scholarly journals The effects of a variable surfactant dose (poractant alfa) on short term respiratory outcomes in very and extremely preterm infants

2017 ◽  
Vol 53 ◽  
pp. 104-104
Keyword(s):  
Preterm Infants ◽  
Short Term ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Respiratory Outcomes

scholarly journals Bronchopulmonary Dysplasia: Can We Agree on a Definition?

2018 ◽  
Vol 35 (06) ◽  
pp. 537-540 ◽  
Author(s):  
Deepak Jain ◽  
Eduardo Bancalari
Keyword(s):  
Respiratory Failure ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Nasal Cannula ◽  
Clinical Practices ◽  
Unique Challenge ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Respiratory Outcomes

AbstractThe advances in obstetric and neonatal care over the last half century have resulted in changes in pathophysiology and clinical presentation of bronchopulmonary dysplasia (BPD). In contrast to the original description of BPD by Northway et al as a severe lung injury in relatively mature preterm infants, the most common form of BPD currently is characterized by chronic respiratory insufficiency in extremely preterm infants. This evolution in the presentation of BPD, along with changes in respiratory support strategies such as increased use of nasal cannula oxygen, has presented a unique challenge to find a definition that describes the severity of lung damage and predict the long-term respiratory outcomes with some accuracy.The limitations of current definitions of BPD include inconsistent correlation with long-term respiratory outcomes, inability to classify infants dying from severe respiratory failure prior to 36 weeks' postmenstrual age, and potential inappropriate categorization of infants on nasal cannula oxygen or with extrapulmonary causes of respiratory failure. In the long term, the aim for a new definition of BPD is to develop a classification based on the pathophysiology and objective lung function evaluation providing a more accurate assessment for individual patients. Until then, a consensus definition that encompasses current clinical practices, provides reasonable prediction of later respiratory outcomes, and is relatively simple to use should be achieved.

scholarly journals Placental transfusion and short-term outcomes among extremely preterm infants

2020 ◽  
Vol 106 (1) ◽  
pp. 62-68
Author(s):  
Neha Kumbhat ◽  
Barry Eggleston ◽  
Alexis S Davis ◽  
Krisa P Van Meurs ◽  
Sara Bonamo DeMauro ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Random Effect ◽  
Research Network ◽  
Composite Outcome ◽  
Short Term ◽  
Delayed Cord Clamping ◽  
Major Morbidity ◽  
Cord Clamping ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

ObjectiveTo compare short-term outcomes after placental transfusion (delayed cord clamping (DCC) or umbilical cord milking (UCM)) versus immediate cord clamping among extremely preterm infants.DesignRetrospective study.SettingThe Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network registry.PatientsInfants born <29 weeks’ gestation in 2016 or 2017 without congenital anomalies who received active treatment after delivery.Intervention/exposureDCC or UCM.Main outcome measuresPrimary outcomes: (1) composite of mortality or major morbidity by 36 weeks’ postmenstrual age (PMA); (2) mortality by 36 weeks PMA and (3) composite of major morbidities by 36 weeks’ PMA. Secondary composite outcomes: (1) any grade intraventricular haemorrhage or mortality by 36 weeks’ PMA and (2) hypotension treatment in the first 24 postnatal hours or mortality in the first 12 postnatal hours. Outcomes were assessed using multivariable regression, adjusting for mortality risk factors identified a priori, significant confounders and centre as a random effect.ResultsAmong 3116 infants, 40% were exposed to placental transfusion, which was not associated with the primary composite outcome of mortality or major morbidity by 36 weeks’ PMA (adjusted OR (aOR) 1.26, 95% CI 0.95 to 1.66). However, exposure was associated with decreased mortality by 36 weeks’ PMA (aOR 0.71, 95% CI 0.55 to 0.92) and decreased hypotension treatment in first 24 postnatal hours (aOR 0.66, 95% CI 0.53 to 0.82).ConclusionIn this extremely preterm infant cohort, exposure to placental transfusion was not associated with the composite outcome of mortality or major morbidity, though there was a reduction in mortality by 36 weeks’ PMA.Trial registration numberNCT00063063.

scholarly journals Changes of Infant- and Family-Centered Care Practices Administered to Extremely Preterm Infants During Implementation of the NIDCAP Program

2021 ◽  
Vol 9 ◽  
Author(s):  
Valérie Klein ◽  
Claire Zores-Koenig ◽  
Laurence Dillenseger ◽  
Claire Langlet ◽  
Benoît Escande ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Short Term ◽  
Mortality And Morbidity ◽  
Developmental Care ◽  
Skin Contact ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Time Periods ◽  
The Impact ◽  
Family Centered

Introduction: Many studies have evaluated the Neonatal Individualized Developmental Care and Assessment Program (NIDCAP), but few studies have assessed changes in infant- and family-centered developmental care (IFCDC) practices during its implementation.Objectives: The primary objective of this single center study was to investigate the impact of the implementation of the NIDCAP program on IFCDC practices used for management of extremely preterm infants (EPIs). The secondary objective was to determine during implementation the impact of this program on the short-term medical outcomes of all EPIs hospitalized at our center.Methods: All EPIs (&lt;28 weeks gestational age) who were hospitalized at Strasbourg University Hospital from 2007 to 2014 were initially included. Outborn infants were excluded. The data of EPIs were compared for three time periods: 2007 to 2008 (pre-NIDCAP), 2010 to 2011, and 2013 to 2014 (during-NIDCAP implementation) using appropriate statistical tests. The clinical and caring procedures used during the first 14 days of life were analyzed, with a focus on components of individualized developmental care (NIDCAP observations), infant pain management (number of painful procedures, clinical pain assessment), skin-to-skin contact (SSC; frequency, day of initiation, and duration), and family access and involvement in the care of their children (duration of parental presence, parental participation in care). The short-term mortality and morbidity at discharge were evaluated.Results: We examined 228 EPIs who received care during the three time periods. Over time, painful procedures decreased, but pain evaluations, parental involvement in care, individualized observations, and SSC increased (all p &lt; 0.01). In addition, the first SSC was performed earlier (p = 0.03) and lasted longer (p &lt; 0.01). There were no differences in mortality and morbidity, but there were reductions in the duration of mechanical ventilation (p = 0.02) and the time from birth to first extubation (p = 0.02), and an increase of weight gain at discharge (p = 0.02).Conclusion: NIDCAP implementation was accompanied by progressive, measurable, and significant changes in IFCDC strategies. There were, concomitantly, moderate but statistically significant improvements in multiple important outcome measures of all hospitalized EPI.

scholarly journals Dose-Response Effects of Early Vitamin D Supplementation on Neurodevelopmental and Respiratory Outcomes of Extremely Preterm Infants at 2 Years of Age: A Randomized Trial

Neonatology ◽  
2018 ◽  
Vol 113 (3) ◽  
pp. 256-262 ◽  
Author(s):  
Ariel A. Salas ◽  
Taylor Woodfin ◽  
Vivien Phillips ◽  
Myriam Peralta-Carcelen ◽  
Waldemar A. Carlo ◽  
...  
Keyword(s):  
Vitamin D ◽  
Randomized Trial ◽  
Preterm Infants ◽  
Dose Response ◽  
Vitamin D Supplementation ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Respiratory Outcomes

Impact of Intensive Care Practices on Short-Term and Long-term Outcomes for Extremely Preterm Infants: Comparison Between the British Isles and France

PEDIATRICS ◽  
2008 ◽  
Vol 122 (5) ◽  
pp. e1014-e1021 ◽  
Author(s):  
F. Bodeau-Livinec ◽  
N. Marlow ◽  
P.-Y. Ancel ◽  
J. J. Kurinczuk ◽  
K. Costeloe ◽  
...  
Keyword(s):  
Intensive Care ◽  
Preterm Infants ◽  
British Isles ◽  
Long Term Outcomes ◽  
Short Term ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Care Practices

Life expectancy of extremely preterm infants

2007 ◽  
Vol 148 (48) ◽  
pp. 2279-2284 ◽  
Author(s):  
Gabriella Vida ◽  
Ilona Sárkány ◽  
Simone Funke ◽  
Judit Gyarmati ◽  
Judit Storcz ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Preterm Infants ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Optimális esetben a 24–28. gesztációs hét közötti, igen éretlen újszülöttek olyan szülészeti intézményben születnek, ahol neonatalis intenzív centrum működik, így mind az akut, mind a hosszú távú ellátásukat magas színvonalon biztosítják. A PTE OEKK ÁOK Szülészeti és Nőgyógyászati Klinikán 2000. január 1. és 2004. december 31. között 7499 újszülött született. A koraszülési frekvencia 20% (1499/7499), ezen belül az extrém alacsony gesztációs korúak aránya (≦28. gesztációs hét) 18% (272/1499), míg a 25. gesztációs hét alattiaké 3,2% (48/1499) volt. A túlélés a gesztációs hetek emelkedésével fokozatosan javul. Az életben maradt koraszülöttek későbbi életkilátásai és társadalmi beilleszkedése függ az olyan maradandó károsodásoktól, mint a látáscsökkenés, halláskárosodás, somatomentalis fejlődés zavarai, krónikus tüdőbetegség. A klinikán vizsgált alacsony gesztációs korú csoportban az összes fogyatékkal élő betegek aránya 15,3%. Döntő többségük a 25. gesztációs hétnél korábban született koraszülöttek közül kerül ki. A 26. gesztációs héttől a koraszülöttek több mint fele tartós károsodás nélkül éli túl az extrém éretlenség társuló problémáit. Megállapították, hogy a korai koponya-ultrahangvizsgálattal, szemészeti szűréssel, otoacusticus emissio mérésével jól prognosztizálhatók a maradandó károsodások, így lehetővé válik a korai kezelés.

Sign in / Sign up

Export Citation Format

Share Document