scholarly journals Decrease in the Use of Parenteral Fluids in Premature Infants from 31 to 34 Weeks of Gestation at Birth

2021 ◽  
Author(s):  
Angela Hoyos ◽  
Pablo Vasquez-Hoyos
Keyword(s):  
Breast Milk ◽  
Premature Infants ◽  
Demographic Characteristics ◽  
Fluid Restriction ◽  
Z Score ◽  
Premature Babies ◽  
Oral Fluids ◽  
Before And After ◽  
Low Incidence ◽  
Second Period

Introduction: Some of the practices in medicine are carried out of habit without proven benefits. This is the case of premature babies from 31 to 34 weeks of gestation who are always given parenteral fluids, even though this practice has been associated with an increase incidence of infection. In 2017, we started a protocol of parenteral fluid restriction. To administer nutrition/fluids, we used oral fluids by suction if this was possible or otherwise by oral/nasogastric tube at volumes of 15-20 mL intake every 3 hours, with 5 mL increments every 12-24 hours until 200 mL/K/day was achieved, always using breast milk when possible.Material and methods: The present study sought to compare cases before and after this new policy. For this work, we review all premature babies between 31-34 weeks of gestation discharged home in two periods of time, the first from 01/01/2012 to 12/31/2017 and the second from 01/01/2018 to 08/31/2021. The number of cases with and without parenteral fluids (PF), the incidence of infection, the weight at admission and discharge, and the fall in the weight Z score between birth and discharge were compared. Both the anthropometric and outcome variables were compared using the different statistical methods according to each variable.Results: 725 cases were found with the described characteristics. The groups before and after the intervention did not show significant differences in their general demographic characteristics. A lower use of PF was observed in the second period from 348 cases (79%) to 70 (24%), p <0.001 and fewer days of use (4.1 days/case vs 1.3, p <0.0001) of PF. The weight at discharge and the change in weight Z-score were the same in both groups. Infections went from three cases to zero but it was not statistically significant. There were no complications due to less use of PF.Discussion: This study showed that the use of PF is not associated with significant changes in outcomes of interest, which reinforces that its use does not generate any benefit for the patient. Larger number of cases is required to detect differences in low incidence events such as infections.

scholarly journals Might the Mothers of Premature Babies Feed Them and Devote Some Milk to the Milk Bank?

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Pasqua Anna Quitadamo ◽  
Giuseppina Palumbo ◽  
Liliana Cianti ◽  
Matteo Luigi Napolitano ◽  
Ciro Coviello ◽  
...  
Keyword(s):  
Breast Milk ◽  
Premature Infants ◽  
Gestational Age ◽  
Psychological Trauma ◽  
Premature Baby ◽  
Single Donor ◽  
Premature Babies ◽  
Milk Bank ◽  
Starting Point ◽  
Healthy Growth

The breast milk is the gold standard food for the feeding of the premature baby: it is the natural way to provide excellent nutritional, immunological, and biological nutriment so as to facilitate a healthy growth and the development of the infants. When the breast milk is not available, the alternative is represented by the donated milk. The mothers of premature infants are important opportunity if we consider the fact that they could devote some milk both because they provide a food which is closer to the needs of the vulnerable category of newborns and because it is, for the mothers, a way to overcome the detachment and the psychological trauma of a premature birth. There are no data on this kind of donation. The aim of the study is to evaluate the contribution of the milk donation to the HMB of CSS by women who gave birth to premature infants of gestational age <35 weeks and to analyze the macronutrient composition of the “preterm” donated milk. The CSS HMB has recruited 659 donors totalling 2236 liters of donated milk over a period of 7 years. 38 donors (5.7%) gave birth to a gestational age <35 weeks. Almost 20% of the donated milk comes from mothers of premature babies and this is a very important fact because it shows the huge potential belonging to this category of mothers. Taking into account the parameter regarding the birth weight, it was found that VLBW mothers contributed for 56% to preterm donation while ELBW mothers contributed for 41%. By evaluating the variable gestational age, about 40% of the average total donation derives from mothers who gave birth before the 25 weeks, while a contribution of 46% is attributable to the category of newborns with a GA between 25 and 32 weeks. Besides, some other exceptional examples can be outlined. Regarding the correlation analysis DM resulted in negative correlation with GA weeks (r=-0.31, p=0.058) and with BW g (r=-0.30, p=0.068) achieving values which are very close to the significance. The comparison between the donor volume averages of the preterm and full-term groups is statistically significant. The composition data are in line with the literature: there is an increase by 18 % in the protein component of the milk deriving from the mothers of the premature infants; the gap in carbohydrates is less significant (5-6%) and the gap in calories is similarly low being only 2% higher than the single donor milk and 11% more than the pooled milk. The data on the lipids line up to single donor term milk, while it grows by 24% compared to the pooled one. The study shows that even at very low or extreme gestational age it is possible to obtain an appropriate production of breast milk. This awareness becomes a fundamental starting point for the activation in a standardized way of all the strategies of promotion and support of food that have proven effective with the HM in NICU.

scholarly journals Pediatric resuscitation, emergencies in pediatrics. Various infusion methods for children

2020 ◽  
pp. 97-99
Author(s):  
T. Erler
Keyword(s):  
Body Weight ◽  
Breast Milk ◽  
Premature Infants ◽  
Premature Birth ◽  
Mortality Rates ◽  
Modern Medicine ◽  
Premature Baby ◽  
Multiple Pregnancies ◽  
Premature Babies ◽  
Great Progress

Background. Medical care for premature babies in Germany is divided into two levels. Perinatal centers of the first level provide care for infants with body weight at birth <1500 g. Perinatal centers of the second level provide care for children whose body weight exceeds 1500 g. In order to be included in the list of first level institutions, the hospital must, among other, be able to pick up children from other institutions in the surrounding region. Mobile incubators are used for this purpose. Such an incubator is a kind of a mobile intensive care unit. In some cases, the incubator is delivered to the desired location by helicopter, but in most cases, specialized road transport is used. Objective. To describe neonatological medical care in Germany. Materials and methods. Analysis of own experience and available literature data on this issue. Results and discussion. In recent years, Germany experiences a decrease in the number of births, which causes the problem of professional training of doctors. Hospitals with the fewest births are closed due to lack of efficiency. Although there are some fluctuations from year to year, in general, the number of premature babies with extremely low birth weight remains approximately constant. Prematurity remains one of the most important problems of modern medicine, as it is accompanied by high mortality rates. The earlier the premature birth is and the lower the body weight is, the higher these rates are. Prematurity is caused by numerous risk factors. Multiple pregnancies are accompanied by the highest risk of premature birth. The presence of twins or triples increases this risk by 7.7 times. Other risk factors include vaginal bleeding in late pregnancy, preeclampsia, and a history of preterm birth. Over the past 20 years, the survival of children born before 32 weeks of pregnancy or weighing <1500 g has increased by almost 20 %. The smallest premature baby born in our clinic is a baby born at 24 weeks of gestation with a body weight of 350 g. Nowadays in Germany, the survival rate of infants born after 24 weeks of gestation is almost 80 %, and after 29 weeks – almost 100 %. It should be noted that maintaining the life of a premature baby from birth to discharge costs 250-300 thousand euros. Bronchopulmonary dysplasia is an important problem of premature infants, especially in case of mechanical lung ventilation (MLV) or joining infections. Up to 40 % of children who die from complications of bronchopulmonary dysplasia can be saved. If possible, MLV and infections should be avoided, premature births should be prevented, so-called neuroprotective ventilation and nasal or mask devices that do not require intubation should be used. Surfactants have made great progress in the management of premature infants. The modern LISA (less invasive surfactant administration) method allows to inject a surfactant into a child’s lungs without intubation. In the early 20th century, 100 % oxygen was used in the resuscitation of newborns, but now we use air (21 % oxygen) or a mixture containing up to 30 % oxygen. To prevent necrotizing enterocolitis, premature infants are prescribed probiotics based on lyophilized lactic acid bacteria and bifidobacteria. Breast milk is an another way to prevent this complication of prematurity. There is a breast milk bank in Potsdam. Conclusions. 1. Prematurity remains one of the most important problems of modern medicine, as it is accompanied by high mortality rates. 2. Multiple pregnancies are accompanied by the highest risk of premature birth. 3. Nowadays in Germany, the survival rate of children born after 24 weeks of gestation is almost 80 %, and after 29 weeks – almost 100 %. 4. Surfactants and the LISA method have made great progress in the management of premature infants. 5. Probiotics and breast milk are prescribed to premature babies to prevent necrotizing enterocolitis.

scholarly journals Pengaruh Booklet Stimulasi Intervensi Pertumbuhan Dan Perkembangan Pada Bayi Prematur Terhadap Peningkatan Pertumbuhan Dan Perkembangan Bayi

2019 ◽  
Vol 4 (2) ◽  
pp. 4
Author(s):  
Rosalinna Rosalinna ◽  
Asti Andriyani
Keyword(s):  
Body Weight ◽  
Premature Infants ◽  
Growth And Development ◽  
Positive Impact ◽  
Intervention Group ◽  
Height Growth ◽  
Control Group ◽  
Risk Of Death ◽  
Premature Babies ◽  
Before And After

Background: Premature infants have a risk of death in the first year of life mainly due to prematurity. Developmental stimulation interventions in premature infants can have a positive impact on weight gain and infant development. The purpose of this study was to determine the effect of the application of growth and development intervention booklets on mothers who had a premature baby to increase the growth and development of infants aged 0-6 months in Karanganyar Regency. Method: The method used in this study is the method in this study. This research uses a quantitative method with a Quasy experiment in the form of a pre-post test design. The sample in this study was Mother and Baby in Karanganyar District who had met the inclusion and exclusion criteria. Results: The results of this study showed that there were differences in body weight and height growth before and after the study in the control group (ρ <0.05). There were no differences in development before and after the study in the control group (ρ> 0.05). There were differences in body weight and height growth before and after the study in the intervention group (ρ <0.05). There are differences in development before and after the study in the control group (ρ <0.05). There is no effect of the application of growth intervention booklet stimulation, but there is a developmental influence on premature infants aged 0-6 months in Karanganyar Regency. Conclusion: SDIDTK booklet can significantly improve the development of premature babies. It is expected that parents can provide stimulation to premature babies well to increase growth and development

scholarly journals Analysis of the composition and antioxidant status of breast milk in women giving birth prematurely and on time

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255252
Author(s):  
Agnieszka Chrustek ◽  
Agnieszka Dombrowska-Pali ◽  
Dorota Olszewska-Słonina
Keyword(s):  
Breast Milk ◽  
Antioxidant Status ◽  
Digestive System ◽  
Total Antioxidant Status ◽  
Cortisol Concentration ◽  
Basic Composition ◽  
Milk Samples ◽  
Premature Babies ◽  
Before And After ◽  
Total Antioxidant

Background Breastfeeding with mother’s milk is the best form of nutrition not only for newborn babies, but especially for premature babies, due to the health benefits of taking human food. Objectives The aim of the study was to examine the basic composition, cortisol concentration and antioxidant status of breast milk samples from women giving birth before 37 weeks of pregnancy and comparing it with milk samples from women giving birth after 37 weeks of pregnancy. Methods The material for the study was milk taken from women giving birth before and after 37 weeks of pregnancy. The basic composition of breast milk was determined using a MIRIS analyzer, cortisol concentration in samples by an enzyme-linked immunosorbent test and their total antioxidant status was assessed by DPPH and FRAP methods. Results It has been shown that the concentration of cortisol in samples of human milk in the group of women giving birth before 37 weeks was 13.95 ng / ml [4,71–86,84], while in the group of women giving birth after week 37 of pregnancy—10.31 ng / ml [2.35-39-02] (p = 0.014), while% inhibition of DPPH was 65.46% and 58.30%, respectively (p = 0.014). Conclusions Milk from women giving birth prematurely is qualitatively different from the milk of women giving birth on time. The total antioxidant status of preterm milk is higher than term milk, which promotes the development of premature babies. Higher cortisol levels in samples from women giving birth before 37 weeks of pregnancy may stimulate the digestive system.

Postnatally acquired CMV meningitis diagnosed via BioFire FilmArray: A case report

2020 ◽  
pp. 1-6
Author(s):  
A. Stark ◽  
J. Peterson ◽  
K. Weimer ◽  
C. Hornik
Keyword(s):  
Case Report ◽  
Birth Weight ◽  
Breast Milk ◽  
Premature Infants ◽  
Gold Standard ◽  
Very Low Birth Weight ◽  
Definitive Treatment ◽  
Cmv Infection ◽  
Term Infants ◽  
Low Birth Weight Infant

Postnatally acquired cytomegalovirus (CMV) is commonly acquired via breast milk, with premature infants more frequently developing symptoms of CMV infection in comparison to term infants. Meningitis is a rare clinical manifestation of CMV infection. The diagnosis of meningitis is difficult to make in infants, particularly those who are preterm. Consequentially, broad-spectrum empiric antimicrobial coverage is often administered for several days while waiting for current gold standard CSF testing to result. The BioFire FilmArray (BFA) simultaneously tests for 14 different pathogens, including CMV, allowing for quicker diagnosis and shorter time to definitive treatment. Here, we report a very low birth weight infant with postnatally acquired CMV meningitis, the first to our knowledge to be diagnosed using the BioFire FilmArray.

Abstract TP409: Reporting of Key Demographic Characteristics in Neurological Trials Registered on ClinicalTrials.gov

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Kush Fansiwala ◽  
Lauren Southwick ◽  
Emily Goldmann ◽  
Nina S Parikh ◽  
Joy Madubuonwu ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Race And Ethnicity ◽  
Neurological Diseases ◽  
Demographic Characteristics ◽  
Mandatory Reporting ◽  
Trial Participation ◽  
Limited Participation ◽  
Chi Square ◽  
Before And After ◽  
Race Ethnicity

Introduction: To increase the transparency of clinical trial information, U.S. Congress passed the Food and Drug Administration (FDA) Amendments Act of 2007, which expanded prior legislation to mandate inclusion of specific trial characteristics, such as funding source and gender demographics, in a new basic results section on ClinicalTrials.gov. Few studies have examined the extent to which key demographic characteristics such as sex and race/ethnicity are reported for neurological trials on ClinicalTrials.gov. Methods: As part of the National Initiative for Minority Involvement in Neurological Clinical Trials (NIMICT), we systematically identified neurological clinical trials on ClinicalTrials.gov (for stroke, epilepsy, Alzheimer’s Disease [AD]) and examined the proportion that reported sex, race, and ethnicity (Hispanic/Latino or not) of study participants. We used the website’s advanced search feature to evaluate demographic information reported from trials conducted between 1999 and 2015. We first calculated frequencies of trials reporting these characteristics, then assessed differences in reporting of each characteristic (yes/no) by condition (stroke, epilepsy, AD) and between trials conducted before and after the basic results section update (pre- and post-2008) using chi-square tests. Results: Our sample comprised 251,847 subjects across 393 trials (147 stroke, 127 epilepsy, 115 AD). Overall, sex was reported for nearly all trials (99.0%), while reporting of race and ethnicity was low (ethnicity: 14.0%, race: 19.8%). Reporting of these characteristics did not differ significantly across the three conditions or between periods preceding and following the FDA act. Conclusion: While ClinicalTrials.gov mandates reporting of sex, it does not require reporting of race/ethnicity, and few trials report these characteristics. This lack of information prevents understanding of neurological trial participation and how interventions might impact patients differently by race/ethnicity. Mandatory reporting of race/ethnicity would enhance transparency and increase awareness of the limited participation of racial/ethnic minorities-who suffer disproportionately from neurological diseases-in neurological trials.

EARLY FEEDING OF DEXTROSE AND SALINE SOLUTION TO PREMATURE INFANTS

PEDIATRICS ◽  
1960 ◽  
Vol 26 (5) ◽  
pp. 756-761
Author(s):  
William Allen Bauman
Keyword(s):  
Premature Infants ◽  
Saline Solution ◽  
Treated Group ◽  
Controlled Study ◽  
Early Feeding ◽  
Premature Babies ◽  
Hyaline Membranes ◽  
Average Intake ◽  
Feeding Trials ◽  
Physiologic Responses

Conflicting opinions concerning the optimum age at which to commence feeding premature infants have resulted in either early or late regimens. In order to test the hypothesis that the early administration of fluids to premature babies was beneficial, a controlled study of 50 newborn premature subjects was undertaken. Fluids consisting of 5% dextrose in 0.45% saline were started before the age of 6 hours by constant drip through a nasogastric plastic catheter in 24 subjects selected by a predesigned method using a table of random permutations. The average intake during the test period was 54.5 ml/kg/24 hours. The other 26 control subjects received no fluids until age 36 hours, when both groups were started on formula. There was no alteration of symptoms of respiratory distress in the group receiving early feedings. One-half of these subjects did not lose weight while being fed the dextrose and saline solution. They promptly lost weight, however, when regular milk feedings were commenced. The seven infants who died had similar pathologic findings. It was noted that three of the five in the fluid treated group also had pulmonary hyaline membranes. There were no hyaline membranes in the lungs of the two subjects deprived of water. From this study neither beneficial nor detrimental effects of early feeding could be demonstrated by use of the criteria of dyspnea or mortality. The question of when to start to feed premature babies is still unanswered. There is need for further feeding trials, in which associations among age of commencement, nature of substances fed and the consequent physiologic responses, can be observed.

HYPERGLYCEMIAAS AN INDEPENDENT RISK FACTOR FOR RETINOPATHY OF PREMATURITY (ROP): A COHORT STUDY

2021 ◽  
pp. 54-57
Author(s):  
Kali Shankar Das ◽  
Athokpam Poireiton ◽  
Niladri Sekhar Mandal ◽  
Samim Ahmed
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Blood Glucose ◽  
Premature Infants ◽  
Gestational Age ◽  
Independent Risk Factor ◽  
Logistic Regression Model ◽  
Bivariate Analysis ◽  
Premature Babies ◽  
Average Blood Glucose

OBJECTIVE: Retinopathy of prematurity (ROP) is a severe morbidity that can lead to blindness in premature babies. Neonatal hyperglycemia has been related to the growth of ROP in a variety of studies. However, there aren't many observational trials to show whether hyperglycemia is linked to ROP in the absence of other comorbidities. The aim of this research was to see if hyperglycemia in premature babies is linked to ROP in a different way. STUDY DESIGN: Premature infants (<1500 g or⩽ 32 weeks gestational age) were enrolled in a prospective longitudinal cohort study. All demographic, clinical and laboratory data were collected. Bedside whole-blood glucose concentration was measured every 8 hours daily for rst 7 , days of live. For any glucose reading <50 or>150 mg dl 1 serum sample was sent to the laboratory for conrmation. Hyperglycemia was dened as any blood glucose level⩾ 150 mg dl − 1. ROP patients were compared with non-ROP patients in a bivariate analysis. Variables signicantly associated with ROP were studied in a logistic regression model. RESULT:Atotal of 100 patients were enrolled with gestational age <32weeks and birth weight <1500g. Forty-eight patients (48%) were identied with hyperglycemia. On eye examination, 30 cases (30%) had ROP (19 with stage 1, 10 with stage 2 and 1 with stage 3). There were more cases of ROPin the hyperglycemia group compared with the euglycemia group (45.83% vs 15.38%, P = 0.007). Patients who developed ROP had signicantly higher maximum and average glucose concentrations when compared with non-ROP patients. Multiple factors have been associated with ROP on bivariate analysis, including gestational age, exposure to oxygen, respiratory support and poor weight gain. However, in a logistic regression model including all signicant variables, average blood glucose in the rst week of life was the factor independently associated with ROPwith an odds ratio of: 1.77 (95% condence interval: 1.08 to 2.86), P= 0.024 CONCLUSION: In a prospective cohort study of premature infants, elevated average blood glucose concentrations in the rst week of life is an independent risk factor associated with the development of ROP.

scholarly journals Perfusion Imaging of the Brain Using Z-Score and Dynamic Images Obtained by Subtracting Images from before and after Contrast Injection

2004 ◽  
Vol 5 (3) ◽  
pp. 143 ◽  
Author(s):  
Sunseob Choi ◽  
Haiying Liu ◽  
Tae Beom Shin ◽  
Jin Hwa Lee ◽  
Seong Kuk Yoon ◽  
...  
Keyword(s):  
Perfusion Imaging ◽  
Z Score ◽  
Contrast Injection ◽  
Before And After ◽  
The Brain

Perinatal Profile of Twin Pregnancies: A Retrospective Review of 11 Years (1969–1979) at Hôpital Notre-Dame, Montréal, Canada

1982 ◽  
Vol 31 (3-4) ◽  
pp. 157-163 ◽  
Author(s):  
Marie-Françoise Desgranges ◽  
Xavier De Muylder ◽  
Jean-Marie Moutquin ◽  
Francisco Lazaro-Lopez ◽  
Bernard Leduc
Keyword(s):  
Perinatal Mortality ◽  
Perinatal Care ◽  
Fetal Mortality ◽  
Ultrasound Technique ◽  
Intrauterine Growth ◽  
Before And After ◽  
The Impact ◽  
Second Period ◽  
Twin Pregnancies ◽  
Main Factor

Four hundred and thirty four twins occurring in 220 women were studied during a period of 11 years (1969–1979) at Notre-Dame Hospital.Perinatal mortality (< 28 days) was compared before and after 1974, and the impact of ultrasound technique upon perinatal outcome was assessed during the second period (1974–1979). The main factor associated with perinatal mortality was low birth weight caused by either prematurity or intrauterine growth retardation.While fetal mortality remained unchanged within the two study periods, neonatal mortality decreased from 68.2/1,000 to 28.9/1,000 mainly due to increased survival rate of twins below 1,500 g at birth.With identical perinatal care during the same period, perinatal mortality and incidence of intrauterine growth-retarded twins remained unchanged despite early diagnosis by ultrasound.

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