scholarly journals P24 Caffeine in preterm neonates: impact on sleep wake regulation

2019 ◽  
Vol 104 (6) ◽  
pp. e26.3-e27
Author(s):  
AN Datta ◽  
G Koch ◽  
N Schönfeld ◽  
K Jost ◽  
A Atkinson ◽  
...  
Keyword(s):  
Birth Weight ◽  
Very Low Birth Weight ◽  
Internal Clock ◽  
Lower Percentage ◽  
Preterm Neonates ◽  
Quiet Sleep ◽  
Caffeine Concentration ◽  
Very Preterm ◽  
Caffeine Citrate ◽  
Apnea Of Prematurity

BackgroundSleep wake regulation undergoes distinctive maturational changes. Ultradian sleep wake rhythm predominates at preterm age and is mainly driven by the internal clock. Increased perinatal morbidity in preterm neonates often appears with breathing disorders, among which apnea of prematurity (AOP) is the most frequently observed. Pharmacological support with caffeine has been successfully employed in the treatment of AOP. Nowadays, caffeine citrate is administered to all preterm neonates suffering from AOP. Objective of our study was a quantitative investigation of whether caffeine citrate treatment for reduction of apnea and bradycardia of prematurity affects sleep-wake behavior in preterm neonates.MethodsObservational study of 64 preterm neonates during their first five days of life with gestational age (GA) < 32 weeks or very low birth weight of < 1500 g. Total of 52 patients treated with caffeine and 12 controls without caffeine were included. Sleep-wake behavior was scored in wakefulness (W), active sleep (AS), and quiet sleep (QS) associated with physical and cerebral regeneration. Individual caffeine concentration of every neonate was simulated with a pharmacokinetic model.ResultsFor increasing caffeine concentration, W increased, AS decreased, and QS was unchanged for GA > or = 28 weeks. No caffeine effect for GA < 28 weeks could be demonstrated. Maturational effects could be seen when comparing preterm neonates of GA >32 weeks with a birth weight of < 1500 g with very preterm neonates born of GA < 32: Neonates born >32 weeks had a significantly higher amount of W and lower percentage of AS.ConclusionsTreatment of apnea and bradycardia as well as stabilization of respiration with standard caffeine treatment is not at cost of QS, i.e. time for physical and cerebral regeneration during sleep remains unchanged. There is an increased fraction of W, alertness and most probably also arousability.Disclosure(s)Nothing to disclose

Neonatal Outcomes of Very Low Birth Weight and Very Preterm Neonates: An International Comparison

2016 ◽  
Vol 177 ◽  
pp. 144-152.e6 ◽  
Author(s):  
Prakesh S. Shah ◽  
Kei Lui ◽  
Gunnar Sjörs ◽  
Lucia Mirea ◽  
Brian Reichman ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
International Comparison ◽  
Very Low Birth Weight ◽  
Neonatal Outcomes ◽  
Preterm Neonates ◽  
Very Preterm

Prevention of Periventricular Hemorrhage

PEDIATRICS ◽  
1994 ◽  
Vol 93 (4) ◽  
pp. 677-679
Author(s):  
E. Osmund R. Reynolds ◽  
Judith Meek
Keyword(s):  
Computed Tomography ◽  
Birth Weight ◽  
Very Low Birth Weight ◽  
Focus Of Attention ◽  
Preterm Neonates ◽  
Germinal Layer ◽  
Major Focus ◽  
Very Preterm ◽  
Neurodevelopmental Impairment ◽  
Periventricular Hemorrhage

Cerebral periventricular hemorrhage (PVH) of preterm neonates can be defined as hemorrhage arising in the germinal layer that may rupture into the ventricles or provoke hemorrhagic parenchymal infarction. PVH has been a major focus of attention for perinatologists since the 1970s and 1980s when studies by computed tomography and echosonography showed that it was very common in neonates who were of very low birth weight (&lt; 1500 g) or born very preterm (&lt; 33 weeks gestation). Up to 50% of such neonates were affected and the prevalence in survivors was about one in three.1,2 As well as being an important cause of death, PVH has been a significant cause of neurodevelopmental impairment in surviving neonates.3

scholarly journals Probiotics to prevent necrotising enterocolitis and nosocomial infection in very low birth weight preterm infants

2017 ◽  
Vol 117 (7) ◽  
pp. 994-1000 ◽  
Author(s):  
J. Uberos ◽  
E. Aguilera-Rodríguez ◽  
A. Jerez-Calero ◽  
M. Molina-Oya ◽  
A. Molina-Carballo ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Necrotising Enterocolitis ◽  
Stage Ii ◽  
Preterm Neonates ◽  
Probiotic Supplementation ◽  
Late Onset Sepsis ◽  
Reduced Risk

AbstractThe aim of the study was to determine whether routine probiotic supplementation (RPS) with Lactobacillus rhamnosus GG (LGG) or Lactobacillus acidophilus +Lactobacillus bifidum is associated with reduced risk of necrotising enterocolitis (NEC)≥Stage II in preterm neonates born at ≤32 weeks’ gestation. We conducted a retrospective cohort study on the effect of probiotic supplementation in very low birth weight infants in our neonatal unit by comparing two periods: before and after supplementation. The incidence of NEC≥Stage II, late-onset sepsis and all-cause mortality was compared for an equal period ‘before’ (Period I) and ‘after’ (Period II) RPS with LGG or L. acidophillus+L. bifidum. Multivariate logistic regression analysis was conducted to adjust for relevant confounders. The study population was composed of 261 neonates (Period I v. II: 134 v. 127) with comparable gestation duration and birth weights. In <32 weeks, we observed a significant reduction in NEC≥Stage II (11·3 v. 4·8 %), late-onset sepsis (16 v. 10·5 %) and mortality (19·4 v. 2·3 %). The benefits in neonates aged ≤27 weeks did not reach statistical significance. RPS with LGG or L. acidophillus+L. bifidum is associated with a reduced risk of NEC≥Stage II, late-onset sepsis and mortality in preterm neonates born at ≤32 weeks’ gestation.

scholarly journals Role of Sequential Functional Echocardiography in Predicting Clinically Apparent Patent Ductus Arteriosus in Preterm Very Low Birth Weight Newborns-An Observational Study

2020 ◽  
Author(s):  
Anchala Bhardwaj ◽  
ARVIND SAILI ◽  
Dinesh Kumar Yadav ◽  
Ajay Kumar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Left Atrial ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Predictive Utility ◽  
Patent Ductus

Abstract Background The management of patent ductus arteriosus in preterm neonates continues to be a topic of discussion and controversy. Prolonged ductal patency in preterm neonates has been associated with significant short and long term morbidities and with increased mortality however, policy of routine treatment of all during neonatal period has failed to show significant improvement in long term outcome. Echocardiography has emerged as a promising modality to screen the newborns at risk of adverse effects of ductal shunting. This helps in identifying PDAs that require treatment to ultimately prevent unnecessary therapy or delay of necessary therapy. There are multitude of studies that have evaluated large number of echocardiographic markers for their predictive utility but only few have included all ductal markers together in a single study. The reported sensitivity (26-100%) and specificity (6-100%) of echocardiographic markers vary over a wide range. Thus, this study was planned with an aim to assess the predictive utility of all available ductal markers and their added advantage of having all over few ones in clinically apparent PDA in preterm VLBW newborns.Methods It was an observational prospective study conducted in tertiary care NICU at Lady Hardinge Medical College, Delhi. Fifty preterm very low birth weight (VLBW) newborns underwent four sequential Echo scans within first 72 hrs; first scan within 12 hours then at 24 hrs ,48 hrs and 72 hrs of age and were monitored clinically for the signs of PDA up to two weeks of life or discharge whichever comes later.Results The Ductal diameter, pulsatile ductal flow pattern, Left pulmonary artery (LPA) velocity, Left atrial to aortic width (La/Ao) ratio, Left atrial volume index (LAVI), Left ventricle to aortic width (Lv/Ao) ratio, E/A ratio and Left ventricular output/superior vena caval (LVO/SVC) flow ratio predicted clinically apparent PDA during first 72 hours of life.Conclusion This study provides insights into the predictive utility of other ductal echo markers along with the routinely measured conventional ones during first 72 hours of life in preterm VLBW newborns.

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