RESPIRATORY FAILURE IN EXTREMELY PREMATURE BABIES: ANATOMICAL AND PHYSIOLOGICAL FEATURES, RISK FACTORS, AND CLINICAL VARIANTS OF THE COURSE IN THE EARLY NEONATAL PERIOD

One of the urgent problems of nursing premature babies is the timely prediction, diagnosis and treatment of anemia, the frequency of which reaches 90%. Of particular importance is the study of reticulocytic blood parameters in deep-premature newborns, since the correct assessment of hemograms is crucial in the management of this category of children. To determine the characteristics of red blood cells and reticulocyte parameters of venous blood hemogram in premature newborns 24-32 weeks of gestation in the dynamics of the neonatal period. 111 newborns were examined at 24-32 weeks of gestation in the early neonatal period (on day 3-7) and at the age of 1 month of life. Along with standard diagnostic procedures, in accordance with current clinical recommendations and standards, 28 parameters of erythrocyte and reticulocyte hemogram parameters were determined for children. Venous blood was examined using an automatic hematological analyzer ADVIA 2120i, Siemens, USA. In deep-premature newborns in the early neonatal period, there is a high activity of erythropoiesis, respectively, the severity of respiratory and metabolic disorders with rejuvenation of reticulocytic subpopulations. Negative values of Delta hemoglobin were found against the background of a decrease in the average amount of hemoglobin in reticulocytes in children 24-27 weeks of gestation, which characterizes the lowest values of iron availability for erythropoiesis in this category of newborns. It is shown that a decrease in reticulocyte counts and normochromia in all examined newborns by the age of one month are accompanied by high levels of immature reticulocyte fraction, while a third of children still have limited iron availability for erythropoiesis.

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Neonatal hypoglycemia in children with risk factors

Pacific Medical Journal ◽

10.34215/1609-1175-2021-4-80-84 ◽

2022 ◽

pp. 80-84

Author(s):

E. V. Antsiferova ◽

T. E. Taranushenko ◽

N. G. Kiseleva ◽

E. A. Belyaeva ◽

T. I. Donskaya

Keyword(s):

Risk Factors ◽

Body Weight ◽

Blood Glucose ◽

Growth Retardation ◽

Intrauterine Growth Retardation ◽

Neonatal Period ◽

Large Body ◽

Neonatal Hypoglycemia ◽

Intrauterine Growth ◽

Early Neonatal Period

Objective: The analysis of clinical-laboratory peculiarities and the dynamics of glycemia clarifying the terms of blood glucose stabilization during the early neonatal period in children having risk factors of the development of such state.Methods: Open, retrospective , continuous, single-center study was conducted. It was aimed at getting preliminary data that is important for planning further tactics of examining newborns having risk factors on hypoglycemia development (kids having large body weight at birth, children whose mothers have diabetes, newborns having intrauterine growth retardation).The target group of the survey included 522 newborns of both genders in the early neonatal period (from 0 to 7 days of life).Results: There is data on the frequency of first indicated hypoglycemia in newborns having risk factors of the development of such state, clinicallaboratory peculiarities, the dynamics of glycemia during early neonatal period, and also the period of blood glucose stabilization (the age of reaching normoglycemia). Neonatal hypoglycemia was detected in 40.2% of examined children. Laboratory manifestation during the first day of life was noticed 62.9% of cases with the further normalization of glucose level in blood in 24 hours in 73.3% of newborns. Significant reduction of blood glucose was observed in 54.8% of cases requiring hypoglycemia therapy with parenteral prescription of 10% glucose solution. Hypoglycemia jugulated against oral correction of 5% glucoses solution in 40.5 % of cases. 4.8% of children got the level of glucose stabilized after introduction of supplementary feeding.Conclusion: The results of the newborns having risk factors on hypoglycemia development (kids having large body weight at birth, children whose mothers have diabetes, newborns having intrauterine growth retardation) examinations are presented. The peculiarities of neonatal hypoglycemia are: the absence of a typical clinical symptoms among 89% of children. Asymptomatic course of hypoglycemia confirms the importance and necessity of glycemia monitoring in the early neonatal period in order to conduct timely and adequate therapy.

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Vaccinate Your Baby and Do Not Smoke: Integrated Approach of Lung Health for Premature Babies

Journal of Global Oncology ◽

10.1200/jgo.18.36200 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 128s-128s

Author(s):

O. Turcanu ◽

M. Guzun

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care ◽

Neonatal Period ◽

Premature Baby ◽

Second Hand Smoke ◽

Premature Babies ◽

Lung Health

Background and context: Since 2008 Republic of Moldova registers and provides medical care to newborns from 500 g and 22 weeks of gestation. Thus, challenges related to lung health (respiratory distress in neonatal period, respiratory infections in childhood) are faced while taking care of premature babies. More 400 of them (from 2000 preterms in the country) are born in our institution. While in neonatal period we succeed to save them, the quality of their life depends on further protection from risk factors, as infections, environment polluants and second hand smoke. Aim: To rise awareness among parents about evidence based approaches for protecting a premature baby from infection (one of that being the immunization) and from second hand smoke harm (through smoking cessation among parents, but also among other family members). Strategy/Tactics: Early neonatal period is a very sensitive, but also a precious opportunity to speak with parents about risk factors for a healthy childhood. Smoking being one of factors for premature birth, but also for lung diseases in childhood, our neonatal team included “smoking” issue while speaking with parents about the severity of baby´s condition in neonatal intensive care unit. The discussion target the risk factors for respiratory diseases. This year we changed the approach - we include in the same discussion not only smoking issue, but also immunization, to see if it´s more effective than to aware about smoking only. Program/Policy process: When combining two topics (immunization and no-smoking) parents are less reticent to discussion, thus measured by: •How often they recall discussion, or come back with other questions. •Their reaction (body language, duration of discussion) to physicians´ explanation. Outcomes: 1. Targeting both topics help a smoking parent “not to fill so guilty”, “obtaining other leverages to ensure good quality of life for the baby”. Comparing to the period when we were targeted only smoking issue, parents (especially fathers) were more likely to recall discussion (72%, compared with 41% in the previous stage) and they were more willing/open for communication (77%, compared with 48%). 2. This strategy it´s an opportunity to catch parents´ attention for important things. Usually, when they come in neonatal intensive care unit to see their baby, they expect to be told only about the treatment the baby receives in the unit, and not about smoking (“this is not a drug?”) or vaccination (“something that they see long further”). What was learned: A holistic preventive approach for healthy lifestyle (vaccination + not to expose to tobacco smoke) as measures for premature baby respiratory health, seems to be better accepted by smoking parents, that related on smoking only.

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HEART RHYTHM DISTURBANCES IN NEWBORNS IN THE EARLY NEONATAL PERIOD

Inter Collegas ◽

10.35339/ic.5.3.148-152 ◽

2018 ◽

Vol 5 (3) ◽

pp. 148-152

Author(s):

M. Gonchar ◽

I. Kondratova ◽

Ye. Ivanova ◽

V. Komova

Keyword(s):

Risk Factors ◽

Cardiac Rhythm ◽

Neonatal Period ◽

Significant Risk ◽

Rare Condition ◽

Heart Rhythm ◽

Structural Heart Disease ◽

Ecg Monitoring ◽

Early Neonatal Period ◽

Basic Parameters

HEART RHYTHM DISTURBANCES IN NEWBORNS IN THE EARLY NEONATAL PERIODGonchar M., Kondratova I., Ivanova Ye., Komova V.Neonatal arrhythmia is not a rare condition, and may occur both in patients with structural heart disease and in children with functional cardiovascular disorders as well as in a relatively small number of healthy newborns. The article presents the results of the study of basic parameters of electrical activity of the heart in newborns with administration of daily ECG monitoring. The study involved examination of 187 infants in the early neonatal period. Assessment of the data of obstetric and gynecological history and extragenital pathology of the mothers of the examined children, analysis of the data of Holter ECG monitoring of newborns showed the most frequently occurring types of neonatal arrhythmias and significant risk factors for their development.Key words: cardiac rhythm disturbances in newborns, neonatal arrhythmias, risk factors. ПОРУШЕННЯ СЕРЦЕВОГО РИТМУ У НОВОНАРОДЖЕНИХ В РАННІЙ НЕОНАТАЛЬНИЙ ПЕРІОДГончарь М., Кондратова І., Іванова Є., Koмoвa В.Аритмії у неонатальному періоді не є рідким явищем та можуть виникати як серед тих, хто має структурні аномалії серця, так і серед дітей з функціональними серцево-судинними розладами, а також у відносно невеликої кількості здорових новонароджених. В статті представлено результати дослідження основних параметрів електричної активності серця у новонароджених за допомогою добового моніторування ЕКГ. Було обстежено 187 немовлят в ранній неонатальний період. За результатами аналізу даних акушерсько-гінекологічного анамнезу та екстрагенітальної патології матерів обстежених дітей, аналізу даних Холтерівського моніторування ЕКГ новонароджених визначено найбільш часто виникаючи види неонатальних аритмій та значущі факторів ризику їх розвитку.Ключові слова: порушення серцевого ритму у новонароджених, неонатальні аритмії, фактори ризику.НАРУШЕНИЯ СЕРДЕЧНОГО РИТМА У НОВОРОЖДЕННЫХ В РАННИЙ НЕОНАТАЛЬНЫЙ ПЕРИОДГончарь М., Кондратова И., Иванова Е., Комова В.Аритмии в неонатальном периоде не является редким явлением и могут возникать как среди новорожденных, которые имеют структурные аномалии сердца, так и среди детей с функциональными сердечно-сосудистыми расстройствами, а также - у небольшого числа здоровых новорожденных. В статье представлены результаты исследования основных параметров электрической активности сердца у новорожденных с помощью суточного мониторирования ЭКГ. Было обследовано 187 новорожденных в ранний неонатальный период. По результатам анализа данных акушерско-гинекологического анамнеза и экстрагенитальной патологии матерей обследованных детей, анализа данных суточного мониторирования ЭКГ новорожденных определены наиболее часто возникающие виды неонатальных аритмий и значимые факторов риска их развития.Ключевые слова: нарушение сердечного ритма у новорожденных, неонатальные аритмии, факторы риска.

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A Case of Congenital Glucose Galactose Malabsorption with a New Mutation in the SLC5A1 Gene

Journal of Pediatric Genetics ◽

10.1055/s-0040-1719161 ◽

2020 ◽

Author(s):

Hasan Akduman ◽

Dilek Dilli ◽

Serdar Ceylaner

Keyword(s):

Mutation Analysis ◽

Autosomal Recessive ◽

Glucose Transporter ◽

Neonatal Period ◽

Autosomal Recessive Disorder ◽

Homozygous Mutation ◽

New Mutation ◽

Early Neonatal Period ◽

Sodium Dependent ◽

Hypernatremic Dehydration

AbstractCongenital glucose-galactose malabsorption (CGGM) is an autosomal recessive disorder originating from an abnormal transporter mechanism in the intestines. It was sourced from a mutation in the SLC5A1 gene, which encodes a sodium-dependent glucose transporter. Here we report a 2-day-old girl with CGGM who presented with severe hypernatremic dehydration due to diarrhea beginning in the first hours of life. Mutation analysis revealed a novel homozygous mutation NM_000343.3 c.127G > A (p.Gly43Arg) in the SLC5A1 gene. Since CGGM can cause fatal diarrhea in the early neonatal period, timely diagnosis of the disease seems to be essential.

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FEATURES OF CARDIORESPIRATORY ADAPTATION OF LATER PRETERM INFANTS IN THE EARLY NEONATAL PERIOD

World of Medicine and Biology ◽

10.26724/2079-8334-2018-4-66-100-103 ◽

2018 ◽

Vol 14 (66) ◽

pp. 100

Author(s):

G. A. Solovyova ◽

V. I. Pokhilko ◽

S. N. Tsvirenko ◽

N. I. Gasyuk ◽

Yu. Yu. Klimchuk

Keyword(s):

Preterm Infants ◽

Neonatal Period ◽

Early Neonatal Period

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Patients With Idiopathic Pulmonary Fibrosis Admitted to the ICU With Acute Respiratory Failure—A Reevaluation of the Risk Factors and Outcomes

Journal of Intensive Care Medicine ◽

10.1177/0885066621989244 ◽

2021 ◽

pp. 088506662198924

Author(s):

Matthew Schrader ◽

Matheni Sathananthan ◽

Niranjan Jeganathan

Keyword(s):

Risk Factors ◽

Respiratory Failure ◽

Mortality Rate ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Acute Respiratory Failure ◽

Small Sample ◽

Apache Score ◽

Non Invasive ◽

Organ Failures

Introduction: Idiopathic pulmonary fibrosis (IPF) patients admitted to the ICU with acute respiratory failure (ARF) are known to have a poor prognosis. However, the majority of the studies published to date are older and had small sample sizes. Given the advances in ICU care since the publication of these studies, we sought to reevaluate the outcomes and risk factors associated with mortality in these patients. Methods: Retrospective study using a large multi-center ICU database. We identified 411 unique patients with IPF admitted with ARF between 2014-2015. Results: Of all IPF patients admitted to the ICU with ARF, 81.3% required mechanical ventilation (MV): 48.9% invasive and 32.4% non-invasive alone. The hospital mortality rate was 34.5% for all patients; 48.8% in patients requiring invasive MV, 21.8% in those requiring non-invasive MV and 19.5% with no MV. In multiple regression analyses, age, APACHE score, invasive MV, and hyponatremia at admission were associated with increased mortality whereas post-op status was associated with lower mortality. In patients requiring invasive MV, baseline PaO2/FiO2 ratio was also predictive of mortality. Non-pulmonary organ failures were present in less than 20% of the patients. Conclusions: Although the overall mortality rate for IPF patients admitted to the ICU with ARF has improved, the mortality rates for patients requiring invasive MV remains high at approximately 50%. Older age, high APACHE score, and low baseline PaO2/FiO2 ratio are factors predictive of increased mortality in this population.

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Incidence, Risk Factors and Outcomes of New Onset Supraventricular Arrhythmias in African American Patients with Severe Sepsis

Ethnicity & Disease ◽

10.18865/ed.26.2.205 ◽

2016 ◽

Vol 26 (2) ◽

pp. 205 ◽

Cited By ~ 6

Author(s):

O'Dene Lewis ◽

Julius Ngwa ◽

Richard F. Gillum ◽

Alicia Thomas ◽

Wayne Davis ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Congestive Heart Failure ◽

Severe Sepsis ◽

Intensive Care ◽

Respiratory Failure ◽

Hospital Mortality ◽

Supraventricular Arrhythmias ◽

Incidence Risk ◽

New Onset

Purpose: New onset supraventricular arrhythmias (SVA) are commonly reported in mixed intensive care settings. We sought to determine the incidence, risk factors and outcomes of new onset SVA in African American (AA) patients with severe sepsis admitted to medical intensive care unit (MICU).Methods: Patients admitted to MICU between January 2012 through December 2012 were studied. Patients with a previous history of arrhythmia or with new onset of ventricular arrhythmia were excluded. Data on risk factors, critical care interventions and outcomes were obtained.Results: One hundred and thirty-one patients were identified. New onset SVA occurred in 34 (26%) patients. Of those 34, 20 (59%) had atrial fibrillation (AF), 6 (18%) had atrial flutter and 8 (24%) had other forms of SVA. Compared with patients without SVA, patients with new onset SVA were older (69 ± 12 yrs vs 59 ± 13 yrs, P=.003), had congestive heart failure (47% vs 24%, P=.015) and dyslipidemia (41% vs 15%, P=.002). Additionally, they had a higher mean mortality prediction model (MPM II) score (65 ± 25 vs 49 ± 26, P=.001) and an increased incidence of respiratory failure (85% vs 55%, P=.001). Hospital mortality in patients with new onset SVA was 18 (53%) vs 30 (31%); P=.024; however, in a multivariate analysis, new onset SVA was associated with nonsignificantly increased odds (OR 2.58, 95% CI 0.86-8.05) for in-hospital mortality.Conclusion: New onset SVA was prevalent in AA patients with severe sepsis and occurred more frequently with advanced age, increased severity of illness, congestive heart failure, and acute respiratory failure; it was associated with higher unadjusted in hospital mortality. However, after multiple adjustments, new onset SVA did not remain an independent predictor of mortality. Ethn Dis.2016;26(2):205-212; doi:10.18865/ ed.26.2.205

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