Urinary tract infections in very low birthweight infants: A two-center analysis of microbiology, imaging and heart rate characteristics

2020 ◽  
pp. 1-8
Author(s):  
N. Aviles-Otero ◽  
M. Ransom ◽  
J. Weitkamp ◽  
J.R. Charlton ◽  
B.A. Sullivan ◽  
...  
Keyword(s):  
Heart Rate ◽  
Urinary Tract ◽  
Continuous Monitoring ◽  
Low Birthweight ◽  
Very Low Birthweight ◽  
Vlbw Infants ◽  
Before And After ◽  
Very Low Birthweight Infants ◽  
The Mean ◽  
Tract Infections

BACKGROUND: Increased understanding of characteristics of urinary tract infection (UTI) among very low birthweight infants (VLBW) might lead to improvement in detection and treatment. Continuous monitoring for abnormal heart rate characteristics (HRC) could provide early warning of UTIs. OBJECTIVE: Describe the characteristics of UTI, including HRC, in VLBW infants. METHODS: We reviewed records of VLBW infants admitted from 2005–2010 at two academic centers participating in a randomized clinical trial of HRC monitoring. Results of all urine cultures, renal ultrasounds (RUS), and voiding cystourethrograms (VCUG) were assessed. Change in the HRC index was analyzed before and after UTI. RESULTS: Of 823 VLBW infants (27.7±2.9 weeks GA, 53% male), 378 had > / = 1 urine culture obtained. A UTI (≥10,000 CFU and >five days of antibiotics) was diagnosed in 80 infants, (10% prevalence, mean GA 25.8±2.0 weeks, 76% male). Prophylactic antibiotics were administered to 29 (36%) infants after UTI, of whom four (14%) had another UTI. Recurrent UTI also occurred in 7/51 (14%) of infants not on uroprophylaxis after their first UTI. RUS was performed after UTI in 78%, and hydronephrosis and other major anomalies were found in 19%. A VCUG was performed in 48% of infants and 18% demonstrated vesicoureteral reflux (VUR). The mean HRC rose and fell significantly in the two days before and after diagnosis of UTI. CONCLUSIONS: UTI was diagnosed in 10% of VLBW infants, and the HRC index increased prior to diagnosis, suggesting that continuous HRC monitoring in the NICU might allow earlier diagnosis and treatment of UTI.

HOW TO PROLONG LACTATION IN MOTHERS OF VLBW INFANTS

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. A42-A42
Author(s):  
Student
Keyword(s):  
Developing Countries ◽  
Low Birthweight ◽  
Randomised Trial ◽  
Control Group ◽  
Very Low Birthweight ◽  
Vlbw Infants ◽  
Skin Contact ◽  
Very Low Birthweight Infants ◽  
Skin To Skin

We have carried out a randomised trial [of skin to skin contact with their mothers] among babies of less than 1500 gm . . . Mothers using skin to skin contact lactated for four weeks longer on average than the control group . . . [This maneuver] can enjoyably be offered to very low birthweight infants especially in developing countries where mother's lactation is vital.

scholarly journals Postnatal hemodynamic changes in very-low-birthweight infants

1999 ◽  
Vol 87 (1) ◽  
pp. 370-380 ◽  
Author(s):  
Toby Debra Yanowitz ◽  
Alice C. Yao ◽  
Karen D. Pettigrew ◽  
John C. Werner ◽  
William Oh ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Stroke Volume ◽  
Cardiac Function ◽  
Low Birthweight ◽  
Ductus Arteriosus ◽  
Mesenteric Arteries ◽  
Very Low Birthweight ◽  
Hemodynamic Changes ◽  
Before And After ◽  
Very Low Birthweight Infants

The purpose of this study was to characterize postnatal changes in regional Doppler blood flow velocity (BFV) and cardiac function of very-low-birthweight infants and to examine factors that might influence these hemodynamic changes. Mean and end-diastolic BFV of the middle cerebral and superior mesenteric arteries, cardiac output, stroke volume, and fractional shortening were measured in 20 infants birthweight 1,002 ± 173 g, gestational age 28 ± 2 wk) at 6, 30, and 54 h after birth and before and after feedings on days 7 and 14. Postnatal increases in cerebral BFV, mesenteric BFV, and cardiac output were observed that were not associated with changes in blood pressure, hematocrit, pH, arterial[Formula: see text], or oxygen saturation. The postnatal pattern of relative vascular resistance (RVR) differed between the cerebral and mesenteric vasculatures. RVR decreased in the middle cerebral but not the superior mesenteric artery. Physiological patency of the ductus arteriosus did not alter postnatal hemodynamic changes. In response to feeding, mesenteric BFV and stroke volume increased, and mesenteric RVR and heart rate decreased. Postprandial responses were not affected by postnatal age or the age at which feeding was initiated. However, the initiation of enteral nutrition before 3 days of life was associated with higher preprandial mesenteric BFV and lower mesenteric RVR than was later initiation of feeding. We conclude that in very-low-birthweight infants over the first week of life 1) systemic, cerebral, and mesenteric hemodynamics exhibit region-specific changes; 2) asymptomatic ductus arteriosus patency and early feedings do not significantly influence these postnatal hemodynamic changes; and 3) cardiac function adapts to increase local mesenteric BFV in response to feedings.

scholarly journals Cross-Correlation of Heart Rate and Oxygen Saturation in Very Low Birthweight Infants: Association with Apnea and Adverse Events

2017 ◽  
Vol 35 (05) ◽  
pp. 463-469 ◽  
Author(s):  
Douglas Lake ◽  
Karen Fairchild
Keyword(s):  
Heart Rate ◽  
Adverse Events ◽  
Oxygen Saturation ◽  
Cross Correlation ◽  
Low Birthweight ◽  
Late Onset ◽  
Periodic Breathing ◽  
Central Apnea ◽  
Very Low Birthweight ◽  
Vlbw Infants

Background Analysis of subtle vital sign changes could facilitate earlier treatment of acute inflammatory illnesses. We previously showed that high cross-correlation of heart rate and oxygen saturation (XCorr-HR-SpO2) occurs in some very low birthweight (VLBW) infants with sepsis, and hypothesized that this corresponds to apnea. Methods In 629 VLBW infants, we analyzed XCorr-HR-SpO2 in relation to central apnea with bradycardia and desaturation (ABD), BD with or without central apnea (BD), and percent time in periodic breathing (PB) throughout the neonatal intensive care unit (NICU) stay (75 infant-years). We reviewed 100 days with extremely high XCorr-HR-SpO2 (>0.7) and control days for clinical associations. Next, we identified all cases of late-onset septicemia (LOS) and necrotizing enterocolitis (NEC) and analyzed change in XCorr-HR-SpO2 before diagnosis. Results Mean XCorr-HR-SpO2 was ∼0.10, and increasing XCorr-HR-SpO2 was associated with increasing ABD, BD, and PB (correlation coefficients >0.93). Days with maximum XCorr-HR-SpO2 >0.7 were more likely to have an adverse event than control days (49% versus 13%). In 93 cases of LOS or NEC, there was a 67% increase in XCorr-HR-SpO2 in the 24-hour period prior to diagnosis compared with the previous day (p < 0.01). Conclusion High XCorr-HR-SpO2 is associated with apnea and adverse events including LOS and NEC.

HOW TO PROLONG LACTATION IN MOTHERS OF VLBW INFANTS

PEDIATRICS ◽  
1989 ◽  
Vol 84 (6) ◽  
pp. 994-994
Author(s):  
Student
Keyword(s):  
Developing Countries ◽  
Low Birthweight ◽  
Randomised Trial ◽  
Control Group ◽  
Very Low Birthweight ◽  
Vlbw Infants ◽  
Skin Contact ◽  
Very Low Birthweight Infants ◽  
Skin To Skin

We have carried out a randomised trial [of skin to skin contact with their mothers] among babies of less than 1500 gm...Mothers using skin to skin contact lactated for four weeks longer on average than the control group....[This maneuver] can enjoyably be offered to very low birthweight infants especially in developing countries where mother's lactation is vital.

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