Neuropsychological Outcomes in Extremely Preterm Preschoolers Exposed to Tiered Low Oxygen Targets: An Observational Study

2015 ◽  
Vol 22 (3) ◽  
pp. 322-331 ◽  
Author(s):  
Ida Sue Baron ◽  
Brandi A. Weiss ◽  
Robin Baker ◽  
Margot D. Ahronovich ◽  
Fern R. Litman ◽  
...  
Keyword(s):  
Observational Study ◽  
Oxygen Saturation ◽  
Preschool Age ◽  
Preterm Neonates ◽  
Quality Improvement Initiative ◽  
Low Oxygen ◽  
Extremely Preterm ◽  
Visual Motor ◽  
Neuropsychological Outcomes ◽  
Group Comparisons

AbstractAn observational study of neuropsychological outcomes at preschool age of tiered lowered oxygen (O2) saturation targets in extremely preterm neonates. We studied 111 three-year-olds born <28 weeks’ gestational age. Fifty-nine participants born in 2009–2010 during a time-limited quality improvement initiative each received three-tiered stratification of oxygen rates (83–93% until age 32 weeks, 85–95% until age 35 weeks, and 95% after age 35 weeks), the TieredO2group. Comparisons were made with 52 participants born in 2007–2008 when pre-initiative saturation targets were non-tiered at 89–100%, the Non-tieredO2group. Neuropsychological domains included general intellectual, executive, attention, language, visuoperceptual, visual-motor, and fine and gross motor functioning. Descriptive and inferential analyses were conducted. Group comparisons were not statistically significant. Descriptively, the TieredO2group had better general intellectual, executive function, visual-motor, and motor performance and the Non-tieredO2group had better language performance. Cohen’sdand confidence intervals arounddwere in similar direction and magnitude across measures. A large effect size was found for recall of digits-forward in participants born at 23 and 24 weeks’ gestation,d=0.99 and 1.46, respectively. Better TieredO2outcomes in all domains except language suggests that the tiered oxygen saturation target method is not harmful and merits further investigation through further studies. Benefit in auditory attention appeared greatest in those born at 23 and 24 weeks. Participants in the tiered oxygen saturation group also had fewer ventilation days and a lower incidence of bronchopulmonary dysplasia, perhaps explanatory for these neuropsychological outcomes at age 3. (JINS, 2015,21, 322–331)

scholarly journals High Mortality among Premature Neonates with Positive Blood Culture Neonatal Sepsis in a Tertiary Hospital, Tanzania: A Call for Action

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1037
Author(s):  
Delfina R. Msanga ◽  
Fatema Parpia ◽  
Eveline T. Konje ◽  
Adolfine Hokororo ◽  
Stephen E. Mshana
Keyword(s):  
Blood Glucose ◽  
Blood Culture ◽  
Oxygen Saturation ◽  
Positive Blood Culture ◽  
Vital Signs ◽  
Limited Resource ◽  
Preterm Neonates ◽  
Low Oxygen ◽  
Premature Neonates ◽  
Random Blood Glucose

Well-documented vital signs are key in the prediction of sepsis in low- and middle-income countries. We determined prevalence, associated factors, and outcomes of positive blood culture sepsis in premature neonates at Bugando Medical Centre Mwanza, Tanzania. Temperature, oxygen saturation, heart rate, respiratory rate, and random blood glucose were repeatedly recorded at admission, 8 h, and 24 h in all 250 neonates enrolled. Clinical and microbiological data were collected from patient records followed by descriptive data analysis. The mean age of the neonates was 3 ± 5.2 days, with the majority (90%) aged <10 days. The prevalence of positive blood culture sepsis was 21.2% (95% CI: 16.1–26.2). The fluctuation of the random blood glucose (RBG) (aOR = 1.34, 95% CI: (1.07–1.67), p = 0.010), low oxygen saturation (aOR = 0.94, 95% CI: (0.88–0.99), p = 0.031), premature rupture of membrane aOR = 4.28, 95% CI: (1.71–10.71), p = 0.002), gestational age < 34 weeks (aOR = 2.73, 95% CI: (1.20–6.24), p = 0.017), and home delivery (aOR = 3.90, 95% CI: (1.07–14.19), p = 0.039) independently predicted positive blood culture. Significantly more deaths were recorded in neonates with a positive blood culture than those with a negative blood culture (32.1% vs. 5.1%, p < 0.001). In limited-resource settings, clinicians should use the vital signs and clinical information to initiate timely sepsis treatment among preterm neonates to prevent deaths and other morbidities.

scholarly journals Association of early skin breaks and neonatal thalamic maturation

Neurology ◽  
2020 ◽  
Vol 95 (24) ◽  
pp. e3420-e3427
Author(s):  
Emma G. Duerden ◽  
Ruth E. Grunau ◽  
Vann Chau ◽  
Floris Groenendaal ◽  
Ting Guo ◽  
...  
Keyword(s):  
Standardized Tests ◽  
Linear Models ◽  
Central Venous Line ◽  
Preschool Age ◽  
Multiple Infections ◽  
Preterm Neonates ◽  
Arterial Line ◽  
Invasive Procedures ◽  
Very Preterm ◽  
Extremely Preterm

ObjectiveTo test the hypothesis that a strategy of prolonged arterial line (AL) and central venous line (CVL) use is associated with reduced neonatal invasive procedures and improved growth of the thalamus in extremely preterm neonates (<28 weeks' gestation).MethodsTwo international cohorts of very preterm neonates (n = 143) with prolonged (≥14 days) or restricted (<14 days) use of AL/CVL were scanned serially with MRI. General linear models were used to determine the association between skin breaks and thalamic volumes, accounting for clinical confounders and site differences. Children were assessed at preschool age on standardized tests of motor and cognitive function. Outcome scores were assessed in relation to neonatal thalamic growth.ResultsProlonged AL/CVL use in neonates (n = 86) was associated with fewer skin breaks (median 34) during the hospital stay compared to restricted AL/CVL use (n = 57, median 91, 95% confidence interval [CI] 60.35–84.89). Neonates with prolonged AL/CVL use with fewer skin breaks had significantly larger thalamic volumes early in life compared to neonates with restricted line use (B = 121.8, p = 0.001, 95% CI 48.48–195.11). Neonatal thalamic growth predicted preschool-age cognitive (B = 0.001, 95% CI 0.0003–0.001, p = 0.002) and motor scores (B = 0.01, 95% CI 0.001–0.10, p = 0.02). Prolonged AL/CVL use was not associated with greater incidence of sepsis or multiple infections.ConclusionsProlonged AL/CVL use in preterm neonates may provide an unprecedented opportunity to reduce invasive procedures in preterm neonates. Pain reduction in very preterm neonates is associated with optimal thalamic growth and neurodevelopment.

scholarly journals Role of remdisivir among COVID-19 patient’s recovery.

2021 ◽  
Vol 28 (12) ◽  
pp. 1862-1868
Author(s):  
Ather Mehmood ◽  
Javaria Malik ◽  
Attiya Hameed Khan ◽  
Wajid Hussain ◽  
Akhtar Ali Bandeshah ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Observational Study ◽  
Oxygen Saturation ◽  
Length Of Hospital Stay ◽  
Low Oxygen ◽  
Good Clinical Outcome ◽  
The Mean ◽  
Study Setting ◽  
Positive Effect

Objective: To assess the effect of Remedisvir, its safety Profile, and efficacy among COVID-19 patients. Study Design: Retrospective Observational study. Setting: South East Hospital and Research Center, Islamabad, Pakistan. Period: December 2020 to July 2021. Material & Methods: 100 patients were included in this study who received Remedisvir infusion, day 5, 7, and 10 after admitting the hospital with COVID-19 symptoms. We infuse 200mg I/V Remedisvir in 100cc N/S followed by 100mg I/V daily into 100cc N/S. After infusion, all patients were monitored strictly. Results: The mean age of the patients was (51. 89±15.441). The outcome of Remedisvir showed that 14% improved their condition, 42% discharged with oxygen, 27% discharged without oxygen, and only 17% expired). Remedisvir showed a positive effect at (p≤0.001) among laboratory values and oxygen support category. Conclusion: When patient suffering from COVID-19 symptoms and low oxygen saturation show good clinical outcome treated with Remedisvir. According to the results of our study, it is concluded that, at present Remedisvir remains a good drug, it shows a positive effect on oxygen saturation and length of hospital stay.

Immediate Effects of Phototherapy on Sleep of Very Preterm Neonates: An Observational Study

2015 ◽  
Vol 46 (S 01) ◽  
Author(s):  
M. Cremer ◽  
K. Jost ◽  
S. Schulzke ◽  
P. Weber ◽  
A. Datta
Keyword(s):  
Observational Study ◽  
Preterm Neonates ◽  
Very Preterm

scholarly journals Breathing space: deoxygenation of aquatic environments can drive differential ecological impacts across biological invasion stages

2021 ◽  
Author(s):  
James W. E. Dickey ◽  
Neil E. Coughlan ◽  
Jaimie T. A. Dick ◽  
Vincent Médoc ◽  
Monica McCard ◽  
...  
Keyword(s):  
Climate Change ◽  
Oxygen Saturation ◽  
Ecological Impacts ◽  
Neogobius Melanostomus ◽  
Aquatic Environments ◽  
Relative Impact ◽  
Low Oxygen ◽  
Per Capita ◽  
The Impact ◽  
Prey Populations

AbstractThe influence of climate change on the ecological impacts of invasive alien species (IAS) remains understudied, with deoxygenation of aquatic environments often-overlooked as a consequence of climate change. Here, we therefore assessed how oxygen saturation affects the ecological impact of a predatory invasive fish, the Ponto-Caspian round goby (Neogobius melanostomus), relative to a co-occurring endangered European native analogue, the bullhead (Cottus gobio) experiencing decline in the presence of the IAS. In individual trials and mesocosms, we assessed the effect of high, medium and low (90%, 60% and 30%) oxygen saturation on: (1) functional responses (FRs) of the IAS and native, i.e. per capita feeding rates; (2) the impact on prey populations exerted; and (3) how combined impacts of both fishes change over invasion stages (Pre-invasion, Arrival, Replacement, Proliferation). Both species showed Type II potentially destabilising FRs, but at low oxygen saturation, the invader had a significantly higher feeding rate than the native. Relative Impact Potential, combining fish per capita effects and population abundances, revealed that low oxygen saturation exacerbates the high relative impact of the invader. The Relative Total Impact Potential (RTIP), modelling both consumer species’ impacts on prey populations in a system, was consistently higher at low oxygen saturation and especially high during invader Proliferation. In the mesocosm experiment, low oxygen lowered RTIP where both species were present, but again the IAS retained high relative impact during Replacement and Proliferation stages at low oxygen. We also found evidence of multiple predator effects, principally antagonism. We highlight the threat posed to native communities by IAS alongside climate-related stressors, but note that solutions may be available to remedy hypoxia and potentially mitigate impacts across invasion stages.

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