scholarly journals Analysis of Characteristics of Peripheral Arterial Ischemia in Premature Babies and Effects of Nitroglycerin Patch Application

2020 ◽  
Vol 26 (4) ◽  
pp. 434-444
Author(s):  
Jeongeun Kim ◽  
Jin Won Lee ◽  
Dong Yeon Kim
Keyword(s):  
Premature Infants ◽  
Gestational Age ◽  
Skin Color ◽  
Neonatal Intensive Care ◽  
Umbilical Artery ◽  
Clinical Information ◽  
Patch Application ◽  
Premature Babies ◽  
Lower Blood ◽  
Peripheral Arterial

Purpose: The aim of this retrospective study was to analyze the characteristics of peripheral arterial ischemia and tissue necrosis in premature babies, as well as the effects of nitroglycerin.Methods: In total, 513 newborns were enrolled who were admitted to the neonatal intensive care unit with a gestational age of 34 weeks or younger. Data were collected on general personal and clinical information, peripheral arterial ischemia, and nitroglycerin patch application in the premature infants. The collected data were analyzed using the x<sup>2</sup> test, t-test, Mann-Whitney U test, logistic regression.Results: Thirty-six (7.0%) infants had peripheral arterial ischemia, while 477 (93.0%) infants did not. Lower gestational age (x<sup>2</sup>=35.97, p<.001), lower birth weight (x<sup>2</sup>=29.40, p<.001), lower blood pressure (x<sup>2</sup>=23.10, p<.001), and insertion of an umbilical artery catheter (p<.001) were significantly associated with the occurrence of peripheral arterial ischemia. Among the preterm infants in whom nitroglycerin patches were applied, 30 (83.3%) premature infants without necrosis improved without complications, 4 (11.1%) showed hypotension, and 2 (5.6%) showed skin damage.Conclusion: Based on a review of our experiences with nitroglycerin patches, we recommend closely observing skin color and using nitroglycerin patches on the skin to help improve flow in premature infants with peripheral arterial ischemia.

HYPERGLYCEMIAAS AN INDEPENDENT RISK FACTOR FOR RETINOPATHY OF PREMATURITY (ROP): A COHORT STUDY

2021 ◽  
pp. 54-57
Author(s):  
Kali Shankar Das ◽  
Athokpam Poireiton ◽  
Niladri Sekhar Mandal ◽  
Samim Ahmed
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Blood Glucose ◽  
Premature Infants ◽  
Gestational Age ◽  
Independent Risk Factor ◽  
Logistic Regression Model ◽  
Bivariate Analysis ◽  
Premature Babies ◽  
Average Blood Glucose

OBJECTIVE: Retinopathy of prematurity (ROP) is a severe morbidity that can lead to blindness in premature babies. Neonatal hyperglycemia has been related to the growth of ROP in a variety of studies. However, there aren't many observational trials to show whether hyperglycemia is linked to ROP in the absence of other comorbidities. The aim of this research was to see if hyperglycemia in premature babies is linked to ROP in a different way. STUDY DESIGN: Premature infants (<1500 g or⩽ 32 weeks gestational age) were enrolled in a prospective longitudinal cohort study. All demographic, clinical and laboratory data were collected. Bedside whole-blood glucose concentration was measured every 8 hours daily for rst 7 , days of live. For any glucose reading <50 or>150 mg dl 1 serum sample was sent to the laboratory for conrmation. Hyperglycemia was dened as any blood glucose level⩾ 150 mg dl − 1. ROP patients were compared with non-ROP patients in a bivariate analysis. Variables signicantly associated with ROP were studied in a logistic regression model. RESULT:Atotal of 100 patients were enrolled with gestational age <32weeks and birth weight <1500g. Forty-eight patients (48%) were identied with hyperglycemia. On eye examination, 30 cases (30%) had ROP (19 with stage 1, 10 with stage 2 and 1 with stage 3). There were more cases of ROPin the hyperglycemia group compared with the euglycemia group (45.83% vs 15.38%, P = 0.007). Patients who developed ROP had signicantly higher maximum and average glucose concentrations when compared with non-ROP patients. Multiple factors have been associated with ROP on bivariate analysis, including gestational age, exposure to oxygen, respiratory support and poor weight gain. However, in a logistic regression model including all signicant variables, average blood glucose in the rst week of life was the factor independently associated with ROPwith an odds ratio of: 1.77 (95% condence interval: 1.08 to 2.86), P= 0.024 CONCLUSION: In a prospective cohort study of premature infants, elevated average blood glucose concentrations in the rst week of life is an independent risk factor associated with the development of ROP.

scholarly journals Might the Mothers of Premature Babies Feed Them and Devote Some Milk to the Milk Bank?

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Pasqua Anna Quitadamo ◽  
Giuseppina Palumbo ◽  
Liliana Cianti ◽  
Matteo Luigi Napolitano ◽  
Ciro Coviello ◽  
...  
Keyword(s):  
Breast Milk ◽  
Premature Infants ◽  
Gestational Age ◽  
Psychological Trauma ◽  
Premature Baby ◽  
Single Donor ◽  
Premature Babies ◽  
Milk Bank ◽  
Starting Point ◽  
Healthy Growth

The breast milk is the gold standard food for the feeding of the premature baby: it is the natural way to provide excellent nutritional, immunological, and biological nutriment so as to facilitate a healthy growth and the development of the infants. When the breast milk is not available, the alternative is represented by the donated milk. The mothers of premature infants are important opportunity if we consider the fact that they could devote some milk both because they provide a food which is closer to the needs of the vulnerable category of newborns and because it is, for the mothers, a way to overcome the detachment and the psychological trauma of a premature birth. There are no data on this kind of donation. The aim of the study is to evaluate the contribution of the milk donation to the HMB of CSS by women who gave birth to premature infants of gestational age <35 weeks and to analyze the macronutrient composition of the “preterm” donated milk. The CSS HMB has recruited 659 donors totalling 2236 liters of donated milk over a period of 7 years. 38 donors (5.7%) gave birth to a gestational age <35 weeks. Almost 20% of the donated milk comes from mothers of premature babies and this is a very important fact because it shows the huge potential belonging to this category of mothers. Taking into account the parameter regarding the birth weight, it was found that VLBW mothers contributed for 56% to preterm donation while ELBW mothers contributed for 41%. By evaluating the variable gestational age, about 40% of the average total donation derives from mothers who gave birth before the 25 weeks, while a contribution of 46% is attributable to the category of newborns with a GA between 25 and 32 weeks. Besides, some other exceptional examples can be outlined. Regarding the correlation analysis DM resulted in negative correlation with GA weeks (r=-0.31, p=0.058) and with BW g (r=-0.30, p=0.068) achieving values which are very close to the significance. The comparison between the donor volume averages of the preterm and full-term groups is statistically significant. The composition data are in line with the literature: there is an increase by 18 % in the protein component of the milk deriving from the mothers of the premature infants; the gap in carbohydrates is less significant (5-6%) and the gap in calories is similarly low being only 2% higher than the single donor milk and 11% more than the pooled milk. The data on the lipids line up to single donor term milk, while it grows by 24% compared to the pooled one. The study shows that even at very low or extreme gestational age it is possible to obtain an appropriate production of breast milk. This awareness becomes a fundamental starting point for the activation in a standardized way of all the strategies of promotion and support of food that have proven effective with the HM in NICU.

Smart Jacket Design for Improving Comfort of Neonatal Monitoring

2012 ◽  
pp. 361-385
Author(s):  
Wei Chen ◽  
Sibrecht Bouwstra
Keyword(s):  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Functional Performance ◽  
Patient Comfort ◽  
Design Work ◽  
Premature Babies ◽  
Textile Sensors ◽  
Neonatal Monitoring

Health monitoring is crucial for the survival of ill and premature infants admitted at the neonatal intensive care unit (NICU) in a hospital. The reliability and comfort of monitoring systems will impact on the quality of life and long-term health prospects of the neonates. This chapter presents the ongoing design work of a smart jacket for improving comfort of neonatal monitoring. Textile sensors, a reflectance pulse oximeter, and a wearable temperature sensor are developed to be embedded into the smart jacket. The authors also report a power supply and wireless communication system developed for the smart jacket. Sensor locations, materials, and appearance are designed to optimize the functionality, patient comfort and the possibilities for aesthetic features. Prototypes are presented for demonstrating the design concept, and experimental results for functional performance are shown from the tests on premature babies at the NICU of Máxima Medical Centre (MMC) in Veldhoven, the Netherlands.

Tracheostomy in the Extremely Premature Neonate: A Multi-Institutional Study

2020 ◽  
Vol 162 (4) ◽  
pp. 559-565
Author(s):  
Kevin D. Pereira ◽  
Kevin Shaigany ◽  
Karen B. Zur ◽  
Carolyn M. Jenks ◽  
Diego A. Preciado ◽  
...  
Keyword(s):  
Lung Disease ◽  
Premature Infants ◽  
Gestational Age ◽  
Chronic Lung Disease ◽  
Neonatal Intensive Care ◽  
Premature Neonate ◽  
Neurodevelopmental Outcomes ◽  
Children's Hospitals ◽  
Children’S Hospitals ◽  
The Mean

Objective (1) To describe characteristics associated with tracheostomy placement and (2) to describe associated in-hospital morbidity in extremely premature infants. Study Design Pooled retrospective analysis of charts. Setting Academic children’s hospitals. Subjects and Methods The patient records of premature infants (23-28 weeks gestational age) who underwent tracheostomy between January 1, 2012, and December 31, 2017, were reviewed from 4 academic children’s hospitals. Demographics, procedural morbidity, feeding, respiratory, and neurodevelopmental outcomes at the time of transfer from the neonatal intensive care unit (NICU) were obtained. The contribution of baseline characteristics to mortality, neurodevelopmental, and feeding outcomes was also assessed. Results: The charts of 119 infants were included. The mean gestational age was 25.5 (95% confidence interval, 25.2-25.7) weeks. The mean birth weight was 712 (671-752) g. Approximately 50% was African American. The principal comorbidity was chronic lung disease (92.4%). Overall, 60.5% of the infants had at least 1 complication. At the time of transfer, most remained mechanically ventilated (94%) and dependent on a feeding tube (90%). Necrotizing enterocolitis increased the risk of feeding impairment ( P = .002) and death ( P = .03). Conclusions Tracheostomy in the extremely premature neonate is primarily performed for chronic lung disease. Complications occur frequently, with skin breakdown being the most common. Placement of a tracheostomy does not seem to mitigate the systemic morbidity associated with extreme prematurity.

scholarly journals Characteristic of exocrine function of the pancreas in premature newborns

2021 ◽  
pp. 21-25
Author(s):  
A.Sh. Fazylova ◽  
◽  
D.I. Akhmedova ◽  
A.T. Kamilova ◽  
S.S. Khasanova ◽  
...  
Keyword(s):  
Premature Infants ◽  
Gestational Age ◽  
Pancreatic Insufficiency ◽  
Clear Relationship ◽  
Exocrine Function ◽  
Term Infants ◽  
Fecal Elastase ◽  
Early Postnatal Ontogenesis ◽  
Premature Babies ◽  
Study Results

Premature babies in early postnatal ontogenesis are characterized by the immaturity of many functional systems, including the digestive system. The imperfection of the motor-evacuation function of the gastrointestinal tract in them is combined with insufficient activity of the enzyme systems, the peculiarities of the formation of the microbial landscape of the colon, which contributes to the development of digestive dysfunctions and complicates enteral feeding, especially in deeply premature infants. In order to determine the parameters pancreatic elastase (PE) in premature infants, depending on the gestational age and the nature of feeding, 135 newborns were examined (108 premature infants with a gestational age of 22 to 32 weeks and 27 term infants). All children underwent a general clinical examination, as well as a study for PE on the 13–14th day of life, when the volume of enteral nutrition reached 70 percent or more. Analysis of the study results revealed a clear relationship between the degree of prematurity and the severity of pancreatic insufficiency. A clear relationship between fecal elastase indicators and the type of feeding was determined. The most favorable situation is observed in exclusively breastfed children, who have the highest fecal elastase values, which practically do not differ from the control values. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: premature, elastase, pancreatic insufficiency.

scholarly journals The recombinant human erythropoietin therapy for extremely and very low birth weight infants

2019 ◽  
Vol 18 (2) ◽  
pp. 75-82 ◽  
Author(s):  
D. R. Sharafutdinova ◽  
E. N. Balashova ◽  
O. V. Ionov ◽  
A. R. Kirtbaya ◽  
J. M. Golubtsova ◽  
...  
Keyword(s):  
Body Weight ◽  
Premature Infants ◽  
Gestational Age ◽  
Recombinant Human Erythropoietin ◽  
Very Low Birth Weight ◽  
Control Group ◽  
Low Birth Weight Infants ◽  
Human Erythropoietin ◽  
Premature Babies ◽  
Anemia Of Prematurity

Anemia of prematurity is a common pathology in premature infants. The prevalence of anemia of prematurity is inversely proportional to the gestational age and body weight at birth. The pathogenetic importance of impaired erythropoietin (EPO) production in anemia of prematurity provides the rationale for therapy with erythropoiesis stimulating agents (ESAs) including recombinant EPO. A comparative analysis of the effectiveness of different regimens of recombinant human erythropoietin in extremely and very low birth weight infants (ELBW and VLBW) was studied. Research has been set as a prospective analysis of 133 VLBW and ELBW infants (in the period from December 2017 to February 2019). Gestational age (GA) of the children ranged from 26 to 33 weeks, of these, GA of 75 children (56%) was 30 weeks or less. Depending on the treatment of anemia of prematurity all infants were divided into 5 groups: group 1 (n = 26) – premature babies who were prescribed ESAs since 3 day of life 200 IU/kg 3 times per week subcutaneously; group 2 (n = 21) – premature babies who were prescribed ESAs since 3 day of life 400 IU/kg 3 times per week subcutaneously; group 3 (n = 37) – premature babies who were prescribed ESAs since 8 day of life 200 IU/kg 3 times per week subcutaneously; group 4 (n = 18) – premature babies who were prescribed ESAs since 8 day of life 400 IU/kg 3 times per week subcutaneously; group 5 (n = 31) premature infants who did not receive treatment with recombinant human erythropoietin (control group). Subgroups of children of gestational age ≤ 30 weeks were identified in each group. The groups and subgroups did not differ significantly in gestational age, weight, birth length, and Apgar score at 1 and 5 minutes of life, p > 0.05. Also, there were no statistically significant differences in the age of the 1st transfusion, the frequency and total volume of transfusions, the duration of respiratory therapy, the duration of hospitalization, including treatment in NICU, body weight and age at discharge. The frequency of retinopathy of prematurity stage ≥ 3, periventricular leukomalacia, bronchopulmonary dysplasia of moderate and severe severity, intraventricular hemorrhages of varying severity, necrotizing enterocolitis was not statistically significant in the study groups and subgroups. Statistically significant differences in the concentration of hemoglobin in the peripheral blood of premature infants were revealed at discharge. In the control group, children had a lower level of hemoglobin at discharge (94 g/l) compared with the groups with early appointment of ESAs (109 g/l and 107 g/l in groups 1 and 2, respectively, P0-1 = 0.048 and P0-2 = 0.047) due to newborn GA ≤ 30 weeks. It is preferable to use of the drug ESAs at a dose of 200 IU/kg 3 p/week p/, starting from the 3rd day of life. The effectiveness of erythropoietin therapy, the time of its start and various treatment regimens remain controversial issues that require further study. The study was approved by the Independent Ethics Committee of the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov.

scholarly journals Treatment status of extremely premature infants with gestational age < 28 weeks in a Chinese perinatal center from 2010 to 2019

2021 ◽  
Author(s):  
Wen-Wen Zhang ◽  
Yong-Hui Yu ◽  
Xiao-Yu Dong ◽  
Simmy Reddy
Keyword(s):  
Survival Time ◽  
Premature Infants ◽  
Active Treatment ◽  
Gestational Age ◽  
Real World ◽  
Neonatal Intensive Care ◽  
Total Mortality ◽  
Delivery Room ◽  
Real World Data ◽  
Perinatal Medicine

Abstract Background There is a paucity of studies conducted in China on the outcomes of all live-birth extremely premature infants (EPIs) and there is no unified recommendation on the active treatment of the minimum gestational age in the field of perinatal medicine in China. We aimed to investigate the current treatment situation of EPIs and to provide evidence for formulating reasonable treatment recommendations. Methods We established a real-world ambispective cohort study of all live births in delivery rooms with gestational age (GA) between 24+0 and 27+6 weeks from 2010 to 2019. Results Of the 1163 EPIs included in our study, 241 (20.7%) survived, while 849 (73.0%) died in the delivery room and 73 (6.3%) died in the neonatal intensive care unit. Among all included EPIs, 862 (74.1%) died from withholding or withdrawal of care. Regardless of stratification according to GA or birth weight, the proportion of total mortality attributable to withdrawal of care is high. For infants with the GA of 24 weeks, active treatment did not extend their survival time (P = 0.224). The survival time without severe morbidity of the active treatment was significantly longer than that of withdrawing care for infants older than 25 weeks (P < 0.001). Over time, the survival rate improved, and the withdrawal of care caused by socioeconomic factors and primary nonintervention were reduced significantly (P < 0.001). Conclusions The mortality rate of EPIs is still high. Withdrawal of care is common for EPIs with smaller GA, especially in the delivery room. It is necessary to use a multi-center, large sample of real-world data to find the survival limit of active treatment based on our treatment capabilities.

scholarly journals Vertically transmitted infections and extrauterine growth restriction in preterm neonates: a new risk factor

2021 ◽  
Vol 21 (1) ◽  
pp. 107-115
Author(s):  
Verônica Cheles Vieira ◽  
Raquel Cristina Gomes Lima ◽  
Daiane Borges Queiroz ◽  
Danielle Souto de Medeiros
Keyword(s):  
Premature Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Positive Association ◽  
Final Analysis ◽  
Growth Restriction ◽  
Preterm Neonates ◽  
Clinical Practices ◽  
Increased Risk ◽  
Extrauterine Growth Restriction

Abstract Objectives: to investigate the association between Vertically Transmitted Infections (VTI) and Extrauterine Growth Restriction (EUGR) among premature infants in Neonatal Intensive Care Units (NICU). Methods: part of a large non-concurrent cohort study with medical records analysis. We evaluated EUGR in premature infants at a gestational age at birth of > 32 weeks and <36 weeks and presented a corrected gestational age of 36 completed weeks during a 27-day birth follow-up. Premature infants with major congenital anomalies were excluded. We analyzed associations among EUGR, VTI and covariables related to maternal disease, birth characteristics, perinatal morbidities and clinical practices. Results: out of the 91 premature infants, 59.3% (CI95%=48.9-69.0%) developed EUGR. VTI were observed in 4.4%o of the population; all premature infants affected by VTI had EUGR. The VTI found were syphilis, cytomegalovirus disease and toxoplasmosis. The final analysis has showed a positive association between VTI and EUGR (RR=1.57; CI95%o=1.07-2.30); the female covariables (RR=1.50; CI95%=1.11-2.02), moderate premature classification (RR=1.41; CI95%=1.06-1.87) and small for gestational age (RR=2.69; CI95% 1.853.90) have also influenced this outcome. Conclusion: this study revealed VTI as an important morbidity factor, with impact on the increased risk of EUGR between premature infants affected by these diseases.

About the system of rehabilitation of preterm infants within walking distance

2016 ◽  
Vol 7 (2) ◽  
pp. 140-144
Author(s):  
Inga N Surenkova ◽  
Galina A Suslova ◽  
Anna P Skoromets
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Gestational Age ◽  
Integrated Approach ◽  
Premature Baby ◽  
Medical Rehabilitation ◽  
Walking Distance ◽  
Negative Consequences ◽  
Premature Babies ◽  
The Family

During last five years there was increasing preterm infants, these children were born with a gestational age of 26 weeks and weighing 800 g, with severe combined pathology. Preterm infants came to the nearest polyclinics after the first stage of rehabilitation in hospitals. There are many questions how and when specialists should begin rehabilitation of such children. Specialists observes that is required an integrated approach to the rehabilitation of premature babies by analyzing the development of these children. Considering that children’s polyclinic allows monitoring children till 18 years of age, there is a possibility of observing and assisting these children during longer period. It is also very essential to realize that without an adequate intensive nursery care the negative consequences become irreversible for premature infants. Birth of a premature infant is a severe psychological stress for both parents. Often without completely realizing it, the family begins to live in conditions of high emotional stress. The department of medical rehabilitation must operate with the parents of a premature baby, in order to help them adapting to the new conditions of life. The task of differentiated medical and psychological rehabilitation can be fulfilled only by the district polyclinic in which the child will be observed until the age of 18. In the article considered features of modern rehabilitation of preterm infants in the in ambulatory-polyclinic service.

scholarly journals Accuracy of Transcutaneous Carbon Dioxide Measurement in Premature Infants

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Marie Janaillac ◽  
Sonia Labarinas ◽  
Riccardo E. Pfister ◽  
Oliver Karam
Keyword(s):  
Carbon Dioxide ◽  
Partial Pressure ◽  
Premature Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Wide Limit ◽  
Cerebral Lesions ◽  
Carbon Dioxide Measurement

Background.In premature infants, maintaining blood partial pressure of carbon dioxide (pCO2) value within a narrow range is important to avoid cerebral lesions. The aim of this study was to assess the accuracy of a noninvasive transcutaneous method (TcpCO2), compared to blood partial pressure of carbon dioxide (pCO2).Methods.Retrospective observational study in a tertiary neonatal intensive care unit. We analyzed the correlation between blood pCO2and transcutaneous values and the accuracy between the trends of blood pCO2and TcpCO2in all consecutive premature infants born at <33 weeks’ gestational age.Results.248 infants were included (median gestational age: 29 + 5 weeks and median birth weight: 1250 g), providing 1365 pairs of TcpCO2and blood pCO2values. Pearson’sRcorrelation between these values was 0.58. The mean bias was −0.93 kPa with a 95% confidence limit of agreement of −4.05 to +2.16 kPa. Correlation between the trends of TcpCO2and blood pCO2values was good in only 39.6%.Conclusions.In premature infants, TcpCO2was poorly correlated to blood pCO2, with a wide limit of agreement. Furthermore, concordance between trends was equally low. We warn about clinical decision-making on TcpCO2alone when used as continuous monitoring.

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