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Extremely low birth weight infant

M Stavel, J Wong, Z Cieslak, R Sherlock, M Claveau, P S Shah
OBJECTIVE: To determine the effect of concomitant administration of prophylactic indomethacin and early enteral feeds on the risk of spontaneous intestinal perforation (SIP) in extremely low-birth-weight (ELBW) infants, and to describe the variation in prophylactic indomethacin use in Canada. STUDY DESIGN: A retrospective cohort study of 4268 ELBW infants born at <30 weeks' gestation admitted to Canadian neonatal units between 2010 and 2014 was conducted. Prophylactic indomethacin (I+ or I-, administered within 24 h) and early feeding (E+ or E-, initiated in the first 2 days) exposures were studied concurrently and independently...
October 20, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Sezin Unal, Dilek Ulubas Isik, Ahmet Yagmur Bas, Zehra Arslan, Nihal Demirel
Introduction The incidence and risk factors for inguinal hernia (IH) is not a thoroughly evaluated issue of preterms. Prematurity is the single most important risk factor. There exists no study in our country which reported the incidence of IH in preterms. The purpose of this study is to investigate the incidence and time of diagnosis of IH in very low-birth-weight (VLBW) infants. Patients and Methods This retrospective case-control study was conducted in Etlik Zubeyde Hanim Women's Health Training and Research Hospital and included discharged VLBW infants with gestational age less than 32 weeks...
October 18, 2016: European Journal of Pediatric Surgery
Rebecca L Wilson, Jessica A Grieger, Tina Bianco-Miotto, Claire T Roberts
Adequate zinc stores in the body are extremely important during periods of accelerated growth. However, zinc deficiency is common in developing countries and low maternal circulating zinc concentrations have previously been associated with pregnancy complications. We reviewed current literature assessing circulating zinc and dietary zinc intake during pregnancy and the associations with preeclampsia (PE); spontaneous preterm birth (sPTB); low birthweight (LBW); and gestational diabetes (GDM). Searches of MEDLINE; CINAHL and Scopus databases identified 639 articles and 64 studies were reviewed...
October 15, 2016: Nutrients
Feng Liu, Shu-Ping Han, Zhang-Bin Yu, Jun Zhang, Xiao-Hui Chen, Wei-Min Wu, Xue Chu, Bei-Bei Liu
OBJECTIVE: To study the effect of breastfeeding quality improvement on the breastfeeding rate in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU). METHODS: A retrospective analysis was performed for the clinical data of VLBW and ELBW infants who were admitted from July 2014 to July 2015 (pre-improvement group) and those who were admitted from August 2015 to June 2016 after the implementation of breastfeeding quality improvement measures (post-improvement group)...
October 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Paola Salvatori, Erica Neri, Ilaria Chirico, Federica Andrei, Francesca Agostini, Elena Trombini
Introduction: Although preterm birth represents a risk factor for early mother-infant interactions, few studies have focused on toddlerhood, an important time for the development of symbolic play, autonomous skills, and child's socialization competences. Moreover, no study has looked at the effect of birth weight on mother-child interactions during this period. Expanding on the available literature on prematurity, the main objective of this study was to explore the quality of mother-toddler interactions during play, using a longitudinal research design, as well as taking into account the effect of birth weight...
2016: Frontiers in Psychology
Cristiane Ribeiro Ambrósio, Adriana Sanudo, Maria Fernanda Branco de Almeida, Ruth Guinsburg
AIM: The aim of this study was to survey paediatricians, who taught neonatal resuscitation in Brazil, about when they would apply advanced resuscitation in the delivery room for newborn infants born at 23-26 weeks of gestational age. METHODS: This cross-sectional study focused on an electronic questionnaire that was sent to paediatricians who acted as instructors for the Brazilian Neonatal Resuscitation Program from December 2011 to September 2013. The primary outcome was the gestational age at which the respondent would apply advanced resuscitation in the delivery room...
October 14, 2016: Acta Paediatrica
A J Spittle, J Olsen, A Kwong, L W Doyle, P B Marschik, C Einspieler, Jly Cheong
INTRODUCTION: Infants born extremely preterm (EP; <28 weeks' gestation) and/or with extremely low birth weight (ELBW; <1000 g birth weight) are at increased risk for adverse neurodevelopmental outcomes. However, it is challenging to predict those EP/ELBW infants destined to have long-term neurodevelopmental impairments in order to target early intervention to those in most need. The General Movements Assessment (GMA) in early infancy has high predictive validity for neurodevelopmental outcomes in preterm infants...
October 3, 2016: BMJ Open
Calan Savoy, Mark A Ferro, Louis A Schmidt, Saroj Saigal, Ryan J Van Lieshout
BACKGROUND: Mortality rates among extremely low birthweight (ELBW) infants have declined since the advent of antenatal glucocorticoid use. However, the long term neuropsychiatric effects of exposure are not well understood. We utilized the world's oldest longitudinally followed cohort of ELBW survivors to compare psychopathology over two decades in adulthood in those exposed to prenatal betamethasone and those who were not. METHODS: ELBW survivors (n=179) and matched normal birth weight (NBW) controls (n=145) completed the Young Adult Self-Report questionnaire at 22-26 and 29-36 years, and the Beck Depression and Anxiety Inventories at 29-36 years...
September 28, 2016: Psychoneuroendocrinology
Andreas Repa, Ruth Lochmann, Lukas Unterasinger, Michael Weber, Angelika Berger, Nadja Haiden
BACKGROUND: Parenteral nutrition associated cholestasis (PNAC) is a frequently observed pathology in extremely low birth weight (ELBW) infants. Its pathogenesis is determined by the composition and duration of parenteral nutrition (PN) as well as the tolerance of enteral feeds (EF). "Aggressive" nutrition is increasingly used in ELBW infants to improve postnatal growth. Little is known about the effect of "aggressive" nutrition on the incidence of PNAC. We analyzed the influence of implementing an "aggressive" nutritional regimen on the incidence of PNAC and growth in a cohort of ELBW infants...
2016: PeerJ
Sascha Meyer, Ludwig Gortner
The aim of the NeoVitaA Trial is to assess the role of postnatal additional high-dose oral vitamin A supplementation for 28 days in reducing Bronchopulmonary dysplasia (BPD) or death in extremely low birth weight (ELBW) infants at 36 weeks postmenstrual age (PMA). All infants (both intervention and control group) will be provided with basic vitamin A (1000 IU/kg/day) in addition to trial intervention.In this short communication, we will give an up-date on obstacles, challenges as well as perspectives and potential solutions when putting into place a multicenter, double-blind, randomized trial in this cohort of extremely susceptible infants...
September 26, 2016: Wiener Medizinische Wochenschrift
Chien-Yi Chen, An-Kuo Chou, Yu-Lien Chen, Hung-Chieh Chou, Po-Nien Tsao, Wu-Shiun Hsieh
BACKGROUND: Nasal continuous positive airway pressure (NCPAP) therapy is widely used in neonates, but the clinical practice varies. However, nursing practice differs among individuals, and an inappropriate application method may delay the respiratory therapy, influence the beneficial effect of NCPAP, and increase complications. We introduced a quality improvement project to expedite the application of NCPAP therapy and decrease the incidence of nasal trauma. METHODS: A new strategy of mobile NCPAP cart with prepacked fixation kits and a written protocol was implemented from April 2006...
July 26, 2016: Pediatrics and Neonatology
Airi Tiirats, Triin Viltrop, Margit Nõukas, Ene Reimann, Andres Salumets, Sulev Kõks
BACKGROUND: Despite extensive research the genetic component of extremely low birth weight (ELBW) in newborns has remained obscure. RESULTS: The aim of the case study was to identify candidate gene(s) causing ELBW in newborns and hypotrophy in infants. A family of four was studied: mother, father and two ELBW-phenotype children. Studies were made of the medical conditions of the second child at birth and post-partum - peculiar phenotype, micro-anomalies, recurrent infections, suspicion of autoimmune hepatitis, multifactorial encephalopathy and suspected metabolic and chromosomal abnormalities...
2016: BMC Genetics
Alan H Jobe
Although bronchopulmonary dysplasia (BPD) is the most frequent adverse outcome for infants born at < 30 weeks gestational age, there remain major gaps in understanding the pathophysiology, and thus there are few effective targeted therapies to prevent and treat BPD. This review will focus on the substantial problems and knowledge gaps for the clinician and investigator when considering lung injury and BPD. The epidemiology of BPD is clear: BPD is a lung injury syndrome predominantly in extremely low-birth-weight infants with an incidence that increases as gestation/birth weight decrease, with growth restriction, in males and with fetal exposures and with injury from postdelivery respiratory care...
September 2016: American Journal of Perinatology
Veronica Mardegan, Elena Priante, Elisabetta Lolli, Paola Lago, Eugenio Baraldi
Heated, humidified high-flow delivered by nasal cannulae (HHHFNC) is increasingly used for noninvasive respiratory support in preterm infants and critically ill children due to its perceived effectiveness and ease of use. Evidence from randomized controlled trials suggests that HHHFNC and continuous positive airway pressure (CPAP) are equally effective as postextubation support in preterm infants. HHHFNC is also used for weaning preterm infants from CPAP. Data on HHHFNC used as the primary support for treating respiratory distress syndrome are conflicting...
September 2016: American Journal of Perinatology
Lex W Doyle, Anne-Marie Adams, Colin Robertson, Sarath Ranganathan, Noni M Davis, Katherine J Lee, Jeanie L Cheong
BACKGROUND: The evolution of airway obstruction into late adolescence of extremely preterm (gestational age <28 weeks) or extremely low-birthweight (birth weight <1000 g) survivors in the era after surfactant was introduced is unclear. OBJECTIVE: To compare changes in spirometry from 8 to 18 years of age of a geographical cohort of preterm survivors with normal birth weight controls, and to determine higher risk groups within the preterm cohort. METHODS: Of 297 extremely preterm/low-birthweight survivors born in 1991-1992 in the state of Victoria, Australia, 81% and 70% had spirometry at 8 and 18 years of age, respectively...
September 6, 2016: Thorax
Changsin Kim, Jeong Eun Shin, Soon Min Lee, Ho Seon Eun, Min Soo Park, Kook In Park, Ran Namgung, Sungsoo Lee, Choon Sik Yoon
The pulmonary interstitial emphysema (PIE) is a life-threatening illness in premature infants with mechanical ventilation. While most are managed conservatively, decompression would be necessary. Here, we report the first case of PIE treated by percutaneous catheter insertion in an extremely low birth weight (ELBW) infant in Korea. The patient, born with 660 g in 23+2 weeks of gestation, showed PIE in left lower lung on postnatal day 12. Percutaneous catheter insertion was performed on postnatal day 25. The size of PIE decreased, but didn't disappear completely...
November 2016: Yonsei Medical Journal
J L Dickson, C G Pretty, J Alsweiler, A Lynn, J G Chase
BACKGROUND: Models of human glucose-insulin physiology have been developed for a range of uses, with similarly different levels of complexity and accuracy. STAR (Stochastic Targeted) is a model-based approach to glycaemic control. Elevated blood glucose concentrations (hyperglycaemia) are a common complication of stress and prematurity in very premature infants, and have been associated with worsened outcomes and higher mortality. This research identifies and validates the model parameters for model-based glycaemic control in neonatal intensive care...
August 30, 2016: Mathematical Biosciences
Kevin N Johnson, Tina Thomas, Jason Grove, Marcus D Jarboe
BACKGROUND: Neonates commonly require central access, and in those with very low or extremely low birthweight this can be challenging. Described here is a technique that uses ultrasound guidance in the placement of peripherally inserted central catheters (PICC) in neonates and an analysis of outcomes. METHODS: A retrospective chart review was conducted of all patients below 1500 g that underwent placement of a peripherally inserted central catheter under ultrasound guidance between January 1, 2012, and December 31, 2014 at a single center...
November 2016: Pediatric Surgery International
M Miyata, K Toyoshima, H Yoda, M Murase, H Kawato, K Yamamoto, K Tanaka, M Kotani, M Kobayashi
National surveys were conducted in Japan to assess the current practices for circulatory management of extremely-low-birth-weight infants (ELBWIs) in acute phases. Approximately 80 and 100 institutions were surveyed in 2006 and 2011, respectively. Echocardiography was identified as an important diagnostic tool at 95% of the surveyed institutions. Furthermore, 74% of the institutions survey in 2011 used vasodilator agents. In 2011, the mean velocity of circumferential fiber shortening (mVcfc) and left ventricular end-systolic wall stress (ESWS) were used by 60% of the surveyed institutions to evaluate the relationship between afterload of the left ventricle and left ventricular contractility...
September 16, 2016: Journal of Neonatal-perinatal Medicine
Robert J Morse, Robin Fretwell Wilson
This Essay examines the elegantly simple idea that consent to medical treatment or participation in human research must be "informed" to be valid. It does so by using as a case study the controversial clinical research trial known as the Surfactant, Positive Pressure, and Oxygenation Randomized Trial ("SUPPORT"). The Essay begins by charting, through case law and the adoption of the common rule, the evolution of duties to secure fully informed consent in both research and treatment. The Essay then utilizes the SUPPORT study, which sought to pinpoint the level of saturated oxygen that should be provided to extremely low birth weight infants to demonstrate modern complexities and shortcomings of the duty to secure informed consent...
September 2016: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
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