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

Benzyl Alcohol Toxicity: Impact on Mortality and Intraventricular Hemorrhage Among Very Low Birth Weight Infants

PEDIATRICS ◽  
1986 ◽  
Vol 77 (4) ◽  
pp. 500-506 ◽  
Author(s):  
Janet L. Hiller ◽  
Gerda I. Benda ◽  
Mohammadtaglii Rahatzad ◽  
James R. Allen ◽  
David H. Culver ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Benzyl Alcohol ◽  
Medical Records ◽  
Intraventricular Hemorrhage ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Prenatal Factors ◽  
Improvement In Survival

Benzyl alcohol preservative in intravascular flush solutions has been reported to cause neurologic deterioration and death in very low birth weight infants. Following the widespread discontinuation of the use of such solutions in newborns, scattered reports of decreased mortality and decreased incidence of intraventricular hemorrhage among small premature infants appeared in the pediatric literature. To better assess the true impact of benzyl alcohol toxicity in this group of infants, we undertook a detailed review of the medical records of all babies &lt;1,250 g birth weight admitted to our neonatal intensive care unit for 13 months before and 13 months after the use of solutions containing benzyl alcohol was stopped. Significant decreases were found in both mortality rate (from 80.7% to 45.7%) and incidence of grade III/IV intraventricular hemorrhage (from 46% to 19%) among infants &lt;1,000 g birth weight who did not receive the preservative compared with those who did. No significant changes were found in several other prenatal factors that could have contributed to this improvement in survival. We conclude that benzyl alcohol toxicity contributed significantly to both mortality and the occurrence of major intraventricular hemorrhage among infants weighing &lt;1,000 g at birth and that solutions containing benzyl alcohol should never again be used in the care of such infants.

scholarly journals Teamwork in the NICU Setting and Its Association with Health Care–Associated Infections in Very Low-Birth-Weight Infants

2017 ◽  
Vol 34 (10) ◽  
pp. 1032-1040 ◽  
Author(s):  
Paul Sharek ◽  
Peiyi Kan ◽  
Joseph Rigdon ◽  
Manisha Desai ◽  
Courtney Nisbet ◽  
...  
Keyword(s):  
Health Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Clinical Care ◽  
Random Effect ◽  
Low Birth Weight Infants ◽  
Cross Sectional ◽  
Vlbw Infants

Background and Objective Teamwork may affect clinical care in the neonatal intensive care unit (NICU) setting. The objective of this study was to assess teamwork climate across NICUs and to test scale-level and item-level associations with health care–associated infection (HAI) rates in very low-birth-weight (VLBW) infants. Methods Cross-sectional study of the association between HAI rates, defined as any bacterial or fungal infection during the birth hospitalization, among 6,663 VLBW infants cared for in 44 NICUs between 2010 and 2012. NICU HAI rates were correlated with teamwork climate ratings obtained in 2011 from 2,073 of 3,294 eligible NICU health professionals (response rate 63%). The relation between HAI rates and NICU teamwork climate was assessed using logistic regression models including NICU as a random effect. Results Across NICUs, 36 to 100% (mean 66%) of respondents reported good teamwork. HAI rates were significantly and independently associated with teamwork climate (odds ratio, 0.82; 95% confidence interval, 0.73–0.92, p = 0.005), such that the odds of an infant contracting a HAI decreased by 18% with each 10% rise in NICU respondents reporting good teamwork. Conclusion Improving teamwork may be an important element in infection control efforts.

scholarly journals The Evidence Base for the Cues Program for Mothers of Very Low Birth Weight Infants: An Innovative Approach to Reduce Anxiety and Support Sensitive Interaction

2011 ◽  
Vol 20 (3) ◽  
pp. 142-153 ◽  
Author(s):  
Nancy Feeley ◽  
Phyllis Zelkowitz ◽  
Ruta Westreich ◽  
David Dunkley
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Intervention Program ◽  
Very Low Birth Weight ◽  
Evidence Base ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Developmental Problems ◽  
Program Content

Very low birth weight (VLBW) infants, born weighing less than 1,500 g, are at risk for several developmental problems. Consequently, there has been interest in developing intervention programs to prevent such problems. This article describes the empirical evidence that guided the development of an innovative, multicomponent intervention program for mothers of VLBW infants, as well as the program content and features. Based on the evidence, the program was designed to include six sessions and commence shortly after birth to reduce maternal psychological distress during the infant’s hospitalization in the neonatal intensive care unit and to promote sensitive mother–infant interaction. The program incorporates various learning activities, including written materials, observational exercises, discussion, and video feedback.

Device-associated pneumonia of very low birth weight infants in Polish Neonatal Intensive Care Units

2016 ◽  
Vol 61 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Jadwiga Wójkowska-Mach ◽  
T. Allen Merritt ◽  
Maria Borszewska-Kornacka ◽  
Joanna Domańska ◽  
Ewa Gulczyńska ◽  
...  
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Neonatal Intensive Care Units ◽  
Low Birth Weight Infants

Very Low Birth Weight Outcomes

PEDIATRICS ◽  
1992 ◽  
Vol 89 (2) ◽  
pp. 357-357
Author(s):  
HELEN HARRISON
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Meta Analysis ◽  
Low Birth Weight Infants ◽  
Randomized Controlled Clinical Trials ◽  
Weight Outcomes ◽  
Term Evaluation

To the Editor.— The authors of the National Institute of Child Health and Human Development report on neonatal care1 found "important" variations among neonatal intensive care units in philosophies of treatment, methods of treatment, and short-term outcomes. In a recent meta-analysis of follow-up studies,2 researchers document a similarly haphazard approach to the long-term evaluation of very low birth weight survivors. Until randomized controlled clinical trials validate the safety and efficacy of neonatal therapies, and until long-term outcomes are assessed accurately, the treatment of very low birth weight infants should be declared experimental.

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

scholarly journals Short- and long-term outcomes of very low birth weight infants in Korea: Korean Neonatal Network update in 2019

2020 ◽  
Vol 63 (8) ◽  
pp. 284-290 ◽  
Author(s):  
Jang Hoon Lee ◽  
YoungAh Youn ◽  
Yun Sil Chang ◽  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Annual Reports ◽  
Long Term Outcomes ◽  
Post Discharge ◽  
Low Birth Weight Infants ◽  
Korean Society

Korea currently has the world’s lowest birth rate but a rapidly inreasing number of preterm infants. The Korean Neonatal Network (KNN), launched by the Korean Society of Neonatology under the support of Korea Centers for Disease Control, has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. In terms of the short-term outcomes of VLBWIs born from 2013 to 2016 registered in the KNN, the survival rate of all VLBWIs was 86%. Respiratory distress syndrome and bronchopulmonary dysplasia were observed in 78% and 30% of all VLBWIs, respectively. Necrotizing enterocolitis occurred in 7%, while 8% of the VLBWIs needed therapy for retinopathy of prematurity in the neonatal intensive care unit (NICU). Sepsis occurred in 21% during their NICU stay. Intraventricular hemorrhage (grade ≥III) was diagnosed in 10%. In terms of the long-term outcomes for VLBWIs born from 2013 to 2014 registered in the KNN, the post-discharge mortality rate was approximately 1.2%–1.5%, mainly owing to their underlying illness. Nearly half of the VLBWIs were readmitted to the hospital at least once in their first 1–2 years of life, mostly as a result of respiratory diseases. The overall prevalence of cerebral palsy was 6.2%–6.6% in Korea. Bilateral blindness was reported in 0.2%–0.3% of VLBWIs, while bilateral hearing loss was found in 0.8%–1.9%. Since its establishment, the KNN has published annual reports and papers that facilitate the improvement of VLBWI outcome and the formulation of essential healthcare policies in Korea.

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