scholarly journals Vital signs analysis algorithm detects inflammatory response in premature infants with late onset sepsis and necrotizing enterocolitis

2018 ◽  
Vol 117 ◽  
pp. 83-89 ◽  
Author(s):  
Leena B. Mithal ◽  
Ram Yogev ◽  
Hannah L. Palac ◽  
Daniel Kaminsky ◽  
Ilan Gur ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Necrotizing Enterocolitis ◽  
Premature Infants ◽  
Late Onset ◽  
Vital Signs ◽  
Analysis Algorithm ◽  
Late Onset Sepsis

scholarly journals Vital signs analysis algorithm detects inflammatory response in premature infants with late onset sepsis and necrotizing enterocolitis

2017 ◽  
Author(s):  
Leena B. Mithal ◽  
Ram Yogev ◽  
Hannah L. Palac ◽  
Daniel Kaminsky ◽  
Ilan Gur ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Necrotizing Enterocolitis ◽  
Premature Infants ◽  
Inflammatory Responses ◽  
Late Onset ◽  
Clinical Signs ◽  
Vital Signs ◽  
Clinical Suspicion ◽  
Accurate Identification ◽  
Late Onset Sepsis

BackgroundNonspecific clinical signs and suboptimal diagnostic tests limit accurate identification of late onset sepsis (LOS) and necrotizing enterocolitis (NEC) in premature infants, resulting in significant morbidity and antibiotic overuse. An infant’s systemic inflammatory response may be identified earlier than clinical suspicion through analysis of multiple vital signs by a computerized algorithm (RALIS).AimTo evaluate the revised RALIS algorithm for detection of LOS and NEC in preterm infants.MethodsIn this nested case-control study, VS data (heart rate, respiratory rate, temperature, desaturations, bradycardias) were extracted from medical records of infants 23-32 weeks gestation. RALIS generated an output, with score >5 triggering an alert. Patient episodes were classified based on culture, radiograph, and antibiotic data into categories: LOS, expanded LOS, NEC, and controls. Paired t-tests, linear regression and cross-validation analyses were used to evaluate the relationship between RALIS alert and LOS/NEC.ResultsAmong 155 infants with 161 episodes, there were 41 expanded LOS (+ blood, CSF, urine, respiratory culture), 31 LOS (+ blood, CSF, urine), 9 NEC, and 93 controls. RALIS alert was 43.1+/-79 hours before culture in LOS (p=0.012). There was a significant association between RALIS alert and LOS/NEC (β=0.72, p<0.0001). Sensitivity and specificity for LOS/NEC were 84% and 80%, (PPV=63%; NPV=93%). The regression model demonstrated an AUC of 89.9%.ConclusionsFor infants <32 weeks, RALIS detects systemic inflammatory responses in LOS and NEC in the first month of life. The algorithm identifies infection earlier than clinical suspicion, even for NEC with negative cultures. RALIS has high NPV to rule-out LOS and NEC, and may, after prospective validation, aid in antibiotic treatment decisions.

Tocopherol Efficacy and Safety for Preventing Retinopathy of Prematurity: A Randomized, Controlled, Double-Masked Trial

PEDIATRICS ◽  
1987 ◽  
Vol 79 (4) ◽  
pp. 489-500 ◽  
Author(s):  
Dale L. Phelps ◽  
Arthur L. Rosenbaum ◽  
Sherwin J. lsenberg ◽  
Rosemary D. Leake ◽  
Frederick J. Dorey
Keyword(s):  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Plasma Levels ◽  
Late Onset ◽  
Retinal Hemorrhage ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Late Onset Sepsis ◽  
Prospective Monitoring

To test the efficacy and safety of vitamin E in preventing retinopathy of prematurity, 287 infants with birth weights of less than 1.5 kg or gestational ages of less than 33 weeks were enrolled within 24 hours of birth in a randomized, double-masked trial of IV, followed by oral, placebo v tocopherol (adjusted to plasma levels of 3 to 3.5 mg/dL). In the 196 infants completing ophthalmic follow-up, tocopherol did not prevent retinopathy of prematurity of any stage (28% placebo treated v 26% tocopherol treated) or moderately severe retinopathy of prematurity (8% placebo treated v 11% tocopherol treated). Cicatricial sequelae were not significantly different (1/97 placebo treated v 3/99 tocopherol treated), with one placebo-treated infant and one tocopherol-treated infant having retinal detachments. Among all 232 infants examined, those treated with tocopherol had more retinal hemorrhage than placebo-treated infants (8/121 placebo treated v 16/111 tocopherol treated), and retinal hemorrhage correlated positively (P &lt; .01) with plasma levels of tocopherol after the first 2 weeks of age. Prospective monitoring of morbidity including late-onset sepsis, necrotizing enterocolitis, etc revealed no differences between groups except that grades 3 and 4 intraventricular hemorrhage occurred more frequently in infants weighing less than 1 kg at birth who had received tocopherol (14/42, 33%) v those who had received placebo (4/43, 9%) (P &lt; .02). Our data do not support the use of tocopherol for prophylaxis against retinopathy of prematurity in premature infants and suggest that IV tocopherol treatment starting on day 1 may increase the incidence of hemorrhagic complications of prematurity, particularly in infants with birth weights of less than 1 kg.

Optimized Detection of Central Apneas Preceding Late-Onset Sepsis in Premature Infants

2021 ◽  
Author(s):  
Gabriele Varisco ◽  
Deedee Kommers ◽  
Xi Long ◽  
Zhuozhao Zhan ◽  
Marina M. Nano ◽  
...  
Keyword(s):  
Premature Infants ◽  
Late Onset ◽  
Late Onset Sepsis ◽  
Central Apneas

Targeted LC-MS/MS for the evaluation of proteomics biomarkers in the blood of neonates with necrotizing enterocolitis and late-onset sepsis

2018 ◽  
Vol 410 (27) ◽  
pp. 7163-7175 ◽  
Author(s):  
Anastasia Chrysovalantou Chatziioannou ◽  
Justina Clarinda Wolters ◽  
Kosmas Sarafidis ◽  
Agathi Thomaidou ◽  
Charalampos Agakidis ◽  
...  
Keyword(s):  
Necrotizing Enterocolitis ◽  
Late Onset ◽  
Late Onset Sepsis

scholarly journals Oropharyngeal Administration of Colostrum for Preventing Necrotizing Enterocolitis and Late-onset Sepsis in Preterm Infants with Gestational Age ≤ 32 Weeks: A Single-center Randomized Controlled Trial

2021 ◽  
Author(s):  
xia ouyang ◽  
changyi yang ◽  
wenlong xiu ◽  
yanhua hu ◽  
susu mei ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Enteral Feeding ◽  
Gestational Age ◽  
Late Onset ◽  
Controlled Trial ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Late Onset Sepsis ◽  
Full Enteral Feeding

Abstract BackgroundOropharyngeal administration of colostrum (OAC) may provide immunoprotective and anti-inflammatory effects that potentially reduce the incidence of necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) and improve short-term outcomes.ObjectiveTo evaluate the role of OAC in the early prevention of NEC and LOS in preterm infants with gestational age (GA) ≤ 32 weeks.MethodsA randomized, placebo-controlled trial was conducted in a 40-bed tertiary neonatal intensive care unit (NICU) in China. Preterm infants with GA ≤ 32 weeks were divided randomly into an OAC group, which received 0.4 ml maternal colostrum smearing via the oropharyngeal route every 3 hours for 10 days beginning within the first 48 hours after birth, and a control group, which received normal saline instead. Data from the two groups were collected and compared.ResultsA total of 127 patients in the OAC group and 125 patients in the control group were finally enrolled. The incidence of NEC (Bell stage 2 or 3) and LOS was lower in the OAC group [2.4% vs. 10.4%, χ2 = 6.845, ༰=0.009; 4.7% vs. 13.6%, χ2 = 5.983, ༰=0.014]. In addition, the incidence of intraventricular hemorrhage (IVH) (stage 3 or 4) was lower [1.6% vs. 7.2%,χ2 = 4.775, ༰=0.029], and the time of achieving full enteral feeding was shorter [ 22.0 days vs. 25.0 days༌Z = 6༌424.500༌P = 0.009)] in the OAC group. No cases of adverse reactions were observed in either group.ConclusionsOAC is a safe and simple NICU procedure that yields a potential advantage in decreasing the incidence of NEC, LOS, and severe IVH and shortening the time to achieve full enteral feeding in preterm infants with GA ≤ 32 weeks.Trial registrationChinese Clinical Trial Registry, ChiCTR1900023697, Registered 8 June 2019, Retrospectively registered, http://www.chictr.org.cn/edit.aspx? pid = 39398

scholarly journals Intestinal microbiome colonization patterns differ prior to late onset sepsis in premature infants (637.3)

2014 ◽  
Vol 28 (S1) ◽  
Author(s):  
Diana Taft ◽  
Doyle Ward ◽  
Kurt Schibler ◽  
Zhuoteng Yu ◽  
David Newburg ◽  
...  
Keyword(s):  
Premature Infants ◽  
Late Onset ◽  
Intestinal Microbiome ◽  
Late Onset Sepsis ◽  
Colonization Patterns
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