PREVENTION OF HYPERBILIRUBINEMIA OF PREMATURITY BY PHOTOTHERAPY

PEDIATRICS ◽  
1968 ◽  
Vol 41 (6) ◽  
pp. 1047-1054 ◽  
Author(s):  
Jerold Lucey ◽  
Mario Ferreiro ◽  
Jean Hewitt
Keyword(s):  
Premature Infants ◽  
Fluid Intake ◽  
Serum Bilirubin ◽  
Newborn Infants ◽  
Controlled Clinical Trial ◽  
Simple Method ◽  
Decomposition Products ◽  
Significant Difference ◽  
Photochemical Decomposition ◽  
The Ideal

The ideal treatment for hyperbilirubinemia of prematurity would be a safe and simple method for preventing its occurrence. In 1958 it was first demonstrated that serum bilirubin concentrations of newborn infants can be reduced by exposure to light. This treatment has not been widely used because of doubts as to its effectiveness and concern for the possible toxicity of the photochemical decomposition products of bilirubin. Recent experimental evidence indicates that these products are non-toxic. A controlled clinical trial has been carried out among 111 premature infants to test the effectiveness of artificial blue light in preventing hyperbilirubinemia of prematurity. Treated infants were placed in light from 12 to 144 hours of age and serial bilirubin determinations were carried out. The control (58 infants) and treated (53 infants) groups were comparable with respect to birth weight, gestational age, fluid intake, and weight loss. The results indicate a statistically significant difference between the groups. By taking advantage of this alternate route of elimination of bilirubin in the newborn infant, it should be possible to greatly reduce the need for exchange transfusion for hyperbilirubinemia of prematurity.

scholarly journals A randomized controlled clinical trial of the effect of supportive counseling on mental health in Iranian mothers of premature infants

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leila Seiiedi-Biarag ◽  
Mojgan Mirghafourvand ◽  
Khalil Esmaeilpour ◽  
Shirin Hasanpour
Keyword(s):  
Mental Health ◽  
Clinical Trial ◽  
Premature Infants ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Randomized Controlled Clinical Trial ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Postpartum Bonding ◽  
Supportive Counseling

Abstract Background Premature birth can affect maternal mental health. Considering that the mental health disorder in mothers may play a vital role in the growth and development of their children, therefore, this study was conducted to determine the effect of supportive counseling on mental health (primary outcome), mother-child bonding and infant anthropometric indices (secondary outcomes) in mothers of premature infants. Methods This randomized controlled clinical trial was carried out on 66 mothers with hospitalized neonates in the NICU of Alzahra hospital in Tabriz- Iran. Participants were randomly allocated into two groups of intervention (n = 34) and control (n = 32) through a block randomization method. The intervention group received 6 sessions of supportive counseling (45–60 minutes each session) by the researcher, and the control group received routine care. Questionnaires of Goldberg General Health and the postpartum bonding were completed before the intervention (first 72 hours postpartum) and 8 weeks postpartum. Also, the anthropometric index of newborns were measured at the same time. Results There was no statistically significant difference between the two groups in terms of socio-demographic characteristics. After the intervention, based on ANCOVA with adjusting the baseline score, mean score of mental health (AMD: -9.8; 95% Confident Interval (95% CI): -12.5 to -7.1; P < 0.001) and postpartum bonding (AMD: -10.0; 95% CI: -0.6 to 13.9; P < 0.001) in the counseling group was significantly lower than those of the control group; however, in terms of weight (P = 0.536), height (P = 0.429) and head circumference (P = 0.129), there was no significant difference between the two groups. Conclusions Supportive counseling may improve mental health and postpartum bonding in mothers of premature infants. Thus, it may be recommendable for health care providers to offer it to mothers. Trial registration Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N45. Date of registration: October 29, 2018.

Oral Vitamin E Supplementation for the Prevention of Anemia in Premature Infants: A Controlled Trial

PEDIATRICS ◽  
1987 ◽  
Vol 79 (1) ◽  
pp. 61-68 ◽  
Author(s):  
A. Zipursky ◽  
E. J. Brown ◽  
J. Watts ◽  
R. Milner ◽  
C. Rand ◽  
...  
Keyword(s):  
Vitamin E ◽  
Premature Infants ◽  
Controlled Trial ◽  
Newborn Infants ◽  
Serum Vitamin ◽  
Hemoglobin Concentration ◽  
Erythrocyte Morphology ◽  
Significant Difference ◽  
Vehicle Treatment ◽  
Vitamin E Supplementation

Serum vitamin E levels are reduced in newborn infants. It has been reported that this deficiency is responsible, in part, for the development of anemia in premature infants during the first 6 weeks of life. The efficacy of vitamin E supplementation for the prevention of anemia in premature infants has been studied in a randomized, controlled, and blinded trial. Premature infants whose birth weights were less than 1,500 g were given, by gavage, 25 IU of dl-α-tocopherol or a similar volume of the drug vehicle. Treatment was continued for the first 6 weeks of life. A total of 178 infants were studied. Vitamin E levels were significantly higher in a supplemented group by day 3 and for the remainder of the 6-week period. At 6 weeks of age, there was no significant difference between the supplemented and unsupplemented groups in hemoglobin concentration, reticulocyte and platelet counts, or erythrocyte morphology. It is concluded that there is no evidence to support a policy of administering vitamin E to premature infants to prevent the anemia of prematurity.

The Combined Effect of Phototherapy and Phenobarbital on Serum Bilirubin Levels of Premature Infants

PEDIATRICS ◽  
1972 ◽  
Vol 49 (1) ◽  
pp. 110-112
Author(s):  
Michael G. Blackburn ◽  
Marcello M. Orzalesi ◽  
Penelope Pigram
Keyword(s):  
Premature Infants ◽  
Serum Bilirubin ◽  
Combined Therapy ◽  
Newborn Infants ◽  
Neonatal Hyperbilirubinemia ◽  
Combined Effect ◽  
Sufficient Evidence ◽  
Monochorionic Twins ◽  
Photo Oxidation ◽  
Prevention And Treatment

The effectiveness of phototherapy in the prevention and treatment of neonatal hyperbilirubinemia is well established. There is also sufficient evidence to indicate that phenobarbital is effective in decreasing serum bilirubin levels in newborn infants. Since light is thought to break down bilirubin in the skin by photo-oxidation, and phenobarbital is known to induce bilirubin conjugating activity in the liver, the possibility of an additive effect in combined therapy was investigated in the present study. Materials and Methods Six sets of premature identical (monochorionic) twins (33 to 35 weeks' gestation) were studied after obtaining parental permission. Each set of twins was admitted to the study at 12 hours of life if both infants were considered normal with the exception of prematurity.

Non-Hemolytic Hyperbilirubinemia

PEDIATRICS ◽  
1965 ◽  
Vol 36 (5) ◽  
pp. 807-808 ◽  
Author(s):  
HAROLD M. MAURER
Keyword(s):  
Premature Infants ◽  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Study Groups ◽  
Serum Bilirubin Level ◽  
Study Group ◽  
Neurological Sequelae ◽  
Indirect Bilirubin ◽  
Significant Difference ◽  
Symptoms And Signs

On what basis do Drs. Wishingrad, Cornblath, Takakuwa, Rozenfeld, Elegant, Kaufman, Lassers, and Klein (Studies of Non-Hemolytic Hyperbilirubinemia in Premature Infants, Pediatrics, 36:162, 1965) recommend exchange transfusion for non-hemolytic hyperbilirubinemia of the premature at a serum bilirubin level equal to or greater than 24 mg/100 ml when no significant difference is apparent in mortality and neurological sequelae in the study groups at greater than 24 mg/100 ml serum indirect bilirubin? The only patient who developed kernicterus in the study already demonstrated symptoms and signs at 10.8 mg/100 ml indirect serum bilirubin which tends to exclude him from the study group called "greater than 24 mg/100 ml."

scholarly journals The value of transcutaneous method of bilirubin measurement in newborn population with the risk of ABO hemolytic disease

Medicina ◽  
2009 ◽  
Vol 45 (10) ◽  
pp. 792 ◽  
Author(s):  
Dalia Stonienė ◽  
Jūratė Buinauskienė ◽  
Eglė Markūnienė
Keyword(s):  
Bilirubin Level ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Newborn Infants ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Hemolytic Disease ◽  
Significant Difference ◽  
Abo Hemolytic Disease

Objective of the study. To evaluate the correlation between total serum bilirubin (TSB) and transcutaneous bilirubin (TcB) levels in newborn infants at risk of ABO hemolytic disease. Material and methods. During a prospective study, 130 full-term (≥37 weeks of gestation) newborn infants with diagnosed ABO blood group incompatibility were examined. TSB level was measured at the age of 6 hours; further measurements were performed at 24, 48, and 72 hours following the first measurement. Blood samples were collected from the peripheral veins. In clinical laboratory, total serum bilirubin level was measured using Jendrassik-Grof method. TcB level in the forehead was measured using a noninvasive bilirubinometer BiliCheck (SpectRX Inc, Norcross, GA) according to the manufacturer’s instructions within ±30 min after getting a blood sample. Results. During the study, 387 double tests were performed to measure TSB and TcB levels. TSB level (114.83 [62.85] μmol/L) closely correlated with TcB level (111.51 [61.31] μmol/L) (r=0.92, P<0.001). The strongest correlation was reported at the age of 54 hours (r=0.873, P<0.001), the weakest – at the age of 6 hours (r=0.729, P<0.001). TSB and TcB levels showed a strong correlation; the difference between these values was significant (95% CI, 0.70; 5.93; P<0.05). The greatest difference between TSB and TcB levels was detected at the age of 6 hours (5.58 [17.46] μmol/L, 95% CI, 2.55; 8.61; P<0.001). No significant difference was reported at the age of 30, 54, and 78 hours. Using linear regression analysis, it was established that correlation of TSB and TcB was described by equation y=14.13+0.903x. Transcutaneously measured bilirubin level underestimated serum bilirubin level. When at the age of 6 hours TcB level is ≥98 μmol/L, ABO hemolytic disease in newborns may be diagnosed with 100% sensitivity and 98% specificity; positive predictive value was 62% and negative predictive value was 100%. While a newborn’s age increases, TcB sensitivity and specificity for diagnosing ABO hemolytic disease decrease. Conclusion. While evaluating bilirubin level transcutaneously according to nomograms of serum bilirubin level, the results should be considered with caution, especially for newborns with a risk of ABO hemolytic disease. The hour-specific nomograms of transcutaneous

SULFOBROMOPHTHALEIN SODIUM METABOLISM IN NEWBORN INFANTS

PEDIATRICS ◽  
1962 ◽  
Vol 29 (6) ◽  
pp. 899-906
Author(s):  
Sidney Sussman ◽  
J. V. Carbone ◽  
G. Grodsky ◽  
V. Hjelte ◽  
Phebe Miller
Keyword(s):  
Premature Infants ◽  
Standard Dose ◽  
Newborn Infants ◽  
Full Term ◽  
Hemolytic Disease ◽  
The Third ◽  
Significant Difference ◽  
The Mean ◽  
The Difference ◽  
Sodium Metabolism

With the use of a standard dose of sulfobromophthalein sodium (BSP), the metabolism of this substance was studied in a group of full-term and premature infants (normal, hypoxic, and hyperbilirubinemic). Elevated total BSP and BSP conjugate at birth in normal full-term and premature infants approached normal adult levels toward the end of the third week of life. There was no significant difference between the rate of decrease of total or conjugated BSP in the full-term and premature infant. During the first 20 days of life the decrease in total BSP levels proceeded at a faster rate than the decline in BSP conjugate in both normal groups. The mean concentrations of total BSP and BSP conjugate were higher in infants with hypoxia, hyperbilirubinemia, and hemolytic disease of the newborn than in normal infants, but the difference was not statistically significant.

scholarly journals Oral erythromycin for treatment of gastrointestinal dysmotility in premature infants

2007 ◽  
Vol 47 (5) ◽  
pp. 234
Author(s):  
Armelia Moesri ◽  
Bugis Mardina Lubis ◽  
Asrul Asrul ◽  
Atan Baas Sinuhaji ◽  
Guslihan Dasa Tjipta
Keyword(s):  
Clinical Trial ◽  
Preterm Infants ◽  
Premature Infants ◽  
Controlled Clinical Trial ◽  
Randomized Controlled Clinical Trial ◽  
Gastrointestinal Dysmotility ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Functional Immaturity ◽  
Enteral Feedings

Background Functional immaturity of gastrointestinal (GI)motility predisposes preterm infants to feeding intolerance.Erythromycin as a prokinetic agent has been given to preterminfants for the management of non-obstructive GI dysmotility.Objective To evaluate the efficacy of oral erythromycin for thetreatment of GI dysmotility in preterm infants.Methods A randomized controlled clinical trial was done at AdamMalik Hospital and Pirngadi Hospital, Medan, between October2004 – March 2005. Fifty preterm infants with feeding intolerancewere randomly assigned to either receive oral erythromycin (12.5mg/kg, every 6 hours) or placebo for 7 days. Improved tolerancefor enteral feedings was evaluated by the amount of gastric residuebefore feeding.Results On the sixth day, there was a significant difference in theamount of residue from gastric residue between the oralerythromycin group and placebo group (mean 21.7 and 29.4;P<0.05) and so were results on the seventh day (mean 14.1 and26.9; P<0.05).Conclusion Oral erythromycin reduces the amount of gastricresidue before feed in premature infants.

scholarly journals Serum C-Reactive Protein and Interleukin6 Levels in Neonatal Sepsis

2002 ◽  
Vol 45 (3) ◽  
pp. 111-113
Author(s):  
Dilara Içağasioğlu ◽  
Hüseyn Çaksen ◽  
Idris Sütçu ◽  
Ömer Cevit
Keyword(s):  
Neonatal Sepsis ◽  
Complete Blood Count ◽  
Newborn Infants ◽  
Study Group ◽  
C Reactive Protein ◽  
Simple Method ◽  
Reactive Protein ◽  
Significant Difference ◽  
Serum Crp ◽  
The Relationship

In this article, we studied complete blood count, serum C-reactive protein (CRP) and interleukin (IL-6) levels in 30 newborn infants with sepsis at admission, in the 24th hour of admission and at the end of the treatment. Our purpose was to determine the relationship among these parameters in the early diagnosis of neonatal sepsis. In our study, there was not a significant difference in white blood cell (WBC) and thrombocyte count among the values of the first, 24th hour and end of therapy in the study group (P>0.05). However, there was not a significant difference in B/N ratio among the values at admission, 24th hour and end of therapy in the study group (P>0.05). Both serum CRP and IL-6 levels were found to be significantly higher than those of control subjects at the beginning (P<0.05). Similarly, the values obtained on the 24th hour were also elevated. However, at the end of therapy both decreased to normal level (P<0.05). Based on these data, we think that serum CRP levels only which is a simple method may be used in the diagnosis of neonatal sepsis. However, WBC and serum IL-6 levels may be useful to establish mortality, because there was a statistically significant difference for these parameters between the survivors and deaths (P<0.05).

An Assessment of Red Cell Deformability Using a Simple Filtration Method

1979 ◽  
Author(s):  
M Drummond ◽  
G Lowe ◽  
J Belch ◽  
C Forbes ◽  
J Barbenel
Keyword(s):  
Cell Count ◽  
Shear Viscosity ◽  
White Cell Count ◽  
White Cell ◽  
Red Cell ◽  
Cell Deformability ◽  
Red Cell Deformability ◽  
Simple Method ◽  
Filtration Method ◽  
Significant Difference

We investigated the reproducibility and validity of a simple method of measuring red cell deformability (filtration of whole blood through 5 µ sieves) and its relationship to haematocrit, blood viscosity, fibrinogen, white cell count, sex and smoking. The mean coefficient of variation in normals was 3. 7%. Tanned red cells showed marked loss of deformability. Blood filtration rate correlated with haematocrit (r = 0. 99 on dilution of samples, r = 0. 7 in 120 normals and patients). After correction for haematocrit, deformability correlated with high shear viscosity, but not low shear viscosity, fibrinogen or white cell count. In 60 normals there was no significant difference between males and females, or smokers and non-smokers, but in 11 smokers there was an acute fall in deformability after smoking 3 cigarettes (p<0. 05). Reduced deformability was found in acute myocardial infarction (n = 15, p<0. 01) and chronic peripheral arterial disease (n = 15, p<0. 01). The technique is reproducible, detects rigid cells and appears useful in the study of vascular disease.

A COMPARISON OF TWO METHODS FOR MEASUREMENT OF ALDOSTERONE SECRETION RATE IN MAN

1966 ◽  
Vol 53 (2) ◽  
pp. 177-188 ◽  
Author(s):  
P. Lund-Johansen ◽  
T. Thorsen ◽  
K. F. Støa
Keyword(s):  
Urinary Excretion ◽  
Normal Subjects ◽  
Secretion Rate ◽  
Aldosterone Secretion ◽  
Simple Method ◽  
Mean Values ◽  
Pathological Conditions ◽  
Significant Difference ◽  
Derivative Method ◽  
The Mean

ABSTRACT A comparison has been made between (A), a relatively simple method for the measurement of aldosterone secretion rate, based on paper chromatography and direct densitometry of the aldosterone spot and (B) a more elaborate isotope derivative method. The mean secretion rate in 9 normal subjects was 112 ± 26 μg per 24 hours (method A) and 135 ± 35 μg per 24 hours (method B). The »secretion rate« in one adrenalectomized subject after the intravenous injection of 250 μg of aldosterone was 230 μg per 24 hours (method A) and 294 μg per 24 hours (method B). There was no significant difference in the mean values, and correlation between the two methods was good (r = 0.80). It is concluded that the densitometric method is suitable for clinical purposes as well as research, being more rapid and less expensive than the isotope derivative method. Method A also measures the urinary excretion of the aldosterone 3-oxo-conjugate, which is of interest in many pathological conditions. The densitometric method is obviously the less sensitive and a prerequisite for its use is an aldosterone secretion of 20—30 μg per 24 hours. Lower values are, however, rare in adults.

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