scholarly journals Role of beta-2-microglobulin as a biomarker in very preterm and extremely preterm infants with CNS inflammation

PLoS ONE ◽  
2019 ◽  
Vol 14 (5) ◽  
pp. e0216498
Author(s):  
Albert Batista Muñoz ◽  
Stephanie Hadley ◽  
Marti Iriondo Sanz ◽  
Thais Agut Quijano ◽  
Marta Camprubí Camprubí
Keyword(s):  
Preterm Infants ◽  
Cns Inflammation ◽  
Very Preterm ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Beta 2 ◽  
Beta 2 Microglobulin

scholarly journals Early oxygen levels contribute to brain injury in extremely preterm infants

2021 ◽  
Author(s):  
Krista Rantakari ◽  
Olli-Pekka Rinta-Koski ◽  
Marjo Metsäranta ◽  
Jaakko Hollmén ◽  
Simo Särkkä ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Brain Structures ◽  
High Oxygen ◽  
List Type ◽  
Neurodevelopmental Outcomes ◽  
Oxygen Levels ◽  
Arterial Blood ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Abstract Background Extremely low gestational age newborns (ELGANs) are at risk of neurodevelopmental impairments that may originate in early NICU care. We hypothesized that early oxygen saturations (SpO2), arterial pO2 levels, and supplemental oxygen (FiO2) would associate with later neuroanatomic changes. Methods SpO2, arterial blood gases, and FiO2 from 73 ELGANs (GA 26.4 ± 1.2; BW 867 ± 179 g) during the first 3 postnatal days were correlated with later white matter injury (WM, MRI, n = 69), secondary cortical somatosensory processing in magnetoencephalography (MEG-SII, n = 39), Hempel neurological examination (n = 66), and developmental quotients of Griffiths Mental Developmental Scales (GMDS, n = 58). Results The ELGANs with later WM abnormalities exhibited lower SpO2 and pO2 levels, and higher FiO2 need during the first 3 days than those with normal WM. They also had higher pCO2 values. The infants with abnormal MEG-SII showed opposite findings, i.e., displayed higher SpO2 and pO2 levels and lower FiO2 need, than those with better outcomes. Severe WM changes and abnormal MEG-SII were correlated with adverse neurodevelopment. Conclusions Low oxygen levels and high FiO2 need during the NICU care associate with WM abnormalities, whereas higher oxygen levels correlate with abnormal MEG-SII. The results may indicate certain brain structures being more vulnerable to hypoxia and others to hyperoxia, thus emphasizing the role of strict saturation targets. Impact This study indicates that both abnormally low and high oxygen levels during early NICU care are harmful for later neurodevelopmental outcomes in preterm neonates. Specific brain structures seem to be vulnerable to low and others to high oxygen levels. The findings may have clinical implications as oxygen is one of the most common therapies given in NICUs. The results emphasize the role of strict saturation targets during the early postnatal period in preterm infants.

scholarly journals Extremely Preterm Infants Have a Higher Fat Mass Percentage in Comparison to Very Preterm Infants at Term-Equivalent Age

2020 ◽  
Vol 8 ◽  
Author(s):  
Marlies Bruckner ◽  
Zahra Khan ◽  
Christoph Binder ◽  
Nicholas Morris ◽  
Bernadette Windisch ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Fat Mass ◽  
Mass Percentage ◽  
Very Preterm Infants ◽  
Equivalent Age ◽  
Very Preterm ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Role of Early Pulmonary Hypertension as a Risk Factor for Late Pulmonary Hypertension in Extremely Preterm Infants

2017 ◽  
Vol 35 (02) ◽  
pp. 120-126 ◽  
Author(s):  
Dinushan Kaluarachchi ◽  
Kaitlin Woo ◽  
Tarah Colaizy
Keyword(s):  
Pulmonary Hypertension ◽  
Risk Factor ◽  
Preterm Infants ◽  
Clinical Suspicion ◽  
Pulmonary Vascular Disease ◽  
University Of Iowa ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
The University

Objective The evidence on the role of early pulmonary vascular disease (PVD) in the development of late pulmonary hypertension (PH) in the extremely preterm infants is limited. Objectives were to determine the incidence of early and late PH in extreme preterm infants and to evaluate the role of early PH as a risk factor for development of clinically detected late PH. Methods It was a retrospective analysis of early echocardiograms (day of life 5–14) in preterm infants, 22 to 27 weeks' gestation, admitted to the University of Iowa NICU between July 01, 2012 to June 30, 2015. Late echocardiograms performed for clinical suspicion of PH were also analyzed. Results A total of 154 infants were included in the study. Early PH was diagnosed in 31 (20%) infants. Twenty-four (16%) infants were evaluated for clinically suspected PH. Eight (5%) infants were diagnosed with late PH. Infants with early PH had echocardiograms performed earlier than infants without the evidence of early PH. Early PH was not associated with the development of late PH (p = 0.99). Conclusion Early PH is common among extremely preterm infants (20%). Five percent of infants had clinically detected late PH. Infants with early PH had echocardiograms performed earlier than infants without the evidence of early PH. Early PH was not associated with the development of clinically detected late PH.

Changes in perinatal care and survival in very preterm and extremely preterm infants in The Netherlands between 1983 and 1995

2004 ◽  
Vol 112 (2) ◽  
pp. 170-177 ◽  
Author(s):  
Sabine Anthony ◽  
Lya den Ouden ◽  
Ronald Brand ◽  
Pauline Verloove-Vanhorick ◽  
Jack Bennebroek Gravenhorst
Keyword(s):  
The Netherlands ◽  
Preterm Infants ◽  
Perinatal Care ◽  
Very Preterm ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Temporal Trends of Acute Kidney Injury and Associated Risk Exposures in Extremely Preterm Infants

2021 ◽  
pp. CJN.19301220
Author(s):  
Chih-Chia Chen ◽  
Yung-Chieh Lin ◽  
Shan-Tair Wang ◽  
Chao-Ching Huang ◽  
Keyword(s):  
Serum Creatinine ◽  
Preterm Infants ◽  
Gestational Age ◽  
Temporal Trends ◽  
Content Type ◽  
Very Preterm ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Preterm Group ◽  
Care Practices

Background and objectivesNeonatal AKI in the preterm population is an under-recognized morbidity. Detecting AKI in preterm infants is important for their long-term kidney health. We aimed to examine the yearly trends of incidence and the related morbidities and care practices affecting the occurrence of neonatal AKI in extremely preterm (gestational age <29 weeks) and very preterm (gestational age 29–32 weeks) infants.Design, setting, participants, & measurementsThe trends and the related risk factors and care practices of AKI were examined in the extremely preterm (n=434) and very preterm (n=257) infants who were admitted within 14 days after birth from 2005 to 2018 to the University Hospital and had at least two serum creatinine measurements during hospitalization. We defined AKI as a serum creatinine rise of 0.3 mg/dl or more within 48 hours or a 1.5-fold increase within 7 days.ResultsThe extremely preterm group had a three-fold higher incidence of AKI (30% versus 10%) than the very preterm group. Among preterm infants with AKI, 92% had one episode of AKI, and 45% experienced stage 2 or 3 AKI; the mean duration of AKI was 12±9 days. Across the 14-year period, the crude incidence of AKI declined markedly from 56% to 17% in the extremely preterm group and from 23% to 6% in the very preterm group. After adjustment, a significant decline of AKI incidence was still observed in the extremely preterm group. The declining AKI in the extremely preterm infants was related to the trends of decreasing incidences of neonatal transfer, prolonged aminoglycoside exposure, prophylactic use of nonsteroidal anti-inflammatory drugs, and sepsis.ConclusionsWe observed a declining trend in the incidence of neonatal AKI among extremely preterm infants from 2005 to 2018, which may be related to improvement of care practices.

scholarly journals When does prone sleeping improve cardiorespiratory status in preterm infants in the NICU?

SLEEP ◽  
2019 ◽  
Vol 43 (4) ◽  
Author(s):  
Kelsee L Shepherd ◽  
Stephanie R Yiallourou ◽  
Alexsandria Odoi ◽  
Emma Yeomans ◽  
Stacey Willis ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Respiratory Function ◽  
Sleep Position ◽  
Prone Positioning ◽  
Quiet Sleep ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Postmenstrual Age

Abstract Study Objectives Preterm infants undergoing intensive care are often placed prone to improve respiratory function. Current clinical guidelines recommend preterm infants are slept supine from 32 weeks’ postmenstrual age, regardless of gestational age at birth. However, respiratory function is also related to gestational and chronological ages and is affected by sleep state. We aimed to identify the optimal timing for adopting the supine sleeping position in preterm infants, using a longitudinal design assessing the effects of sleep position and state on cardiorespiratory stability. Methods Twenty-three extremely (24–28 weeks’ gestation) and 33 very preterm (29–34 weeks’ gestation) infants were studied weekly from birth until discharge, in both prone and supine positions, in quiet and active sleep determined by behavioral scoring. Bradycardia (heart rate ≤100 bpm), desaturation (oxygen saturation ≤80%), and apnea (pause in respiratory rate ≥10 s) episodes were analyzed. Results Prone positioning in extremely preterm infants reduced the frequency of bradycardias and desaturations and duration of desaturations. In very preterm infants, prone positioning only reduced the frequency of desaturations. The position-related effects were not related to postmenstrual age. Quiet sleep in both preterm groups was associated with fewer bradycardias and desaturations, and also reduced durations of bradycardia and desaturations in the very preterm group. Conclusions Cardiorespiratory stability is improved by the prone sleep position, predominantly in extremely preterm infants, and the improvements are not dependent on postmenstrual age. In very preterm infants, quiet sleep has a more marked effect than the prone position. This evidence should be considered in individualizing management of preterm infant positioning.

scholarly journals Behavioural and cognitive outcomes following an early stress-reduction intervention for very preterm and extremely preterm infants

2019 ◽  
Vol 86 (1) ◽  
pp. 92-99
Author(s):  
Jeannette Milgrom ◽  
Paul R. Martin ◽  
Carol Newnham ◽  
Christopher J. Holt ◽  
Peter J. Anderson ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Stress Reduction ◽  
Cognitive Outcomes ◽  
Very Preterm ◽  
Early Stress ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

scholarly journals Drug utilisation in neonatal units in England and Wales: a national cohort study

2022 ◽  
Author(s):  
Asma Al-Turkait ◽  
Lisa Szatkowski ◽  
Imti Choonara ◽  
Shalini Ojha
Keyword(s):  
Cohort Study ◽  
Preterm Infants ◽  
Drug Utilisation ◽  
Late Preterm ◽  
Research Database ◽  
Term Infants ◽  
England And Wales ◽  
Very Preterm ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Abstract Purpose To describe drug utilisation patterns in neonatal units. Methods Retrospective observational cohort study using data held in the National Neonatal Research Database (NNRD) for neonatal units in England and Wales including infants born at 23 to 44 weeks’ gestational age (GA) from 01 January 2010 to 31 December 2017. Results The cohort included 17,501 (3%) extremely preterm infants; 40,607 (7%) very preterm infants; 193,536 (31%) moderate-to-late preterm infants; and 371,606 (59%) term infants. The number of unique drugs received by an infant (median (IQR)) increased with decreasing GA: 17 (11–24) in extremely preterm, 7 (5–11) in very preterm, 3 (0–4) in moderate-to-late preterm, and 3 (0–3) in term infants. The two most frequently prescribed drugs were benzylpenicillin and gentamicin in all GA groups, and caffeine in extremely preterm. Other frequently used drugs among preterm infants were electrolytes, diuretics and anti-reflux medications. Among infants <32 weeks’ GA, the largest increase in use was for surfactant (given on the neonatal unit), caffeine and probiotics, while domperidone and ranitidine had the largest decline. Conclusion Antibiotics, for all GAs and caffeine, among preterm infants, are the most frequently used drugs in neonatal medicine. Preterm infants are exposed to a high burden of drugs, particularly antibiotics. Changing patterns in use reflect the emergence of evidence in some areas but several non-evidence-based drugs continue to be used widely. Improvements are needed to ensure rational drug use on neonatal units. Registration ClinicalTrials.gov (NCT03773289). Date of registration 21 Dec 2018.

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