scholarly journals Initial and delayed thyroid-stimulating hormone elevation in extremely low-birth-weight infants

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Shin Ae Yoon ◽  
Yun Sil Chang ◽  
So Yoon Ahn ◽  
Se In Sung ◽  
Won Soon Park
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Perinatal Asphyxia ◽  
Thyroid Stimulating Hormone ◽  
Extremely Low Birth Weight ◽  
Free T4 ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes ◽  
Levothyroxine Replacement ◽  
Stimulating Hormone

Abstract Background To determine the incidence, etiology, and outcomes of thyroid-stimulating hormone (TSH) elevation in extremely low-birth-weight infants (ELBWIs). Methods Newborn thyroid screening data of 584 ELBWIs (birth weight, < 1000 g; gestational age, ≥ 23 weeks) were retrospectively analyzed to identify initial (≤ 2 postnatal weeks) and delayed (> 2 weeks) TSH elevations. Growth and neurodevelopmental outcomes at 2 years’ corrected age (CA) were assessed according to levothyroxine replacement. Results Initial and delayed TSH elevations were detected at CAs of 27 and 30 weeks, respectively, with incidence rates of 0.9 and 7.2%, respectively. All infants with initial TSH elevations had perinatal asphyxia, and 95% of those with delayed TSH elevation were exposed to various stressors, including respiratory support, drugs, and surgery within 2 weeks before diagnosis of TSH elevation. Free thyroxine (T4) levels were simultaneously reduced in 80 and 57% of infants with initial and delayed TSH elevations, respectively. Both initial and delayed TSH elevations were transient, regardless of levothyroxine replacement. Infants receiving levothyroxine replacement therapy had significantly higher TSH elevations, significantly lower free T4 levels, and significantly reduced mortality, compared to untreated infants. However, levothyroxine replacement had no significant effect on long-term growth and neurodevelopmental outcomes. Conclusions The timing of insult superimposition on hypothalamic–pituitary–thyroid axis maturation is a major determinant of initial or delayed TSH elevation in ELBWIs. Levothyroxine replacement did not affect growth or neurodevelopmental outcomes in this population.

scholarly journals Influence of PCO2 Control on Clinical and Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants

Neonatology ◽  
2018 ◽  
Vol 113 (3) ◽  
pp. 221-230 ◽  
Author(s):  
Ulrich H. Thome ◽  
Jens Dreyhaupt ◽  
Orsolya Genzel-Boroviczeny ◽  
Bettina Bohnhorst ◽  
Manuel Schmid ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes

Outpatient Follow-up Status and Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants

2012 ◽  
Vol 19 (1) ◽  
pp. 17 ◽  
Author(s):  
Suyeong Kim ◽  
In Gu Song ◽  
Kyu lee Kim ◽  
Yoon-Joo Kim ◽  
Seung Han Shin ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes

scholarly journals Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study

2020 ◽  
Author(s):  
Jihyun Noh ◽  
Chae Young Kim ◽  
Euiseok Jung ◽  
Joo Hoon Lee ◽  
Young-Seo Park ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Asphyxia ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants

Abstract Background: Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD.Methods: In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 hours.Results: Twelve ELBW infants (seven male and five female infants) were treated, and their mean gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. Two patients had severe perinatal asphyxia (5-min Apgar score ≤ 3). The most important indication for starting PD was AKI due to sepsis. The average duration of PD was 9.4 (± 7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (± 4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75 %). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7 %.Conclusions: The mortality rate of ELBW infants with AKI treated with PD is quite high because their organ system is not completely developed. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI in terms of decisions regarding resuscitation.

scholarly journals Effect of Peritoneal Dialysis on Extremely Low Birth Weight Infants: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Jihyun Noh ◽  
Chae Young Kim ◽  
Euiseok Jung ◽  
Joo Hoon Lee ◽  
Young-Seo Park ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Asphyxia ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants

Abstract Background: Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD.Methods: In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 hours.Results: Twelve ELBW infants (seven male and five female infants) were treated, and their mean gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. There were two patients who had severe perinatal asphyxia (5-min Apgar score ≤3). The most important indication for starting PD was AKI due to sepsis. The average duration of PD was 9.4 (±7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (±4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75%). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7%.Conclusions: The mortality rate of ELBW infants with AKI treated with PD is quite high because their organ system is not completely developed. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI.

scholarly journals Cytokines and Neurodevelopmental Outcomes in Extremely Low Birth Weight Infants

2011 ◽  
Vol 159 (6) ◽  
pp. 919-925.e3 ◽  
Author(s):  
Waldemar A. Carlo ◽  
Scott A. McDonald ◽  
Jon E. Tyson ◽  
Barbara J. Stoll ◽  
Richard A. Ehrenkranz ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes
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