scholarly journals COMPARISON OF SHORT TERM OUTCOMES IN STABLE EXTREMELY PRETERM INFANTS MANAGED WITH AND WITHOUT UMBILICAL CATHETERS

2019 ◽  
Vol 55 (S1) ◽  
pp. 116-116
Keyword(s):  
Preterm Infants ◽  
Short Term ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Umbilical Catheters

Association between Umbilical Catheters and Neonatal Outcomes in Extremely Preterm Infants

2017 ◽  
Vol 35 (03) ◽  
pp. 233-241
Author(s):  
Mohamed Elboraee ◽  
Jennifer Toye ◽  
Xiang Ye ◽  
Prakesh Shah ◽  
Khalid Aziz ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Neonatal Morbidity ◽  
Neonatal Intensive Care Units ◽  
Design Data ◽  
Major Morbidity ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Umbilical Catheters ◽  
Multivariable Analyses

Objective The objective of this study was to examine the association between umbilical catheters and a composite outcome of mortality or major neonatal morbidity in extremely preterm infants. Study Design Data were abstracted from the Canadian Neonatal Network database for infants born at <29 weeks' gestational age and admitted to 29 neonatal intensive care units between January 2010 and December 2012. Four groups were identified: those with no umbilical catheters, umbilical venous catheters (UVCs), umbilical artery catheters (UACs), and those with both UVCs and UACs. The outcomes were compared among the groups using univariate and multivariable analyses. Results Of 4,623 eligible infants, 820 (17.7%) had no catheters, 1,032 (22.3%) a UVC only, 120 (2.6%) a UAC only, and 2,651 (57.3%) had both catheters. After adjustment for acuity and other potential confounders, umbilical catheters were associated with higher odds of mortality or any major morbidity (UVC vs. no catheter: adjusted odds ratio [aOR]: 1.47; 95% CI: 1.18–1.85; UAC vs. no catheter: aOR: 1.67; 95% CI: 1.05–2.63; and both UVC + UAC vs. no catheter: aOR: 2.17; 95% CI: 1.79–2.70). Conclusion Most of the infants born at <29 weeks' gestation had UVC and/or UAC placement. The presence of either catheter was associated with mortality or major morbidity, and the association was stronger when both catheters were present.

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.

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.

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