scholarly journals Hemidiaphragmatic paralysis related to extravasation of parenteral solution in very low birthweight neonates

2021 ◽  
Vol 14 (5) ◽  
pp. e242390
Author(s):  
Hai-Bo Huang ◽  
Qian-Shen Zhang ◽  
David G Tingay ◽  
Po-Yin Cheung
Keyword(s):  
Low Birthweight ◽  
Preterm Neonate ◽  
Spontaneous Recovery ◽  
Clinical Course ◽  
Venous Catheter ◽  
Preterm Neonates ◽  
Significant Morbidity ◽  
Very Low Birthweight ◽  
Central Venous ◽  
Extremely Preterm

Central venous catheter (CVC) placement is common in the care of very low birthweight (VLBW) preterm neonates. Although it is generally considered to be safe, CVC placement is associated with complications, including extravasation that may lead to significant morbidity and mortality. We report the clinical course of an extremely preterm neonate born at 27 weeks gestation, and another 5 VLBW preterm neonates reported in the literature with hemidiaphragmatic paralysis related to extravasation of parenteral solution from CVC placement. In VLBW preterm neonates, spontaneous recovery of diaphragmatic paralysis related to extravasation of parenteral solution is possible.

scholarly journals Bacteremia Due to Kosakonia cowanii in a Preterm Neonate

2020 ◽  
Author(s):  
Claire Duployez ◽  
Marie-Eve Edun-Renard ◽  
Eric Kipnis ◽  
Rodrigue Dessein ◽  
Rémi Le Guern
Keyword(s):  
Central Venous Catheter ◽  
Gut Microbiota ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Preterm Neonate ◽  
Venous Catheter ◽  
Preterm Neonates ◽  
Central Venous ◽  
Gut Colonization ◽  
Rdna Sequencing

Abstract Objective Low-birthweight infants admitted to neonatal intensive care units are at high risk of hospital-acquired infections by opportunistic pathogens. The gut microbiota of preterm neonates lacks commensal bacteria providing a barrier against pathogens. We report a case of bacteremia due to Kosakonia cowanii in a preterm neonate. Case Report A female baby of 680 g was delivered through a cesarean-section at 28 weeks of gestation due to intrauterine growth retardation and fetal rhythm abnormalities. On day 27, two blood cultures grew gram-negative bacilli in a context of functional ileus. No reliable identification could be obtained using matrix assisted laser desorption ionization-time of flight, biochemical reactions with the VITEK 2 GN ID card, or 16S rDNA sequencing. K. cowanii was finally identified by gyrB sequencing. The source of infection may have been either the central venous catheter or translocation from the gut microbiota. Evolution was favorable after 14 days of cefepime (combined with amikacin for 5 days) and central venous catheter removal. Conclusion K. cowanii is a member of the Enterobacteriaceae family that was recently reclassified from the Enterobacter genus. Human infections due to K. cowanii are scarce and have mainly been associated with traumatic inoculation from plants or transient gut colonization. K. cowanii may be an underestimated opportunistic pathogen in susceptible populations such as preterm neonates.

scholarly journals A Rare Complication of Central Venous Catheter Extravasation in a Preterm Neonate: Hemidiaphragmatic Paralysis

2017 ◽  
Vol 07 (02) ◽  
pp. e65-e67
Author(s):  
C. Hobson ◽  
D. Dubillot ◽  
H. Lardy ◽  
D. Sirinelli ◽  
E. Saliba ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Phrenic Nerve ◽  
Preterm Neonate ◽  
Spontaneous Recovery ◽  
Rare Complication ◽  
Venous Catheter ◽  
Diaphragmatic Paralysis ◽  
X Rays ◽  
Central Venous ◽  
Phrenic Nerve Palsy

AbstractWe report a case of a preterm neonate born at 26 weeks' of gestation diagnosed with unilateral diaphragmatic paralysis. This paralysis was a consequence of a phrenic nerve injury due to extravasation of hyperosmolar parenteral nutrition fluid in the upper thorax. Chest X-rays and ultrasonography confirmed the diagnosis. The neonate was treated with prolonged respiratory support and did not require surgical treatment. This report describes a case of hemidiaphragmatic paralysis as a complication of central venous catheter insertion. In neonates, spontaneous recovery of diaphragmatic paralysis is possible. This study concludes that recovery of extravasation injury-induced phrenic nerve palsy in the context of conservative management is possible.

Centrally inserted central catheters in preterm neonates with weight below 1500 g by ultrasound-guided access to the brachio-cephalic vein

2020 ◽  
pp. 112972982094017
Author(s):  
Giovanni Barone ◽  
Mauro Pittiruti ◽  
Gina Ancora ◽  
Giovanni Vento ◽  
Francesca Tota ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Neonatal Intensive Care ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Cephalic Vein ◽  
Preterm Neonates ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Vein Catheterization

Objective: Central venous access in critically ill newborns can be challenging. Ultrasound-guided brachio-cephalic vein catheterization is a relatively new procedure, recently introduced in several neonatal intensive care units. The aim of this study is to evaluate the safety and feasibility of such a technique in preterm babies. Design: Retrospective analysis of prospectively collected data on ultrasound-guided central venous catheter insertion in preterm neonates. Setting: Neonatal intensive care unit. Patients: Critically ill preterm neonates with weight below 1500 g requiring a central access. Interventions: Ultrasound-guided brachio-cephalic vein catheterization. Main Results: Thirty centrally inserted catheters were placed in 30 neonates. The success rate of the procedure was 100%. No case of accidental arterial or pleural puncture was registered during the study period. Conclusion: The brachio-cephalic vein can be safely catheterized in preterm newborns requiring intensive care after appropriate training.

scholarly journals Safety and efficacy of 2% chlorhexidine gluconate aqueous versus 2% chlorhexidine gluconate in 70% isopropyl alcohol for skin disinfection prior to percutaneous central venous catheter insertion in preterm neonates: the ARCTIC randomised-controlled feasibility trial protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e028022 ◽  
Author(s):  
Paul Clarke ◽  
Jean V Craig ◽  
John Wain ◽  
Catherine Tremlett ◽  
Louise Linsell ◽  
...  
Keyword(s):  
Large Scale ◽  
Controlled Trial ◽  
Venous Catheter ◽  
Chlorhexidine Gluconate ◽  
Feasibility Trial ◽  
Preterm Neonates ◽  
Central Venous ◽  
Skin Disinfection ◽  
Randomised Controlled ◽  
Catheter Colonisation

IntroductionCatheter-related sepsis is one of the most dangerous complications of neonatal intensive care and is associated with significant morbidity and mortality. Use of catheter-care ‘bundles’ has reduced the incidence of catheter-related sepsis, although individual components have not been well studied. Better evidence is needed to guide selection of the most appropriate antiseptic solution for skin disinfection in preterm neonates. This study will inform the feasibility and design of the first randomised controlled trial to examine the safety and efficacy of alcohol-based versus aqueous-based chlorhexidine antiseptic formulations for skin disinfection prior to percutaneous central venous catheterisation in preterm neonates. The antiseptics to be compared are 2% chlorhexidine gluconate (CHG) aqueous and 2% CHG in 70% isopropyl alcohol.Methods and analysisThe Antiseptic Randomised Controlled Trial for Insertion of Catheters (ARCTIC) is a two-centre randomised-controlled feasibility trial. At least 100 preterm infants born at <34 weeks’ gestation and due to undergo percutaneous insertion of a central venous catheter will be randomly allocated to receive prior skin disinfection with one of the two antiseptic solutions. Outcomes include: i) recruitment and retention rates; ii) completeness of data collection; iii) numbers of enrolled infants meeting case definitions for definite catheter-related sepsis, catheter-associated sepsis and catheter colonisation and iv) safety outcomes of skin morbidity scores recorded daily from catheter insertion until 48 hours post removal. The key feasibility metrics will be reported as proportions with 95% CIs. Estimated prevalence of catheter colonisation will allow calculation of sample size for the large-scale trial. The data will inform whether it will be feasible to progress to a large-scale trial.Ethics and disseminationARCTIC has been approved by the National Health Service Health Research Authority National Research Ethics Service Committee East of England (Cambridge South) (IRAS ID 163868), was adopted onto the National Institute of Health Research Clinical Research Network portfolio (CPMS ID 19899) and is registered with an International Standard Randomised Control Trials Number (ISRCTN: 82571474; Pre-results) and European Clinical Trials Database number 2015-000874-36. Dissemination plans include presentations at scientific conferences, scientific publications and sharing of the findings with parents via the support of Bliss baby charity.Trial registration numberISRCTN82571474; Pre-results.

scholarly journals ASSOCIATION OF PERINATAL FACTORS WITH INTRACRANIAL HEMORRHAGE (ICH) IN THE VERY LOW BIRTHWEIGHT (VLBW) PRETERM NEONATE

1984 ◽  
Vol 18 ◽  
pp. 328A-328A
Author(s):  
Alastair A Hutchison ◽  
Jeffrey M Barrett ◽  
Arthur C Fleischer ◽  
Ronald G Thomas ◽  
A Everette James ◽  
...  
Keyword(s):  
Intracranial Hemorrhage ◽  
Low Birthweight ◽  
Preterm Neonate ◽  
Perinatal Factors ◽  
Very Low Birthweight

scholarly journals Case Report: Treatment of Extremely Preterm Infants With Birthweight Below 300 g: Case Series

2021 ◽  
Vol 9 ◽  
Author(s):  
Yoshihiko Shitara ◽  
Satsuki Kakiuchi ◽  
Takeo Mukai ◽  
Kohei Kashima ◽  
Motohiro Kato ◽  
...  
Keyword(s):  
Best Practices ◽  
Low Birthweight ◽  
Clinical Course ◽  
Case Series ◽  
Hepatic Rupture ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Neurodevelopmental Impairment ◽  
Parental Counseling ◽  
Extremely Low Birthweight

Reports on the birth of infants weighing &lt;300 g are quite rare and little is known about the best practices in treating such micropreemies. Therefore, we report here on three cases of low birthweight infants weighing &lt;300 g, of whom two infants survived. The birthweights and gestational ages were ranging 279–293 g and 22 + 6/7 – 23 + 6/7 weeks, respectively. All the infants had severe fetal growth restriction and prematurity. The infant in case 1 died of hepatic rupture, perhaps due to birth trauma, which emphasized the need for less invasive obstetric procedures including en caul delivery. The infant in case 2 managed to survive through severe prematurity secondary to hydrops fetalis. However, complications followed soon as tracheal granulation tissue was formed with neurodevelopmental impairment. The infant in case 3 was born recently and her clinical course was less remarkable without severe complications, despite having the least gestational age and birthweight among the three patients. The improved care protocols for extremely low birthweight infants over these years through experiential learning including that with cases 1 and 2 may have ensured the better outcome of case 3. Accumulating evidence and recording the experience of such cases with continuous constructive discussion can contribute to better outcomes and appropriate parental counseling for extremely small babies in the future.

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