• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제23권4호
• /
• pp.377-387
• /
• 2020

Purpose: To compare between sodium acetate (SA) and sodium chloride (SC) in parenteral nutrition (PN) with associated metabolic acidosis and neonatal morbidities in preterm infants. Methods: Preterm infants below 33 weeks gestational age, and with a birth weight under 1,301 g were enrolled and further stratified into two groups: i) <1,000 g, or ii) ≥1,000 g in birth weight. The subjects were randomized to receive PN containing SA or SC within the first day of life. The results of routine blood investigations for the first 6 days of PN were collated, and the neonatal outcomes were recorded upon discharge or demise. Results: Fifty-two infants entered the study, with 26 in each group: 29 infants had extremely low birth weight (ELBW). There were no significant differences in birth weight, gestation, sex, exposure to chorioamnionitis and antenatal steroids, surfactant doses and duration of mechanical ventilation between groups. The SA group had significantly higher mean pH and base excess (BE) from days 4 to 6 than the SC (mean pH, 7.36 vs. 7.34; mean BE -1.6 vs. -3.5 [p<0.01]), with a two-fold increase in the mean BE among ELBW infants. Significantly fewer on SA required additional bicarbonate (n=4 vs. 13, p=0.01). The rate of bronchopulmonary dysplasia (BPD) was approximately four-fold lower in SA than SC (n=3 vs. 11, p<0.01). No significant differences were observed in necrotizing enterocolitis, patent ductus arteriosus, retinopathy of prematurity, cholestatic jaundice, and mortality between groups. Conclusion: The use of SA in PN was associated with reduced metabolic acidosis and fewer BPD.

• Journal of Animal Science and Technology
• /
• 제63권1호
• /
• pp.1-15
• /
• 2021

As a result of intensive breeding, litter size has considerably increased in pig production over the last three decades. This has resulted in an increase in farrowing complications. Prolonged farrowing will shorten the window for suckling colostrum and reduce the chances for high-quality colostrum intake. Studies also agree that increasing litter sizes concomitantly resulted in decreased piglet birth weight and increased within-litter birth weight variations. Birth weight, however, is one of the critical factors affecting the prognosis of colostrum intake, and piglet growth, welfare, and survival. Litters of uneven birth weight distribution will suffer and lead to increased piglet mortality before weaning. The proper management is key to handle the situation. Feeding strategies before farrowing, management routines during parturition (e.g., drying and moving piglets to the udder and cross-fostering) and feeding an energy source to piglets after birth may be beneficial management tools with large litters. Insulin-like growth factor 1 (IGF-1)-driven recovery from energy losses during lactation appears critical for supporting follicle development, the viability of oocytes and embryos, and, eventually, litter uniformity. This paper explores certain management routines for neonatal piglets that can lead to the optimization of their colostrum intake and thereby their survival in large litters. In addition, this paper reviews the evidence concerning nutritional factors, particularly lactation feeding that may reduce the loss of sow body reserves, affecting the growth of the next oocyte generation. In conclusion, decreasing birth weight and compromised immunity are subjects warranting investigation in the search for novel management tools. Furthermore, to increase litter uniformity, more focus should be placed on nutritional factors that affect IGF-1-driven follicle development before ovulation.

• Clinical and Experimental Pediatrics
• /
• 제64권4호
• /
• pp.172-179
• /
• 2021

Background: Evidence shows that fluconazole prophylaxis is an effective treatment against invasive fungal infections in preterm neonates, however, the most efficient schedule of fluconazole prophylaxis for the colonization and mortality of invasive candidiasis (IC) is unknown. Purpose: This systematic review and meta-analysis aimed to assess the efficiency of different prophylactic fluconazole schedules in controlling IC colonization, infection, and mortality in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in neonatal intensive care units. Methods: We searched the PubMed, Scopus, Embase, and Cochrane databases using the keywords "candida," "invasive candidiasis," "IC," "fluconazole prophylaxis," "preterm infants," "very low birth weight infants," "VLBW," "extremely low birth weight," and "ELBW." Results: Mortality was significantly decreased in a meta-analysis of studies using different fluconazole prophylaxis regimens. The meta-analysis also indicated a significant decrease in the incidence of IC-associated mortality in ELBW infants using the same fluconazole prophylaxis schedules. Conclusion: Future studies should explore the effectiveness of other different fluconazole prophylaxis schedules on IC colonization, infection, and mortality.

• Child Health Nursing Research
• /
• 제27권3호
• /
• pp.297-307
• /
• 2021

Purpose: This descriptive study compared the perceived parental stress levels between parents with very low birth weight infants (VLBWIs) and nurses in the neonatal intensive care unit (NICU). Methods: In total, 83 parents of VLBWIs and 78 NICU nurses were enrolled. Data were collected with the Parental Stress Scale (PSS) and analyzed using the t-test and analysis of variance in SAS version 9.4. Results: The average PSS score was 3.31 among parents and 3.45 among nurses. The stress score was significantly higher among nurses with children (t=2.46, p=.016) and senior nurses (t=2.12, p=.037). There was a significant difference in the stress score according to parents' education (t=3.29, p=.002) and occupation (F=3.14, p=.049) in the sights and sounds subscale. Mothers had significantly higher stress scores than fathers in the parental role alterations subscale (t=2.32, p=.023). Parental stress scores were higher than those perceived by nurses in the infant's appearance and behaviors subscale for breathing patterns (t=2.95, p=.004), followed by jerky/ restless behavior (t=2.70, p=.008). Conclusion: Nurses should provide explanations to parents of VLBWIs in order to reduce parental stress about the appearances and behavior of VLBWIs. This is more important than aspect of the NICU environment and education about parental roles.

• Clinical and Experimental Pediatrics
• /
• 제62권5호
• /
• pp.166-172
• /
• 2019

Purpose: This study aimed to evaluate vitamin D status at birth in very-low-birth-weight infants (VLBWIs: <1,500 g) and to determine the association between vitamin D level and respiratory morbidity. Methods: A retrospective study was conducted at Soonchunhyang University Bucheon Hospital between November 2013 and November 2017. We collected blood samples and data on respiratory morbidity from 230 VLBWIs on the first day of life. Patients who were transferred to other hospitals (n=19), died before 36 weeks of gestational age (n=18), or whose blood samples were not collected immediately after birth (n=5) were excluded. Finally, 188 patients were enrolled. VLBWIs with different vitamin D levels were compared with respect to demographic features, maternal diseases, respiratory morbidities, and other neonatal diseases. Results: The mean serum vitamin D level, as measured by 25-hydroxyvitamin D (25(OH)D), was $13.4{\pm}9.3ng/mL$. The incidence of vitamin D deficiency (<20 ng/mL) was 79.8%, and 44.1% of preterm infants had severe vitamin D deficiency (<10 ng/mL). Logistic analysis shows that a low serum 25(OH)D level (<20 ng/mL) was a risk factor for respiratory distress syndrome (odds ratio [OR], 4.32; P=0.010) and bronchopulmonary dysplasia (OR, 4.11; P=0.035). Conclusion: The results showed that 79.8% of preterm infants in this study had vitamin D deficiency at birth. Low vitamin D status was associated with respiratory morbidity, but the exact mechanism was unknown. Additional studies on the association between vitamin D level and neonatal morbidity are required.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제28권2호
• /
• pp.141-148
• /
• 2017

Objectives: The current study examined the effect of birth weight on the relationship between age and IQ of children, who were born preterm with very low birth weight (VLBW) or extremely low birth weight (ELBW). Methods: The study subjects were 82 children, aged between 3-5 years, who visited the neonatal intensive care unit of a university hospital located in Seoul. The children had been born prematurely with VLBW or ELBW. Their IQ was tested using the performed Korean-Wechsler Preschool and Primary Scale of Intelligence fourth edition. Results: A hierarchical regression analysis showed a significant interaction effect of birth weight and age on Full Scale IQ (FSIQ); the effect of age on FSIQ differed according to birth weight. For the group with VLBW, FSIQ was more likely to be higher with increasing age. Conversely, for the group with ELBW, FSIQ remained low regardless of the age level. In addition, birth weight and age had a significant interaction effect on the Visual Spatial Index. Birth weight had a significant main effect on Verbal Comprehension Index. Conclusion: This research suggested the possibility of predicting the cognitive developmental of premature children, by highlighting the fact that prematurely born children, with VLBW/ELBW, have different cognitive developmental trajectories.

• Child Health Nursing Research
• /
• 제17권2호
• /
• pp.145-152
• /
• 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.

• Pediatric Infection and Vaccine
• /
• 제24권1호
• /
• pp.1-6
• /
• 2017

목적: 본 연구에서는 delta neutrophil index (DNI)가 신생아 균혈증을 예측하는 지표로서의 효용성을 다른 지표들과의 비교를 통해 알아보고자 하였다. 방법: 원주세브란스 기독병원 신생아 중환자실에 발열을 주소로 입원한 환아들과 입원 중 발열이 있었던 생후 31일 미만 환아 146명을 대상으로 혈액배양검사와 동시에 시행한 총 백혈구 수, 절대호중구수, DNI, 혈소판 수, C-반응단백(C-reactive protein, CRP)에 대하여 분석하였다. 결과: 균혈증이 있었던 환아 77명의 평균 재태주수는 38.74주, 출생 체중은 3.20 kg였다. 대조군의 평균 재태주수는 33.34주, 출생 체중은 2.20 kg였다. 균혈증의 원인은 Staphylococcus aureus (22명), Staphylococcus epidermidis (18명), Streptococcus agalactiae (8명) 등이었다. DNI와 CRP만이 재태주수와 출생 체중 보정 후 균혈증과 연관성을 보여 area under the ROC curve를 조사하였고 DNI 0.70, CRP 0.68이었다. 결론: DNI는 신생아 균혈증을 예측하는 데 효과적인 지표이다. 다른 인자들과 함께 고려한다면 균혈증을 예측하는 데 더 도움이 될 것이다.

• 부모자녀건강학회지
• /
• 제2권
• /
• pp.30-52
• /
• 1999

The purpose of this study is to clarify that neonatal massage is a nursing intervention which is desirable to LBW by making nurses provide such massage service to LBW hospitalized at NICU and confirming effects of the service on weight gain, vital signs and stress hormones(cortisol, norepinephrine, epinephrine). The data were collected from Dec. 14, 1998 to Oct. 4, 1999. The subjects were 28 LBW infants. The data were analyzed with the SAS program with T-test, Chi-square test and ANOVA. 1. The Experimental group that received neonatal massage showed a higher daily gain of weight than the comparative group. Weight gain for 10 days and weight gain of seven days after the massage were also higher in the former group than in the latter, indicating that there are statistically significant differences between the two groups.

• Neonatal Medicine
• /
• 제15권1호
• /
• pp.54-60
• /
• 2008

목 적 : 신생아 패혈증의 원인균 및 항생제 감수성의 변화를 조사하여 극소 저출생 체중아 및 미숙아의 이환율 및 사망률 증가와 관련된 패혈증에 대하여 가능한 신속하고 적절한 치료 방침을 세우는데 도움을 주고자 하였다. 방 법 : 2000년 1월부터 2006년 6월까지 을지대학병원 신생아집중치료실에 입원한 출생체중 1,500 g 미만의 극소 저출생 체중아를 대상으로 의무기록을 후향적으로 분석하여 패혈증의 원인균과 항생제 감수성에 대해 조사하여 시기별 분포를 비교하였다. 결 과 : 대상 환아 164명 중 균이 증명된 환아는 19명(11.6%)이었다. 균이 증명된 19명의 환아에서 총 26례의 패혈증 발생을 보였으며, 후기 지발형 패혈증의 발생빈도가 제일 높았다. K. pneumoniae가 가장 흔한 원인균이였으며, 그 뒤로 Streptococcus spp., CNS, Enterobacter spp.의 순으로 배양되었고, 대부분이 경험적 항균제에 내성을 나타내었다. 결 론 : 과거 연구나 타 의료기관에서 증명된 흔한 원인균과 항생제 감수성 결과에 의존하여 광범위 경험적 항생제를 사용하기보다는 주기적으로 원인균 및 항균제 감수성의 변화를 파악하고 적절한 항생제를 사용하는 것이 신생아 패혈증의 치료의 효과뿐만 아니라, 다제내성균의 출현을 막을 수 있을 것으로 사료된다.