scholarly journals Outcome of Surfactant Replacement Therapy in Preterm Babies with Hyaline Membrane Disease at Neonatal Intensive Care Unit of a Tertiary Hospital

2019 ◽  
Vol 3 (3) ◽  
pp. 537-541
Author(s):  
Sunil Raja Manandhar
Keyword(s):  
Birth Weight ◽  
Replacement Therapy ◽  
Gestational Age ◽  
College Teaching ◽  
Hyaline Membrane Disease ◽  
Medical College ◽  
Surfactant Replacement ◽  
Surfactant Replacement Therapy ◽  
Hyaline Membrane ◽  
Preterm Babies

Introduction: Hyaline membrane disease (HMD) is an acute lung disease of preterm babies caused by surfactant insufficiency. Decreased surfactant results in insufficient surface tension in the alveolus during expiration leading to alveolar collapse, atelectasis, impaired gas exchange, severe hypoxia and acidosis, leading to respiratory failure. Surfactant replacement therapy (SRT) is now accepted as the standard treatment of preterm babies with HMD. Objective: The objective of this study was to analyze the outcome of surfactant replacement therapy in preterm babies with hyaline membrane disease. Methodology: This is a prospective observational study conducted at 10 bedded neonatal unit of Pediatrics Department, Kathmandu Medical College Teaching Hospital, Sinamangal. Study duration was of one year period (15 May 2017 – 14 May 2018). Preterm babies from 26 wks–35 wks of gestation with Hyaline Membrane Disease were included in this study whereas babies with lethal congenital malformations eg: Meningomyelocele, Anencephaly, Gastrochisis, Diaphragmatic Hernia were excluded. All preterm babies who had clinical and radiological features of HMD were considered for Surfactant Replacement Therapy (SRT). The surfactant (Survanta; Abboti Laboratories, USA; Dose: 4 ml/kg) was administered intra-tracheally according to standard procedures in four divided aliquot applying INSURE (intubation, surfactant administration and extubation to Bubble CPAP) Technique. Ethical clearance was received from Institutional Review Committee (IRC) of Kathmandu Medical College and Statistical analysis was done with SPSS 19 version with frequency and cross tabulation. Results: In this study of 30 preterm babies with HMD received SRT, 47% (14) were male and 53% (16) were female. The mean birth weight of preterm babies with HMD was 1372.17 ± 395 gms and mean gestational age was 30.1±2.6 weeks. Among 30 preterm babies with HMD receiving SRT, 73.3% (22 babies) discharged from the hospital and 6.3% (8 babies) expired. Among eight expired babies, five died due to pulmonary hemorrhage and three died due to septicemia with DIC. Maximum survival was seen in the gestational age of 30-35 wks and birth weight 1200-2100gms. Conclusion: The use of SRT has improved the survival outcome and decreased the associated morbidities in babies with HMD. The maximum impact of survival was seen among the preterm babies of 30- 35 weeks with birth weight of 1200 -2100 grams. 

scholarly journals Comparison of the Pharmacoeconomics of Calfactant and Poractant Alfa in Surfactant Replacement Therapy

2018 ◽  
Vol 23 (2) ◽  
pp. 146-151
Author(s):  
Michael M. Zayek ◽  
Fabien G. Eyal ◽  
Robert C. Smith
Keyword(s):  
Birth Weight ◽  
Replacement Therapy ◽  
Gestational Age ◽  
Drug Costs ◽  
Pharmacy Records ◽  
Patient Cost ◽  
Consistent Effect ◽  
Surfactant Replacement ◽  
Surfactant Replacement Therapy ◽  
The University

OBJECTIVE To compare the pharmacy costs of calfactant (Infasurf, ONY, Inc.) and poractant alfa (Curosurf, Chiesi USA, Inc., Cary, NC). METHODS The University of South Alabama Children's and Women's Hospital switched from calfactant to poractant alfa in 2013 and back to calfactant in 2015. Retrospectively, we used deidentified data from pharmacy records that provided type of surfactant administered, gestational age, birth weight, and number of doses on each patient. We examined differences in the number of doses by gestational ages and the differences in costs by birth weight cohorts because cost per dose is based on weight. RESULTS There were 762 patients who received calfactant and 432 patients who received poractant alfa. The average number of doses required per patient was 1.6 administrations for calfactant-treated patients and 1.7 administrations for poractant alfa-treated patients, p = 0.03. A higher percentage of calfactant patients needed only 1 dose (53%) than poractant alfa patients (47%). The distribution of the number of doses for calfactant-treated patients was significantly lower than for the poractant alfa-patients, p < 0.001. Gestational age had no consistent effect on the number of doses required for either calfactant or poractant alfa. Per patient cost was higher for poractant alfa than for calfactant in all birth weight cohorts. Average per patient cost was $1160.62 for poractant alfa, 38% higher than the average per patient cost for calfactant ($838.34). Using poractant alfa for 22 months is estimated to have cost $202,732.75 more than it would have cost if the hospital had continued using calfactant. CONCLUSION Our experience showed a strong pharmacoeconomic advantage for the use of calfactant compared to the use of poractant alfa because of similar average dosing and lower per patient drug costs.

Surfactant replacement therapy in utero for prevention of hyaline membrane disease in the preterm baboon

1993 ◽  
Vol 169 (4) ◽  
pp. 817-824 ◽  
Author(s):  
Henry L. Galan ◽  
Cheryl Cipriani ◽  
Jacqueline J. Coalson ◽  
Jolene D. Bean ◽  
Gerald Collier ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Hyaline Membrane Disease ◽  
In Utero ◽  
Surfactant Replacement ◽  
Surfactant Replacement Therapy ◽  
Hyaline Membrane

scholarly journals Prediction of nutritive sucking in preterm babies (<34 weeks) and preterm sucking readiness scale

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Nisha Kumari ◽  
Ashish Jain ◽  
Siddarth Ramji
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Observational Study ◽  
Gestational Age ◽  
Negative Association ◽  
Medical College ◽  
Longitudinal Observational Study ◽  
Nutritive Sucking ◽  
Preterm Babies ◽  
Prospective Longitudinal

Abstract Objective To determine predictors of nutritive-sucking in babies < 34 weeks and estimate the appropriate preterm sucking readiness (PTSR) score as an indicator of readiness of nutritive-sucking. Methods Prospective longitudinal observational study conducted in Neonatal unit of a referral hospital attached to Medical College. Forty-nine inborn babies of 28-34 weeks’ gestation and on full gavage feeds were enrolled. Results (a) Nutritive-sucking was achieved at a median age of 14 days (Range 7–50). (b) Low birth weight (LBW) (< 1531.1 ± 142.8) and lesser gestational age (GA) (< 32.8 ± 1) were poor predictors (p < 0.05) and have a significant independent negative association (Correlation birth weight (BW) - 0.0222, GA − 2.2177) with age at which established nutritive-sucking was achieved. (c) PTSR score of ≥9 had the best prediction for achievement of nutritive-sucking at 14-days of life, with a sensitivity of 92.3% and specificity of 100%. Conclusion PTSR score is a sensitive and specific tool to predict the readiness for nutritive-sucking in preterm babies < 34 weeks.

scholarly journals OUTCOME OF PRETERM BABIES WITH RESPIRATORY DISTRESS SYNDROME

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Shaitan Singh Balai ◽  
Vivek Arora
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Prospective Study ◽  
Gestational Age ◽  
Distress Syndrome ◽  
Preterm Neonates ◽  
Medical College ◽  
Preterm Babies

Background: To study outcome of preterm babies with RDS in babies admitted in NICU. Methods: This study was hospital based prospective study of preterm neonates with respiratory distress syndrome admitted in NICU of MBGH RNT medical college Udaipur, from February 2017 to January 2018. Results: Among 200 preterm neonates included in the study 31 neonates expired. Mortality was 15.5%. The mortality was 10.17% among the preterm neonates with RDS and hospitalized within 6 hrs. It was 31.81% among neonates hospitalized between 6-12 hrs and 62.5% and 66.66% among neonates hospitalized between 12-24 hrs and after 24 hrs of birth respectively. Conclusion: Mortality rate is inversely related to birth weight and gestational age and directly related to age at admission and severity of respiratory distress (Silverman-Anderson score). Keywords: Preterm, Neonates, Birth weight.

scholarly journals Gestational Age Specific Anthropometric Percentile Charts Of Newborns At Kathmandu Medical College Teaching Hospital

2015 ◽  
Vol 3 (3) ◽  
pp. 97-101
Author(s):  
Sunil Raja Manandhar ◽  
Dharma Sharna Manandhar
Keyword(s):  
Birth Weight ◽  
Standard Deviation ◽  
Low Birth Weight ◽  
Teaching Hospital ◽  
Gestational Age ◽  
Head Circumference ◽  
National Level ◽  
College Teaching ◽  
Intrauterine Growth ◽  
Medical College

Background: A gestational age specific c birth weight, length and head circumference centile chart will help to identify intrauterine growth of a baby. Since the first published gestational age specific anthropometric study done in Nepal by Manandhar DS et al in 1993-94, there have been significant changes in socioeconomic conditions with improved health indicators. This study was done for identifying any changes in anthropometric measurements of the newborns born at Kathmandu Medical College Teaching Hospital (KMCTH). Objectives: To produce gestational age specific c birth weight, length and head circumference centile charts of the New born babies born at KMCTH and to calculate incidence of low birth weight (LBW) babies at KMCTH. Methods: This is a cross sectional observational study. Study was done at labour room, operation theatre, special care baby unit and postnatal wards of KMCTH. Study period was from 18th Aug 2011 to 28th Nov 2012 (15 months duration). Within 24 hours of birth, baby’s weight, length and head circumference were measured by medical officers and post graduate Residents of the Paediatrics Department. Mother’s weight, height and ethnicity were also recorded. Maturity of the baby was assessed by maternal history and corroborated by using modified Ballard score and Obstetric USG (Ultra sonogram) findings. Data were entered in excel database programme and later transferred into SPSS (Statistical package of social science) 16. Mean, standard deviation, range and percentiles values at different gestational age specific c groups were calculated. Results: A total of 2029 live babies without gross congenital malformations were included in this study, among which 57% (1154) were male. While analyzing maturity assessment, 89.1% (1808) were term, 8.7% (176) were preterm and 2.2 % (45) babies were post term. Mean birth weight at 40 weeks of gestation was 3.10 kg with Standard Deviation (SD) of 0.4 kg, mean head circumference was 34.0 cm (SD 1.2 cm) and mean length was 49.2 cm (SD 2.2 cm). Out of 2029 babies, 16.2% (328) babies were low birth weight (LBW) and 1.4% (28) babies weighed >4 kg. Conclusion: Percentile charts of newborns will help to assess the intrauterine growth of babies. Further more studies of these percentile charts will help to produce national level percentile charts of newborns of Nepal.DOI: http://dx.doi.org/10.3126/jkmc.v3i3.12244Journal of Kathmandu Medical CollegeVol. 3, No. 3, Issue 9, Jul.-Sep., 2014,Page: 97-101

scholarly journals Foot length as a surrogate maker to identify birth weight

2021 ◽  
Vol 8 (12) ◽  
pp. 1926
Author(s):  
Nitesh Upadhyay ◽  
Minhajuddin Ahmed
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Study Group ◽  
Medical College ◽  
Foot Length ◽  
Low Birth Weight Babies ◽  
Positive Linear Correlation ◽  
Preterm Babies ◽  
Higher Sensitivity

Background: Gestational age and birth weight is an important predicator for morbidity and mortality in neonates. Aim was to determine the correlation of foot length with birth weight and gestational age in neonates.Methods: This was a prospective observational study done in the neonatal unit department of pediatrics in Chirayu medical college and hospital, Bhopal. There were 1739 deliveries included during the study period from January 2016 to December 2020. Study group comprised of all live born babies delivered in within 24 hours of birth who fulfilled the inclusion criteria.Results: The study comprised of 1739 newborn babies, out of which 896 (51.51%) were males and 843 (48.49%) were females. Male:female ratio 1.06:1. In our study group, 337 (15.6%) babies were preterm and 1385 (84.39%) were of term gestation. We found a positive linear correlation of foot length with all birth weight groups in a newborn with a correlation coefficient (r=0.78) and p<0.001 was found. Similarly, a positive correlation of foot length and gestational age of newborn in both term and preterm babies with (r=0.83) with p<0.01. Foot length has 87.4% sensitivity and 91.7% specificity among low-birth-weight babies with respect to cut off foot length of 75.5 mm. Foot length has 78.7% sensitivity and 63.7% specificity among preterm babies.Conclusions: Foot length can be used as a screening tool to identify low birth weight (LBW) and preterm babies as it had a higher sensitivity and specificity.

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