1
|
Neumoencéfalo a tensión, una extraña complicación del uso de oxígeno en neonatos. Descripción de un caso y revisión de la literatura. Neurocirugia (Astur) 2021; 32:84-88. [DOI: 10.1016/j.neucir.2019.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/01/2019] [Accepted: 09/15/2019] [Indexed: 11/18/2022]
|
2
|
Differential determinants of patent ductus arteriosus closure for prematurity of varying birth body weight: A Retrospective Cohort Study. Pediatr Neonatol 2020; 61:513-521. [PMID: 32620378 DOI: 10.1016/j.pedneo.2020.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 04/11/2020] [Accepted: 05/26/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Patent ductus arteriosus (PDA) remains a critical issue in prematurity care. To predict the PDA closure early, we aimed to clarify the association of PDA closure with the initial postnatal 24-hour clinical characteristics and maternal and gestational histories of preterm neonates. METHODS A retrospective cohort study was conducted in a pediatric-neonatal-intensive-care-unit from 2008 to 2013. Data relating to birth histories, maternal histories, and clinical data from the first 24 h of life were analyzed according to three types of PDA closure-non-treated, medically-responsive, and surgically-ligated PDA and birth body weights (BBWs). Univariate analysis was performed using non-parametric analysis and Chi-square test or Fisher's exact test. Multivariate analysis was performed using multinomial logistic regression to determine the independent risk factors for the PDA closure. RESULTS This study involved 682 preterm infants with median gestational age of 31 (interquartile, IQR: 28-34) weeks and BBW of 1360 (IQR: 1085-1861) g. Inclusively, 16.7% of (P)DAs underwent medical and/or surgical treatment. For very low birth body weight (VLBW) neonates, surfactant use not only predicted the requirement of PDA treatment, but together with dopamine use and the larger amount of first 24-hour intravenous fluid (IVF) per kilogram of BBW, it also predicted the possibility of surgical ligation. Meanwhile, the cut-off values of the IVF amount (87 and 89.5 ml/kg/day, respectively) might predict the PDA treatment necessity and surgical ligation. For neonates with BBW ≥1500 g, placenta previa and lower BBW and systolic blood pressure (SBP) predicted the risk of treatment for PDA and its treatment response. CONCLUSIONS Neonatal care for PDA in prematurity should be meticulously personalized. Surfactant use, dopamine administration and the first 24-hour IVF management may be critical for PDA closure in VLBW neonates. Antepartum history of placenta previa, BBW and SBP control may be important for BBW≥1500 g.
Collapse
|
3
|
Wu T, Wang Y, Xiong T, Huang S, Tian T, Tang J, Mu D. Risk factors for the deterioration of periventricular-intraventricular hemorrhage in preterm infants. Sci Rep 2020; 10:13609. [PMID: 32788671 PMCID: PMC7423930 DOI: 10.1038/s41598-020-70603-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 07/30/2020] [Indexed: 02/05/2023] Open
Abstract
Preterm infants with periventricular–intraventricular hemorrhage (PV–IVH) have a high risk of neurological sequelae, with severity depending on the severity of the PV–IVH. Previous studies on the pathogenesis of PV–IVH have focused mainly on comparisons of perinatal risk factors between patients with and without PV–IVH. Notably, most cases of PV–IVH occur within the first 3 days after birth, and the condition may worsen within 1 week following the initial diagnosis. However, the risk factors that contribute to the deterioration of PV–IVH have not been investigated. In this cohort study, 514 PV–IVH infants with a gestational age (GA) < 32 weeks were enrolled. The dependent variable was initially diagnosed as mild PV–IVH (grade I or II) that subsequently progressed to severe PV–IVH (grade III or IV) within 1 week. A stepwise forward multivariate logistic regression model was adopted to select potential or related factors that affected the deterioration of PV–IVH in preterm infants. Overall, 42 of the 514 infants with PV–IVH (8.2%) showed deterioration within 1 week. The results showed that maternal lower genital tract infection (OR 3.73, 95% CI 1.75–7.95) was an independent risk factor for PV–IVH deterioration. Higher GA (OR 0.62, 95% CI 0.48–0.80) was a protective factor. Our results suggest that maternal lower genital tract infection and a lower GA may contribute to PV–IVH deterioration in preterm infants.
Collapse
Affiliation(s)
- Tian Wu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Yan Wang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Tao Xiong
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. .,Deep Underground Space Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Sheng Huang
- Department of Information Management, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tian Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing, China
| | - Jun Tang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Dezhi Mu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| |
Collapse
|
4
|
Elfarargy MS, Eltomey MA, Soliman NA. Early predictors of neonatal intraventricular hemorrhage. Electron Physician 2017; 9:4946-4951. [PMID: 28979727 PMCID: PMC5614277 DOI: 10.19082/4946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 07/06/2017] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Current study aimed toward the early prediction of neonatal intraventricular hemorrhage (IVH) for better management and prognosis. METHODS This prospective study was conducted on forty neonates at the Neonatal Intensive Care Unit of Pediatrics and Medical Biochemistry department (Tanta University, Egypt) from July 2016 to June 2017. Cord blood erythropoietin and venous blood Activin A were assayed within the first hour of life. Neonates were divided into 2 groups: Group 1 (with IVH) included twenty neonates who developed IVH proved by transcranial ultrasonography (u/s) and Group 2 (without IVH) included twenty neonates who were admitted to the NICU but did not develop IVH, also proved by transcranial u/s. Data were analyzed using Chi Square and t-test. RESULTS Group 1 had a significantly higher cord blood erythropoietin concentration than group 2 (46.75±27.98 mIU/mL vs. 18.82±8.91 mIU/mL), respectively (p<0.05). Group 1 had a significantly higher venous blood Activin A concentration than group 2 (3.18±2 ng/L vs. 0.42±0.25 ng/L) with (p<0.05). CONCLUSION Cord blood erythropoietin and venous blood Activin A were presumed to be used as early predictors of IVH in neonates with early treatment and better prognosis.
Collapse
Affiliation(s)
- Mohamed Shawky Elfarargy
- MD, Assistant Professor of Pediatrics and Neonatology, Departments of Pediatrics, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Neama Ali Soliman
- Departments of Medical Biochemistry, Faculty of Medicine, Tanta University, Tanta, Egypt
| |
Collapse
|