• Neonatal Medicine
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• v.17 no.2
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• pp.193-200
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• 2010

Purpose: Feeding desaturation is a common problem among preterm infants which can result in prolonged hospital stays, longterm feeding difficulties and growth delay. The purpose of this study was to identify the characteristics of premature infants with feeding desaturation and to examine the effect of orocutaneous stimulation on oral feeding. Methods: During the first phase of this study, 125 extremely low birth weight infants were reviewed retrospectively. Characteristics between infants with feeding desaturation (n=34) and those without feeding desaturation (n=91) were examined. During the second phase, 29 infants recruited from March, 2009 to May, 2010 were subjected to orocutaneous stimulation. The results of orocutaneous stimulation were compared to a control group (n=81). Results: The first phase of the study revealed that extremely low birth weight infants with feeding desaturation were significantly lower in gestational ages at birth, and had lower 5 minute apgar scores, more gastroesophageal refluxes and bronchopulmonary dysplasia. Infants without feeding desaturation reached full enteral feeding significantly earlier and showed shorter duration of hospital stay. At the second phase, infants in the intervention group showed shorter days to achieve initiation of bottle feeding, shorter days in achievement of full bottle feeding, last episodes of feeding desaturation and length of hospital stay compared to the control group of similar characteristics. Conclusion: Orocutaneous stimulation among extremely low birth weight infants results in earlier achievement of full bottle feedings without episodes of feeding desaturation hence shortens the length of hospital stay.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.245-249
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• 2000

Listeria monocytogenes is one of the important causes of neonatal sepsis and listerial neonatal infection manifests in two forms : Early-onset sepsis syndrome, associated with spontaneous abortion, still birth, preterm labor, granulomatosis infantiseptica, respiratory distress, sepsis, hemodynamic compromise and late-onset listerosis mainly associated with meningitis. Cases of neonatal listerosis reported in Korea have been rare and all were full term newborns. We, herein, report a case of early-onset sepsis due to L. monocytogenes in a extremely low birth weight infant who were born in a critical condition and succumbed in the second day of life despite the intensive care.

• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.857-863
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• 2006

Purpose : To evaluate the immunogenicity of hepatitis B vaccine among very low birth weight infants(VLBWI) who were vaccinated at 0, 1, 6 months of chronological age and to determine the factors associated with antibody formations. Methods : A total of 243 VLBWI admitted to Seoul and Gangneung Asan Medical Center neonatal intensive care units from 1997 to 2004 were included. Of 243, 13 infants were born to HBs Ag positive mother. All infants were given DNA recombinant vaccine at 0, 1, and 6 months of chronological age. Infants born to HBs Ag positive mothers received hepatitis B immunoglobulin at birth and a total of 4 doses of vaccinations. An antibody level over 10 mIU/mL, tested at 3-4 months after last vaccination, was regarded as a positive seroconversion. Results : The seroconversion rates were 84.4 percent and 84.5 percent for VLBWI and extremely low birth weight infants(ELBWI), respectively. Of 28 seronegative infants who were given revaccinations, 60.7 percent seroconverted, resulting in 95.3 percent, 97.5 percent seroconversion rates for VLBWI and ELBWI, respectively. 76.9 percent of infants born to HBsAg positive mothers seroconverted and none became hepatitis B carriers. Factors such as gestational age, sex, various neonatal illness, and kinds of vaccinations did not influence the formation of the hepatits B antibody, however, the higher the weight at time of first vacciation yielded better seroconversion rate. Conclusion : Revaccination of seronegative VLBWI after 3 doses of hepatitis B vaccinaton is very effective. Therefore, testing the immune status after the hepatitis B vaccination, a practice not routinely done, is highly recommended.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.800-804
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• 2006

Necrotizing enterocolitis(NEC) is the most common life-threatening surgical emergency in neonates, and remains a major cause of morbidity and mortality. In addition to conventional laparotomy, intraperitoneal drains have been used for the treatment of perforated NEC, especially in extremely low birth weight(ELBW) infants. We report a case of perforated NEC with bacterial peritonitis in an ELBW infant managed with primary peritoneal drainage(PD) without further need for surgery. To our knowledge, this is the first documented Korean case of an ELBW infant where PD was used as primary treatment for perforated NEC. Primary PD is effective and safe in ELBW infants with perforated NEC; although it is not considered a definitive procedure, it should be considered in all cases where infants are too unstable to tolerate anesthesia and surgery.

• 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.

• Neonatal Medicine
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• v.16 no.1
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• pp.36-46
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• 2009

Purpose: To evaluate the neonatal statistics on a national basis, data for birth characteristics and neonatal mortality were collected and analyzed from 57 hospitals in Korea. Methods: Questionnaires were distributed to determine the characteristics of neonatal births and mortality rates in 57 hospitals in Korea during 2007. We analyzed the characteristics of all inborn births and hospitalized neonates in the neonatal care units (NICUs) and compared the results with published Korean data from 1996 and 2002. Results: A total of 40,433 inborn live births were reported from the 57 hospitals during 2007. Pre-term, term, and post-term births comprised 24.2%, 75.6%, and 0.2% of the neonates, respectively. Low birth weight infants (LBWIs), very low birth weight infants (VLBWIs), and extremely low birth weight infants (ELBWIs) made up 22.0%, 4.6%, and 1.7% of the neonates, respectively. A total of 21,957 (collected by gestational period) and 21,356 (collected by birth weight) neonates were hospitalized in the 57 NICUs. Pre-term, term, and post-term neonates comprised 39.8%, 59.8%, and 0.4% of the neonates, respectively. LBWIs, VLBWIs, and ELBWIs made up 37.3%, 9.5%, and 3.3% of the neonates, respectively. Pre-term, term, and post-term neonates had mortality rates of 4.5%, 0.7%, and 3.7%, respectively, while the mortality rates of LBWIs, VLBWIs, and ELBWIs were 4.7%, 15.3%, and 32.2%, respectively. In comparison with prematurity data from 1996 and 2002, LBWIs, and ELBWIs had a marked increase in birth frequency and a decreased mortality rate in Korea during 2007. Conclusion: The number of live births and the survival rate of pre-term neonates, especially VLBWIs and ELBWIs, are increasing. Even though the outcomes of neonatal care are improving, further efforts to manage these premature infants are needed.

• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.902-905
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• 2006

We report a case in which routine chest roentgenograms of an 840 g infant led to the belief that the peripherally inserted central catheter (PICC) was appropriately positioned within the superior vena cava when, in actuality, it was within the azygous arch. Although many cases of pleural effusions have been reported to be caused by a central venous catheter, a right-sided hydrothorax caused by azygous vein rupture from the use of a PICC is an extremely rare complication. Sudden changes in the condition of a preterm infant with PICC should raise the suspicion of a catheter-related problem.

• Neonatal Medicine
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• v.18 no.1
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• pp.76-81
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• 2011

Purpose: The object of this study was to evaluate the efficacy of early total parenteral nutrition with early amino acid in extremely low birth weight infant (ELBWI). Methods: We retrospectively analyzed the medical records of all ELBWIs who were born and admitted to Samsung Medical Center from January 2003 to December 2003 and January 2009 to December 2009 and alive at the time of discharge. Data for nutritional status and morbidities were compared between period 1 (2003, n=22), in which parenteral nutritional support was started gradually over several days and period 2 (2009, n=38), in which parenteral nutrition with amino acid was started as soon as possible after birth. Results: Compared to period 1, birth weight and Apgar score were lower in period 2. The intake amount of glucose, amino acid and total calorie was higher and the level of blood urea nitrogen was increased more from 7th day to 14th day after birth in period 2 when compared than period 1. The weight gain velocity was faster at 7th and 14th postnatal day in period 2. There were no differences in the incidence of necrotizing enterocolitis, moderate to severe bronchopulmonary dysplasia, and severe intraventricular hemorrhage (${\geq}$ Gr III) between two periods but, the incidence of periventricular leukomalacia(PVL) was significantly lower in period 2. Conclusion: Early initiation of total parenteral nutrition with early amino acid in ELBWIs was beneficial at weight gain with lowering catabolism and increasing anabolism. And it could be related with reducing the incidence of PVL.

• Clinical and Experimental Pediatrics
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• v.49 no.9
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• pp.959-965
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• 2006

Purpose : The purpose of this study was to investigate the effect of prophylactic indomethacin on reduction of patent ductus arteriosus(PDA) and intraventricular hemorrhage(IVH) in extremely low birth weight infants(ELBWI). Methods : Retrospective review of 84 ELBWI who were admitted to our neonatal intensive care unit from June 2004 to April 2006 was performed. Patients were divided into prophylactic group(n=28) and control group(n=56), where prophylactic indomethacin were given within 6 hours after birth. Clinical outcomes were compared between these groups. Results : There were no significant differences in gestational age, birth weight, incidence of hemodynamically significant PDA and severe IVH, and mortality between prophylactic group and control group. However, there were more frequent indications for therapeutic indomethacin, higher incidence of intestinal perforation, and longer time to achieve full enteral feeding in prophylactic group than control group. The incidence of other adverse events attributed to indomethacin prophylaxis did not differ between two groups. Conclusions : Prophylactic indomethacin may not prevent hemodynamically significant PDA and severe IVH in ELBWI. On the contrary, it may be associated with increased risk of adverse events. Further efforts should be investigated to decrease PDA and severe IVH in ELBWI.

• Neonatal Medicine
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• v.16 no.2
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• pp.234-238
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• 2009

Posthemorrhagic hydrocephalus is a major problem in premature infants. We describe our experience with a neonate that was an extremely low birth weight infant with posthemorrhagic hydrocephalus, who was treated by repeated ventricular drainage through an Ommaya reservoir for more than two months until the placement of a ventriculoperitoneal shunt was possible. The Ommaya reservoir served as a bridge to definitive treatment. The patient required sodium supplements due to excessive salt loss from the repeated ventricular drainage procedures. Regular measurement of serum electrolytes in any infant requiring serial ventricular drainage is recommended.