Hepatic Lesions of Total Parenteral Nutrition (Tpn) Secondary to Umbilical Venous Catheter (Uvc) Malposition in A Very Low-Birth Weight Infant in China

Umbilical vein catheterization (UVC) is a common operation for vascular access in preterm infants. However, there are complications associated with their use. We here a case of extravasation of the fluids due to misplacement of the catheter causing hepatic collection of TPN in a very low-birth weight preterm (VLBW) infant.

Hepatic Lesions of Total Parenteral Nutrition (Tpn) Secondary to Umbilical Venous Catheter (Uvc) Malposition in A Very Low-Birth Weight Infant in China

Umbilical vein catheterization (UVC) is a common operation for vascular access in preterm infants. However, there are complications associated with their use. We here a case of extravasation of the fluids due to misplacement of the catheter causing hepatic collection of TPN in a very low-birth weight preterm (VLBW) infant.

The Association Between Very Premature Infant Body Temperatures Over Time and Respiratory Care

Background: Due to global immaturity, very low birthweight (VLBW) infants (<1,500 g) require auxiliary thermal and respiratory care. However, the impact of respiratory care on infant thermal stability remains unclear. Aims: Examine the association between VLBW infant body temperatures over time and respiratory support type (mechanical ventilation (MV), continuous positive airway pressure (CPAP), room air (RA)), respiratory care interventions, and nursing care. Design: Exploratory, longitudinal, and correlational design. Subjects: 12 infants <29 weeks’ gestation (median = 27.1, 25.9–27.9) and <1,200 g (median = 865 g, 660–1,050 g). Measurements: Minute-to-minute body temperatures and continuous video data were collected over the first 5 days of life. Video data was coded with Noldus Observer®XT software. Respiratory support was retrieved from the electronic health record. Hierarchical multi-level, mixed-effects models for intensive longitudinal data examined the associations. Results: Body temperatures were associated with respiratory support type, respiratory care, and care events (all p < .0001). Pairwise comparison found significant differences in body temperatures between all respiratory support types (all p < .0001). The covariate-adjusted risk of hypothermia (<36.5 °C) was significantly greater during MV vs. RA ( aOR = 2.6); CPAP vs. MV ( aOR = 1.2); CPAP vs RA ( aOR = 3.1); respiratory care vs. other types of care (aOR = 1.5); care event vs. closed portholes ( aOR = 2.6). Conclusion: Our results found an association between VLBW infant thermal instability and respiratory support type, respiratory care, and care events. Larger studies with advanced longitudinal analysis are needed to assess the causal impact of these interventions on infant temperatures over time, as well as the implications of longitudinal thermal instability on infant outcomes.

Breast Milk Quality Improvement Bundle for Very Low Birth Weight Neonates

Purpose: To assess the effect of a quality improvement (QI) bundle on improving breast milk output among very low birth weight (VLBW) mothers. Design: Before and after nonrandomized QI project. Sample: Mothers who delivered a VLBW infant in October and November 2015 were the prospective cohort. Those who delivered a VLBW infant in August and September 2015 were the retrospective cohort. The QI bundle consisted of early expression of milk, use of breast pumps, frequent expressions, videos, and regular counseling. This bundle was done for the prospective cohort. Outcomes measures: Quantity of expressed breast milk on day 7. Results: There were 13 mothers in the retrospective cohort and 18 mothers in the prospective one. The mean birth weight (1297.80 and 1207.70 g, p = .19) and gestation (32.5 and 31.5 wk, p = .27) were similar. There was a significant increase in the milk output on day 7 in the prospective group 113.6 ± 45 vs 182 ± 63 mL (p = .001).