scholarly journals SAFETY AND QUALITY OF INTRAVENOUS LIPIDS FOR NEWBORNS: EFFECTS ON CRITICAL DISEASES AND METABOLIC DISORDERS (PART II)

2021 ◽  
Vol 11 (4(42)) ◽  
pp. 68-74
Author(s):  
I. Anikin ◽  
V. Snisar
Keyword(s):  
Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Metabolic Disorders ◽  
Ductus Arteriosus ◽  
Lipid Emulsions ◽  
Intravenous Lipids ◽  
Patent Ductus

Premature birth and its complications cause stress in newborns, which restrains their physical growth for several weeks after birth and is associated with chronic morbidity and neurological disability in the future. Preterm infants face such difficulties as respiratory distress, cardiovascular disease, gastrointestinal dysfunction and very low birth weight. Most complications in newborns are associated with oxidative stress that develops during the early period of growth. The formation of free radicals entails oxidative damage to many organs and systems of the body and is the main factor responsible for the development of typical diseases of preterm infants, such as bronchopulmonary dysplasia, patent ductus arteriosus, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage, and respiratory distress syndrome. Premature infants depend on adequate early parenteral nutrition, which not only guarantees they will survive but also ensures positive health outcomes later in life. Early use of intravenous lipids helps to prevent essential fatty acid deficiencies, provides energy and substrates for cell membrane synthesis, which are important for the growth and development of infants with very low and extremely low birth weight. This publication represents data on the effect of intravenous lipids on critical conditions and metabolic disorders in newborns. Literature sources are analyzed and the existing evidence of the possible influence of lipid emulsions on critical diseases in newborns is presented: intraventricular hemorrhage; necrotizing enterocolitis, patent ductus arteriosus and thrombocytopenia; glucose metabolism (hypo- and hyperglycemia); hyperbilirubinemia and chronic liver damage. The literature review is aimed at finding optimal strategies for the use of lipid emulsions in intensive care of newborns to improve the quality of care for premature infants. The purpose of this work is to analyze the results of published studies and systematize data on the feasibility and safety of lipid emulsions used in newborns with critical diseases of the perinatal period.

Prophylactic Indomethacin for Prevention of Intraventricular Hemorrhage in Premature Infants

PEDIATRICS ◽  
1988 ◽  
Vol 82 (4) ◽  
pp. 533-542
Author(s):  
Emmalee Setzer Bandstra ◽  
Berta M. Montalvo ◽  
Ronald N. Goldberg ◽  
Irma Pacheco ◽  
Pedro L. Ferrer ◽  
...  
Keyword(s):  
Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Prophylactic Use ◽  
Clinically Significant ◽  
The Impact ◽  
Patent Ductus

The impact of early prophylactic use of intravenous indomethacin on the incidence and severity of periventricular-intraventricular hemorrhage and patent ductus arteriosus in 199 oxygen-requiring premature infants (≤1300 g birth weight) was prospectively investigated. The trial was controlled, the infants were randomized, and the investigators were unaware of the group assignments. Patients with minimal (grade I) or no periventricular-intraventricular hemorrhage determined by prestudy echoencephalography were randomized within two birth weight subgroups (500 to 899 and 900 to 1300 g) to receive either prophylactic indomethacin (n = 99) or an equal volume of saline-vehicle placebo (n = 100). The first dose (0.2 mg/kg) was given within 12 hours of delivery and two subsequent doses (0.1 mg/kg) were administered at 12 hourly intervals. Prophylactic indomethacin significantly reduced the incidence of grades II to IV periventricular-intraventricular hemorrhage. Intraventricular hemorrhage was half as common in infants given prophylactic indomethacin as in control infants (23% v 46%, P < .002). The reduction was manifested in both birth weight subgroups. Results of this study also confirmed a lower incidence of clinically significant patent ductus arteriosus in infants who received prophylactic indomethacin in contrast to those who received placebo (11% v 42%, P < .001). No significant differences were found between treatment and control groups in the duration of oxygen therapy, mechanical ventilation, or hospitalization or in the incidence of pneumothorax, chronic lung disease, sepsis, necrotizing enterocolitis, retinopathy of prematurity, or death. Early prophylactic indomethacin initiated within 12 hours of delivery is effective in reducing the incidence of intraventricular hemorrhage as well as clinically significant patent ductus arteriosus in very low birth weight premature infants.

Low-Dose Indomethacin and Prevention of Intraventricular Hemorrhage: A Multicenter Randomized Trial

PEDIATRICS ◽  
1994 ◽  
Vol 93 (4) ◽  
pp. 543-550
Author(s):  
Laura R. Ment ◽  
Richard A. Ehrenkranz ◽  
Charles C. Duncan ◽  
David T. Scott ◽  
Kenneth J.W. Taylor ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Intraventricular Hemorrhage ◽  
Low Dose ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Trend Test ◽  
Cranial Ultrasound ◽  
Patent Ductus

Objectives. Parenchymal involvement of intraventricular hemorrhage (IVH) is a major risk factor for neurodevelopmental handicap in very low birth weight neonates. Previous trials have suggested that indomethacin would lower the incidence and severity of IVH in very low birth weight neonates. Methods. We enrolled 431 neonates of 600- to 1250-g birth weight with no evidence for IVH at 6 to 11 hours of age in a prospective, randomized, placebo-controlled trial to test the hypothesis that low-dose indomethacin (0.1 mg/kg intravenously at 6 to 12 postnatal hours and every 24 hours for two more doses) would lower the incidence and severity of IVH. Serial cranial ultrasound examinations and echocardiographs were performed. Results. There were no differences in the birth weight, gestational age, sex, Apgar scores, and percent of neonates treated with surfactant between the indomethacin and placebo groups. Within the first 5 days, 25 (12%) indomethacin-treated and 40 (18%) placebo-treated neonates developed IVH (P = .03, trend test). Only one indomethacin-treated patient experienced grade 4 IVH compared with 10 placebo-treated neonates (P = .01). Sixteen indomethacin-treated neonates and 29 control neonates died (P = .08); there was a difference favoring indomethacin with respect to survival time (P = .06). Eighty-six percent of all neonates had a patent ductus arteriosus on the first postnatal day; indomethacin was associated with significant ductal closure by the fifth day of life (P < .001). There were no differences in adverse events attributed to indomethacin between the two treatment groups. Conclusions. Low-dose prophylactic indomethacin significantly lowers the incidence and severity of IVH, particularly the severe form (grade 4 IVH). In addition,indomethacin closes the patent ductus arteriosus and is not associated with significant adverse drug events in very low birth weight neonates.

scholarly journals Ligation of patent ductus arteriosus in very low birth weight premature infants

2020 ◽  
Vol 61 (4) ◽  
pp. 399-405
Author(s):  
Hasan F. Othman ◽  
Debra T. Linfield ◽  
Mohamed A. Mohamed ◽  
Hany Aly
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Patent Ductus

Patent Ductus Arteriosus Device Closure in Low Birth Weight Premature Infants: A Single Center Experience

2021 ◽  
Author(s):  
Elizabeth E. LaSalle ◽  
Carolyn M. Wilhelm ◽  
Renelle S. George ◽  
Mohammad Shahnewaz Khan ◽  
Vidhi Shah ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Single Center ◽  
Device Closure ◽  
Single Center Experience ◽  
Patent Ductus

scholarly journals Transcatheter Closure of Patent Ductus Arteriosus in Premature Infants With Very Low Birth Weight

2021 ◽  
Vol 8 ◽  
Author(s):  
Jieh-Neng Wang ◽  
Yung-Chieh Lin ◽  
Min-Ling Hsieh ◽  
Yu-Jen Wei ◽  
Ying-Tzu Ju ◽  
...  
Keyword(s):  
Body Weight ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Vascular Plug ◽  
The Mean ◽  
Patent Ductus

Background: The aim of this study was to describe our experience with transcatheter device closure of patent ductus arteriosus (PDA) in symptomatic low-birth-weight premature infants.Methods: We performed a retrospective study of infants born with a birth body weight of < 2,000 g and admitted to National Cheng Kung University Hospital from September 2014 to December 2019. Basic demographic and clinical information as well as echocardiographic and angiographic data were recorded.Results: Twenty-five premature infants (11 boys and 14 girls) born at gestational ages ranging between 22 and 35 weeks (mean, 25 weeks) were identified. The mean age at procedure was 34.5 ± 5.5 days, and the mean weight was 1,209 ± 94 g (range, 478–1,980 g). The mean diameter of the PDA was 3.4 ± 0.2 mm (range, 2.0–5.4 mm). The following devices were used in this study: Amplatzer Ductal Occluder II additional size (n = 20), Amplatzer Vascular Plug I (n = 1), and Amplatzer Vascular Plug II (n = 4). Complete closure was achieved in all patients. The mean follow-up period was 30.1 ± 17.3 months (range, 6–68 months). In total, 3 patients had left pulmonary artery (LPA) stenosis and 1 patient had coarctation of the aorta during the follow-up period. Younger procedure age and smaller procedure body weight were significantly associated with these obstructions.Conclusions: Performing transcatheter PDA closure in symptomatic premature infants weighing more than 478 g is feasible using currently available devices; moreover, the procedure serves as an alternative to surgery.

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