• Title/Summary/Keyword: 저출생 체중아

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Prevalence and Risk Factors of Candida Sepsis in Neonatal Intensive Care Unit (신생아 중환자실에서 캔디다 패혈증의 발생 추이와 위험 인자)

  • Choi, Ic Sun;Lim, Suk Hwan;Cho, Chang Yee;Choi, Young Youn;Hwang, Tai Ju
    • Clinical and Experimental Pediatrics
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    • v.45 no.7
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    • pp.836-846
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    • 2002
  • Purpose : With the development of neonatal intensive care and the increased use of systemic antibiotics, candida sepsis has become one of the most important causes of neonatal morbidity and mortality. The purpose of this study was to investigate the prevalence rate and its associated risk factors. Methods : We retrospectively reviewed medical records of 28 cases with candida sepsis who were admitted in the neonatal intensive care unit(NICU) of Chonnam University Hospital from July 1995 to June 2001. Twenty-nine patients without candida sepsis were enrolled for the control group to verify the risk factors. Results : The overall incidence of candida sepsis was 0.61% for all NICU admissions and 3.68% for all very low birth weight infants with the gradual increase of the annual prevalance rate over time. The endotracheal intubation, percutaneous central vein catheter(PCVC), umbilical vein catheter, total parenteral nutrition, intralipid and dopamine were more applied than the control group (P<0.01 for all). The durations of mechanical ventilator care, central catheter appliance, nothing per os, and admission were also significantly longer than the control group(P<0.01 for all). Ampicillin/ sulbactam, ceftazidime, amikacin, netilmicin, teicoplanin and imipenem/cilastatin were significantly more used than the control group(P<0.05). The durations of ampicillin/sulbactam, ceftazidime, netilmicin and imipenem/cilastatin administration were also proved to be significant as the risk factors(P<0.01). Conclusion : The average annual prevalence rate of candida sepsis in NICU for six years was 0.61% with gradual increasing tendency over time. The elimination of the above risk factors is important in decreasing neonatal morbidity and mortality associated with candida sepsis.

Staged Repair of Esophageal Atresia with Tracheoesophageal Fistula in a Very Low-birth-weight Infant - A case report- (극소저체중출생아에서 기관식도루를 동반한 식도폐쇄의 단계적 수술 - 1예 보고 -)

  • Sung, Si-Chan;Kim, Hyung-Tae;Ra, Yong-Joon;Byun, Shin-Yun;Kwon, Kyung-Ah;Jo, Yong-Hoon
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.820-823
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    • 2010
  • There are still some controversies in treatment strategy for the very low-birth-weight baby with esophageal atresia even though the result of primary repair has been improving. We report a successful end to end anastomosis with staged approach in one of twin weighing 1,270 g at birth.

Weight Gain Study of Very Low Birth Weight Infants in Relation to Gestational Age and Birth Weight (출생시 체중과 재태기간에 따른 극소 저출생 체중아의 체중 변화)

  • Kim Hae-Soon;Shin Yeong-Hee
    • Child Health Nursing Research
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    • v.10 no.1
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    • pp.5-13
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    • 2004
  • Purpose: The aim of this study was to analyze the correlation of gestational age and birth weight with weight gain of very low birth weight infants(VLBWI) during their hospital stay. Method: This is a 5 year retrospective study of which data were collected through review of medical records. Subjects were 124 VLBW infants with a birth weight more than 1000g and less than 1500g who received neonatal intensive care at the university hospital between January 1, 1997 to December 31, 2001. Result: After calculating the z scores of birth weights and discharge weights, z scores of discharge weight and birth weight were compared with the median weight of a fetus of comparable gestational age based on an intrauterine growth reference. There was a significant difference between z scores of birth weight and discharge weight(t=11.60, df=122, p=0.000). Regardless of intensive care during the prolonged hospital stay, VLBW infants showed slow growth rate compared with the median weight of a fetus of comparable gestational age. Conclusion: VLBW infants developed a poor velocity of weight gain during the prolonged hospital stay after birth. The development worsened during the period of physiological weight loss and regain, and they did not reach to comparable growth rate of normal fetus even at the time of discharge. This poor growth velocity of VLBW infants influence negatively for their future growth. Therefore nureses who work at the neonatal intensive care unit must develop an effective nursing intervention protocol to promote the velocity of weight gain and to conduct the parental educational sessions to emphasize the importance of weight gain for VLBW infants at home.

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A Case of in-utero Vesicoamniotic Shunting and Postnatal Vesicostomy in Very Low Birth Weight Baby with Posterior Urethral Valve Syndrome (산전 방광 양막강 문합술(Vesicoamniotic shunt)과 출생 후 방광 조루술(Vesicostomy)을 실시한 극소 저출생 체중아의 후부 요도 판막증 1례)

  • Kim, Sung-Hye;Shim, Jae-Won;Chang, Yun-Shil;Yang, Soon-Ha;Park, Kwan-Hyeun;Jin, Dong-Kyu;Park, Won-Soon
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1038-1042
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    • 2002
  • We present a case of in-utero vesicoamniotic shunting and postnatal vesicostomy in a very low birth weight baby with posterior urethral valve syndrome. He was diagnosed as posterior urethral valve at $24^{+5$ weeks' gestation. Because of severe hydronephrosis and oligohydroamnios, the shunt was established by basket-shaped catheter at $27^{+0}$ weeks' gestation. After shunt, hydronephrosis improved. At $29^{+4}$ weeks' gestation, the shunt catheter escaped from its position and severe urinary ascites and hydronephrosis developed. At 30 weeks' gestation, the baby was born and showed elevated BUN and creatinine. On the 10th day of birth, vesicostomy was done for urinary drainage. Thereafter, the baby has been followed up for 10 months and has had recurrent episodes of urinary infection. We report the case with a brief review of literature.

Influence of Intrauterine Position on Fetal Weight in Albino Rats Exposed to Carton Monoxide (일산화탄소중독 수태백서의 자궁내 착상위치가 태자의 발육에 미치는 영향)

  • Cho, Soo-Hun;Choi, Jang-Seok;Yun, Dork-Ro
    • Journal of Preventive Medicine and Public Health
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    • v.19 no.1 s.19
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    • pp.123-129
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    • 1986
  • Fetal weight data from 84 litters of Sprague-Dawley rats were statistically analyzed for the effect of position in the uterine horn on fetal weight. The standard score obtained from the mean weight and standard deviation of all fetuses in a uterine horn were studied for position effect. In control group, the heaviest fetus occupied the middle position with a progressive decrease in weights toward the ovarian and cervical ends of the horn. But the effect related to position for the fetal weight was not statistically significant. In contrast, rats acutely or chronically exposed to carbon monoxide showed statistically significant positional differences of fetal weight within the uterine horns. The findings that the intrauterine position effect on fetal weight which is not signicant in control group may act one of confounders at the situation of transplacental toxicological studios.

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Impact of Changes in Maternal Age and Parity Distribution on Low Birth Weight Incidence Rate (모성연령과 출산순위의 변화가 저체중아 출생률에 미친 영향)

  • Kim, Young-Ae;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.2 s.26
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    • pp.276-282
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    • 1989
  • The objective of this study was to examine the impact of changes in maternal age and parity distribution on birth weight. The study population included 7,786 single live births in 1977 and 8,671 single live births in 1987 delivered at 9 medical facilities in Pusan. Data were obtained from the delivery record. The proportion of infants born to the mothers of 25-29 years increased from 56.475 in 1977 to 65.1% in 1987 and the proportion to the mothers of 30-34 years increased from 18.8% in 1977 to 21.6% in 1987. In the same period, the proportions of 1st and 2nd birth order were increased from 56.9% and 28.8% to 59.9% and 36.8%, respectively. The proportion of infants born to the age group of ${\leq}24\;and\;35{\leq}$ years were decreased in 1987. The proportion of births of the third or higher birth order was decreased from 14.2% in 1977 to 3.3% in 1987. Low birth weight (<2500gm) incidence rate was 5.3% in 1977 and it was decreased to 4.0% in 1987. It was estimated that changes in maternal age-parity distribution accounted for 10.7% of the decreased in low birth weight incidence rate. Rest of the change (89.3%) was attributed to the reduction of age-parity specific low birth weight incidence rate. Application of the direct adjustment method was considered to be an adequate tool for evaluating the impact of family planning on neonatal health.

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Hypernatremia and Intraventricular Hemorrhage in Very Low Birth Weight Infants(<1,250 g) (극소 저체중 출생아(<1,250 g)에서 고나트륨혈증 발생 및 뇌출혈과의 관계)

  • Lee, Soo-Ho;So, Cheol-Hwan;Keum, Seung-Hoon;Yoo, Seung-Taek;Choi, Doo-Young;Oh, Yeon-Kyun
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.89-95
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    • 2011
  • Purpose: Hypernatremia most frequently occurs in the immature newborn and be severe in association with intraventricular hemorrhage (IVH). This study examined the frequency, onset and risk factors of hypernatremia, and the relationship between hypernatremia and IVH in very low birth weight (VLBW; <1,250 g) infants. Methods: We retrospectively reviewed the medical records of 55 VLBW infants admitted between January 2006 and December 2009 to the neonatal intensive care unit of Wonkwang University Hospital and who survived over 7 days. Serum sodium concentration, sodium intake, fluid and weight loss, as suggested risk factors of hypernatremia, and the incidence of IVH were evaluated. The infants were divided into a hypernatremia group (${\geq}$150 mEq/L) and nonhypernatremia group, and were compared. Results: Incidence of hypernatremia in the VLBW infants was 52.7%, and mean starting time of hypernatremia was 2.8${\pm}$1.3 days. There were no differences in the sodium and fluid intake between the two groups. Weight loss at day 3 after birth was significantly higher in the hypernatremia compared to the nonhypernatremia group (P<0.05); thereafter weight loss was non-significantly higher. The incidence of IVH in VLBW infants was 38.2%, and the difference between the two groups was not significant. Conclusion: Hypernatremia occurs commonly in VLBW infants and is most commonly caused by weight loss in the early days after birth. Incidence of IVH is not likely influenced by hypernatremia with marginally elevated sodium concentration.

Changes in Pathogens and Antibiotic Sensitivities in very Low Birth Weight Infants with Neonatal Sepsis (극소저출생체중아에서 신생아 패혈증의 원인균 및 항생제 감수성의 변화)

  • Kim, Kyung-Nam;Park, Ho-Jin
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.54-60
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    • 2008
  • Purpose : To set up an appropriate treatment plan for neonatal sepsis by investigating changes in pathogens and antibiotic sensitivities. Methods : The medical records of very low birth weight infants (VLBWI) admitted to the neonatal intensive care unit (NICU) of the Eulji University Hospital between January 2000 and June 2006 were retrospectively reviewed. The culture reports were analyzed for causative microorganisms and antibiotic sensitivities. Results : Among 164 neonates, 19 neonates (11.6%) had 26 episodes of culture-proven sepsis. Very late onset sepsis was the most common type. The dominant pathogens of sepsis included Klebsiella pneumoniae, Streptococcus spp., coagulase negative Staphylococcus and Enterobacter spp., and were mostly multi-drug resistant. Conclusion : For the appropriate treatment of neonatal sepsis, proper use of antibiotics through the periodic review and understanding of changes of the microorganisms and antimicrobial sensitivities is necessary to prevent multi-drug resistant microorganisms and to avoid excessive use of broad-spectrum empiric antibiotics.

Effect of Optimal Humidification for Extremely Low Birth Weight Infants During Nasal Continuous Positive Airway Pressure (인공호흡기 가습기 적용방법이 초극소 저출생 체중아의 경비지속 기도 양압 환기법 유지기간에 미치는 영향)

  • Kim, Jung-Sook;Lee, Eun-Jung
    • Child Health Nursing Research
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    • v.17 no.2
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    • pp.145-152
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    • 2011
  • Purpose: To evaluate the efficacy of Optimal humidification during Nasal Continuous Positive Airway Pressure (nCPAP) for Extremely Low Birth Weight Infant (ELBWI). Methods: The study design was a pre-test-post-test nonequivalent nonsynchronized quasi-experimental design. The participants were 218 ELBWI on nCPAP (experimental group: 102 and control group: 116). Data collection was conducted from January 2005 to April 2010. In order to measure and analyze the nCPAP duration, reintubation and nasal condition, Chi-square test and t-test were used. Results: Hypothesis 1, that the duration with nCPAP in the experimental group is longer than that of the control group and hypothesis 2-3, that the rate of reintubation and nasal problems in the experimental group are lower than the control group, were all supported as there were statistically significant differences between two groups. Conclusion: The findings suggest that the Optimal humidification in this study is an efficient intervention because it helps increase the last time of nCPAP with ELBWI and minimize complications. It is expected that Optimal humidification is beneficial and helpful in preventing and caring for respiratory problems in these infants.