Risk for Late-onset Blood-culture Proven Sepsis in Very-low-birth Weight Infants Born Small for Gestational Age

2014 ◽  
Vol 33 (3) ◽  
pp. 238-243 ◽  
Author(s):  
Birte Tröger ◽  
Wolfgang Göpel ◽  
Kirstin Faust ◽  
Thilo Müller ◽  
Gerhard Jorch ◽  
...  
Keyword(s):  
Birth Weight ◽  
Blood Culture ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Low Birth Weight Infants

Sepsis and Mortality Prediction in Very Low Birth Weight Infants: Analysis of HeRO and nSOFA

2021 ◽  
Author(s):  
Angela C. Zeigler ◽  
John E. Ainsworth ◽  
Karen D. Fairchild ◽  
James L. Wynn ◽  
Brynne A. Sullivan
Keyword(s):  
Birth Weight ◽  
Blood Culture ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Mortality Prediction ◽  
Blood Cultures ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Prediction Of Mortality

Objective Scores to predict sepsis or define sepsis severity could improve care for very low birth weight (VLBW) infants. The heart rate characteristics (HRC) index (HeRO score) was developed as an early warning system for late-onset sepsis (LOS), and also rises before necrotizing enterocolitis (NEC). The neonatal sequential organ failure assessment (nSOFA) was developed to predict sepsis-associated mortality using respiratory, hemodynamic, and hematologic data. The aim of this study was to analyze the HRC index and nSOFA near blood cultures in VLBW infants relative to diagnosis and sepsis-associated mortality. Study Design Retrospective, single-center study of VLBW infants from 2011 to 2019. We analyzed HRC index and nSOFA around blood cultures diagnosed as LOS/NEC. In a subgroup of the cohort, we analyzed HRC and nSOFA near the first sepsis-like illness (SLI) or sepsis ruled-out (SRO) compared with LOS/NEC. We compared scores by diagnosis and mortality during treatment. Results We analyzed 179 LOS/NEC, 93 SLI, and 96 SRO blood culture events. In LOS/NEC, the HRC index increased before the blood culture, while nSOFA increased at the time of culture. Both scores were higher in nonsurvivors compared with survivors and in LOS/NEC compared with SRO. The nSOFA 12 hours after the time of blood culture predicted mortality during treatment better than any other time point analyzed (area under the curve 0.91). Conclusion The HRC index provides earlier warning of imminent sepsis, whereas nSOFA after blood culture provides better prediction of mortality. Key Points

scholarly journals The role of serum and urinary urea in the evaluation of enteral protein intake in adequate and small-for-gestational-age very low birth weight infants

2005 ◽  
Vol 123 (6) ◽  
pp. 261-265
Author(s):  
Silvana Darcie ◽  
Cléa Rodrigues Leone
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Protein Intake ◽  
Very Low Birth Weight ◽  
Pearson Correlation ◽  
Serum Urea ◽  
Low Birth Weight Infants ◽  
Vlbw Infants

CONTEXT AND OBJECTIVE: Very low birth weight (VLBW) infants have special nutritional needs. There is a current tendency to individualize their protein needs. The objective of this study was to determine the suitability of serum and urinary urea as indicators for protein intake in adequate-for-gestational-age (AGA) and small-for-gestational-age (SGA) VLBW infants. DESIGN AND SETTING: Prospective study in the nursery attached to the Maternity Ward of the "Prof. Pedro de Alcântara" Children's Institute, Hospital das Clínicas, Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo, Brazil. METHODS: Seventy-two VLBW infants (mean protein intake = 3.7 mg/kg/day) were enrolled in a prospective cohort study in two groups: AGA (n = 34) and SGA (n = 38). Blood samples, six-hour urine (6hUr) collections and urine sample tests (STUr) were obtained for urea and creatinine assays at three and five weeks of life. Statistical analysis: Student's t test, Pearson correlation and linear regression (p < 0.05). RESULTS: There were no differences between groups for serum urea, 6hUr and STUr, or between two assessments within each group. Serum urea correlated with 6hUr in both AGA and SGA, and to STUr in SGA; 6hUr correlated with STUr in both AGA and SGA. There was no correlation between protein intake and serum or urine urea. CONCLUSIONS: Serum and urinary urea did not reflect protein intake when mean intakes of 3.7 g/kg/day were used. Sample tests of urinary urea can be as reliable as urea from urine collected over longer periods.

scholarly journals Characteristics of Catch-Up Growth in Very Low Birth Weight Infants (<1500 g)

2021 ◽  
Author(s):  
Teodoro Durá-Travé ◽  
Isabel San Martín-García ◽  
Fidel Gallinas-Victoriano ◽  
María Malumbres-Chacón ◽  
Paula Moreno-González ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Very Low Birth Weight ◽  
Control Group ◽  
Low Birth Weight Infants ◽  
Normal Height ◽  
Appropriate For Gestational Age ◽  
Catch Up

Features of catch-up growth are not well established in very low birth weight infants (VLBW). The aim of this study is to analyze the catch-up growth in height and some factors associated in a cohort of VLBW (<1500 g) from birth to age 14 years. Retrospective registration of weight and height at birth and ages 0.5, 1, 2, 3, 4, 6, 8, 10, 12 and 14 years in a cohort of 170 VLBW have been recorded Anthropometric variables were compared with those from a control group. Sixty-nine (40.6%) were small for gestational age (SGA subgroup) and 101 (59.4%) were appropriate for gestational age (AGA subgroup). Thirty-seven (21.8%) were extremely low birth weight (ELBW), and 32 (18.8%) extremely preterm (EPT). At age 2, 4 and 10 years, 49.4%, 78.9% and 87.1% VLBW, respectively, did reach normal height. Between 4 and 10 years of age, only 8.2% of VLBW reached normal height. At 10 years of age, 7% of VLBW (1000–1500 g) and 35% of ELBW (<1500 g) showed short stature (p = 0.001). Almost the entire sample of VLBW with normal height at age 2, 4 and 10 have reached an adequate catch-up growth in weight in the previous evaluations. ELBW, SGA and EPT were found to be independent predictors for inadequate catch-up growth in height at 2, 4, and 10 years of age. The growth pattern of children born preterm has particular features: they have a lower rate and/or slowness in the catch-up growth in height with respect to that described in full-term small-for-gestational-age infants. Catch-up in weight appears to be a decisive factor for catch-up in height, and, on this basis, we recommend a rigorous nutritional follow-up in these individuals. If these measures do not help improve catch-up in height, they may be eligible for the establishment of rhGH therapy.

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