IgM and IgA enriched polyclonal immunoglobulins reduce short term mortality in extremely low birth weight infants with sepsis: a retrospective cohort study

Abstract Background: Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD.Methods: In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 hours.Results: Twelve ELBW infants (seven male and five female infants) were treated, and their mean gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. Two patients had severe perinatal asphyxia (5-min Apgar score ≤ 3). The most important indication for starting PD was AKI due to sepsis. The average duration of PD was 9.4 (± 7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (± 4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75 %). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7 %.Conclusions: The mortality rate of ELBW infants with AKI treated with PD is quite high because their organ system is not completely developed. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI in terms of decisions regarding resuscitation.

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Effect of Peritoneal Dialysis on Extremely Low Birth Weight Infants: A Retrospective Cohort Study

10.21203/rs.2.17326/v2 ◽

2020 ◽

Author(s):

Jihyun Noh ◽

Chae Young Kim ◽

Euiseok Jung ◽

Joo Hoon Lee ◽

Young-Seo Park ◽

...

Keyword(s):

Cohort Study ◽

Peritoneal Dialysis ◽

Birth Weight ◽

Mortality Rate ◽

Low Birth Weight ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Perinatal Asphyxia ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infants

Abstract Background: Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD.Methods: In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 hours.Results: Twelve ELBW infants (seven male and five female infants) were treated, and their mean gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. There were two patients who had severe perinatal asphyxia (5-min Apgar score ≤3). The most important indication for starting PD was AKI due to sepsis. The average duration of PD was 9.4 (±7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (±4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75%). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7%.Conclusions: The mortality rate of ELBW infants with AKI treated with PD is quite high because their organ system is not completely developed. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI.

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Increase in Weight in Low Birth Weight and Very Low Birth Weight Infants Fed Fortified Breast Milk versus Formula Milk: A Retrospective Cohort Study

Nutrients ◽

10.3390/nu9050520 ◽

2017 ◽

Vol 9 (5) ◽

pp. 520 ◽

Cited By ~ 6

Author(s):

Kris Lok ◽

Pui Chau ◽

Heidi Fan ◽

Kam Chan ◽

Bill Chan ◽

...

Keyword(s):

Cohort Study ◽

Birth Weight ◽

Breast Milk ◽

Low Birth Weight ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Formula Milk

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Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study

10.21203/rs.2.17326/v5 ◽

2020 ◽

Author(s):

Jihyun Noh ◽

Chae Young Kim ◽

Euiseok Jung ◽

Joo Hoon Lee ◽

Young-Seo Park ◽

...

Keyword(s):

Cohort Study ◽

Peritoneal Dialysis ◽

Birth Weight ◽

Mortality Rate ◽

Low Birth Weight ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Perinatal Asphyxia ◽

Extremely Low Birth Weight ◽

Organ Systems

Abstract Background: Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD.Methods: In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 hours.Results: Twelve ELBW infants (seven male and five female infants) were treated, and their mean (±SD) gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. Two patients had severe perinatal asphyxia (5-min Apgar score ≤ 3). The most important indication for starting PD was AKI due to sepsis. The average (±SD) duration of PD was 9.4 (± 7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (± 4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75 %). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7 %.Conclusions: In this series, the mortality rate of ELBW infants with AKI treated with PD was relatively high because of their incompletely developed organ systems. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI in terms of decisions regarding resuscitation.

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Survival until Discharge of Very-Low-Birth-Weight Infants in Two Croatian Perinatal Care Regions: A Retrospective Cohort Study of Time and Cause of Death

Acta Clinica Croatica ◽

10.20471/acc.2019.58.03.07 ◽

2019 ◽

Author(s):

Darjan Kardum

Keyword(s):

Cohort Study ◽

Birth Weight ◽

Low Birth Weight ◽

Cause Of Death ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Very Low Birth Weight ◽

Perinatal Care ◽

Low Birth Weight Infants

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Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study

10.21203/rs.2.17326/v4 ◽

2020 ◽

Author(s):

Jihyun Noh ◽

Chae Young Kim ◽

Euiseok Jung ◽

Joo Hoon Lee ◽

Young-Seo Park ◽

...

Keyword(s):

Cohort Study ◽

Peritoneal Dialysis ◽

Birth Weight ◽

Mortality Rate ◽

Low Birth Weight ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Perinatal Asphyxia ◽

Extremely Low Birth Weight ◽

Organ Systems

Abstract Background: Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD. Methods: In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 hours. Results: Twelve ELBW infants (seven male and five female infants) were treated, and their mean (±SD) gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. Two patients had severe perinatal asphyxia (5-min Apgar score ≤ 3). The most important indication for starting PD was AKI due to sepsis. The average (±SD) duration of PD was 9.4 (± 7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (± 4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75 %). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7 %. Conclusions: In this series, the mortality rate of ELBW infants with AKI treated with PD was relatively high because of their incompletely developed organ systems. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI in terms of decisions regarding resuscitation .

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Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study

BMC Nephrology ◽

10.1186/s12882-020-02092-1 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Jihyun Noh ◽

Chae Young Kim ◽

Euiseok Jung ◽

Joo Hoon Lee ◽

Young-Seo Park ◽

...

Keyword(s):

Cohort Study ◽

Peritoneal Dialysis ◽

Birth Weight ◽

Mortality Rate ◽

Low Birth Weight ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Perinatal Asphyxia ◽

Extremely Low Birth Weight ◽

Organ Systems

Abstract Background Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD. Methods In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 h. Results Twelve ELBW infants (seven male and five female infants) were treated, and their mean (±SD) gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. Two patients had severe perinatal asphyxia (5-min Apgar score ≤ 3). The most important indication for starting PD was AKI due to sepsis. The average (±SD) duration of PD was 9.4 (± 7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (± 4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75%). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7%. Conclusions In this series, the mortality rate of ELBW infants with AKI treated with PD was relatively high because of their incompletely developed organ systems. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI in terms of decisions regarding resuscitation.

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Abdominal Obesity and Short-term Mortality in Critically Ill Patients with Sepsis: A Retrospective Cohort Study Based on the MIMIC-IV Database

10.21203/rs.3.rs-1040005/v1 ◽

2021 ◽

Author(s):

Zhou Lv ◽

Minglu Gu ◽

Miao Zhou ◽

Yanfei Mao ◽

Lai Jiang

Keyword(s):

Metabolic Syndrome ◽

Cohort Study ◽

Intensive Care ◽

Abdominal Obesity ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Obese Patients ◽

Short Term ◽

Icu Admission ◽

Short Term Mortality

Abstract Purpose: Multiple studies have demonstrated an obesity paradox such that obese septic patients have a lower mortality rate and a relatively favorable prognosis. However, less is known on the association between abdominal obesity and short-term mortality in patients with sepsis. We conducted this study to determine whether the obesity-related survival benefit remains among abdominal obese patients.Methods: A retrospective cohort study was conducted using data derived from the Medical Information Mart for Intensive Care IV database. Septic patients (≥18 years) with or without abdominal obesity of first intensive care units (ICU) admission in the database were enrolled. The primary outcome was mortality within 28 days of ICU admission and multivariable logistic regression analyses were employed to assess any association between abdominal obesity and the outcome variable.Results: A total of 21534 patients were enrolled finally, the crude 28-day mortality benefit after ICU admission was not observed in patients with abdominal obesity (15.8% vs. 15.3%, p=0.32). In the extended multivariable logistic models, the odds ratio (OR) of abdominal obesity was significantly inversed after incorporating metabolic variables into the logistic model (OR range 1.094-2.872, p = 0.02). The subgroup analysis showed interaction effects in impaired fasting blood glucose/diabetes and metabolic syndrome subgroups (P = 0.001 and <0.001, respectively). In the subgroups of blood pressure, high-density lipoprotein cholesterol, and triglyceride level, no interaction was detected in the association between abdominal obesity and mortality. After propensity score matching, 6523 pairs of patients were selected. The mortality significantly higher in the abdominal obesity group (17.0% vs. 14.8%, p = 0.015). Notably, the non-abdominal obese patients were weaned off vasopressors and mechanical ventilation more quickly than those in the abdominal obesity group (vasopressor‑free days on day 28 of 27.0 vs. 26.8, p < 0.001; ventilation-free days on day 28 of 26.7 vs. 25.6, p < 0.001).Conclusion: Abdominal obesity was associated with increased risk of adjusted sepsis-related mortality within 28 days after ICU admission and was partially mediated through metabolic syndrome components.

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