scholarly journals Incidence of periventricular/intraventricular hemorrhage in very low birth weight infants: a 15-year cohort study

2011 ◽  
Author(s):  
Sérgio T. M. Marba ◽  
Jamil P. S. Caldas ◽  
Luís E. F. Vinagre ◽  
Mônica A. Pessoto
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants

scholarly journals School-Age Outcomes of Very Low Birth Weight Infants in the Indomethacin Intraventricular Hemorrhage Prevention Trial

PEDIATRICS ◽  
2003 ◽  
Vol 111 (4) ◽  
pp. e340-e346 ◽  
Author(s):  
B. R. Vohr ◽  
W. C. Allan ◽  
M. Westerveld ◽  
K. C. Schneider ◽  
K. H. Katz ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Prevention Trial ◽  
School Age ◽  
Low Birth Weight Infants

Early Vital Sign Differences in Very Low Birth Weight Infants with Severe Intraventricular Hemorrhage

2021 ◽  
Author(s):  
Santina A. Zanelli ◽  
Maryam Abubakar ◽  
Robert Andris ◽  
Kavita Patwardhan ◽  
Karen D. Fairchild ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Vital Sign ◽  
Intraventricular Hemorrhage ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Cranial Ultrasound ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Arterial Blood

Objective Severe intraventricular hemorrhage (sIVH, grades 3 and 4) is a serious complication for very low birth weight (VLBW) infants and is often clinically silent requiring screening cranial ultrasound (cUS) for detection. Abnormal vital sign (VS) patterns might serve as biomarkers to identify risk or occurrence of sIVH. Study Design This retrospective study was conducted in VLBW infants admitted to two level-IV neonatal intensive care units (NICUs) between January 2009 and December 2018. Inclusion criteria were: birth weight <1.5 kg and gestational age (GA) <32 weeks, at least 12 hours of systemic oxygen saturation from pulse oximetry (SpO2) data over the first 24 hours and cUS imaging. Infants were categorized as early sIVH (sIVH identified in the first 48 hours), late sIVH (sIVH identified after 48 hours and normal imaging in the first 48 hours), and no IVH. Infants with grades 1 and 2 or unknown timing IVH were excluded. Mean heart rate (HR), SpO2, mean arterial blood pressure (MABP), number of episodes of bradycardia (HR < 100 bpm), and desaturation (SpO2 < 80%) were compared. Results A total of 639 infants (mean: 27 weeks' gestation) were included (567 no IVH, 34 early sIVH, and 37 late sIVH). In the first 48 hours, those with sIVH had significantly higher HR compared with those with no IVH. Infants with sIVH also had lower mean SpO2 and MABP and more desaturations <80%. No significant differences in VS patterns were identified in early versus late sIVH. Logistic regression identified higher HR and greater number of desaturations <80% as independently associated with sIVH. Conclusion VLBW infants who develop sIVH demonstrate VS differences with significantly lower SpO2 and higher mean HR over the first 48 hours after birth compared with VLBW infants with no IVH. Abnormalities in early VS patterns may be a useful biomarker for sIVH. Whether VS abnormalities predict or simply reflect sIVH remains to be determined. Key Points

Implementation of Potentially Better Practices for the Prevention of Brain Hemorrhage and Ischemic Brain Injury in Very Low Birth Weight Infants

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_E1) ◽  
pp. e497-e503
Author(s):  
Debra McLendon ◽  
Jennifer Check ◽  
Patricia Carteaux ◽  
Laura Michael ◽  
Jim Moehring ◽  
...  
Keyword(s):  
Birth Weight ◽  
Brain Injury ◽  
Low Birth Weight ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Periventricular Leukomalacia ◽  
Communication Education ◽  
Low Birth Weight Infants ◽  
Head Positioning ◽  
Ventilator Management

Objective. Using an evidence-based approach, a Vermont Oxford Network focus group whose goal was to reduce brain injury developed and implemented a number of potentially better practices. Each center approached implementation of the practices differently. Reducing the incidence of intraventricular hemorrhage and periventricular leukomalacia are important for improving long-term outcomes for low birth weight infants. Methods. Implementation approaches for some but not all of the practices at the various centers are discussed. The practices reviewed include optimal peripartum management, such as resuscitation, avoidance of hypothermia, optimal surfactant delivery, early neonatal management by the most experienced providers, and measures to minimize pain and stress. Additional practices include maintenance of neutral head positioning, fluid volume therapy for hypotension, indomethacin prophylaxis, ventilator management, avoidance of routine suctioning, and limiting the use of sodium bicarbonate and postnatal dexamethasone. Results. Approaches to implementation were center specific, and results vary. Although some practices were easier to implement than others, communication, education, and leadership were critical to the process. Conclusions. The quality improvement multidisciplinary approach is a useful tool for finding ways to reduce the incidence of intraventricular hemorrhage and periventricular leukomalacia.

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