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Parenteral nutrition neonate

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https://www.readbyqxmd.com/read/28222962/safety-of-parenteral-nutrition-in-newborns-results-from-a-nationwide-prospective-cohort-study
#1
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
#2
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
#3
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
#4
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
#5
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 birth weight babies should be fed with pasteurised, expressed breast milk 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
https://www.readbyqxmd.com/read/28128283/a-uk-wide-cohort-study-describing-management-and-outcomes-for-infants-with-surgical-necrotising-enterocolitis
#6
Benjamin Allin, Anna-May Long, Amit Gupta, Marian Knight, Kokila Lakhoo
The Royal College of Surgeons have proposed using outcomes from necrotising enterocolitis (NEC) surgery for revalidation of neonatal surgeons. The aim of this study was therefore to calculate the number of infants in the UK/Ireland with surgical NEC and describe outcomes that could be used for national benchmarking and counselling of parents. A prospective nationwide cohort study of every infant requiring surgical intervention for NEC in the UK was conducted between 01/03/13 and 28/02/14. Primary outcome was mortality at 28-days...
January 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28111747/neonatal-predictors-of-cognitive-ability-in-adults-born-very-preterm-a-prospective-cohort-study
#7
Linda D Breeman, Julia Jaekel, Nicole Baumann, Peter Bartmann, Dieter Wolke
AIM: To identify neonatal predictors to allow a developmental prognosis of the cognitive abilities of survivors born very preterm/very low birthweight (VLBW) into adult life. METHOD: The Bavarian Longitudinal Study is a prospective whole-population study that followed 260 infants born very preterm/VLBW from birth to adulthood. Regression analyses examined which neonatal factors predicted adult IQ. RESULTS: Neonatal morbidity, neonatal treatment, and early social environment of infants born very preterm/VLBW explained 37...
January 23, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28079870/impact-of-l-carnitine-supplementation-on-metabolic-profiles-in-premature-infants
#8
R H Clark, D H Chace, A R Spitzer
OBJECTIVE: To describe the influence that of l-carnitine supplementation on acylcarnitine (AC) profiles and hospital outcomes in premature infants. STUDY DESIGN: This study is a secondary analysis of previously reported work. Metabolic profiles were obtained using standard newborn techniques on infants born between 23 and 31 completed weeks of gestation. The profiles were drawn within the first 24 h after birth and on approximately days 7, 28 and 42 of life, or at the time of discharge...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28052307/ultrashort-bowel-syndrome-outcome-in-children-treated-in-a-multidisciplinary-intestinal-rehabilitation-unit
#9
Mariela Dore, Paloma Triana Junco, Ane Andres Moreno, Vanesa Nuñez Cerezo, Martha Romo Muñoz, Alba Sánchez Galán, Alejandra Vilanova Sánchez, Gerardo Prieto, Esther Ramos, Francisco Hernandez, Leopoldo Martínez Martínez, Manuel Lopez Santamaria
Aim Short bowel syndrome (SBS) is the leading cause of intestinal failure (IF) in the pediatric population. Our aim was to review long-term outcome of ultrashort bowel syndrome (USBS) in an Intestinal Rehabilitation Unit (IRU). Patients and Methods Retrospective study of patients with USBS (defined as < 10 cm of remnant small bowel) treated between 2000 and 2015. Demographic data, clinical, and treatment variables including parenteral nutrition (PN), surgical techniques, and intestinal transplantation (IT) were analyzed...
February 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28045772/nutritional-practices-and-growth-in-premature-infants-after-surgical-necrotizing-enterocolitis
#10
Grace C Lin, Daniel T Robinson, Steven Olsen, Kristina M Reber, Mohannad Moallem, Robert DiGeronimo, Cecilia Mulroy, Ankur Datta, Karna Murthy
OBJECTIVE: To describe the nutritional provisions received by infants with surgical NEC and the associated effects on short-term growth. STUDY DESIGN: Through the Children's Hospitals Neonatal Database we identified infants born ≤32 weeks' gestation with surgical NEC from 5 regional neonatal intensive care units over 4 years. Excluded infants had isolated intestinal perforation and died <14 days post-operatively. Infants were stratified by their median parenteral protein dose (low (LP) or high (HP) protein) over the first post-operative week...
December 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28033194/neonatal-soft-tissue-reconstruction-using-a-bioengineered-skin-substitute
#11
Scott D Hirsch, Jeremy M Powers, Jennifer L Rhodes
Total parenteral nutrition (TPN) can be a lifesaving intervention for premature neonates and it is often delivered through peripheral access in this unique population. However, extravasation and tissue damage can result. Current literature lacks strong evidence regarding the treatment and reconstruction of such injuries in this age group. The authors present a patient with a 30-week gestational age premature newborn whom suffered an extravasation injury with peripherally administered TPN leading to full thickness skin and soft tissue necrosis of the dorsum of the right hand...
December 28, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28028560/pathophysiology-prevention-treatment-and-outcomes-of-intestinal-failure-associated-liver-disease
#12
REVIEW
Noora H Al-Shahwani, David L Sigalet
BACKGROUND: Intestinal failure-associated liver disease (IFALD) remains a serious problem in the treatment of infants with nutritional problems and short bowel syndrome. METHODS: A review of the recent literature from 2010 to 2016, concentrating on articles related to the pathophysiology of IFALD and to outcomes of novel nutritional and pharmacological therapies for neonatal cholestasis in the post-surgical neonate. RESULTS: The pathophysiology of IFALD relates to an increase sensitivity of the neonatal liver to cholestasis in the non-fed state; prolonged cholestasis almost inevitably results in liver damage which will progress from fibrosis to cirrhosis...
December 27, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27989360/complications-in-neonatal-surgery
#13
Mauricio A Escobar, Michael G Caty
Neonatal surgery is recognized as an independent discipline in general surgery, requiring the expertise of pediatric surgeons to optimize outcomes in infants with surgical conditions. Survival following neonatal surgery has improved dramatically in the past 60 years. Improvements in pediatric surgical outcomes are in part attributable to improved understanding of neonatal physiology, specialized pediatric anesthesia, neonatal critical care including sophisticated cardiopulmonary support, utilization of parenteral nutrition and adjustments in fluid management, refinement of surgical technique, and advances in surgical technology including minimally invasive options...
December 2016: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/27980881/obstetric-obesity-is-associated-with-neonatal-hyperbilirubinemia-with-high-prevalence-in-native-hawaiians-and-pacific-island-women
#14
Luc Ra Rougée, Shogo J Miyagi, Abby C Collier
Obesity and pregnancy both place the liver under metabolic stress, but interactions between obstetric obesity and bilirubin metabolism have not been studied. We determined associations between obesity, maternal/neonatal bilirubin levels, and uridine 5'diphosphate-glucuronosyltransferase 1A1 (UGT1A1) enzyme that eliminates bilirubin. Adult livers were analyzed for UGT1A1 expression, activity, and bilirubin clearance by pharmacokinetic modeling. Then, matched maternal and neonatal sera (N = 450) were assayed for total and unconjugated bilirubin...
December 2016: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/27884125/epidemiology-of-and-risk-factors-for-neonatal-candidemia-at-a-tertiary-care-hospital-in-western-china
#15
Jichang Chen, Yongjiang Jiang, Ba Wei, Yanling Ding, Shaolin Xu, Peixu Qin, Jinjian Fu
BACKGROUND: The prevalence and clinical characteristics of neonatal candidemia are poorly understood in western China. The aim of our study was to evaluate the epidemiological features of neonatal candidemia in the Liuzhou Maternity and Child Healthcare Hospital. METHODS: A retrospective case-control study was conducted between January 2012 and November 2015. Electronic databases were reviewed and data on Candida species were isolated from blood cultures and candidemia incidence, risk factors, and mortality were extracted...
November 24, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27866210/body-composition-in-very-preterm-infants-role-of-neonatal-characteristics-and-nutrition-in-achieving-growth-similar-to-term-infants
#16
Geneviève Tremblay, Christine Boudreau, Sylvie Bélanger, Odette St-Onge, Etienne Pronovost, David Simonyan, Isabelle Marc
BACKGROUND: The identification of factors involved in the postnatal growth of preterm infants will help achieve growth similar to that of term infants. OBJECTIVES: As per protocol: to compare body composition in very preterm infants at term-corrected age (TCA) with that in term infants, and to explore relationships between neonatal characteristics and body composition in preterm infants. METHODS: Anthropometry, nutritional characteristics, and neonatal outcomes were prospectively collected in 26 preterm (<29 weeks) and 33 term (37-40 weeks) infants...
November 19, 2016: Neonatology
https://www.readbyqxmd.com/read/27836286/acylcarnitine-profiles-reflect-metabolic-vulnerability-for-necrotizing-enterocolitis-in-newborns-born-premature
#17
Karl G Sylvester, Zachary J Kastenberg, R Larry Moss, Gregory M Enns, Tina M Cowan, Gary M Shaw, David K Stevenson, Tiffany J Sinclair, Curt Scharfe, Kelli K Ryckman, Laura L Jelliffe-Pawlowski
OBJECTIVE: To evaluate the association between newborn acylcarnitine profiles and the subsequent development of necrotizing enterocolitis (NEC) with the use of routinely collected newborn screening data in infants born preterm. STUDY DESIGN: A retrospective cohort study was conducted with the use of discharge records for infants born preterm admitted to neonatal intensive care units in California from 2005 to 2009 who had linked state newborn screening results. A model-development cohort of 94 110 preterm births from 2005 to 2008 was used to develop a risk-stratification model that was then applied to a validation cohort of 22 992 births from 2009...
February 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/27795342/performance-of-matrix-assisted-laser-desorption-ionization-time-of-flight-mass-spectrometry-for-identifying-clinical-malassezia-isolates
#18
Julie Denis, Marie Machouart, Florent Morio, Marcela Sabou, Catherine Kauffmann-LaCroix, Nelly Contet-Audonneau, Ermanno Candolfi, Valérie Letscher-Bru
The genus Malassezia comprises commensal yeasts on human skin. These yeasts are involved in superficial infections but are also isolated in deeper infections, such as fungemia, particularly in certain at-risk patients, such as neonates or patients with parenteral nutrition catheters. Very little is known about Malassezia epidemiology and virulence. This is due mainly to the difficulty of distinguishing species. Currently, species identification is based on morphological and biochemical characteristics. Only molecular biology techniques identify species with certainty, but they are time-consuming and expensive...
January 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27781254/-application-of-bishop-koop-stoma-in-refractory-congenital-intestinal-atresia
#19
Hong Zhang, Wei Zhong, Jing Sun, Qiuming He, Yong Wang, Le Li, Jiakang Yu, Zhe Wang, Zhihua Ye, Kailin Tang, Huimin Xia
OBJECTIVE: To explore the feasibility and safety of Bishop-Koop stoma procedure in the treatment of neonates with refractory congenital intestinal atresia. METHODS: Clinical and follow-up data of 25 neonates with refractory congenital intestinal atresia undergoing Bishop-Koop stoma procedure in our center from January 2011 to December 2014 were retrospectively analyzed. Of 25 neonates, 13 (52%) were male, 12(48%) were female, the birth weight was 1600-3800 g (mean 2920 g), the age of admission was 10 hours to 20 days, and the age of operation was 1-58 d (mean 7 d)...
October 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27766283/term-neonate-with-liver-laceration-obstructive-uropathy-and-ascites-secondary-to-extravasation-of-total-parenteral-nutrition-a-complication-of-malpositioned-umbilical-venous-catheter
#20
Olubukunola Adesanya, Mubariz Naqvi
We report a rare, but serious, complication of a malpositioned umbilical venous catheter in a term male infant who developed laceration, hematoma, and necrosis of liver, ascites, and left-sided obstructive uropathy secondary to extravasation of total parenteral nutrition. Abdominal paracentesis confirmed the presence of parenteral nutrition in the peritoneal cavity. Although, the umbilical venous catheterization is a common intravenous access used in neonatal intensive care units, judicious continued monitoring of its use should be practiced to avoid serious complications...
2016: Global Pediatric Health
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