scholarly journals Problem-solving in clinical practice: Persisting respiratory distress in a premature infant

2020 ◽  
pp. edpract-2019-317757
Author(s):  
Daniel R Owens ◽  
Clarissa Michelle Medalla ◽  
Kelly N Brown ◽  
Kishani Wijewardena ◽  
Claire P Thomas ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Practice ◽  
Problem Solving ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Antimicrobial Therapy ◽  
Nosocomial Infections ◽  
Pulmonary Haemorrhage ◽  
Necrotising Enterocolitis ◽  
Anaemia Of Prematurity

The deterioration of a previously stable preterm infant is a common scenario on the neonatal unit. The the most common bacterial causes of deterioration are nosocomial infections, such as coagulase-negative Staphylococcus and Staphylococcus aureus. Non-infective conditions such as pulmonary haemorrhage, anaemia of prematurity and necrotising enterocolitis may also cause preterm infants to deteriorate. This case chronicles the unusual diagnostic journey of an infant born at 27+1 weeks who deteriorated at 26 days of life and did not respond to antimicrobial therapy as anticipated.

scholarly journals Underdosing of Surfactant for Preterm Babies with Respiratory Distress Syndrome in Clinical Practice: A Retrospective Cohort Study

2018 ◽  
Vol 36 (09) ◽  
pp. 943-948 ◽  
Author(s):  
Hector Boix ◽  
Segundo Rite ◽  
Luis Arruza ◽  
Cristina Fernandez ◽  
Itziar Serrano ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Practice ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Distress Syndrome ◽  
Tertiary Care ◽  
The Mean

Objective To evaluate the initial doses of surfactant administered to preterm infants with respiratory distress syndrome. Study Design This is a retrospective cohort study of 206 preterm infants admitted in four level III neonatal intensive care units of acute tertiary care hospitals in Spain between 2013 and 2015. Results The mean initial dose of surfactant was 173.9 (37.3) mg/kg, and 47.5% of infants received a dose of 200 mg/kg ± 10% (180–220 mg/kg), 47% less than 180 mg/kg (–10%), and 5.4% more than 220 mg/kg (+10%). Very preterm infants (<28 weeks) received higher initial doses than more mature infants, but in all cases, the mean doses were below the recommended 200 mg/kg (by 9.2% in gestational age 23–28 weeks, by 15.9% in 29–32 weeks, and by 24.3% in >32 weeks). Conclusion Administration of surfactant below the prescribed dose is a frequent error in clinical practice. Inadvertently rounding down doses seems a plausible explanation.

NASAL CARRIAGE OF STAPHYLOCOCCUS AUREUS AS A RISK OF NOSOCOMIAL INFECTIONS

2014 ◽  
Vol 5 (4) ◽  
pp. 205-209
Author(s):  
MAŁGORZATA M. KOZIOŁ ◽  
AGNIESZKA SIKORA ◽  
SYLWIA TARGOŃSKA ◽  
ANNA SIKORA
Keyword(s):  
Staphylococcus Aureus ◽  
Nosocomial Infections ◽  
Nasal Carriage

Respiratory distress management in moderate and late preterm infants: The NEOBS Study

2021 ◽  
Author(s):  
T. Debillon ◽  
P. Tourneux ◽  
I. Guellec ◽  
P.-H. Jarreau ◽  
C. Flamant
Keyword(s):  
Respiratory Distress ◽  
Preterm Infants ◽  
Late Preterm ◽  
Late Preterm Infants

scholarly journals Trial of aerosolised surfactant for preterm infants with respiratory distress syndrome

2021 ◽  
pp. fetalneonatal-2021-321645
Author(s):  
Luke Jardine ◽  
Kei Lui ◽  
Helen G Liley ◽  
Timothy Schindler ◽  
James Fink ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Failure Criteria ◽  
Open Label ◽  
Dose Escalation Study ◽  
Safety Issues ◽  
Label Dose ◽  
Historical Controls

ObjectiveTo evaluate the safety of an aerosolised surfactant, SF-RI 1, administered via nasal continuous positive airway pressure (nCPAP) and a prototype breath synchronisation device (AeroFact), to preterm infants with respiratory distress syndrome (RDS).DesignMulticentre, open-label, dose-escalation study with historical controls.SettingNewborn intensive care units at Mater Mothers’ Hospital, Brisbane, and Royal Hospital for Women, Sydney, Australia.PatientsInfants 26 weeks through 30 weeks gestation who required nCPAP 6–8 cmH2O and fraction of inspired oxygen (FiO2) <0.30 at <2 hours of age.InterventionsIn part 1, infants received a single dose of 216 mg/kg of aerosolised surfactant. In part 2, infants could receive up to four doses of aerosolised surfactant. Three historical control infants were matched for each enrolled infant.Main outcome measuresTreatment failure was defined as Respiratory Severity Score (FiO2×cmH2O nCPAP) >2.4, nCPAP >8 cmH2O, arterial carbon dioxide >65 mm Hg, pH <7.20 or three severe apnoeas within 6 hours during the first 72 hours of life. Other outcomes included tolerance of the AeroFact treatment and complications of prematurity.Results10 infants were enrolled in part 1 and 21 in part 2 and were compared with 93 historical controls. No safety issues were identified. In part 2, 6 of 21 (29%) AeroFact-treated infants compared with 30 of 63 (48%) control infants met failure criteria. Kaplan-Meier analysis of patients in part 2 showed a trend towards decreased rate of study failure in the AeroFact-treated infants compared with historical controls (p=0.10).ConclusionThe AeroFact system can safely deliver aerosolised surfactant to preterm infants with RDS who are on nCPAP.Trial registration numberACTRN12617001458325.

Sign in / Sign up

Export Citation Format

Share Document