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Neonatal parenteral nutrition

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https://www.readbyqxmd.com/read/28444360/role-of-early-onset-neutropenia-in-development-of-candidemia-in-premature-infants
#1
Nermin Ramy, Mohamed Hashim, Heba Abou Hussein, Happy Sawires, Maha Gaafar, Ayat El Maghraby
Background: The aim of the study was to assess the effect of early-onset neutropenia (EON) on the development of candidemia in premature infants and evaluate other risk factors. Materials and Methods: This prospective study was carried out in a neonatal intensive care unit of Cairo University Hospital. Fifty neutropenic premature infants were matched to 50 non-neutropenics. Subjects were then regrouped into candidemics and non-candidemics to study other risk factors such as central venous catheters, mechanical ventilation, parenteral nutrition, drugs as corticosteroids and others...
April 24, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28443816/segmental-volvulus-in-the-neonate-a-particular-clinical-entity
#2
Naziha Khen-Dunlop, Sylvie Beaudoin, Blandine Marion, Véronique Rousseau, Agnes Giuseppi, Muriel Nicloux, David Grevent, Laurent J Salomon, Yves Aigrain, Alexandre Lapillonne, Sabine Sarnacki
BACKGROUND: Complete intestinal volvulus is mainly related to congenital anomalies of the so-called intestinal malrotation, whereas segmental volvulus appears as a distinct entity, mostly observed during the perinatal period. Because these two situations are still lumped together, the aim of this study was to describe the particular condition of neonatal segmental volvulus. STUDY DESIGN: We analyzed the circumstances of diagnosis and management of 17 consecutives neonates operated for segmental volvulus more than a 10-year period in a single institution...
March 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28443560/advances-in-nutrition-of-the-newborn-infant
#3
REVIEW
Jane E Harding, Barbara E Cormack, Tanith Alexander, Jane M Alsweiler, Frank H Bloomfield
Nutrition of newborn infants, particularly of those born preterm, has advanced substantially in recent years. Extremely preterm infants have high nutrient demands that are challenging to meet, such that growth faltering is common. Inadequate growth is associated with poor neurodevelopmental outcomes, and although improved early growth is associated with better cognitive outcomes, there might be a trade-off in terms of worse metabolic outcomes, although the contribution of early nutrition to these associations is not established...
April 22, 2017: Lancet
https://www.readbyqxmd.com/read/28440869/massive-pleural-effusion-on-the-contralateral-side-of-a-venous-peripherally-inserted-central-catheter
#4
Selim Sancak, Abdulhamit Tuten, Tulin Gokmen Yildirim, Guner Karatekin
A preterm newborn infant, delivered at 30 weeks of gestation and 965 g birth weight, developed respiratory distress with resistant hypoxia after a central catheter line was inserted via the right venae brachialis on postnatal day 21. Left-sided massive pleural effusion, collapsed left lung with air bronchograms, and bidirectional shunting through reopened ductus arteriosus were detected by targeted neonatal echocardiography. Hydrothorax was drained under sonographic guidance, producing a milky-white fluid biochemically compatible with parenteral nutrition...
April 25, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28431170/early-total-enteral-feeding-in-stable-very-low-birth-weight-infants-a-before-and-after-study
#5
Sushma Nangia, Amit Bishnoi, Ankita Goel, Piali Mandal, Soumya Tiwari, Arvind Saili
Background: Fear of necrotizing enterocolitis (NEC) has perpetuated delayed initiation and slow advancement of enteral feeding in very low birth weight (VLBW) infants with inherent risks of parenteral alimentation. The objective of this study was to assess effect of early total enteral feeding (ETEF) on day of achievement of full enteral feeds, feed intolerance, NEC and sepsis. Methods: In total, 208 stable VLBW neonates (28-34 weeks) admitted during 6 month periods of three consecutive years were enrolled...
April 18, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28412957/pattern-of-drug-use-among-preterm-neonates-results-from-an-italian-neonatal-intensive-care-unit
#6
A Girardi, S Galletti, E Raschi, A Koci, E Poluzzi, G Faldella, F De Ponti
BACKGROUND: Drug use in preterm neonates admitted to Neonatal Intensive Care Unit (NICU) has been investigated, so far, in terms of unauthorized or off-label use; very little is known on the use of combinations of different active substances, which is frequently required in this population (prophylaxis of infections, treatment of concomitant diseases). The aim of this study was to describe the most common patterns of drug use in an Italian NICU, focusing on those with nephrotoxic potential...
April 17, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28405492/a-rare-complication-of-central-venous-catheter-extravasation-in-a-preterm-neonate-hemidiaphragmatic-paralysis
#7
C Hobson, D Dubillot, H Lardy, D Sirinelli, E Saliba, E Lopez
We report a case of a preterm neonate born at 26 weeks' of gestation diagnosed with unilateral diaphragmatic paralysis. This paralysis was a consequence of a phrenic nerve injury due to extravasation of hyperosmolar parenteral nutrition fluid in the upper thorax. Chest X-rays and ultrasonography confirmed the diagnosis. The neonate was treated with prolonged respiratory support and did not require surgical treatment. This report describes a case of hemidiaphragmatic paralysis as a complication of central venous catheter insertion...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28393010/successful-treatment-of-familial-congenital-chylothorax-by-ligation-of-the-thoracic-duct-a-case-report
#8
Leopoldini Dori, Eleftherios Smaropoulos, Georgios Tagarakis, Christophoros N Foroulis, Paul Zarogoulidis, Haidong Huang, Bai Chong, Wolfgang Hohenforst-Schmidt, George Tsikopoulos
A full term boy was admitted with respiratory distress in the fourth week of his life due to spontaneous chylothorax in his right hemithorax. Spontaneous chylothorax occurred previously in a first cousin of the neonate establishing that way the final diagnosis of familial idiopathic congenital pneumothorax. Failure of the conservative treatment consisting of chest tube drainage, discontinuation of oral diet and administration of total parenteral nutrition in combination with octreotide for one month was followed by the successful ligation of the thoracic duct through a right thoracotomy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28378134/pediatric-short-bowel-syndrome-and-subsequent-development-of-inflammatory-bowel-disease-an-illustrative-case-and-literature-review
#9
Katherine J Baxter, Jahnavi K Srinivasan, Thomas R Ziegler, Tanvi Dhere, Richard R Ricketts, Megan M Durham
Short bowel syndrome (SBS) in neonates is an uncommon but highly morbid condition. As SBS survival increases, physiologic complications become more apparent. Few reports in the literature elucidate outcomes for adults with a pediatric history of SBS. We present a case report of a patient, born with complicated gastroschisis resulting in SBS at birth, who subsequently developed symptoms and pathologic changes of inflammatory bowel disease (IBD) as an adult. The patient lived from age 7, after a Bianchi intestinal lengthening procedure, to age 34 independent of parenteral nutrition (PN), but requiring hydration fluid via G-tube...
April 4, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28376891/prevention-of-neonatal-late-onset-sepsis-a-randomised-controlled-trial
#10
Gary Alcock, Helen G Liley, Lucy Cooke, Peter H Gray
BACKGROUND: Late-onset sepsis (LOS), defined as sepsis occurring after 48 h of age causes substantial mortality and morbidity in very low birth weight infants. Risk factors for LOS include immaturity, intravascular catheters, mechanical ventilation, and prolonged parenteral nutrition (PN). Little attention has been paid to studying the effects of PN administration methods. The aim of the study was to compare a bundle of measures for PN line management incorporating a strict aseptic technique with standard line management on LOS in very low birth weight infants...
April 4, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28369652/early-versus-late-enteral-feeding-in-preterm-intrauterine-growth-restricted-neonates-with-antenatal-doppler-abnormalities-an-open-label-randomized-trial
#11
Vishal Vishnu Tewari, Sachin Kumar Dubey, Reema Kumar, Shakti Vardhan, C M Sreedhar, Girish Gupta
Background of the study: Enteral feeding in preterm neonates with intrauterine growth restriction (IUGR) and absent or reversed end diastolic flow (AREDF) on umbilical artery (UA) Doppler is delayed owing to an increased risk of necrotizing enterocolitis (NEC). Delaying enteral feeding with longer duration of parenteral nutrition (PN) carries an increased risk of sepsis. Objectives: To study early versus late feeding in preterm IUGR neonates for time required to attain sufficient feed volume to discontinue PN and increased risk of NEC or feed intolerance (FI)...
March 24, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28342580/evidence-based-management-of-chylothorax-in-infants
#12
Joseph T Church, Alexis G Antunez, Ashley Dean, Niki Matusko, Kristopher B Deatrick, Mohammad A Attar, Samir K Gadepalli
PURPOSE: Management guidelines for infants with chylothorax lack substantial evidence. We sought to identify variables that impact outcomes in these patients in order to develop an evidence-based management algorithm. METHODS: We retrospectively reviewed the medical records of all infants diagnosed with chylothorax from June 2005 to December 2014 at our institution. Data collected included demographics, chest tube output (CTO), medical and dietary interventions, surgical procedures, and absolute lymphocyte count (ALC)...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28337935/a-novel-approach-in-the-treatment-of-neonatal-gastroschisis-a-review-of-the-literature-and-a-single-center-experience
#13
Vito Briganti, Daniela Luvero, Caterina Gulia, Roberto Piergentili, Simona Zaami, Elsa Laura Buffone, Cristina Vallone, Roberto Angioli, Claudio Giorlandino, Fabrizio Signore
Gastroschisis is a congenital abdominal wall defect and its management remains an issue. We performed a review of the literature to summarize its evaluation, management and outcome and we describe a new type of surgical reduction performed in our center without anesthesia (GA), immediately after birth, in the delivery room. Between January 2002 and March 2013, we enrolled all live born infants with gastroschisis referred to the third level Division of Obstetrics and Gynecology "San Camillo" of Rome.Two groups of infants were identified: group 1 in which gastroschis reduction was performed by the traditional technique and group 2 in which reduction was immediately performed after birth in the delivery room without GA...
March 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28323667/central-venous-access-in-children-indications-devices-and-risks
#14
Guillermo Ares, Catherine J Hunter
PURPOSE OF REVIEW: Central venous catheters (CVCs) have a prominent role in the diagnostic and therapy of neonates and children. Herein, we describe the multiple indications for CVC use and the different devices available for central venous access. Given the prevalent use of CVCs, healthcare systems are focused on reducing complications from their use, particularly central line-associated bloodstream infections (CLABSIs). The most up-to-date information available sheds light on best practices and future areas of investigation...
March 18, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28304321/calcium-chloride-in-neonatal-parenteral-nutrition-a-15-year-experience
#15
R K Huston, J W Kaempf, M Wang, L Wang, Gary L Grunkemeier, Howard S Cohen
OBJECTIVE: The objective of this study was to determine if outcomes at our neonatal intensive care units (NICUs) since we began using calcium chloride (CaCl2) as our preferred calcium additive in order to reduce aluminum (Al) exposure are within expected outcome ranges for NICUs in the U.S. where calcium gluconate in glass vials (CaGlu-Gl) has been the preferred additive. STUDY DESIGN: A retrospective study of very low birth weight infants born between January 1, 2000 and December 31, 2014...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28222962/safety-of-parenteral-nutrition-in-newborns-results-from-a-nationwide-prospective-cohort-study
#16
Alexandre Lapillonne, Marie-Pierre Berleur, Yvette Brasseur, Sophie Calvez
BACKGROUND & AIMS: Limited or delayed availability of parenteral nutrition (PN) solutions, as well as difficulties in ordering are often identified as reasons for non-compliance with international guidelines in newborns. This study aims at assessing the modality of use and safety of premixed standardized PN solutions in a nationwide prospective cohort of newborns treated in clinical practice. METHODS: Two premixed fixed formulations with respective osmolarity of 715 and 790 mOsm/L specifically designed for neonates were made available throughout the country for clinical use from birth onwards...
February 8, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28203330/risk-factors-for-health-care-associated-bloodstream-infections-in-a-neonatal-intensive-care-unit
#17
Sabahattin Ertugrul, Fesih Aktar, Ilyas Yolbas, Ahmet Yilmaz, Bilal Elbey, Ahmet Yildirim, Kamil Yilmaz, Recep Tekin
BACKGROUND: Healthcare-associated bloodstream infections (HCA-BSI) are a major cause of morbidity and mortality in neonatal intensive care units (NICUs). OBJECTIVES: We aimed to determine the causative organisms and risk factors of HCA-BSIs in NICUs. METHODS: This study was performed between January 2011 and December 2014 in the neonatal intensive care unit of Dicle university, Turkey. The study consisted of 126 patients (infected group) with positive blood culture and 126 randomly selected patients (uninfected control group) with negative blood culture after four days of hospitalization...
October 2016: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/28135431/retrospective-dual-center-study-of-parenteral-nutrition-associated-cholestasis-in-premature-neonates
#18
Weihui Yan, Li Hong, Ying Wang, Yi Feng, Lina Lu, Yijing Tao, Jiang Wu, Huijuan Ruan, Qingya Tang, Wei Cai
BACKGROUND: The pathogenesis of parenteral nutrition-associated cholestasis (PNAC) has not been clarified. The objective of this study was to explore the incidence of PNAC in premature infants without surgery and to identify associated risk factors. MATERIALS AND METHODS: Premature neonates who received parenteral nutrition (PN) at least 14 days were included in a retrospective, dual-center study. Cholestasis was diagnosed as conjugated bilirubin ≥2 mg/dL. Infants with metabolic liver disease, cyanotic congenital heart disease, congenital syphilis, hepadnaviridae infection, and those who underwent surgery were excluded...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28129045/emerging-clinical-benefits-of-new-generation-fat-emulsions-in-preterm-neonates
#19
Gregory Guthrie, Muralidhar Premkumar, Douglas G Burrin
Soybean oil-based intravenous fat emulsions (IVFEs) have been the predominant parenteral nutrition IVFE used in the United States for neonates over the past 45 years. Even though this emulsion has proven useful in supplying infants with energy for growth and essential fatty acids, there have been concerns over its composition in the development of several morbidities, ranging from sepsis to liver disease, bronchopulmonary dysplasia, and impaired neurodevelopment and growth. The exact mechanisms that drive these morbidities in preterm infants are multifactorial, but potential contributors include high omega-6 (n-6) fatty acid composition, low docosahexaenoic acid and antioxidant supplementation, and the presence of potentially harmful nonnutritive components (eg, phytosterols)...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28128874/policy-of-feeding-very-preterm-infants-with-their-mother-s-own-fresh-expressed-milk-was-associated-with-a-reduced-risk-of-bronchopulmonary-dysplasia
#20
Odile Dicky, Virginie Ehlinger, Nathalie Montjaux, Gisèle Gremmo-Féger, Jacques Sizun, Jean-Christophe Rozé, Catherine Arnaud, Charlotte Casper
AIM: Since 2005, the French Food Safety Agency has recommended that very preterm or low-birthweight babies should be fed with pasteurised, expressed breastmilk, and feeding policies on this vary widely in French neonatal units. We investigated the differences between using a mother's expressed milk, in fresh or pasteurised forms, for very preterm infants. METHODS: This observational multicentre study analysed data on 926 very preterm infants: 636 from neonatal units who used the mother's own fresh milk and 290 who used the mother's milk after pasteurisation...
January 27, 2017: Acta Paediatrica
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