 alpha (IL-1 alpha) or lipopolysaccharide (LPS), quantified G-CSF concentrations in cell supernatants and G-CSF mRNA in cell lysates. When stimulated with plateau concentrations of IL-1 alpha for 24 hours, G-CSF concentrations were higher in supernatants of adult cells (8,699 +/- 5,529 pg/10(6) monocytes) than in those from term infants (2,557 +/- 442 pg, P < .05) or from preterm infants (879 +/- 348 pg, P < .05 v adults). When stimulated with plateau concentrations of LPS, supernatants of monocytes from preterm neonates had less G-CSF than did those from term neonates or adults. G-CSF mRNA content was low in cells from preterm infants, higher in those from term infants, and highest in those from adults. On the basis of the in vitro studies, we speculated that serum G-CSF concentrations might be less elevated in neutropenic neonates than in neutropenic adults. Indeed, serum concentrations were relatively low in all nonneutropenic subjects; 92 +/- 34 pg/mL (mean +/- SEM) in 10 preterm neonates, 114 +/- 21 pg/mL in 16 term neonates, and 45 +/- 13 pg/mL in 11 healthy adults. Serum concentrations were not elevated in 7 neutropenic neonates (39 +/- 17 pg/mL) but were in 8 neutropenic adults (2101 +/- 942 pg/mL, P < .05 v healthy adults). Other studies suggested that the lower G-CSF production in neonates is not counterbalanced by a heightened sensitivity of G-CSF--responsive progenitors to G-CSF. Therefore, we speculate that newborn infants, particularly those delivered prematurely, generate comparatively low quantities of G-CSF after inflammatory stimulation, and that this might constitute part of the explanation for their defective upregulation of neutrophil production and function during infection.

INTER-INDIVIDUAL VARIATION IN THEOPHYLLINE CLEARANCE IN CHILDREN

2016 ◽  
Vol 101 (9) ◽  
pp. e2.25-e2
Author(s):  
Mohammed Altamimi ◽  
Imti Choonara ◽  
Helen Sammons
Keyword(s):  
Critically Ill ◽  
Individual Variation ◽  
Critically Ill Patients ◽  
Plasma Clearance ◽  
Age Groups ◽  
Cochrane Library ◽  
Preterm Neonates ◽  
Term Neonates ◽  
The Mean ◽  
The Cochrane Library

BackgroundInter-individual variation in pharmacokinetics in children is an area where there has been little research. We wished to determine the extent of inter-individual variation in the clearance of theophylline in paediatric patients of different ages.MethodsA systematic literature review was performed using the following databases; Embase (1974 to January 2013), Medline (1946 to January 2013), CINAHL (1937 to January 2013), International Pharmaceutical Abstracts (1970 to January 2013) and the Cochrane Library. From the papers, the range in plasma clearance and the coefficient of variation (CV) in plasma clearance were determined.ResultsA total of 56 articles reporting on 1,315 patients met our inclusion criteria. Twenty six studies gave individual data. The majority of the studies were in critically ill patients. Inter-individual variation was a major problem in all age groups. The CV was 9–93% in preterm neonates, 20–97% in term neonates, 18–52% in infants, 2–72% in children and 4.5–43% in adolescents. The mean clearance was higher in children (0.85 to 2 ml/min/kg) than in neonates (0.24 to 0.6 ml/min/kg).ConclusionsLarge inter-individual variation was seen, especially in critically ill patients. Inter-individual variation was higher in neonates than children and adolescents.

scholarly journals Pharmacokinetics of Penicillin G in Preterm and Term Neonates

2018 ◽  
Vol 62 (5) ◽  
Author(s):  
Helgi Padari ◽  
Tuuli Metsvaht ◽  
Eva Germovsek ◽  
Charlotte I. Barker ◽  
Karin Kipper ◽  
...  
Keyword(s):  
Compartment Model ◽  
Interquartile Range ◽  
Penicillin G ◽  
Preterm Neonates ◽  
Parameter Estimates ◽  
Group B Streptococci ◽  
Term Neonates ◽  
Extremely Preterm ◽  
Population Pk ◽  
Group B

ABSTRACTGroup B streptococci are common causative agents of early-onset neonatal sepsis (EOS). Pharmacokinetic (PK) data for penicillin G have been described for extremely preterm neonates but have been poorly described for late-preterm and term neonates. Thus, evidence-based dosing recommendations are lacking. We describe the PK of penicillin G in neonates with a gestational age (GA) of ≥32 weeks and a postnatal age of <72 h. Penicillin G was administered intravenously at a dose of 25,000 or 50,000 IU/kg of body weight every 12 h (q12h). At steady state, PK blood samples were collected prior to and at 5 min, 1 h, 3 h, 8 h, and 12 h after injection. Noncompartmental PK analysis was performed with WinNonlin software. With those data in combination with data from neonates with a GA of ≤28 weeks, we developed a population PK model using NONMEM software and performed probability of target attainment (PTA) simulations. In total, 16 neonates with a GA of ≥32 weeks were included in noncompartmental analysis. The median volume of distribution (V) was 0.50 liters/kg (interquartile range, 0.42 to 0.57 liters/kg), the median clearance (CL) was 0.21 liters/h (interquartile range, 0.16 to 0.29 liters/kg), and the median half-life was 3.6 h (interquartile range, 3.2 to 4.3 h). In the population PK analysis that included 35 neonates, a two-compartment model best described the data. The final parameter estimates were 10.3 liters/70 kg and 29.8 liters/70 kg forVof the central and peripheral compartments, respectively, and 13.2 liters/h/70 kg for CL. Considering the fraction of unbound penicillin G to be 40%, the PTA of an unbound drug concentration that exceeds the MIC for 40% of the dosing interval was >90% for MICs of ≤2 mg/liter with doses of 25,000 IU/kg q12h. In neonates, regardless of GA, the PK parameters of penicillin G were similar. The dose of 25,000 IU/kg q12h is suggested for treatment of group B streptococcal EOS diagnosed within the first 72 h of life. (This study was registered with the EU Clinical Trials Register under EudraCT number 2012-002836-97.)

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