scholarly journals Is Magnesium Sulfate Treatment Really Effective in Moderate to Severe Bronchiolitis?

2021 ◽  
Author(s):  
İlknur Bodur ◽  
Ayla Akca Caglar ◽  
Aysun Tekeli ◽  
Ali Güngör ◽  
Muhammed Mustafa Güneylioglu ◽  
...  
Keyword(s):  
Supportive Care ◽  
Magnesium Sulfate ◽  
Clinical Score ◽  
Clinical Severity ◽  
Care Group ◽  
Acute Bronchiolitis ◽  
Intravenous Magnesium ◽  
Group I ◽  
Severity Scores ◽  
Group Ii

Objectives: The aim of our study is to examine the efficacy and safety of intravenous magnesium sulfate in moderate-severe acute bronchiolitis. Working hypothesis: Intravenous magnesium sulfate treatment may be effective in the treatment of patients with bronchiolitis . Study design: Retrospective, single-center cohort study Methodology: We conducted a study in 150 infants presenting with moderate to severe acute bronchiolitis. A total of 150 infants aged 1 month to 2 years who presented with acute bronchiolitis to our pediatric emergency department between January 2018 and March 2019 were admitted into the study. The demographic characteristics, clinical score, and management of the patients were examined. Results: A total of 150 infants were analyzed: 62 in the magnesium sulfate group (Group I) and 88 in the supportive care group (Group II). Baseline clinical characteristics were similar in both groups. Length of hospitalization was significantly shorter in Group II. Clinical severity scores were also lower significantly earlier in Group I (p=0.031, p=0.008, respectively at first and fourth hour). Conclusions: Intravenous magnesium treatment in moderateto severe acute bronchiolitis does not appear to conferany significant decrease in clinical severity scores when compared to only supportive care

scholarly journals Comparative Efficacy of Nebulized 3% Hypertonic Saline versus 0.9% Normal Saline in Children with Acute Bronchiolitis

2018 ◽  
Vol 42 (3) ◽  
pp. 130-137 ◽  
Author(s):  
Khandaker Tarequl Islam ◽  
Abid Hossan Mollah ◽  
Abdul Matin ◽  
Mahmuda Begum
Keyword(s):  
Hospital Stay ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Severity Score ◽  
Oxygen Therapy ◽  
Length Of Hospital Stay ◽  
Clinical Severity ◽  
Acute Bronchiolitis ◽  
Group I ◽  
Group Ii

Background: Acute bronchiolitis is leading cause of hospitalization in infants below 2 years of age. Bronchiolitis being a viral disease, there is no effective treatment. 3% nebulized hypertonic saline and 0.9% nebulized normal saline are often used, although there is disagreement over their efficacy. The aim of this study was to evaluate the efficacy of 3% hypertonic saline in children with acute bronchiolitis in reducing clinical severity and length of hospital stay. Methodology: A randomized control trial carried out in the Department of Pediatrics, Dhaka Medical College Hospital from January 2013 to December 2013.Ninty children from 1 month to 2 years of age hospitalized with clinical bronchiolitis were randomized to receive 3% nebulized hypertonic saline(Group-I) or 0.9% nebulized normal saline (Group-II). Nebulization was done 8 hourly until discharge. Outcome variable were clinical severity score, duration of oxygen therapy and length of hospital stay. Results: Baseline clinical severity score and O2 saturation were in group-I 9.0±1.0 and 94.9±1.7 and in group- II 9.3±1.8 and 94.6±2.6 respectively (p>0.05). At 72 hours, the mean severity score for the group-I was 1.64±0.99 and that for the group-II was 3.0 ± 1.48 (95% CI -2.17 to - 0.53, p=0.002). The cases of group-I required a shorter duration of oxygen therapy compared to those of group-II (15.0±6.0 hours vs 26.4±5.37 hours, 95% CI -20.35 to -2.44, p<0.05). Forty two (93.3%) of the group-I children recovered by the end of72 hours and discharged whereas 26 (57.8%) of the group-II children recovered during the same period (p<0.05). Length of hospital stay was shorter in group-I compared to group-II (58.1±22.0 hours vs 74.7±27.2 hours, 95% CI -26.89 to- 6.17, p=0.002). None of the cases encountered any side-effects. Conclusion: Nebulization with 3% hypertonic saline significantly reduced clinical severity, length of hospital stay and duration of oxygen therapy in case of acute bronchiolitis in comparison to 0.9% normal saline and was safe. Bangladesh J Child Health 2018; VOL 42 (3) :130-137

scholarly journals Comparative Efficacy of Nebulized 7% Hypertonic Saline versus 0.9% Normal Saline with Salbutamol in Children with Acute Bronchiolitis

2019 ◽  
Vol 43 (2) ◽  
pp. 80-84
Author(s):  
Md Saiful Islam ◽  
Md Abid Hossain Mollah ◽  
Rokeya Khanam ◽  
Abu Sayeed Chowdhury ◽  
Md Mahfuzur Rahman ◽  
...  
Keyword(s):  
Hypertonic Saline ◽  
Normal Saline ◽  
Severity Score ◽  
Length Of Hospital Stay ◽  
Saline Group ◽  
Clinical Severity ◽  
Acute Bronchiolitis ◽  
Clinical Severity Score ◽  
Group I ◽  
Group Ii

Background: Acute bronchiolitis is an acute viral lower respiratory tract infection of infants and is the leading cause of hospitalization of infants below 2 years of age. Being a viral disease, there is no effective treatment of this problem other than supportive care. To provide this care, both 0.9% normal saline with salbutamol and 3% hypertonic saline has been found effective. This study was undertaken to assess the efficacy of 7% hypertonic saline on recovery from acute bronchiolitis. Methodology: This was a randomized controlled trial, carried out in the Department of Paediatrics, Dhaka Medical College Hospital (DMCH), Bangladesh between January 2015 to December 2015. A total of 90 children from 1 month to 2 years of age of either sex who were diagnosed and admitted as acute bronchiolitis were enrolled. After enrollment, they were randomly assigned to either 7% nebulized hypertonic saline (Group-I = 45) or to 0.9% nebulized normal saline with salbutamol (Group-II = 45). The efficacy was determined by assessing clinical severity score and length of hospital stay. Data were analyzed using computer software SPSS version 19. Result: In this study the two groups were almost similar with respect to their demographic and baseline clinical severity score. After intervention the clinical severity score of both treatment modalities were reduced (Group-I(HS) were 7.9, 6.8, 3.8, 1.4, 1.33 while in Group-II(NS+ Salbutamol) score were 8.6, 7.6, 4.9, 3.11, 2.12) but the reduction was significant more in children who received 7% nebulized hypertonic saline than those who received 0.9% nebulized normal saline with salbutamol. Majority 42(93.3%) of group-I(HS) children recovered at the end of 72 hours whereas 17(37.8%) of the children of group-II (NS+ Salbutamol) recovered from the disease during the same period. Length of hospital stay was shorter in hypertonic saline group compared to normal saline with salbutamol group (56.36±12.33 hours vs71.07±13.48 hours, p<.001). The patients of hypertonic saline group required a shorter duration of oxygen therapy compared to normal saline with salbutamol group (12.53±3.58) hours vs (20.25± 4.15) hours, (p=0.009). Conclusion: 7% hypertonic saline was found more effective than 0.9% normal saline with salbutamol in terms of reducing clinical severity, length of hospital stays and duration of oxygen therapy. Bangladesh J Child Health 2019; VOL 43 (2) :80-84

scholarly journals THE EFFECT OF INTRAVENOUS MAGNESIUM SULFATE ON CHILDREN ADMITTED WITH ACUTE BRONCHIOLITIS IN A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 71 (6) ◽  
pp. 2148-51
Author(s):  
Andaleeb Ara ◽  
Farooq Ikram ◽  
Hidayat Ullah ◽  
Shakila Asmat ◽  
Nadia Tareen
Keyword(s):  
Magnesium Sulfate ◽  
Conventional Treatment ◽  
Clinical Severity ◽  
Military Hospital ◽  
Care Hospital ◽  
Acute Bronchiolitis ◽  
Intravenous Magnesium ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: To assess the efficacy of using intravenous Magnesium Sulfate along with the conventional treatment in the management of acute bronchiolitis Study Design: Quasi-experimental study. Place and Duration of Study: Pediatrics department in Sandeman Provincial Hospital, Quetta, from Jan to Jul 2019. Methodology: The study was approved by institutional ethical committee of Combined Military Hospital, Peshawar. Children, 2 months to 2 years of age, with acute bronchiolitis having clinical severity score of ≥5, presenting to the OPD and emergency department were enrolled in the study after getting informed consent from the guardian. They were randomly assigned group A receiving intravenous Magnesium Sulfate and group B receiving placebo along with the conventional treatment for both. Data was analysed with SPSS-21. Results: Total 108 patients were included in the study with 54 (50%) in group A and 54 (50%) in group B. Mean age in the study was 12.02 ± 6.421 months. Mean age in group A and B was 11.17 ± 6.40 and 12.87 ± 6.38 months respectively. Out of 108 patients 50 (46.3%) were males while 58 (53.7%) were females. There was statistically significant difference in the efficacy of treatment between two groups with values being 48 (88.9%) and 37 (68.5%) for Magnesium Sulfate and control groups respectively (p=0.01). Conclusion: From a clinical point of view, intravenous Magnesium Sulfate combined with conventional treatment is more effective than conventional treatment alone in the management of acute bronchiolitis.

scholarly journals Efficacy of nebulised L-adrenaline with 3% hypertonic saline versus normal saline in bronchiolitis

2016 ◽  
Vol 7 (1) ◽  
pp. 15
Author(s):  
Shabnam Sharmin ◽  
Laila Helaly ◽  
Zakir Hossain Sarker ◽  
Ruhul Amin ◽  
Shafi Ahmed ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Severity Score ◽  
Saline Group ◽  
Clinical Severity ◽  
Clinical Severity Score ◽  
Group I ◽  
Group Ii

<p><strong>Background:</strong> Bronchiolitis is one of the most common respiratory diseases requiring hospitalization. Nebulized epineph­rine and salbutamol therapy has been used in different centres with varying results. <strong></strong></p><p><strong>Objective:</strong> The objective of the study was to compare the efficacy of nebulised adrenaline diluted with 3% hypertonic saline with nebulised adrenaline diluted with normal saline in bronchiolitis. <strong></strong></p><p><strong>Methods:</strong> Fifty three infants and young children with bronchiolitis, age ranging from 2 months to 2 years, presenting in the emergency department of Manikganj Sadar Hospital were enrolled in the study. After initial evaluation, patients were randomized to receive either nebulized adrenaline I .5 ml ( 1.5 mg) diluted with 2 ml of3% hypertonic saline (group I) ornebulised adrenaline 1.5 ml (1.5 mg) diluted with 2 ml of normal saline (group II). Patients were evaluated again 30 minutes after nebulization. <strong></strong></p><p><strong>Results:</strong> Twenty eight patients in the group I (hypertonic saline) and twenty five in groupII (normal saline) were included in the study. After nebulization, mean respiratory rate decreased from 63.7 to 48.1 (p&lt;.01), mean clinical severity score decreased from 8.5 to 3.5 (p&lt;.01) and mean oxygen satw·ation increased 94.7% to 96.9% (p&lt;.01) in group I. In group II, mean respiratory rate decreased from 62.4 to 47.4 (p&lt;.01), mean clinical severity score decreased from 7.2 to 4.1 (p&lt;.01) and mean oxygen saturation increased from 94. 7% to 96. 7% (p&lt;.01). Mean respiratory rate decreased by 16 in group I versus 14.8 (p&gt;.05) in group 11, mean clinical severity score decreased by 4.6 in group versus 3 (p&lt;.05) in group, and mean oxygen saturation increased by 2.2% and 1.9% in group and group respectively. Difference in reduction in clinical severity score was statistically significant , though the changes in respiratory rate and oxygen saturation were not statistically significant. <strong></strong></p><p><strong>Conclusion:</strong> The study concluded that both nebulised adrenaline diluted with 3% hypertonic saline and nebulised adrenaline with normal saline are effective in improving respiratory rate, clinical severity score and oxygen saturation in infants with bronchiolitis; and nebulised adrenaline with hypertonic saline is more effective than nebulised adrenaline with normal saline in improving clinical severity score in bronchiolitis.</p>

scholarly journals Rationale of specialized medical care for patients with chronic heart failure in the Russian Federation

2020 ◽  
Vol 1 (3) ◽  
pp. 44-53
Author(s):  
I. V. Fomin ◽  
N. G. Vinogradova
Keyword(s):  
Heart Failure ◽  
Medical Care ◽  
Clinical Severity ◽  
Adherence To Treatment ◽  
Group I ◽  
Patients With Heart Failure ◽  
Group Ii ◽  
Overall Mortality ◽  
Group 1

Objectives: to determine the causes of ineffective observation and poor prognosis in patients undergoing ADHF, in real clinical practice and to consider the basics of the formation of specialized medical care for patients with heart failure (HF).Materials and methods: the study was conducted based on the City Center for the treatment of heart failure (center HF), N. Novgorod. The study consistently included 942 patients with heart failure (HF) at the age of 18 years and older who underwent ADHF and received inpatient treatment in center HF between March 4, 2016 and March 3, 2017. Based on the decisions of patients to continue outpatient monitoring in center HF, two groups of patients were distinguished: patients who continued to be monitored in center HF (group I, n = 510) and patients who continued to be monitored in outpatient clinics at the place of residence (group II, n = 432). The assessment of adherence to treatment, overall mortality, survival and re-admission to a depth of two years of observation was carried out. Statistical data processing was performed using Statistica 7.0 for Windows and the software package R.Results: all patients in the study groups had high comorbidity. Group 2 patients turned out to be statistically significantly older, more often had III functional class (FC) HF, lower the baseline test score of 6-minute walk, and higher the baseline clinical assessment scale. After 2 years of follow-up in group II, there was a significant deterioration in adherence to basic therapy of HF compared with group I. According to the results of multifactorial proportional risk Cox models, it was shown that observation of patients in the group 1 is an independent factor increasing the risk of overall mortality by 2.8 times by the end of the second year of observation. Survival after two years of follow-up was: in group I — 89.8 %, and in group II — 70.1 % of patients (OR = 0.3, 95 % CI 0.2 – 0.4; p1/2 < 0.001). After two years of follow-up, the proportion of re-hospitalized patients in group II was greater (78.0 % of patients) versus group 1 (50.6 % of patients, OR = 3.5, 95 % CI 2.6 – 4.6; p1/2 <0.001). The independent risk of re-hospitalization according to multinominal logit regression was 3.4 times higher in group II and 2.4 times for III – IV FC HF. Conclusions: the inclusion of patients with HF in the system of specialized medical care improves adherence to treatment, prognosis of life and reduces the risk of repeated hospitalizations. Patients of an older age and with an initially greater clinical severity refused specialized supervision in center HF.

scholarly journals Acute hypervolemic hemodilution combined with controlled hypotension to minimize blood loss during operations of spine fusion: remifentanil versus magnesium sulfate

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Khaled Mohammed Elnaghy ◽  
Ibrahimabd-Elsalam Nasr ◽  
Eman Mohamed Kamal
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Magnesium Sulfate ◽  
Spine Fusion ◽  
Controlled Hypotension ◽  
Group Iii ◽  
Group I ◽  
Estimated Blood Loss ◽  
Hypervolemic Hemodilution ◽  
Group Ii

Abstract Background Blood loss is one of the major problems during operations of spine fusion. Several blood-conservative measures were applied to reduce the incidence of blood loss—among them, acute hypervolemic hemodilution (AHH) and controlled hypotension (CH). This study was designed to detect the effect of combination of AHH with CH induced by remifentanil versus magnesium sulfate on the volume of blood loss, allogeneic blood transfusion, hemodynamics, coagulation, and electrolytes during operations for spine fusion which are risky operations with high incidence of blood loss and blood transfusion. Sixty patients scheduled for posterior fusion of the spine were randomly allocated into three groups of 20 patients each (group I (AHH), group II (AHH combined with remifentanil-based CH), and group III (AHH combined with magnesium sulfate-based CH)). Estimated blood loss and total volume of packed red blood cells (PRBCS) transfused were recorded. Arterial blood pressure (ABP) and heart rate (HR) measures were recorded. Blood samples were obtained for the detection of hemoglobin (Hb) and hematocrit (HCT). Results Estimated blood loss, percentage blood loss, and intraoperative RBC transfusion units were significantly high in group I in relation to group II and group III (Table 2). Cardiac output was significantly higher in group I in relation to group II and group III at 10, 15, 30, 45, and 60 min after start of AHH. MBP and HR results were significantly high in group I in comparison with group II and group III at 30, 45, 60, and 90 min and 2 and 3 h after start of study drugs. CVP results were significantly high in group I in relation to group II and group III at 15, 30, 45, 60, and 90 min after start of AHH. PTT was significantly increased in the three study groups in comparison with baseline inside each group after AHH. Conclusion Combination of AHH with CH induced by remifentanil or magnesium sulfate was associated with reduction in estimated blood loss, and total volume of PRBCS transfused. There was no significant difference between hemodynamic parameters with the use of remifentanil or magnesium sulfate except that SBP, DBP, and MBP results were significantly high with magnesium sulfate at 15 min after drug infusion. There was significant increase in PT and PTT after AHH that was not reflected by significant blood oozing from the operative field, or by difficulty in hemostasis.

Quantification of venous reflux parameters using duplex scanning and air plethysmography

2007 ◽  
Vol 22 (1) ◽  
pp. 20-28 ◽  
Author(s):  
T Yamaki ◽  
M Nozaki ◽  
H Sakurai ◽  
M Takeuchi ◽  
T Kono ◽  
...  
Keyword(s):  
Venous Insufficiency ◽  
Femoral Vein ◽  
Clinical Manifestations ◽  
Clinical Severity ◽  
Venous Reflux ◽  
Discrimination Power ◽  
Group I ◽  
Significant Difference ◽  
Air Plethysmography ◽  
Group Ii

Objective: To compare different duplex-and air plethysmography (APG)-derived parameters between patients with relatively early and those with advanced chronic venous insufficiency (CVI), and to investigate the indicative parameters reflecting the progression of CVI. Methods: Design: Prospective study at the University Hospital. Patients: In total 686 limbs in 574 patients at various clinical stages of CVI were included. The clinical manifestations were categorized according to the CEAP (clinical, aetiologic, anatomic and pathophysiologic) classification, and the patients were divided into two groups: group I (C1-3EP,SAS,D,PPR,O, relatively early stage of CVI) and group II (C4-6EP,SAS,D,PPR,O, advanced CVI). The distribution of venous insufficiency including the sapheno-femoral junction (SFJ), great saphenous vein (GSV), sapheno–popliteal junction (SPJ), common femoral vein (CFV), femoral vein (FV), popliteal vein (POPV), thigh perforators (TPV) and calf perforators (CPV) was determined by duplex ultrasound. The main duplex-derived parameters assessed were the reflux time (RT; s), peak reflux velocity (PRV; cm/s) and peak reflux flow (PRF; mL/s). The venous reflux was assumed to be present if the duration of reflux was ≥0.5 s. The data obtained by APG were on VV (mL), VFI (mL/s), EF (%) and RVF (%). Results: There was no significant difference in overall superficial venous reflux between the groups ( P=0.331). The frequency of deep and perforating vein incompetence differed only when superficial reflux was included in group II. The VFI and RVF were significantly higher in secondary CVI than in primary CVI ( P=0.0001, 0.003, respectively). In the secondary CVI, patients with reflux and obstruction showed significantly higher RVF than those with reflux alone ( P=0.003). The RT did not improve the discrimination power between the groups. In contrast, the PRV had significant discrimination power at the SFJ ( P<0.0001) and SPJ ( P=0.022), and in the GSV ( P<0.0001), the FV ( P=0.017), and the POPV ( P=0.0003). The PRF was significantly higher in group II at the SFJ ( P<0.0001), in the GSV ( P=0.002), in the CFV ( P=0.011), in the FV ( P=0.027), and the POPV ( P=0.016). Conclusions: This present study has suggested the importance of superficial venous insufficiency in the development of advanced CVI. In the secondary CVI, obstruction affects the RVF alone. The PRV and PRF are better parameters than the RT for discrimination of clinical severity in both superficial and deep venous insufficiency, and should be used to quantify venous valvular insufficiency.

scholarly journals Intravenous magnesium sulfate for acute bronchiolitis: evaluation of the effect on clinical course and outcomes

2021 ◽  
Author(s):  
Nihan Şık ◽  
Hale Çitlenbik ◽  
Ali Öztürk ◽  
Durgül Yılmaz ◽  
Murat Duman
Keyword(s):  
Magnesium Sulfate ◽  
Total Duration ◽  
Assessment Instrument ◽  
Clinical Severity ◽  
Respiratory Support ◽  
Healthy Children ◽  
Effective Treatment Option ◽  
Severity Scores ◽  
Group 2 ◽  
Group 1

Background: The aim of this study was to assess the efficacy of intravenous (IV) magnesium sulfate (MgSO4) on clinical severity scores, need for respiratory support and outcomes for previously healthy children with bronchiolitis. Methods: We retrospectively assessed children with moderate-severe bronchiolitis. Patients who received 40 mg/kg/dose of IV MgSO4 (group 1) or not (group 2) were compared for vital signs, clinical findings and outcomes. Results: There were 74 patients in group 1 and 33 in group 2. The median age, the mean respiratory rates, oxygen saturation/fraction of inspired oxygen (S/F) ratios and, The Modified Respiratory Distress Assessment Instrument (mRDAI) scores at the time of starting MgSO4 treatment were similar for two groups. Respiratory rate and mRDAI score significantly decreased at the 2th hour of MgSO4 treatment and the decrease was observed for 4th, 8th and 12th hours, compared with group 2. Patients in group 1 had a higher S/F ratio at 4th hour compared with group 2 and in group 1, the elevation was observed at the 4th hour. Patients in group 2 had a higher rate of requirement and an earlier start high flow nasal cannula oxygen therapy but the total duration time was similar for two groups. Patients in group 2 had a longer hospital stay than group 1. Conclusion: Intravenous MgSO4 provided significant improvement on clinical severity, early phase of oxygenation, need for respiratory support, length of stay in the hospital and outcomes. It seems to be an effective treatment option for management of bronchiolitis.

scholarly journals Dose Response Study of Magnesium Sulphate for Attenuation of Haemodynamic Response to Intubation

2021 ◽  
Vol 10 (13) ◽  
pp. 956-961
Author(s):  
Sarita Nandal ◽  
Veena Chatrath ◽  
Harjinder Kaur ◽  
Reeta Reeta
Keyword(s):  
Sample Size ◽  
Magnesium Sulfate ◽  
Endotracheal Intubation ◽  
Magnesium Sulphate ◽  
Serum Magnesium ◽  
Haemodynamic Response ◽  
Hypertensive Patients ◽  
Group Iii ◽  
Group I ◽  
Group Ii

BACKGROUND Effects of pretreatment with magnesium sulphate for attenuation of haemodynamic response to intubation have been studied previously but its effects on hypertensive patients are not much studied. This study was conducted primarily to find the minimal effective dose of magnesium sulphate to control the haemodynamic response to laryngoscopy and endotracheal intubation in controlled hypertensive patients. METHODS After institutional ethical committee clearance, a randomised, double blinded, clinical study was carried out among 90 American Society of Anaesthesiologists (ASA) physical status II, controlled hypertensive patients of age 30 - 60 years posted for elective surgery. Patients were randomly distributed into three equal groups as group I - received 30 mg / Kg magnesium sulfate and group II - received 40 mg / Kg magnesium sulfate before induction of anesthesia, while group III (control group) received 1.5 mg / Kg lidocaine bolus 90 seconds prior to intubation. The patients’ haemodynamic responses were noted before, during, and after intubation for 10 minutes. Steps taken to manage haemodynamic instability along with serum magnesium levels were also noted. To calculate the sample size, mean value of serum magnesium was taken in three groups to find out effect size as 0.0387. Taking alpha error 0.05 and power required 90 %, the sample size in each group was 30. RESULTS Groups were properly matched for their demographic data. Among all the groups changes in heart rate were comparable (P > 0.05) throughout the study period. In group I there was no significant change in mean arterial pressure (MAP) while in group II and group III a significant decrease was noticed (> 20 % of baseline value). Intervention was required to treat hypotension in significant number of patients in group II (nine patients) and group III (three patients). CONCLUSIONS In controlled hypertensive patients, magnesium in a dose of 30 mg / Kg intravenous is found optimal to attenuate the stress response following laryngoscopy and endotracheal intubation, as further increase in dose can lead to significant hypotension. KEY WORDS Hypertension, Laryngoscopy, Lignocaine, Magnesium Sulphate, Intubation

scholarly journals Comparison between Kangaroo Mother Care with Standard Care in Preterm Neonate Management

2019 ◽  
Vol 47 (3) ◽  
pp. 1-8
Author(s):  
Rumpa Mani Chowdhury ◽  
Mohammod Sahidullah ◽  
Md Abdul Mannan ◽  
MA Azad Chowdhury ◽  
Bidhan Chandra Biswas ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Hospital Stay ◽  
Gestational Age ◽  
Standard Care ◽  
Thermal Control ◽  
Kangaroo Mother Care ◽  
Care Group ◽  
Group I ◽  
Group Ii

Preterm low birth weight (LBW) babies are unable to control their body temperature and are at greater risk of illness. Kangaroo Mother Care (KMC) is special ways of caring for low birth weight babies. KMC provide thermal care through continuous skin to skin contact, support for exclusive breast feeding and early recognition and response to complication. The aim of the study is to assess thermal control, morbidities feeding pattern of baby getting KMC in comparison to conventional care. The study also give estimation about duration and cost during hospital stay and growth between the babies of two groups. This Randomized Controlled Trial was conducted in the Department of Neonatology, BSMMU, Dhaka from December 2012 to October 2013. Fifty neonate with birth weight 1250 to 1800 gm, gestational age >30 weeks to <37 weeks, Hemodynamically stable after birth were selected. Twenty five of them were randomly allocated to KMC(Group-I) and 25 of them to Standard Method Care (Group-II). The mother or care giver provided KMC at least 12hours/day in Group-I. Those in Group-II were managed under radiant warmer. During hospital stay both the groups were monitored and after discharge, the neonates were followed weekly till 40 weeks of corrected gestational age. There were no differences in birth weight, gestational age, number of male/female neonates, places of delivery and mode of delivery between two groups. During hospital stay hypothermia (Group-I 4% vs Group-II 24%) and hyperthermia (Group I 8% vs Group II 32%) were significantly low in KMC group. Late onset neonatal sepsis (LONS) developed significantly in Group-II. Though incidence of culture negative LONS did not differ in two groups but incidence of blood culture positive LONS was significantly high in standard care neonates (36% vs.0%; p=0.001). Neonates with KMC care required significantly shorter time to reach full feeding and to start direct breast feeding; also incidence of feeding intolerance was significantly lower in this group. After initial loss, weight gain started earlier as well as achieved the birth weight earlier in KMC group. Morbidities like hyperglycaemia and apnoea were significantly higher in standard care group. Neonates who received standard care stayed significantly longer in the hospital and total cost during hospital stay was also significantly higher in this group. At 40 weeks corrected gestational age, KMC infants showed significantly higher daily weight gain than standard care group. This study concluded that Kangaroo Mother Care provides effective thermal control, decreases the incidence of sepsis, improves feed tolerance, helps to achieving full enteral feeding and birth weight earlier in preterm LBW neonates. KMC enhances growth during postnatal period. KMC also found to reduce hospital stay and treatment cost. Proper implementation of KMC for the management of preterm  low birth weight babies is safe and effective care. Bangladesh Med J. 2018 Jan; 47 (3): 1-8

Sign in / Sign up

Export Citation Format

Share Document