scholarly journals Prevalence of Biochemical Abnormalities in Neonatal Seizures in Term and Preterm Neonates

2020 ◽  
pp. 35-45
Author(s):  
K. M. Vinay ◽  
Goutham Shankargoud Patil ◽  
S. S. Prakash
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Birth Asphyxia ◽  
Categorical Variables ◽  
Preterm Neonates ◽  
Neonatal Seizures ◽  
Biochemical Abnormalities

Background: The most vulnerable period of life to develop seizures is the neonatal period. These events very often signify serious damage or malfunction of the immature developing central nervous system. Neonatal seizures may arise as a result of diverse etiologies and can have varied presentations. Biochemical abnormalities are commonly observed in neonates who are admitted in neonatal intensive care unit with seizures. Early recognition and treatment of biochemical disturbances is essential for optimal management and satisfactory long-term outcome. Objective: To assess clinical types and importance of biochemical abnormalities in neonatal seizures and to evaluate clinical type & time of onset of seizures in term and preterm neonates. Methods: A prospective observational study, where 100 neonates presenting with seizures admitted to neonatal intensive care unit of Jagadguru Jayadeva Murugarajendra Medical College, Davangere, from September 2015 to August 2017 were enrolled in the study. The detailed history along with clinical examination, baseline characteristics of convulsing neonate were recorded at admission. Clinical details of each seizure episode reported by the mother and subsequently observed by the resident doctors on duty were recorded. The relevant biochemical investigations were done immediately after baby had seizures and before instituting any specific treatment. The descriptive statistics such as mean and standard deviation (SD) for continuous variables, frequencies and percentages were calculated for categorical variables. The association between gestational age and other categorical variables were analyzed using chi-square test of independence. The comparison of mean of various quantitative variables was analyzed using ANOVA test. Etiology of neonatal seizures and associated biochemical abnormalities were diagnosed. Results: In the present study, out of 100 neonates studied, 64 were full term of which 49(76.5%) were appropriate for gestational age and 15(23.5%) were small gestational age, whereas 36 cases were preterm. Most neonatal seizures occur in first 3 days of life, i.e. 59%. Most of them occurred on first day of life (34%). Birth asphyxia was the cause of neonatal seizures in 82.35% neonates who developed seizures on day-1 of life. Birth asphyxia and septicemia are common cause of neonatal seizures in our study (38 cases each), followed by pure metabolic disturbances 19%. In pure metabolic seizures, hypoglycemia (47.8%) is most common more in preterm babies (55%) followed by hypocalcemia. In cases of non- metabolic seizures, which showed associated biochemical abnormalities, hypoglycemia was most common abnormality 23 of 52 cases (44.2%). 12 cases (52.1%) are associated with birth asphyxia and 11 cases (47.9%) are associated with septicemia. Subtle seizures were most common type of seizures in our study, followed by focal clonic, multifocal clonic, generalized tonic, subtle with GTC and subtle with clonic. Conclusion: Biochemical abnormalities are common in neonatal seizures and often go unorganized. These abnormalities may significantly contribute to seizure activity correction of these abnormalities work up is necessary for all cases of neonatal seizures.

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>

Electrographic Seizures in Preterm Neonates in the Neonatal Intensive Care Unit

2017 ◽  
Vol 32 (10) ◽  
pp. 880-885 ◽  
Author(s):  
Ersida Buraniqi ◽  
Arnold J. Sansevere ◽  
Kush Kapur ◽  
Ann M. Bergin ◽  
Phillip L. Pearl ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Confidence Interval ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Odds Ratio ◽  
Neonatal Intensive Care ◽  
Preterm Neonates ◽  
Continuous Eeg ◽  
Electrographic Seizures

Objective: Characterize clinical and electroencephalography (EEG) characteristics of preterm neonates undergoing continuous EEG in the neonatal intensive care unit. Methods: Retrospective study of preterm neonates born less than 37 weeks’ gestational age undergoing continuous EEG in the neonatal intensive care unit at Boston Children’s Hospital over a 2-year period. Results: Fifty-two preterms (46% male) had a mean gestational age of 32.8 weeks (standard deviation = 4.17). Seizures were detected in 12/52 (23%), with EEG seizures detected in 4/12 (33%). The median time from EEG to the first seizure was 0.5 hours (interquartile range 0.24-4). Factors associated with seizures were male gender (odds ratio = 4.65 [95% confidence interval = 1.02-21.24], P = .047) and lack of EEG state change (odds ratio = 0.043 [95% confidence interval = 0.005-0.377], P = .04). Conclusion: Twenty-three percent of preterms undergoing continuous EEG had EEG seizures or electrographic seizures with no clear clinical correlate. This confirms recent American Clinical Neurophysiology Society guidelines suggesting that preterm neonates are at high risk for seizures.

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

Early Arterial Lactate and Prediction of Outcome in Preterm Neonates Admitted to a Neonatal Intensive Care Unit

2003 ◽  
Vol 83 (3) ◽  
pp. 171-176 ◽  
Author(s):  
Floris Groenendaal ◽  
Caroline Lindemans ◽  
Cuno S.P.M. Uiterwaal ◽  
Linda S. de Vries
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Preterm Neonates ◽  
Prediction Of Outcome ◽  
Arterial Lactate

scholarly journals Incidence and Characteristics of Infants with Retinopathy of Prematurity in Croatia

2018 ◽  
Vol 1 (1) ◽  
pp. 35-45
Author(s):  
Mirjana Vucinovic ◽  
Ljubo Znaor ◽  
Ana Vucinovic ◽  
Vesna Capkun ◽  
Julijana Bandic
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Small For Gestational Age ◽  
Neonatal Intensive Care ◽  
Type 1 Rop

PURPOSE: To study the incidence of retinopathy of prematurity (ROP) in a neonatal intensive care unit in Croatia and obtain information on risk factors associated with ROP. There have been limited studies on ROP in Croatia where the screening for ROP and its treatment is still insufficient and not introduced in many intensive care units. MATERIAL AND METHODS: This retrospective study included 247 premature infants admitted to the neonatal intensive care unit of University Hospital Split, over a 5-year period between January 2012, and December 2016. In this paper the relationship between clinical risk factors and the development of ROP was analyzed. RESULTS: The overall incidence for ROP was 23,9 % (59 infants), for Type 1 ROP was 9,3% (23 infants); for Type 2 ROP was 14,6% (36 infants). Median gestational age (GA) and birthweight (BW) were significantly lower among infants with ROP versus those without ROP (29: 23-34 vs. 31: 23-34,p<0,001 and 1,180:630-2,000 vs. 1485:590-2000, p<0,001 respectively). Multivariate analysis showed that only BW (p=0,029) and small for gestational age (SGA) (p=0,045) predicted the development of ROP. CONCLUSION: Birth weight and small for gestational age were the most significant risk factors for developing ROP. In comparison with studies from highly developed countries, infants with a much wider range of gestational age and birth weights are developing Type 1 ROP. 

scholarly journals Profile of newborns discharged from the intensive neonatal care unit submitted to the kangaroo ward

2017 ◽  
Vol 4 (3) ◽  
pp. 685
Author(s):  
Karla Camila Lima de Souza ◽  
ANNY Caroline Ferreira de Carvalho ◽  
Natália Maria Chagas Evangelista ◽  
Magnely Moura do Nascimento ◽  
Andrea Stopiglia Guedes Braide ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Apgar Score ◽  
Neonatal Intensive Care ◽  
Cost Effective ◽  
Kangaroo Care ◽  
Microsoft Excel ◽  
Neonatal Care Unit

Background: Describe the profile of newborns discharged from the neonatal intensive care unit (NICU) sent to a kangaroo ward and their neonatal variables.Methods: Retrospective and documentary study with a quantitative approach, performed at the General Hospital César Cals, whose sample consisted of 30 charts. The following variables were analyzed: weight, gestational age, Apgar score, gender, race, adequacy of the pregnancy and assistance provided in the NICU and kangaroo ward. The variables were analyzed using Microsoft Excel® 2010 program to obtain percentages.Results: There was a prevalence of extremely premature infants with high underweight and small size for the gestational age, male gender and browns, with Apgar score at 1st and 5th minutes more than 7, born by cesarean section, who used mechanical ventilation and surfactant, with prevalence of respiratory distress syndrome, with admission weight in Kangaroo ward less than 1.250g, making use of exclusive breast milk, who were attended by physiotherapy and with weight less than 1.600g at discharge, of the variables studied.Conclusions: Kangaroo care is an excellent cost-effective model for the newborn coming from the neonatal intensive care unit.

scholarly journals Beginning to See the Light: Lessons Learned From the Development of the Circadian System for Optimizing Light Conditions in the Neonatal Intensive Care Unit

2021 ◽  
Vol 15 ◽  
Author(s):  
Esther M. Hazelhoff ◽  
Jeroen Dudink ◽  
Johanna H. Meijer ◽  
Laura Kervezee
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Clinical Outcomes ◽  
Neonatal Intensive Care ◽  
Circadian System ◽  
Lessons Learned ◽  
Preterm Neonates ◽  
Negative Effects ◽  
Beneficial Effects

The circadian timing system optimizes health by temporally coordinating behavior and physiology. During mammalian gestation, fetal circadian rhythms are synchronized by the daily fluctuations in maternal body temperature, hormones and nutrients. Circadian disruption during pregnancy is associated with negative effects on developmental outcomes in the offspring, highlighting the importance of regular and robust 24-h rhythms over gestation. In the case of preterm birth (before 37 weeks of gestation), maternal cues no longer synchronize the neonate’s circadian system, which may adversely affect the neonate. There is increasing evidence that introducing robust light-dark cycles in the Neonatal Intensive Care Unit has beneficial effects on clinical outcomes in preterm infants, such as weight gain and hospitalization time, compared to infants exposed to constant light or constant near-darkness. However, the biological basis for these effects and the relationship with the functional and anatomical development of the circadian system is not fully understood. In this review, we provide a concise overview of the effects of light-dark cycles on clinical outcomes of preterm neonates in the NICU and its alignment with the development of the circadian system.

scholarly journals Neonatal admission from emergency department

2020 ◽  
Vol 7 (1) ◽  
pp. 117-120
Author(s):  
Sitaram Shrestha
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Birth Asphyxia ◽  
Vulnerable Period ◽  
Common Causes

Neonatal period is a vulnerable period of life. In Nepal, most common causes of newborn admission in the neonatal intensive care unit (NICU) are birth asphyxia, neonatal sepsis. This study explores the diseases with which 131 neonates were admitted from emergency department. Sepsis was the main cause of admission, followed by pneumonia.

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