scholarly journals Single-centre prospective observational study on postdelivery room care

2020 ◽  
Vol 4 (1) ◽  
pp. e000602
Author(s):  
Frederike Vivien Hartmann ◽  
Gerd Bauerschmitz ◽  
Helmut Küster
Keyword(s):  
Birth Weight ◽  
Observational Study ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Prospective Observational Study ◽  
Total Duration ◽  
Extremely Low Birth Weight ◽  
Single Centre ◽  
Term Outcome ◽  
Long Term Outcome

ObjectivesAs quality of care in the delivery room has major impact on outcome of preterm infants, multiple guidelines have been established in recent years. There is, however, little evidence on how to proceed during postdelivery room care, the time of transfer and admission to the neonatal intensive care unit (NICU). The aim of this study was to identify processes taking place during this period with potential impact on outcome.Study designProspective observational study.SettingSingle-centre German tertiary NICU.Patients40 inborn preterm infants undergoing postdelivery room care.Main outcomePrevalence of prolonged duration of postdelivery room care, disconnections from the ventilator and positioning of preterm infants.ResultsTotal duration of postdelivery room care and NICU admission procedures were shorter in infants transferred in a transport incubator compared with using a NICU care station from birth. Extremely low birth weight (ELBW) infants spend 8% of the time in prone position in contrast to 39% in non-ELBW. Total duration of disconnection from the ventilator was 50 s and was ten times longer in infants who had nasal CPAP compared with infants intratracheally intubated. Infants with nCPAP had longer duration of disconnection from the ventilator if body weight was >1000 g or if they were transferred in a transport incubator.ConclusionsMultiple parameters like birth weight or type of transport affect neonatal care during the postdelivery room period. Prospective studies are needed to identify and optimise parameters within this period that affect long-term outcome.

scholarly journals Sustained favorable long-term outcome in the treatment of schizophrenia: a 3-year prospective observational study

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Gebra B Cuyún Carter ◽  
Denái R Milton ◽  
Haya Ascher-Svanum ◽  
Douglas E Faries
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Long-Term Outcome of the Management of Chronic Neuropathic Pain: A Prospective Observational Study

2015 ◽  
Vol 16 (9) ◽  
pp. 852-861 ◽  
Author(s):  
Dwight E. Moulin ◽  
A. John Clark ◽  
Allan Gordon ◽  
Mary Lynch ◽  
Patricia K. Morley-Forster ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Chronic Neuropathic Pain ◽  
Term Outcome ◽  
Long Term Outcome

Allostatic Load and Biomarkers of Stress in the Preterm Infant: An Integrative Review

2019 ◽  
Vol 21 (2) ◽  
pp. 210-223 ◽  
Author(s):  
Sharon G. Casavant ◽  
Xiaomei Cong ◽  
Roslyn H. Fitch ◽  
James Moore ◽  
Ted Rosenkrantz ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Stress Responses ◽  
Allostatic Load ◽  
Neonatal Intensive Care ◽  
Large Data ◽  
Therapeutic Interventions ◽  
Future Research ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Brain Microstructure

Background: Every year, an estimated 15 million babies are born preterm (<37 weeks’ gestational age) globally. These preterm infants are exposed to repeated stressful and often painful procedures as part of routine life-saving care within the neonatal intensive care unit (NICU). Low thresholds for tactile and nociceptive input make it more difficult for neonates to discriminate between noxious and nonnoxious stimuli, which can result in continuous activation of stress responses in an attempt to achieve stability through adaptation, or allostasis. Rapidly reoccurring stressors can render stress-response systems over- or underactive, creating wear and tear, or allostatic load. A better understanding of biomarkers related to allostatic load might aid in early detection and prevention/alleviation of allostatic load in this population. Purpose: To identify stress biomarkers that have been studied in preterm infants at different time points in the NICU and as long-term outcome measures. Method/search Strategy: Systematic searches were conducted of PubMed, CINAHL, SCOPUS, and PsychInfo databases. Findings/results: Twenty-one studies met inclusion criteria for this review. Several putative biomarkers were identified, including cortisol levels, epigenetic markers, brain microstructure, markers of oxidative stress, and the brain–gut–microbiome axis. Conclusion: The interaction of disease with therapeutic interventions may inadvertently increase infant allostatic load. In addition to human studies, future research should leverage newly available large data sets to conduct additional analyses.

scholarly journals Optimizing parenteral nutrition to achieve an adequate weight gain according to the current guidelines in preterm infants with birth weight less than 1500 g: a prospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nan Wang ◽  
Lianlian Cui ◽  
Zhen Liu ◽  
Yan Wang ◽  
Yuhua Zhang ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Amino Acid ◽  
Low Birth Weight ◽  
Observational Study ◽  
Parenteral Nutrition ◽  
Preterm Infants ◽  
Prospective Observational Study ◽  
Current Guidelines ◽  
Poor Weight Gain

Abstract Aim European Society for Clinical Nutrition and Metabolism released the guidelines on pediatric parenteral nutrition in 2018. We aimed to compare the parenteral nutrition (PN) regimen with the current guidelines, evaluate weight gain and explore the correlation of parenteral macronutrient and energy intakes with weight gain outcome in preterm infants with birth weight less than 1500 g. Methods A prospective observational study was conducted. Parenteral macronutrients and energy intakes were described. Weight gain during PN was assessed. Nutritional factors associated with weight gain outcome after PN were identified using a cox proportional hazards model. Results A total of 163 infants were included in this study, in which 41 were extremely low birth weight (ELBW) infants and 122 were very low birth weight (VLBW) infants. Average glucose, amino acid, lipid, and energy during the first postnatal week were 7.5 g/kg/d, 2.4 g/kg/d, 0.8 g/kg/d, 48 kcal/kg/d. Median maximum glucose, amino acid, lipid, and energy were 11.1 g/kg/d, 3.5 g/kg/d, 3 g/kg/d, 78 kcal/kg/d. Median days to maximum glucose, amino acid, lipid, and energy were 10, 9, 12, 11 days. The proportion of appropriate for gestational age (AGA) infants was 76.9%. The ratio of infants without poor weight gain outcome after PN was 38%. With every 0.1 g/kg/d decrease of maximum amino acid and average lipid during the first postnatal week, the probability of appropriate weight gain outcome decreased by 77.6 and 74.4% respectively. With each additional day to maximum glucose and energy, the probability of appropriate weight gain outcome decreased by 5.6 and 6.1% respectively. Conclusions Most preterm infants with birth weight less than 1500 g remain below the latest recommended nutrition goals. The poor weight gain outcome of these infants after PN is related to insufficient parenteral macronutrient and energy intakes. PN strategies should be improved according to the latest evidence-based recommendations.

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