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Neonatal parenteral nutrition

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https://www.readbyqxmd.com/read/29217722/successfully-implementing-and-embedding-guidelines-to-improve-the-nutrition-and-growth-of-preterm-infants-in-neonatal-intensive-care-a-prospective-interventional-study
#1
Mark J Johnson, Alison A Leaf, Freya Pearson, Howard W Clark, Borislav D Dimitrov, Catherine Pope, Carl R May
OBJECTIVES: We aimed to improve the nutritional care of preterm infants by developing a complex (multifaceted) intervention intended to translate current evidence into practice. We used the sociological framework of Normalization Process Theory (NPT), to guide implementation in order to embed the new practices into routine care. DESIGN: A prospective interventional study with a before and after methodology. PARTICIPANTS: Infants <30 weeks gestation or <1500 g at birth...
December 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/29198897/the-idle-central-venous-catheter-in-the-nicu-when-should-it-be-removed
#2
Cristen N Litz, Jordan G Tropf, Paul D Danielson, Nicole M Chandler
PURPOSE: There is debate regarding the optimal timing of central line removal in the neonatal intensive care unit (NICU). The purpose was to evaluate outcomes of idle peripherally inserted central catheters (PICCs) and tunneled central venous catheters (TCVCs) and determine the incidence of line-related infections and replacements. METHODS: Patients in the NICU with T-CVCs placed between 11/2008 and 8/2015 (n=134) or PICCs placed between 7/2013 and 10/2015 (n=467) were included...
November 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29198532/impact-of-prolonged-mechanical-ventilation-in-very-low-birth-weight-infants-results-from-a-national-cohort-study
#3
Young-Bin Choi, Juyoung Lee, Jisun Park, Yong Hoon Jun
OBJECTIVE: To evaluate the in-hospital consequences of prolonged respiratory support with invasive mechanical ventilation in very low birth weight infants. STUDY DESIGN: A cohort study was performed using prospectively collected data from 69 neonatal intensive care units participating in the Korean national registry. In total, 3508 very low birth weight infants born between January 1, 2013 and December 31, 2014 were reviewed. RESULTS: The adjusted hazard ratio for death increased significantly for infants who received mechanical ventilation for more than 2 weeks compared with those were mechanically ventilated for 7 days or less...
November 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29184590/the-impact-of-an-educational-program-regarding-total-parenteral-nutrition-on-infection-indicators-in-neonates-admitted-to-the-neonatal-intensive-care-unit
#4
Maryam Marofi, Nahid Bijani, Zahra Abdeyazdan, Behzad Barekatain
Background: One of the basic care measures for preterm infants is providing nutrition through total parenteral nutrition (TPN) and one of the most important complications of it is infection. Because prevention of nosocomial infections is an important issue for neonate's safety, this study aimed to determine the effects of a continuing medical education (CME) course on TPN for neonatal intensive care unit (NICU) nurses on indicators of infection in newborns. Materials and Methods: This quasi-experimental study was conducted on 127 neonates who fulfilled the inclusion criteria...
November 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/29172239/strictly-controlled-glucose-infusion-rates-are-associated-with-a-reduced-risk-of-hyperglycaemia-in-extremely-low-birth-weight-preterm-infants
#5
Hans Jorgen Stensvold, Astri M Lang, Kenneth Strommen, Tore G Abrahamsen, Bjorn Ogland, Are H Pripp, Arild E Ronnestad
AIM: We evaluated a strict strategy that aimed to avoid fluctuations in glucose infusion rates (GIRs) and assessed the independent effects of maximal daily GIRs on the hyperglycaemia risk among extremely low birth weight (ELBW) infants receiving early enhanced parenteral nutrition. METHODS: This study comprised all ELBW infants admitted to the neonatal intensive care unit of Oslo University Hospital Rikshospitalet, Norway before (2007-2009) and after (2012-2013) implementing a strict GIR strategy...
November 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29144406/evaluating-differences-in-aluminum-exposure-through-parenteral-nutrition-in-neonatal-morbidities
#6
Megan Fortenberry, Lela Hernandez, Jacob Morton
Aluminum is a common contaminant in many components of parenteral nutrition, especially calcium and phosphate additives. Although long-term effects have been described in the literature, short-term effects are not well-known. Currently, the Food and Drug Administration recommends maintaining aluminum at <5 mcg/kg/day. This was a single center, retrospective case-control study of 102 neonatal intensive care unit patients. Patients were included if they had a diagnosis of necrotizing enterocolitis, rickets/osteopenia, or seizures and received at least 14 days of parenteral nutrition...
November 16, 2017: Nutrients
https://www.readbyqxmd.com/read/29132456/-incidence-of-late-onset-sepsis-in-very-low-birth-weight-and-extremely-low-birth-weight-infants-and-risk-factors-for-late-onset-sepsis
#7
Xiao-Peng Zhao, Wei Zhou, Xu-Fang Li, Yan-Yan Song, Ting-Yan Zhang, Hong Liang
OBJECTIVE: To investigate the incidence of late-onset sepsis (LOS) in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU) and the risk factors for LOS. METHODS: A retrospective analysis was performed for the clinical data of all VLBW and ELBW infants who were hospitalized in the NICU between January 2011 and December 2013. According to the presence or absence of LOS, these infants were divided into LOS group and non-LOS group...
November 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29131014/early-nutrition-and-growth-until-the-corrected-age-of-2-years-in-extremely-preterm-infants
#8
Henni Hiltunen, Eliisa Löyttyniemi, Erika Isolauri, Samuli Rautava
BACKGROUND: Extremely preterm birth is associated with a high risk of extrauterine growth retardation, which has been linked with adverse developmental outcomes. OBJECTIVE: We investigated whether nutritional management during the first 7 days of life affects growth patterns until the corrected age of 2 years in extremely preterm infants. STUDY DESIGN: A retrospective study of 78 extremely preterm (<28 weeks' gestation) neonates was conducted...
November 10, 2017: Neonatology
https://www.readbyqxmd.com/read/29072041/epidemiology-of-serratia-marcescens-infections-in-nicu-of-a-teaching-and-research-hospital-in-northern-italy
#9
Elisa Buttinelli, Ilaria Ardoino, Giulia Domeniconi, Monica Lanzoni, Lorenza Pugni, Andrea Ronchi, Fabio Mosca, Elia Biganzoli, Silvana Castaldi
BACKGROUND: Serratia marcescens (Sm) is a known cause of infection and colonization in neonates receiving intensive care. The aim of this study was to identify the risk factors for colonization and infection with Sm in Neonatal Intensive Care Unit (NICU) of a tertiary care Hospital. METHODS: A casecontrol study was conducted from January to December 2011 in neonates admitted to the NICU. Cases are patients with a microbiologically confirmed infection or colonization, controls were randomly chosen among patients admitted to the same NICU...
October 25, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/29045957/-clinical-characteristics-of-neonatal-fungal-sepsis-in-neonatal-intensive-care-unit
#10
X Zhang, X F Ru, Y Wang, X Li, T Sang, Q Feng
OBJECTIVE: To study the characteristics of neonatal fungal sepsis and the difference between bacterial sepsis and fungal sepsis. To improve the understanding of neonatal fungal sepsis. METHODS: Clinical data of neonatal fungal sepsis in neonatal intensive care unit (NICU) were collected from 2011 to 2016 in Peking University first Hospital. The clinical characteristics were analyzed retrospectively. The difference between neonatal fungal sepsis and bacterial sepsis was also analyzed...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29030727/-parenteral-nutrition-in-premature-babies-with-a-birth-weight-1500g-a%C3%A2-systematic-single-center-analysis-and-comparison-with-current-guidelines
#11
Melanie Sirch, Martin Poryo, Mona Butte, Ulrike Lindner, Ludwig Gortner, Michael Zemlin, Holger Nunold, Sascha Meyer
BACKGROUND: Parenteral and enteral nutrition are essential for both growth and development of preterm infants. Based on the results of many studies, the rate of nutritional growth and the amount of substrate delivered parenterally are under debate. OBJECTIVE: The main aim of this study was to assess parenteral nutrition in very and extremely immature preterm infants, i.e. very low birth weight (VLBW, birth weight <1500g) and extremely low birth weight (ELBW, birth weight <1000g) neonates, and to compare the amount of parenterally delivered substrate in our neonatal intensive care unit (NICU) to current German guidelines...
October 13, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28986615/perforations-associated-with-peripherally-inserted-central-catheters-in-a-neonatal-population
#12
Andrew J Sertic, Bairbre L Connolly, Michael J Temple, Dimitri A Parra, Joao G Amaral, Kyong-Soon Lee
BACKGROUND: Peripherally inserted central catheters (PICCs) are increasingly used in neonates but perforations can result in devastating complications such as pericardial and pleural effusions. Identifying risk factors may guide surveillance and reduce morbidity and mortality. OBJECTIVE: To determine the risk factors for PICC perforation in neonates. MATERIALS AND METHODS: Retrospective case:control (1:2) study of neonates admitted between 2004-2014...
October 6, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28969546/igf-1-as-a-drug-for-preterm-infants-a-step-wise-clinical-development
#13
Ann Hellstrom, David Ley, Boubou Hallberg, Chatarina Lofqvist, Ingrid Hansen-Pupp, Luca A Ramenghi, Jan Borg, Lois E H Smith, Anna-Lena Hard
BACKGROUND: Insulin-like growth factor 1 (IGF-1) is a mitogenic hormone involved in many processes such as growth, metabolism, angiogenesis and differentiation. After very preterm birth, energy demands increase while maternal supplies of nutrients and other factors are lost and the infant may become dependent on parenteral nutrition for weeks. Low postnatal IGF-1 concentrations in preterm infants are associated with poor weight gain, retinopathy of prematurity (ROP) and other morbidities...
October 2, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28964639/early-continuous-renal-replacement-therapy-improves-nutrition-delivery-in-neonates-during-extracorporeal-life-support
#14
Heidi J Murphy, John B Cahill, Katherine E Twombley, James R Kiger
OBJECTIVE: Optimizing nutrition in neonatal patients as soon as possible after extracorporeal life support (ECLS) initiation is imperative as malnutrition can worsen both short- and long-term outcomes. Fluid restriction, used to manage the fluid overload that commonly complicates neonatal ECLS, severely impairs nutrition delivery. Continuous renal replacement therapy (CRRT) can be used to help manage fluid overload. We hypothesize that early CRRT utilization ameliorates the need for fluid restriction and allows providers to prescribe higher parenteral nutrition (PN) volumes leading to better nutrition delivery...
September 27, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28948952/efficacy-of-metformin-in-improving-glycaemic-control-perinatal-outcome-in-gestational-diabetes-mellitus-a-non-randomized-study
#15
Neeta Singh, Malti Madhu, Perumal Vanamail, Nisha Malik, Sunesh Kumar
BACKGROUND & OBJECTIVES: Gestational diabetes mellitus (GDM) can cause adverse perinatal outcome if not treated. Although insulin therapy has been the main treatment modality over decades but considering its cost and parenteral mode of administration, it does not seem to be appropriate, especially in low-resource settings. The objective of this study was to evaluate the role of metformin in GDM and know its efficacy as well as adverse effect on foetus and mother. METHODS: All pregnant women with GDM who were not controlled on medical nutrition therapy and required metformin therapy were included in the study...
May 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28947324/outcomes-of-gastroschisis-early-delivery-a-systematic-review-and-meta-analysis
#16
Rachel M Landisch, Ziyan Yin, Melissa Christensen, Aniko Szabo, Amy J Wagner
BACKGROUND/PURPOSE: Elective preterm delivery (EPD) of a fetus with gastroschisis may prevent demise and ameliorate intestinal injury. While the literature on optimal timing of delivery varies, we hypothesize that a potential benefit may be found with EPD. METHODS: A meta-analysis of publications describing timing of delivery in gastroschisis from 1/1990 to 8/2016 was performed, including studies where either elective preterm delivery (group 1, G1) or preterm gestational age (GA) (group 2, G2) were evaluated against respective comparators...
September 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28912010/first-week-weight-dip-and-reaching-growth-targets-in-early-life-in-preterm-infants
#17
Jorine A Roelants, Koen F M Joosten, Brigitte M A van der Geest, Jessie M Hulst, Irwin K M Reiss, Marijn J Vermeulen
BACKGROUND & AIMS: Aggressive parenteral nutritional practices were implemented in clinical practice over a decade ago to prevent early growth retardation in preterm infants. We aimed to study adherence to current nutritional recommendations in a population of very preterm infants, and to evaluate growth in early life. METHODS: Preterm infants (gestational age <30 weeks and birth weight <1500 g) were included in a prospective observational cohort study. Data on parenteral and enteral intake were collected on days 1-7, 14, 21 and 28 (d28) of life...
August 31, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28887930/pediatric-extracorporeal-membrane-oxygenation
#18
REVIEW
Christopher Loren Jenks, Lakshmi Raman, Heidi J Dalton
Extracorporeal life support is a modified form of cardiopulmonary bypass. Experience in extracorporeal membrane oxygenation (ECMO) has come largely from the neonatal population. Most centers have transitioned the ECMO pumps from roller pumps to centrifugal technology. Modes of support include venovenous for respiratory support and venoarterial for cardiac support. "Awake" ECMO is the trend with extubation and tracheostomy on the rise. Fluid overload is common and managed with diuretics or hemofiltration. Nutrition is important and provided enterally or via total parenteral nutrition...
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28884129/candidemia-in-the-neonatal-intensive-care-unit-a-retrospective-observational-survey-and-analysis-of-literature-data
#19
Giuseppina Caggiano, Grazia Lovero, Osvalda De Giglio, Giovanna Barbuti, Osvaldo Montagna, Nicola Laforgia, Maria Teresa Montagna
We evaluated the epidemiology of Candida bloodstream infections in the neonatal intensive care unit (NICU) of an Italian university hospital during a 9-year period as a means of quantifying the burden of infection and identifying emerging trends. Clinical data were searched for in the microbiological laboratory database. For comparative purposes, we performed a review of NICU candidemia. Forty-one candidemia cases were reviewed (overall incidence, 3.0 per 100 admissions). Candida parapsilosis sensu stricto (58...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28872714/microbial-epidemiology-of-candidemia-in-neonatal-and-pediatric-intensive-care-units-at-children-s-medical-center-tehran
#20
Arezu Charsizadeh, Hossein Mirhendi, Bahram Nikmanesh, Hamid Eshaghi, Koichi Makimura
Invasive candidiasis is a major cause of morbidity and mortality in children. However, limited data is available on the epidemiology of this infection in pediatric settings in Iran. The aim of the present study was to determine the prevalence, microbial epidemiology, risk factors, and clinical outcomes associated with candidemia in intensive care units at Children's Medical Center, Tehran, Iran. All blood and other normally sterile specimen cultures positive for Candida species, were included. Isolates were identified by morphological and molecular methods...
September 5, 2017: Mycoses
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