scholarly journals Radiographic Imaging to Evaluate Food Passage Rate in Preterm Piglets as a Model for Preterm Infants

2021 ◽  
Vol 8 ◽  
Author(s):  
Susanne Soendergaard Kappel ◽  
Per Torp Sangild ◽  
Thomas Scheike ◽  
Christel Renée Friborg ◽  
Magdalena Gormsen ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Contrast Imaging ◽  
Passage Rate ◽  
Food Passage ◽  
Gut Motility ◽  
X Ray ◽  
Near Term ◽  
Gestational Age At Birth ◽  
Contrast Solution ◽  
Age At Birth

Objectives and study: Gut motility in infants mature with increasing post-menstrual age and is affected by numerous hormonal, immunological and nutritional factors. However, it remains unclear how age and diet influence gut motility and its relation to feeding intolerance and gastric residuals in preterm neonates. Using preterm piglets as a model for infants, we investigated if contrast passage rate, as determined by X-ray contrast imaging, is affected by gestational age at birth, advancing postnatal age and different milk diets.Methods: Contrast passage rate was evaluated using serial abdominal X-ray imaging on postnatal day 4 and 18 in preterm and near-term piglets fed infant formula, colostrum or intact bovine milk, with or without added fortifier (total n = 140).Results: Preterm piglets had a faster small intestinal passage rate of contrast solution at day 4 of life than near-term piglets (SIEmpty, hazard ratio (HR): 0.52, 95%CI [0.15, 0.88], p < 0.01). Formula fed piglets at day 4 had a faster passage rate of contrast to caecum (ToCecum, HR: 0.61, 95%CI [0.25,0.96], p = 0.03), and through the colon region (CaecumToRectum, p < 0.05, day 4) than colostrum fed preterm piglets. The time for contrast to leave the stomach, and passage through the colon in day 4 preterm piglets were slower than in older piglets at day 18 (both, p < 0.05). Adding a nutrient fortifier increased body growth, gastric residuals, intestinal length and weight, but did not affect any of the observed passage rates of the contrast solution.Conclusion: Serial X-ray contrast imaging is a feasible method to assess food passage rate in preterm piglets. Contrast passage rate through different gut segments is affected by gestational age at birth, postnatal age, and milk diet. The preterm piglet could be a good model to investigate clinical and dietary factors that support maturation of gut motility and thereby feeding tolerance and gut health in preterm infants.

Intermodal Enhancement of Stimulus Localisation in Infants Born Prematurely

1989 ◽  
Vol 69 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Nigel Foreman ◽  
Alistair Fielder
Keyword(s):  
Visual Fields ◽  
Visual Stimuli ◽  
Peripheral Stimulus ◽  
Term Infants ◽  
Visual Enhancement ◽  
Sensory Space ◽  
Near Term ◽  
Gestational Age At Birth ◽  
Age At Birth ◽  
Prematurely Born Infants

The interaction of auditory and visual modalities in the enhancement of orientation was examined in premature and near-term infants by presenting them auditory or visual stimuli or auditory-visual stimulus combinations at various positions in sensory space. In 4.5–15-mo.-olds, brisk orienting responses could be elicited to very peripheral stimulus positions but only when the stimulus consisted of a spatially coherent auditory-visual combination (i.e., where a sound and a light occurred at the same point in space). This occurred for all infants, irrespective of age or gestational age at birth. First, the result shows that infants can respond to visual stimuli at eccentric positions, beyond the supposed limits of their effective visual fields as measured by standard perimetry. Second, the result extends earlier studies showing that intersensory integration and stimulus localisation develop relatively normally in prematurely born infants. The auditory-visual enhancement test as used here may have a number of further uses and applications in the clinic and laboratory.

Prolonged Episodes of Hypoxemia in Preterm Infants Undetectable by Cardiorespiratory Monitors

PEDIATRICS ◽  
1995 ◽  
Vol 95 (6) ◽  
pp. 860-863 ◽  
Author(s):  
Christian F. Poets ◽  
Valerie A. Stebbens ◽  
David Richard ◽  
David P. Southall
Keyword(s):  
Heart Rate ◽  
Preterm Infants ◽  
Median Duration ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Prolonged Apnea ◽  
Gestational Age At Birth ◽  
Breathing Room ◽  
Age At Birth

Objective. To determine whether episodes of prolonged hypoxemia occur without prolonged apneic pauses (≥20 seconds) and without bradycardia (pulse rate, ≤100 beats per minute) in apparently well preterm infants. Methods. Long-term recordings of arterial oxygen saturation as measured by pulse oximetry (SpO2), photoplethysmographic (pulse) waveforms from the oximeter, and breathing movements were performed in 96 preterm infants (median gestational age at birth, 34 weeks; range, 28 to 36 weeks) who were breathing room air. Recordings started at a median age of 4 days (range, 1 to 60 days). Results. During a median duration of recording of 25 hours, 88 episodes in which SpO2 fell to 80% or less and remained there for 20 seconds or longer were identified in 15 infants. The median duration of these prolonged desaturations was 27 seconds (range, 20 to 81 seconds). In 73 episodes (83%), SpO2 continued to fall to 60% or less. Twenty-three desaturations were associated with prolonged apneic pauses and 54 with bradycardia; 19 of these were associated with both apnea and bradycardia. Thirty desaturations (34%; 10 infants) occurred without bradycardia and without prolonged apnea. Conclusions. These results indicate that a proportion of apparently well preterm infants exhibit episodes of severe prolonged hypoxemia unaccompanied by prolonged apneic pauses or bradycardia. Such episodes, therefore, would be difficult to detect if only breathing movements and heart rate are monitored. Indications for the use of oxygenation monitors in preterm infants should be reconsidered.

Infection and premature rupture of the membranes

1990 ◽  
Vol 2 (1) ◽  
pp. 1-19
Author(s):  
Kyung Seo ◽  
James A McGregor ◽  
Janice I French
Keyword(s):  
Health Care ◽  
Preterm Birth ◽  
Preterm Infants ◽  
Important Determinant ◽  
Premature Rupture ◽  
Neonatal Deaths ◽  
Financial Costs ◽  
The Usa ◽  
Gestational Age At Birth ◽  
Age At Birth

Premature rupture of the membranes (PROM) and preterm birthPreterm birth remains a paramount problem in health care worldwide. In the USA, approximately 6–10% of births occur preterm.1–3Gestational age at birth is the most important determinant of an infant's morbidity and mortality. Preterm infants account for approximately 75% of neonatal deaths,3–5as well as incalculable direct and indirect financial costs and morbidity.6–9

scholarly journals Time to regain birth weight - a marker to predict the severity of retinopathy of prematurity?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ajay Anvekar ◽  
Sam Athikarisamy ◽  
Shripada Rao ◽  
Andy Gill ◽  
Elizabeth Nathan ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Oxygen Therapy ◽  
Control Groups ◽  
Gestational Age At Birth ◽  
And Control ◽  
Type 1 Rop ◽  
Age At Birth

Abstract Background Poor weight gain in the first few weeks of life has been studied as a predictor of retinopathy of prematurity (ROP). Our aim was to assess whether time taken to regain birthweight (BW) be used as an additional marker to identify infants with type 1 ROP. Methods In this retrospective study, preterm infants (< 27 weeks gestational age at birth) born during the period from 1/1/2010–31/12/2015 at a tertiary neonatal intensive care unit in Australia were included. Twenty-seven preterm infants with Type 1 ROP were identified. Controls (No ROP or ROP other than type 1) were matched with cases on gestational age at birth and BW (1:4 ratio). Data were collected from the database and medical records. Results The median (IQR) gestational age for Type 1 ROP and control groups were 24 (24–26) and 25 (24–26) weeks respectively and median (IQR) BW for Type 1 ROP and control groups were 675 (635–810) and 773 (666–884) grams respectively. Preterm infants with Type 1 ROP were more likely to be small for gestational age (SGA) (18.5% vs 3.7%, p = 0.015) and had increased weeks on oxygen therapy (median 11.9 vs 9.1, p = 0.028). Time to regain BW was longer in preterm infants with type 1 ROP than controls but did not reach statistical significance (median 9 vs 7 days, OR 1.08, 95% CI 1.00–1.17, p = 0.059) adjusted for SGA and duration of oxygen therapy. The area under the curve from the time to regain BW model with adjustment for SGA and duration of oxygen therapy was 0.73 (95% CI 0.62–0.83). Conclusion We hypothesize that time to regain BW has potential to aid prediction of Type 1 ROP and this warrants further investigation in a larger prospective study.

scholarly journals Clinical and functional features of the small circle of blood circulation in children with a new form of bronchopulmonary dysplasia

2021 ◽  
Vol 24 (5) ◽  
pp. 292-299
Author(s):  
Milana A. Basargina ◽  
Andrey P. Fisenko ◽  
Irina V. Davydova ◽  
Maksim V. Kondratyev ◽  
Anastasiya S. Petrova ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Group Discussion ◽  
Right Heart ◽  
Functional Features ◽  
Reliable Marker ◽  
The Right ◽  
Gestational Age At Birth ◽  
Age At Birth

The aim of the work is to analyze the data of Echo-CG examination of premature infants who have formed and have not formed bronchopulmonary dysplasia (BPD) to determine the frequency of the formation of pulmonary hypertension (PH). Materials and methods. A total of 199 preterm infants treated in the Department of Pathology of Newborns were examined. The first group included moderate and severe BPD children (n = 117; 59%). The second group consisted of children without BPD within clearly decreed terms (n = 82; 41%). In each group, patients were divided into four subgroups by the gestational age at birth and the timing of the Echo-CG. Results. Only two (1.1%) patients out of 117 BPD children of the first group were diagnosed with pulmonary hypertension (PH). In 3 (2.5%) of 117 infants of the same group, enlargement of the right heart without PH was revealed. Out of 82 children without BPD, two patients had signs of right heart enlargement. PH was not diagnosed in any of the patients in this group. Discussion. To aggravate the efficiency of PH diagnosis, a number of indices of screening echocardiography seem to be increased by additional analysis of changes in the systolic eccentricity index (EI), as a reliable marker of PH in BPD children. Systolic IE should be integrated into screening in preterm infants for the diagnosis of PH. The use of Echo-CG data along with analysis of blood BNP or NT-proBNP blood content be also expanded. Optimizing the diagnosis of PH at the early stages of BPD is necessary to increase the efficacy of targeted therapy and reduce the risk of severe complications of BPD.

scholarly journals Nonphysiological anaemia of prematurity.

1978 ◽  
Vol 53 (11) ◽  
pp. 855-860 ◽  
Author(s):  
C A Wardrop ◽  
B M Holland ◽  
K E Veale ◽  
J G Jones ◽  
O P Gray
Keyword(s):  
Preterm Infants ◽  
Clinical Features ◽  
Gestational Age ◽  
Clinical Consequence ◽  
Feeding Difficulties ◽  
High O2 ◽  
Anaemia Of Prematurity ◽  
Hb Concentration ◽  
Gestational Age At Birth ◽  
Age At Birth

Clinical and haematological findings at the nadir of the refractory, early anaemia of prematurity were compared in a study of 95 preterm infants. 53% of 30 babies less than 32 weeks' gestational age at birth had abnormal clinical features resulting from anaemia at its nadir, with a combination of tachycardia, tachypnoea, dyspnoea and feeding difficulties, diminished activity, and pallor. The expression 'available oxygen', derived from the Hb concentration and Hb-O2 affinity, correlated more closely with clinical features of anaemia that did the Hb concentration alone. A formula is presented that predicts the 'available oxygen', provided the Hb concentration and post-conceptual age are known; this avoids the need for direct measurement of Hb-O2 affinity. Clinical anaemia is common in preterm infants with Hb concentrations of up to 10.5 g/dl, consequent on the high O2 affinity of fetal Hb. This is the first description of any common clinical consequence of high Hb-O2 affinity.

Serial changes in myocardial function in preterm infants over a four week period: the effect of gestational age at birth

2014 ◽  
Vol 90 (7) ◽  
pp. 349-352 ◽  
Author(s):  
Muhammad Shahid Hussain Saleemi ◽  
Afif El-Khuffash ◽  
Orla Franklin ◽  
John David Corcoran
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Myocardial Function ◽  
Gestational Age At Birth ◽  
Age At Birth

scholarly journals Preterm Birth Affects Early Motor Development in Pigs

2021 ◽  
Vol 9 ◽  
Author(s):  
Charlotte Vanden Hole ◽  
Miriam Ayuso ◽  
Peter Aerts ◽  
Steven Van Cruchten ◽  
Thomas Thymann ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Preterm Infants ◽  
Motor Skills ◽  
Gestational Age ◽  
Gait Pattern ◽  
Gestation Length ◽  
Gestation Time ◽  
Gestational Age At Birth ◽  
Normal Gestation ◽  
Age At Birth

Background: Preterm infants frequently show neuromotor dysfunctions, but it is not clear how reduced gestational age at birth may induce developmental coordination disorders. Advancing postnatal age, not only post-conceptional age, may determine neuromuscular development, and early interventions in preterm newborns may improve their later motor skills. An animal model of preterm birth that allows early postnatal detection of movement patterns may help to investigate this hypothesis.Methods: Using pigs as a model for moderately preterm infants, preterm (106-day gestation, equivalent to 90% of normal gestation time; n = 38) and term (115-day gestation, equivalent to 99% of normal gestation time; n = 20) individuals were delivered by cesarean section and artificially reared until postnatal day 19 (preweaning period). The neuromotor skills of piglets were documented using spatiotemporal gait analyses on video recordings of locomotion at self-selected speed at postnatal age 3, 4, 5, 8, and 18 days. Results were controlled for effects of body weight and sex.Results: Both preterm and term piglets reached mature neuromotor skills and performance between postnatal days 3–5. However, preterm pigs took shorter steps at a higher frequency, than term piglets, irrespective of their body size. Within preterm pigs, males and low birth weight individuals took the shortest steps, and with the highest frequency.Conclusion: Postnatal development of motor skills and gait characteristics in pigs delivered in late gestation may show similarity to the compromised development of gait pattern in preterm infants. Relative to term pigs, the postnatal delay in gait development in preterm pigs was only few days, that is, much shorter than the 10-day reduction in gestation length. This indicates rapid postnatal adaptation of gait pattern after reduced gestational age at birth. Early-life physical training and medical interventions may support both short- and long-term gait development after preterm birth in both pigs and infants.

scholarly journals Population Pharmacokinetics of Metronidazole Evaluated Using Scavenged Samples from Preterm Infants

2012 ◽  
Vol 56 (4) ◽  
pp. 1828-1837 ◽  
Author(s):  
Michael Cohen-Wolkowiez ◽  
Daniele Ouellet ◽  
P. Brian Smith ◽  
Laura P. James ◽  
Ashley Ross ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Minimal Risk ◽  
Dosing Regimen ◽  
Data Set ◽  
Relative Standard ◽  
Population Pk ◽  
Postmenstrual Age ◽  
Gestational Age At Birth ◽  
Age At Birth

ABSTRACTPharmacokinetic (PK) studies in preterm infants are rarely conducted due to the research challenges posed by this population. To overcome these challenges, minimal-risk methods such as scavenged sampling can be used to evaluate the PK of commonly used drugs in this population. We evaluated the population PK of metronidazole using targeted sparse sampling and scavenged samples from infants that were ≤32 weeks of gestational age at birth and <120 postnatal days. A 5-center study was performed. A population PK model using nonlinear mixed-effect modeling (NONMEM) was developed. Covariate effects were evaluated based on estimated precision and clinical significance. Using the individual Bayesian PK estimates from the final population PK model and the dosing regimen used for each subject, the proportion of subjects achieving the therapeutic target of trough concentrations >8 mg/liter was calculated. Monte Carlo simulations were performed to evaluate the adequacy of different dosing recommendations per gestational age group. Thirty-two preterm infants were enrolled: the median (range) gestational age at birth was 27 (22 to 32) weeks, postnatal age was 41 (0 to 97) days, postmenstrual age (PMA) was 32 (24 to 43) weeks, and weight was 1,495 (678 to 3,850) g. The final PK data set contained 116 samples; 104/116 (90%) were scavenged from discarded clinical specimens. Metronidazole population PK was best described by a 1-compartment model. The population mean clearance (CL; liter/h) was determined as 0.0397 × (weight/1.5) × (PMA/32)2.49using a volume of distribution (V) (liter) of 1.07 × (weight/1.5). The relative standard errors around parameter estimates ranged between 11% and 30%. On average, metronidazole concentrations in scavenged samples were 30% lower than those measured in scheduled blood draws. The majority of infants (>70%) met predefined pharmacodynamic efficacy targets. A new, simplified, postmenstrual-age-based dosing regimen is recommended for this population. Minimal-risk methods such as scavenged PK sampling provided meaningful information related to development of metronidazole PK models and dosing recommendations.

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