Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
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Effects of Early Phosphorus Intake on Respiratory Distress in Extremely Low-Birth-Weight Infants

  • Bae, Hye Jung (Department of Pharmacy, Seoul National University Hospital) ;
  • Yoon, Hyung Woo (Department of Pharmacy, Seoul National University Hospital) ;
  • Kim, Moon Jin (Department of Pharmacy, Seoul National University Hospital) ;
  • Jung, Ae Hee (Department of Pharmacy, Seoul National University Hospital) ;
  • Jung, Sun Hoi (Department of Pharmacy, Seoul National University Hospital) ;
  • Hahn, Hyeon Joo (Department of Pharmacy, Seoul National University Hospital) ;
  • Jo, Yun Hee (Department of Pharmacy, Seoul National University Hospital) ;
  • Cho, Yoon Sook (Department of Pharmacy, Seoul National University Hospital) ;
  • Kim, Ee-Kyung (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Shin, Seung Han (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Song, In Gyu (Cancer Hospice Center, National Cancer Center) ;
  • Shin, Seung Hyun (Department of Pediatrics, Seoul National University Children's Hospital)
  • Received : 2019.03.02
  • Accepted : 2019.07.18
  • Published : 2019.08.31
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Abstract

Purpose: This study was aimed to investigate the effect of early phosphorus intake on respiratory distress in extremely low-birth-weight infants (ELBWIs) with a high incidence of hypophosphatemia. Methods: We performed a retrospective study to target 164 ELBWIs admitted to the neonatal intensive care unit in Seoul National University Children's Hospital. Birth characteristics, nutritional intake, and electrolyte levels during the first week were investigated as predictors that would affect the clinical outcomes. The correlations among invasive ventilation at postnatal age of 2 weeks, moderate-to-severe broncho-pulmonary dysplasia (BPD), and phosphorous intake were analyzed. Results: Hypophosphatemia (phosphorus level <4 mg/dL) was observed in 72.0% of the subjects. The rates of invasive ventilation (P=0.001) and moderate-to-severe BPD (P=0.005) were significantly lower in the high phosphorus intake group (≥0.7 mM/kg/day) than in the low phosphorus intake group (<0.7 mM/kg/day). Phosphorus intake during the first week was a significant factor affecting invasive ventilation at 2 weeks of age (adjusted odds ratio [OR], 8.212; 95% confidence interval [CI], 2.256 to 28.896; P=0.001) and moderate-to-severe BPD (adjusted OR, 3.402; 95% CI, 1.274 to 9.084; P=0.015). Conclusion: Early insufficient phosphorus intake confers a significantly higher risk with invasive ventilation at 2 weeks of age and moderate-to-severe BPD. Therefore, early sufficient phosphorus supply may improve respiratory outcomes in ELBWIs.

Keywords

Acknowledgement

이 논문은 2017년도 정부(교육부)의 재원으로 한국연구재단의 지원을 받아 수행된 기초연구사업임(No. NRF-2017R1D1A1B04030931).

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