scholarly journals Effect of Fluid Bolus on Clinical Outcomes in Very Low Birth Weight Infants

2020 ◽  
Vol 25 (5) ◽  
pp. 437-444
Author(s):  
Shubham Bakshi ◽  
Taylor Koerner ◽  
Alexander Knee ◽  
Rachana Singh ◽  
Ruben Vaidya
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Clinical Outcomes ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Adverse Outcomes ◽  
Low Birth Weight Infants ◽  
Fluid Bolus ◽  
Vlbw Infants ◽  
The Impact

OBJECTIVE Administration of fluid bolus in very low birth weight (VLBW) infants is a common practice in the NICU, but one without clear evidence demonstrating benefits in clinical outcomes. On the contrary, recent observational studies have suggested a potential detrimental effect of empiric fluid bolus in preterm infants, especially in the absence of clear indications. The aim of this study was to assess the impact of fluid bolus on various clinical outcomes in VLBW infants. METHODS Retrospective cohort study of VLBW infants born at ≤34 weeks' gestation and/or ≤1500-g birth weight at a single level III NICU from January 1, 2008, to December 31, 2013, and who received at least one fluid bolus within the first 48 hours of life. Outcomes studied were in-hospital mortality, need for home oxygen, incidence of chronic lung disease (CLD), prevalence of patent ductus arteriosus (PDA), and intraventricular hemorrhage (IVH). RESULTS Of 516 infants, 112 (21.7%) received a fluid bolus within the first 48 hours of life for various indications. Propensity models suggested no statistical difference for CLD or mortality, but exposed infants had an increased incidence of home on oxygen (p = 0.018), PDA prevalence (p = 0.008), and IVH prevalence (p = 0.038). CONCLUSIONS Fluid bolus in the first 48 hours of life may be associated with increased incidence of need for home oxygen and higher prevalence of PDA and IVH in VLBW infants. Future studies are needed to address these important adverse outcomes.

scholarly journals Early Pulse Oximetry Data Improves Prediction of Death and Adverse Outcomes in a Two-Center Cohort of Very Low Birth Weight Infants

2018 ◽  
Vol 35 (13) ◽  
pp. 1331-1338 ◽  
Author(s):  
A. Wallman-Stokes ◽  
J. Isler ◽  
R. Sahni ◽  
J. Moorman ◽  
K. Fairchild ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pulse Oximetry ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Adverse Outcomes ◽  
Predictive Score ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Net Reclassification Improvement

Background We previously showed, in a single-center study, that early heart rate (HR) characteristics predicted later adverse outcomes in very low birth weight (VLBW) infants. We sought to improve predictive models by adding oxygenation data and testing in a second neonatal intensive care unit (NICU). Methods HR and oxygen saturation (SpO2) from the first 12 hours and first 7 days after birth were analyzed for 778 VLBW infants at two NICUs. Using multivariate logistic regression, clinical predictive scores were developed for death, severe intraventricular hemorrhage (sIVH), bronchopulmonary dysplasia (BPD), treated retinopathy of prematurity (tROP), late-onset septicemia (LOS), and necrotizing enterocolitis (NEC). Ten HR-SpO2 measures were analyzed, with first 12 hours data used for predicting death or sIVH and first 7 days for the other outcomes. HR-SpO2 models were combined with clinical models to develop a pulse oximetry predictive score (POPS). Net reclassification improvement (NRI) compared performance of POPS with the clinical predictive score. Results Models using clinical or pulse oximetry variables alone performed well for each outcome. POPS performed better than clinical variables for predicting death, sIVH, and BPD (NRI > 0.5, p < 0.01), but not tROP, LOS, or NEC. Conclusion Analysis of early HR-SpO2 characteristics adds to clinical risk factors to predict later adverse outcomes in VLBW infants.

Early Vital Sign Differences in Very Low Birth Weight Infants with Severe Intraventricular Hemorrhage

2021 ◽  
Author(s):  
Santina A. Zanelli ◽  
Maryam Abubakar ◽  
Robert Andris ◽  
Kavita Patwardhan ◽  
Karen D. Fairchild ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Vital Sign ◽  
Intraventricular Hemorrhage ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Cranial Ultrasound ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Arterial Blood

Objective Severe intraventricular hemorrhage (sIVH, grades 3 and 4) is a serious complication for very low birth weight (VLBW) infants and is often clinically silent requiring screening cranial ultrasound (cUS) for detection. Abnormal vital sign (VS) patterns might serve as biomarkers to identify risk or occurrence of sIVH. Study Design This retrospective study was conducted in VLBW infants admitted to two level-IV neonatal intensive care units (NICUs) between January 2009 and December 2018. Inclusion criteria were: birth weight <1.5 kg and gestational age (GA) <32 weeks, at least 12 hours of systemic oxygen saturation from pulse oximetry (SpO2) data over the first 24 hours and cUS imaging. Infants were categorized as early sIVH (sIVH identified in the first 48 hours), late sIVH (sIVH identified after 48 hours and normal imaging in the first 48 hours), and no IVH. Infants with grades 1 and 2 or unknown timing IVH were excluded. Mean heart rate (HR), SpO2, mean arterial blood pressure (MABP), number of episodes of bradycardia (HR < 100 bpm), and desaturation (SpO2 < 80%) were compared. Results A total of 639 infants (mean: 27 weeks' gestation) were included (567 no IVH, 34 early sIVH, and 37 late sIVH). In the first 48 hours, those with sIVH had significantly higher HR compared with those with no IVH. Infants with sIVH also had lower mean SpO2 and MABP and more desaturations <80%. No significant differences in VS patterns were identified in early versus late sIVH. Logistic regression identified higher HR and greater number of desaturations <80% as independently associated with sIVH. Conclusion VLBW infants who develop sIVH demonstrate VS differences with significantly lower SpO2 and higher mean HR over the first 48 hours after birth compared with VLBW infants with no IVH. Abnormalities in early VS patterns may be a useful biomarker for sIVH. Whether VS abnormalities predict or simply reflect sIVH remains to be determined. Key Points

Clinical Outcomes of Renal Pelvis Dilatation in Very Low Birth Weight Infants

Perinatology ◽  
2016 ◽  
Vol 27 (4) ◽  
pp. 244
Author(s):  
Mina Jeon ◽  
Juhyun Jin ◽  
Jeong Eun Shin ◽  
Soon Min Lee ◽  
Ho Seon Eun ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Clinical Outcomes ◽  
Renal Pelvis ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Renal Pelvis Dilatation

scholarly journals Beneficial Effects of Probiotic Treatment on Gut Microbiota in Very Low Birth Weight Infants

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yue-feng Li ◽  
Chuan-rui Zhu ◽  
Xue-lei Gong ◽  
Hui-ling Li ◽  
Li-kuan Xiong ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gut Microbiota ◽  
Very Low Birth Weight ◽  
Secondary Outcome ◽  
Rrna Gene ◽  
Low Birth Weight Infants ◽  
Microbial Composition ◽  
Vlbw Infants ◽  
Probiotic Treatment

The very low birth weight (VLBW) infant is at great risk for marked dysbiosis of the gut microbiota. In the present study, a total of 36 VLBW infants were randomly divided into two groups, who were treated with combined probiotics and placebo, and 72 fecal specimens on days 14 and 28 of life were collected from them. Finally, 32 fecal specimens extracted from 16 preterm VLBW infants were qualified and analyzed using 16S rRNA gene sequencing. The primary outcome was to evaluate the change of gut microbiota in VLBW infants after combined probiotic supplement. The secondary outcome was to analyze the correlation gut microbial composition and levels of cytokines. We found that probiotic treatment, but not placebo, decreased the α-diversity of gut microbiota in VLBW infants. At the phylum level, probiotic treatment strongly increased the abundance of Firmicutes, whereas that of Proteobacteria was significantly reduced. At the family level, Streptococcaceae and Lactobacillaceae became prevalent after probiotic treatment, while the relative abundance of Enterobacteriaceae was reduced in the meantime. Most notably, significant correlations were observed between Lactobacillaceae abundance and serum cytokine levels. Further studies are required to shed more light on the characteristics of gut microbiota of VLBW neonates. And the modulation of microbiota should be considered to improve the survival rate of VLBW infants.

scholarly journals Urinary acute kidney injury biomarkers in very low-birth-weight infants on indomethacin for patent ductus arteriosus

2019 ◽  
Vol 85 (5) ◽  
pp. 678-686 ◽  
Author(s):  
Sina Waldherr ◽  
Alexander Fichtner ◽  
Bernd Beedgen ◽  
Thomas Bruckner ◽  
Franz Schaefer ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Kidney Injury ◽  
Low Birth Weight Infants ◽  
Patent Ductus

Urinary NT-proBNP, NGAL, and H-FABP May Predict Hemodynamic Relevance of Patent Ductus Arteriosus in Very Low Birth Weight Infants

Neonatology ◽  
2012 ◽  
Vol 101 (4) ◽  
pp. 260-266 ◽  
Author(s):  
Veronika Tosse ◽  
Frank Pillekamp ◽  
Pablo Verde ◽  
Berit Hadzik ◽  
Hemmen Sabir ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Low Birth Weight Infants ◽  
Patent Ductus
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