scholarly journals Anatomic accuracy, physiologic characteristics, and fidelity of very low birth weight infant airway simulators

2021 ◽  
Author(s):  
Patricia Lengua Hinojosa ◽  
Frank Eifinger ◽  
Michael Wagner ◽  
Jochen Herrmann ◽  
Monika Wolf ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Reference Values ◽  
Very Low Birth Weight ◽  
List Type ◽  
Preterm Baby ◽  
Low Birth Weight Infants ◽  
Low Birth Weight Infant ◽  
Ventilation Technique ◽  
One Simulator

Abstract Background Medical simulation training requires realistic simulators with high fidelity. This prospective multi-center study investigated anatomic precision, physiologic characteristics, and fidelity of four commercially available very low birth weight infant simulators. Methods We measured airway angles and distances in the simulators Premature AirwayPaul (SIMCharacters), Premature Anne (Laerdal Medical), Premie HAL S2209 (Gaumard), and Preterm Baby (Lifecast Body Simulation) using computer tomography and compared these to human cadavers of premature stillbirths. The simulators’ physiologic characteristics were tested, and highly experienced experts rated their physical and functional fidelity. Results The airway angles corresponded to those of the reference cadavers in three simulators. The nasal inlet to glottis distance and the mouth aperture to glottis distance were only accurate in one simulator. All simulators had airway resistances up to 20 times higher and compliances up to 19 times lower than published reference values. Fifty-six highly experienced experts gave three simulators (Premature AirwayPaul: 5.1 ± 1.0, Premature Anne 4.9 ± 1.1, Preterm Baby 5.0 ± 1.0) good overall ratings and one simulator (Premie HAL S2209: 2.8 ± 1.0) an unfavorable rating. Conclusion The simulator physiology deviated significantly from preterm infants’ reference values concerning resistance and compliance, potentially promoting a wrong ventilation technique. Impact Very low birth weight infant simulators showed physiological properties far deviating from corresponding patient reference values. Only ventilation with very high peak pressure achieved tidal volumes in the simulators, as aimed at in very low birth weight infants, potentially promoting a wrong ventilation technique. Compared to very low birth weight infant cadavers, most tested simulators accurately reproduced the anatomic angular relationships, but their airway dimensions were relatively too large for the represented body. The more professional experience the experts had, the lower they rated the very low birth weight infant simulators.

Indomethacin Therapy for Large Patent Ductus Arteriosus in the Very Low Birth Weight Infant: Results and Complications

PEDIATRICS ◽  
1979 ◽  
Vol 64 (2) ◽  
pp. 154-159
Author(s):  
H. L. Halliday ◽  
T. Hirata ◽  
J. P. Brady
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Base Deficit ◽  
Low Birth Weight Infants ◽  
Low Birth Weight Infant ◽  
Surgical Ligation ◽  
Patent Ductus

Of 36 very low birth weight infants (<1,500 gm) with large patent ductus arteriosus, 24 (67%) showed satisfactory constriction or closure after indomethacin therapy (mean total dose 0.4 mg/kg). Twelve infants (33%) responded inadequately with seven infants requiring surgical ligation. Response was better in infants 8 to 14 days old compared to those more than 14 days old (89% vs 33%, P = .048) irrespective of birth weight or gestational age. Major complications were renal and unrelated to ductus response. Urine output fell significantly (3.65 to 1.63 ml/kg/hr, P < .001) and in 47% of infants serum creatinine increased ≥1.5 mg/dl. Creatinine was less likely to rise in infants more than 14 days old. Hyponatremia was found in 36% of infants. Serum potassium increased more frequently in infants more than 8 days old and was >6.0 mEq/liter in 25%. Indomethacin caused a reduction in PaCO2 (41 to 37 mm Hg, P < .01) and an increase in pH (7.32 to 7.36, P < .02) with no change in base deficit. These changes occurred even in the absence of clinical ductus closure. No other side effects of indomethacin therapy were noted. Three infants died but death was unrelated to indomethacin therapy. Overall survival was 92%, and nine infants (25%) developed mild bronchopulmonary dysplasia.

scholarly journals Reference Values of Urinary Neutrophil Gelatinase-Associated Lipocalin in Very Low Birth Weight Infants

2009 ◽  
Vol 66 (5) ◽  
pp. 528-532 ◽  
Author(s):  
Trang K Huynh ◽  
David A Bateman ◽  
Elvira Parravicini ◽  
John M Lorenz ◽  
Sheri L Nemerofsky ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Reference Values ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

scholarly journals Effect of Colostrum Feeding Intervention on the Clinical and Nutritional Outcomes of Very Low Birth Weight Infant

2019 ◽  
Vol 1 (3) ◽  
pp. 16
Author(s):  
Safaa S. Ahmed ◽  
Sahar S. Faheim ◽  
Samya M. A. Hegazy
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Control Groups ◽  
Low Birth Weight Infants ◽  
Low Birth Weight Infant ◽  
Colostrum Feeding ◽  
And Control ◽  
Milk Feeding ◽  
Nutritional Outcomes

Context: Having premature and very low birth weight infants in the Neonatal Intensive Care Unit (NICU), is disempowering for mothers as they lost autonomy over their behavior and lost autonomy over beginning to establish a close relationship with their neonates. Mothers highly value Breastfeeding/breast milk feeding as it is the ‘one thing that only the mother can do to protect and improve their neonates' health. Aim: Evaluate the effect of colostrum feeding intervention on the clinical and nutritional outcomes of very low birth weight infant. Methods: A quasi-experimental research design utilized to achieve the aim of this study. A convenient sample of 80 mothers of very low birth weight infants subjected to colostrum feeding intervention program. Their 80 very low birth weight infants (divided randomly into two groups) study and control groups to examine the effect of the colostrum feeding intervention on their clinical and nutritional outcomes versus artificial milk feeding. Three research tools used that were structured interview questionnaire, mothers’ practice observation checklist, and very low birth weight clinical and Nutritional outcomes’ record. Results: the study reveals a significant improvement of mother knowledge and practices after colostrum feeding intervention at post and follow up compared to their pre-intervention level. The study also revealed a statistically significant difference in all clinical and nutritional outcomes between infants of the study and control groups. Conclusion: A significant improvement in mothers’ knowledge and practice regarding colostrum feeding intervention. The study group of very low birth weight infants had a rapid growth rate, better nutritional outcomes, lesser complications compared with the control group. The study recommended tailored intervention programs for mother that expecting a very low birth weight infant. Besides, policies for training midwives at maternity centers and hospitals early to initiate colostrum feeding. Further research with larger sample size recommended to determine if early colostrum administration can affect positively on very low birth weight infants outcomes.

scholarly journals Lipocalin-2 and calprotectin as stool biomarkers for predicting necrotizing enterocolitis in premature neonates

2021 ◽  
Author(s):  
Marie-Pier Thibault ◽  
Éric Tremblay ◽  
Chantal Horth ◽  
Aube Fournier-Morin ◽  
David Grynspan ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Necrotizing Enterocolitis ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
List Type ◽  
Lipocalin 2 ◽  
Low Birth Weight Infants ◽  
Biomarker Signature ◽  
Fecal Biomarkers

Abstract Background Necrotizing enterocolitis (NEC) is a major challenge for premature infants in neonatal intensive care units and efforts toward the search for indicators that could be used to predict the development of the disease have given limited results until now. Methods In this study, stools from 132 very low birth weight infants were collected daily in the context of a multi-center prospective study aimed at investigating the potential of fecal biomarkers for NEC prediction. Eight infants (~6%) received a stage 3 NEC diagnosis. Their stools collected up to 10 days before diagnosis were included and matched with 14 non-NEC controls and tested by ELISA for the quantitation of eight biomarkers. Results Biomarkers were evaluated in all available stool samples leading to the identification of lipocalin-2 and calprotectin as the two most reliable predicting markers over the 10-day period prior to NEC development. Pooling the data for each infant confirmed the significance of lipocalin-2 and calprotectin, individually and in combination 1 week in advance of the NEC clinical diagnosis. Conclusions The lipocalin-2 and calprotectin tandem represents a significant biomarker signature for predicting NEC development. Although not yet fulfilling the “perfect biomarker” criteria, it represents a first step toward it. Impact Stool biomarkers can be used to predict NEC development in very low birth weight infants more than a week before the diagnosis. LCN2 was identified as a new robust biomarker for predicting NEC development, which used in conjunction with CALPRO, allows the identification of more than half of the cases that will develop NEC in very low birth weight infants. Combining more stool markers with the LCN2/CALPRO tandem such as PGE2 can further improve the algorithm for the prediction of NEC development.

scholarly journals Acute kidney injury in an extremely low birth weight infant with nephrolithiasis: a case report

2019 ◽  
Vol 25 (3) ◽  
pp. 166-172
Author(s):  
Rasa Garunkštienė ◽  
Rimutė Vaitkevičienė ◽  
Ieva Paulavičienė ◽  
Nijolė Drazdienė ◽  
Rimantė Čerkauskienė
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Kidney Injury ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Low Birth Weight Infant ◽  
The Right

Acute kidney injury is associated with mortality of very low birth weight infants and reduces their survival regardless of other factors. The kidneys in the extremely preterm infants are very immature and susceptible to environmental factors. Clinical conditions and medications are risk factors for acute kidney injury in these patients. Nephrolithiasis in preterm infants is an extremely rare phenomenon that usually manifests as a complication of nephrocalcinosis. This is a case report that describes several episodes of acute kidney injury in the first two months of age in an extremely low birth weight infant with kidney stones in the background. The main causes that led to acute kidney injury in this patient were persistent ductus arteriosus, sepsis and captopril. At one month of age, ultrasound detected calcinates in the right kidney. Within two weeks a large number of linear stones formed across the collecting duct system. Small calcinates still remained in the right kidney when the girl was half a year of the corrected age. The evaluation of a neonate who develops acute kidney injury requires a systematic approach. Early identification of the emerging risk factors and prevention of nephrolithiasis along with effective treatment can reduce the risk of developing acute kidney injury in very low birth weight infants.

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