scholarly journals EARLY VS LATE CAFFEINE THERAPY IN PRETERM INFANTS: ANALYSIS OF CLINICAL OUTCOME

2021 ◽  
Vol 71 (2) ◽  
pp. 503-06
Author(s):  
Hafsa Niaz ◽  
Jawad Jalil ◽  
Muhammad Adil ◽  
Faisal Basheer ◽  
Shahzad Akhtar ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Clinical Outcome ◽  
Neonatal Intensive Care Unit ◽  
Intensive Care Unit Stay ◽  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Female Ratio

Objective: To study clinical outcome of early versus late caffeine therapy in preterm infants. Study Design: Prospective comparative study. Place and Duration of Study: Neonatal Intensive Care Unit, Pak Emirates Military Hospital, Rawalpindi, from Jan to Jul 2018. Methodology: A total of 40 preterm infants with gestational age <32 weeks and birth weight <1500 grams were randomly divided into two groups on the basis of initiation of caffeine therapy i.e. group A (early caffeine group) and group B (late caffeine group). Infant’s demographic data and clinical outcomes were compared between both groups using SPSS IBM software. Results: Mean gestational age was 29.9 ± 1.19 weeks with male to female ratio of 1.5:1 Mean birth weight was 1165.3 ± 316 grams. Half (50%) of the infants were delivered by cesarean section while surfactant was given in 29 (72.5%) infants. While comparing both groups we observed that early caffeine shortens duration of Neonatal Intensive Care Unit stay (p<0.05) whereas caffeine therapy initiation timings didn’t influence the risk of development of Respiratory Distress Syndrome or need of mechanical ventilation. Conclusion: Early caffeine therapy in preterm infants is associated with decrease duration of Neonatal Intensive Care Unit stay. However further work is needed in this regards to establish its efficacy and safety.

scholarly journals Course of Stress during the Neonatal Intensive Care Unit Stay in Preterm Infants

Neonatology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Nienke H. van Dokkum ◽  
Marlou L.A. de Kroon ◽  
Peter H. Dijk ◽  
Karianne E. Kraft ◽  
Sijmen A. Reijneveld ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Intensive Care Unit Stay ◽  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Clinical Characteristics ◽  
Gestational Age At Birth ◽  
Medical Morbidity

<b><i>Introduction:</i></b> Understanding the course of stress during the neonatal intensive care unit stay may provide targets for interventions. Our aim was to describe the course of stress in preterm infants during the first 28 days of life, the influence of gestational age, and associations with clinical characteristics. <b><i>Methods:</i></b> In a single centre prospective cohort study, we included infants with a gestational age &#x3c;30 weeks and/or birth weight &#x3c;1,000 g. We measured stress over the first 28 days using the Neonatal Infant Stressor Scale (NISS). We plotted daily NISS total and subcategory scores by gestational age. The subcategories were (1) nursing, (2) skin-breaking, (3) monitoring and imaging, and (4) medical morbidity-related scores. We assessed associations of cumulative NISS scores over the first 7, 14, and 28 days with clinical characteristics using regression analyses. <b><i>Results:</i></b> We included 45 infants, with a median gestational age of 27 weeks. The mean daily NISS score was 66.5 (SD 8.7), with highest scores in the first 7 days of life. Scores decreased the slowest for the lowest gestational ages, in particular for nursing scores, rather than skin-breaking, monitoring and imaging, and medical morbidity-related scores. Adjusted for gestational age, infants with lower Apgar scores, sepsis, intraventricular haemorrhages, and on mechanical ventilation had significantly higher cumulative NISS scores at 7, 14, and 28 days. <b><i>Conclusion:</i></b> NISS scores varied greatly within infants and over time, with the highest mean scores in the first week after birth. The course of declining NISS scores in the first 28 days depended on gestational age at birth.

Evaluation of Morbidities and Complications of Neonatal İntensive Care Unit Patients with Respiratory Disorders at Different Gestational Ages

2021 ◽  
Author(s):  
Erbu Yarci ◽  
Fuat E. Canpolat
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Respiratory Diseases ◽  
Respiratory Disorders ◽  
Live Births

Objective Respiratory distress presented within the first few days of life is life-threatening and common problem in the neonatal period. The aim of this study is to estimate (1) the incidence of respiratory diseases in newborns and related mortality; (2) the relationship between acute neonatal respiratory disorders rates and gestational age, birth weight, and gender; and (3) the incidence of complications associated with respiratory disturbances. Study Design Only inborn patients with gestational age between 230/7 and 416/7 weeks having respiratory distress were included in the study. The data were collected from the medical records and gestational age was based on the menstrual dating. Results There were 8,474 live births between January 1, 2013 and June 30, 2013 in our hospital. A total of 1,367 newborns were hospitalized and oxygen therapy was applied in 903 of them because of respiratory distress. An acute respiratory disorder was found to be in 10.6% (903/8,474) among all live births. Mortality was 0.76% (66/8,474). The incidence of respiratory distress syndrome was 2.8% (n = 242). The occurrence of transient tachypnea of newborn was 3.1% (n = 270). Meconium aspiration syndrome, pneumonia, congenital diaphragmatic hernia, and pulmonary maladaptation and primary persistent pulmonary hypertension rates were 0.1, 0.7, 2.2, and 0%, respectively. Overall, 553 (61%) of the 903 newborns having respiratory diseases had complications. The occurrence of necrotizing enterocolitis, patent ductus arteriosus, bronchopulmonary dysplasia, intraventricular hemorrhage and air leak was 6.8, 19.8, 4.7, 24.9, and 5%, respectively. Conclusion This study offers an epidemiological perspective for respiratory disorders from a single-center level-III neonatal intensive care unit. Although number of births, premature newborns, extremely low birth weight/very low birth weight infants, and complicated pregnancies increase in years, decreasing rates of mortality and complications are very promising. As perinatal and neonatal cares are getting better in every day, we think that more promising results can be achieved over the coming years. Key Points

scholarly journals Confounders for Neonatal Intensive Care Unit Admission ın Neonates of Mothers with Preeclampsia

2018 ◽  
Vol 24 (3) ◽  
pp. 162
Author(s):  
Cetin Kilicci ◽  
Cigdem Yayla Abide ◽  
Enis Ozkaya ◽  
Evrim Bostancı Ergen ◽  
İlter Yenidede ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Intensive Care Unit Admission ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Preterm Neonates ◽  
Apgar Scores ◽  
Gestational Age At Delivery

<p><strong>Objective:</strong> The aim of this study was to investigate the effect of some maternal and neonatal clinical parameters on the neonatal intensive care unit admission rates of neonates born to mothers who had preeclampsia. </p><p><strong>Study Design:</strong> Study included 402 singleton pregnant women with preeclampsia who admitted to Maternal-Fetal Medicine Unit of Zeynep Kamil Children and Women’s Health Training and Research Hospital. Pregnancies with uterine rupture, chorioamnionitis and congenital malformations were excluded. Some maternal and neonatal clinical characteristics were assessed to predict neonatal intensive care unit admission.</p><p><strong>Results:</strong> Among 402 neonates, 140 (35%) of them had an indication for neonatal intensive care unit admission, among 140 neonates, 136 (97%) of them were preterm neonates. Comparison of groups with and without neonatal intensive care unit admission indicated significant differences between groups in terms of gestational age, Apgar scores at 1st and 5th minutes, birth weight, some maternal laboratory parameters (Hemoglobin, hematocrit, alanine aminotransferase, aspartate aminotransferase, albumin). In multivariate analysis, among all study population, gestational age at delivery, birth weight and Apgar scores were found to be significantly associated with neonatal intensive care unit admission. On the other hand, in subgroup of term neonates, none of the variables was shown to be associated with neonatal intensive care unit admission.</p><p><strong>Conclusion:</strong> Gestational age at delivery and the birth weight are the main risk factors for neonatal intensive care unit admission of neonates born to mothers who had preeclampsia.</p>

scholarly journals Coagulase-Negative Staphylococcal Infections in the Neonatal Intensive Care Unit

2011 ◽  
Vol 32 (7) ◽  
pp. 679-686 ◽  
Author(s):  
Naomi Jean-Baptiste ◽  
Daniel K. Benjamin ◽  
Michael Cohen-Wolkowiez ◽  
Vance G. Fowler ◽  
Matthew Laughon ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Lower Mortality ◽  
Coagulase Negative Staphylococci ◽  
Clinical Sepsis ◽  
Significant Difference

Background.Coagulase-negative staphylococci (CoNS) are the most commonly isolated pathogens in the neonatal intensive care unit (NICU). CoNS infections are associated with increased morbidity, including neurodevelopmental impairment.Objective.To describe the epidemiology of CoNS infections in the NICU. To determine mortality among infants with definite, probable, or possible CoNS infections.Methods.We performed a retrospective cohort study of all blood, urine, and cerebrospinal fluid cultures from samples obtained from infants aged <121 postnatal days.Setting.A total of 248 NICUs managed by the Pediatrix Medical Group from 1997 to 2009.Results.We identified 16,629 infants with 17,624 episodes of CoNS infection: 1,734 (10%) definite, 3,093 (17%) probable, and 12,797 (73%) possible infections. Infants with a lower gestational age and birth weight had a higher incidence of CoNS infection. When controlling for gestational age, birth weight, and 5-minute Apgar score, we found that infants with definite, probable, or possible CoNS infection had lower mortality (odds ratio [OR], 0.74 [95% confidence interval {CI}: 0.61, 0.89], 0.68 [95% CI, 0.59, 0.79], and 0.69 [95% CI, 0.63, 0.76], respectively) compared with infants who had negative culture results (P<.001). No significant difference in overall mortality was found in infants who had definite CoNS infection compared with those who had probable or possible CoNS infection (OR, 0.93 [95% CI, 0.75, 1.16] and 0.85 [95% CI,0.70,1.03], respectively).Conclusions.CoNS infection was strongly related to lower gestational age and birth weight. Infants with clinical sepsis and culture-positive CoNS infection had lower mortality rates than infants with clinical sepsis and negative blood culture results. No difference in mortality between infants with a diagnosis of definite, probable, or possible CoNS infection was observed.

scholarly journals GROWTH ANALYSIS OF PRETERM NEWBORNS WITH GASTROSCHISIS DURING HOSPITALIZATION IN A NEONATAL INTENSIVE CARE UNIT

2021 ◽  
Vol 58 (4) ◽  
pp. 504-508
Author(s):  
Juliana Zoboli Del BIGIO ◽  
Mário Cícero FALCÃO ◽  
Ana Cristina Aoun TANNURI
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Weight Gain ◽  
Birth Weight ◽  
Parenteral Nutrition ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Growth Analysis ◽  
Preterm Newborns

ABSTRACT BACKGROUND: Gastroschisis, especially complex type, prematurity and low birth weight are associated with a worse clinical outcome with higher mortality, higher incidence of sepsis and catheter-related infection, cholestasis, short bowel syndrome, greater number of days to achieve full diet, longer time of parenteral nutrition and longer hospitalization time. OBJECTIVE: To evaluate the growth of preterm newborns with gastroschisis during their hospitalization in the neonatal intensive care unit. METHODS: Descriptive study, based on a retrospective cohort (January 2012 to December 2018), including preterm newborns (gestational age less than 37 weeks) with simple and complex gastroschisis admitted in a tertiary neonatal intensive care unit. The following parameters were analyzed: maternal age, parity, type of delivery, birth weight, gender, gestational age, nutritional adequacy, type of gastroschisis, fasting time, parenteral nutrition time, time until achieving full enteral nutrition, hospitalization time, weight gain and outcome. The results were expressed in percentage, average, and median. RESULTS: A total of 101 newborns with gastroschisis were admitted, of which 59.4% were premature (80.7% of late preterm infants). From the maternal data, the mean age was 21.2 years and 68.3% were primiparous. Regarding childbirth: 80% were cesarean sections. From newborns: the average birth weight was 2137 g, 56.6% were female, the average gestational age was 34.8 weeks, the average weight gain was 20.8 g/day during hospitalization and 83.3% were discharged from the hospital. CONCLUSION: The growth analysis by weight gain (grams/day) during hospitalization in the intensive care unit showed that more than 90% of the sample presented acceptable or adequate weight gain.

Sign in / Sign up

Export Citation Format

Share Document