Fatores de Risco para Sépsis Associada aos Cuidados de Saúde em Recém-nascidos de Muito Baixo Peso

Introduction: Healthcare associated infections in very low birth weight infants are associated with significant morbidity and mortality and are also a cause of increased length of stay and hospital costs. The objective of this study was to evaluate the rate of healthcare-associated sepsis and associated risk factors in very low birth weight infants. Material and Methods: Retrospective observational study including very low birth weight infants hospitalized in a Neonatal Intensive Care Unit during ten years (2005-2014). We evaluated the association between several risk factors and healthcare-associated sepsis. Results: 461 very low birth weight infants were admitted. There were 110 episodes of HS in 104 very low birth weight infants and 53 episodes of sepsis associated with central vascular catheter. The density of the sepsis was 7.5/1 000 days of hospitalization and the density of central vascular catheter - associated sepsis was 22.6/1 000 days of use. The infants with HS had lower average birth weight and gestational age (959 ± 228 g vs 1191 ± 249 g and 27.6 ± 2 vs 29.8 ± 2.2 weeks), p < 0.001. After adjusting for birth weight and gestational age we verified an association between healthcare-associated sepsis and antibiotic therapy in D1, the duration of parenteral nutrition and central vascular catheter. After logistic regression only the gestational age and duration of parenteral nutrition remained as independent significant risk factors for healthcare-associated sepsis. Discussion: The independent factors for healthcare-associated sepsis are gestational age and duration of parenteral nutrition. Conclusion: For each extra week on gestational age the risk declined in 20% and for each day of NP the risk increased 22%.

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Parenteral Nutrition Associated Cholestasis Is Earlier, More Prolonged and Severe in Small for Gestational Age Compared with Appropriate for Gestational Age Very Low Birth Weight Infants

Yonsei Medical Journal ◽

10.3349/ymj.2013.54.4.839 ◽

2013 ◽

Vol 54 (4) ◽

pp. 839 ◽

Cited By ~ 6

Author(s):

Soon Min Lee ◽

Ran Namgung ◽

Min Soo Park ◽

Ho Sun Eun ◽

Nam Hyo Kim ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Parenteral Nutrition ◽

Gestational Age ◽

Small For Gestational Age ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Appropriate For Gestational Age

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Risk factors and clinical characteristics for bronchopulmonary dysplasia associated pulmonary hypertension in very-low-birth-weight infants

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02330-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Junfang Sun ◽

Bowen Weng ◽

Xiaoyue Zhang ◽

Xiaoyun Chu ◽

Cheng Cai

Keyword(s):

Risk Factors ◽

Pulmonary Hypertension ◽

Birth Weight ◽

Low Birth Weight ◽

Bronchopulmonary Dysplasia ◽

Clinical Characteristics ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Average Birth Weight ◽

Specific Risk

Abstract Background Pulmonary hypertension (PH) is a common complication of bronchopulmonary dysplasia (BPD) in very-low-birth-weight infants (VLBWIs). Although recent studies have increased awareness that PH contributes significantly to the high morbidity and mortality of BPD, the risk factors and clinical characteristics for PH in VLBWIs are little known. Objectives To investigate the risk factors and clinical characteristics for BPD-associated pulmonary hypertension (BPD-PH) in VLBWIs. Methods A retrospective case–control observational study of VLBWIs with BPD admitted to a neonatal intensive care unit (NICU) over 4 years. According to echocardiograms confirming elevated pulmonary artery pressure after 28 days after birth, we divided BPD infants into PH group (n = 18) and non-PH group (n = 65). We compared pre- and postnatal characteristics between VLBWIs with or without PH. Multivariable logistic regression analysis was conducted with backward selection. Results A total of 83 infants with BPD were divided into PH group (n = 18) or non-PH group (n = 65). The average birth weight of the infants with BPD was 1078.1 g. Compared with those infants of the non-PH group, the birth weight of BPD-PH infants was significantly lower (968.1 ± 187.7 vs. 1108.5 ± 185.8, P = 0.006). Infants in the PH group had a higher incidence of patent ductus arteriosus (PDA) and underwent longer durations of oxygen therapy and mechanical ventilation compared to those in the non-PH group. In all subjects, birth weight (OR 0.995; 95% CI 0.991–0.999; P = 0.025) and PDA (OR 13.355; 95% CI 2.950–60.469; P = 0.001) were found to be specific risk factors for BPD-PH in this cohort. Conclusions The study shows PDA and birth weight are specific risk factors for BPD-PH in VLBWIs.

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Changes in Biochemical Parameters of the Calcium-Phosphorus Homeostasis in Relation to Nutritional Intake in Very-Low-Birth-Weight Infants

10.20944/preprints201611.0129.v1 ◽

2016 ◽

Author(s):

Viola Christmann ◽

Charlotte J. W. Gradussen ◽

Michelle N. Körnmann ◽

Nel Roeleveld ◽

Johannes B. Van Goudoever ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Biochemical Parameters ◽

Mixed Model ◽

Very Low Birth Weight ◽

Significant Risk ◽

Repeated Measurements ◽

Nutritional Intake ◽

Low Birth Weight Infants

Preterm infants are at significant risk to develop reduced bone mineralization based on inadequate supply of calcium and phosphorus (Ca-P). Biochemical parameters can be used to evaluate the nutritional intake. The direct effect of nutritional intake on changes in biochemical parameters has not been studied. Our objective was to evaluate the effect of Ca-P supplementation on biochemical markers as serum (s)/urinary (u) Ca and P; alkaline phosphatase (ALP); tubular reabsorption of P (TrP) and urinary ratios for Ca/creatinin and P/creatinin in Very-Low-Birth-Weight infants on postnatal day 1, 3, 5, 7, 10, and 14. This observational study compared two groups with High (n = 30) and Low (n = 40) intake of Ca-P. Birth weight: median (IRQ) 948 (772-1225) vs. 939 (776-1163) grams; Gestational age: 28.2 (26.5-29.6) vs. 27.8 (26.1-29.4) weeks. Daily median concentrations of biochemical parameter were not different between the groups but linear regression mixed model analyses showed that Ca intake increased the uCa and TrP (p = 0.04) and decreased ALP (p = 0.00). Phosphorus intake increased sP, uP and uP/creat ratio and ALP (p ≤ 0.02) and caused decrease in TrP (p = 0.00). Protein intake decreased sP (p = 0.000), while low gestational age and male gender increased renal excretion of P (p < 0.03). Standardized repeated measurements showed that biochemical parameters were affected by nutritional intake, gestational age and gender.

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