Care Of Preterm Infants Research Articles

Effects of Total Enteral Nutrition on Early Growth, Immunity, and Neuronal Development of Preterm Infants.

The feeding of colostrum and mother’s transitional milk improves immune protection and neurodevelopmental outcomes. It also helps with gut maturation and decreases the risks of infection. The supply of nutrients from human milk (HM) is not adequate for preterm infants, even though preterm mother’s milk contains higher concentrations of protein, sodium, zinc, and calcium than mature HM. The human milk fortifiers, particularly those with protein, calcium, and phosphate, should be used to supplement HM to meet the necessities of preterm infants. The management of fluid and electrolytes is a challenging aspect of neonatal care of preterm infants. Trace minerals such as iron, zinc, copper, iodine, manganese, molybdenum, selenium, chromium, and fluoride are considered essential for preterm infants. Vitamins such as A, D, E, and K play an important role in the prevention of morbidities, such as bronchopulmonary dysplasia, retinopathy of prematurity, and intraventricular hemorrhage. Therefore, supplementation of HM with required nutrients is recommended for all preterm infants.

Evidence Based Skin Care in Preterm Neonates- A Short Review

Preterm neonates are the neonates born alive before completion of 37 weeks of gestation. Prematurity is the real threat for survival of these neonates, especially those who are very-preterm (less than 32 weeks). In developing countries due to lack of basic care such as maintenance of warm chain, breast feeding support, infection control and scarcity of resources to tackle respiratory difficulties; the mortality in preterm infants is very high. Good skin care is a critical component of the basic neonatal care, that can directly reduce complications of prematurity as well address issues arising during the handling of these preterm infants such as injuries due to adhesives or devices, skin dryness, the use of skin emollients and disinfectants etc. In contemporary era, evidence-based practices are the need of hour to guide clinical practice. There are limited research articles dealing with skin care in preterm neonates that offer strong recommendations for skin care modalities. In this short review, the authors have compiled the recent evidences to address various issues related to skin care in very preterm neonates. In this article the evidences related to bathing practices in preterm infants, and the use of disinfectants and emollients for premature skin care has been discussed; besides making general recommendation related to skin care in preterm infants. Keywords: Preterm, skin care, emollients, disinfectant, neonate, prematurity, premature skin.

Neonatal Intensive Care for Very Preterm Infants in China

China is home to 1 in 5 people in the world. Every year, the number of infants born in China (>16 million) exceeds the entire population of Sweden.1 Of these 16 million infants, more than 200 000 are estimated to be born very preterm (<32 weeks’ gestation).2

Nutritional practices and growth of preterm infants in two neonatal units in the UK and Malaysia: a prospective exploratory study

ObjectiveTo explore differences in nutritional practices and growth outcomes among preterm infants in neonatal units in Malaysia and the UK.DesignProspective exploratory study of infants born at <34 weeks gestational age...

Neonatal Care Provider Tasks in the NICU and Delivery Room.

Decreased availability of pediatric residents in neonatal intensive care units (NICUs) has created demand for other neonatal medical care providers. No recent publications exist about how to approach the organization of tasks involved in that care. The purpose of this article is to present a structure and resources to guide the organization of tasks in the care of sick and premature infants in the NICU. The methods included a literature review to develop evidenced-based practice resources. The literature was reviewed regarding the relevant history and resources to support task organization during patient rounds and care in the NICU, and for delivery attendance by skilled providers. The goal, to establish a reference to support education about these approaches, is based upon evidence, which appears to be rooted in tradition. Evidence-based resources include documentation templates, problem list in order of systems, and provider tasks for NICU and delivery attendance. Future studies can measure mentor or learner perceptions of the value of these resources, critical thinking improvement, safety, and clinical outcomes. These resources may provide structure for learners and providers who have studied the physiology, pathophysiology, and problem management concepts, but need to learn how to execute their responsibilities in these busy environments.

Maternal experiences of caring for preterm infants in a vulnerable South African population.

BackgroundCaring for a preterm infant is known to be a stressful experience as these infants are at a high risk of medical sequelae and developmental delays. Early intervention is imperative for the best developmental outcome for the infant. Such interventions are often delivered through the mother or primary caregiver; however, healthcare professionals are seldom aware of all the factors that influence maternal well-being, potentially influencing her ability to provide optimal care.AimTo explore the experiences of a group of vulnerable women, namely, isiXhosa-speaking mothers of preterm infants living in low socio-economic circumstances in the Western Cape province of South Africa, regarding having, caring for and feeding their preterm infants within the first 6 months of the infant’s life.SettingA follow-up clinic for preterm infants and their mothers at a public tertiary hospital in Cape Town, South Africa.MethodsThe study employed a qualitative, cross-sectional design that was explorative and contextual in nature. A discussion schedule was used to guide 15 in-depth interviews with mothers that were later thematically analysed.ResultsSocial support and religion positively influenced maternal coping. The infant’s medical stability was the main concern for mothers and concerns regarding the infant’s development did not arise. Prematurity influenced mothers’ decisions to use traditional medicines and hospital care affected some traditional practices.ConclusionThe study findings highlighted the influence of traditional and religious beliefs, the importance of the cultural education of medical staff members and a support system to improve maternal experiences.ContributionThe findings provide insights into maternal experiences with implications for healthcare practitioners’ continued education in an ethnically diverse setting.

Parental Attitudes toward Consent for Music Intervention Studies in Preterm Infants: A Cross-Sectional Study.

(1) Background: This study investigated parents’ motives for enrolling preterm infants into music therapy intervention studies during Neonatal Intensive Care hospitalization. (2) Methods: We surveyed Israeli parents of preterm infants after they consented or refused to participate in such studies. The pre-piloted questionnaires evaluated attitudes toward research and music therapy intervention studies. The study included 116 (57%) parents who agreed to participate in music therapy studies and 87 (43%) who declined. (3) Results: Infants of those who agreed to participate were younger (17 ± 2.3 vs. 28 ± 4.7 days old, p = 0.03) and sicker (Clinical Risk Index for Babies score 6.1 ± 2.7 vs. 3.68 ± 4.1, p = 0.04). More single-parent families declined to participate (p = 0.05). Parents agreed to participate because they thought the study might help their child, would improve future care of preterm infants and increase medical knowledge (all p < 0.05). In addition, they perceived music as beneficial for brain development, thought it might improve bonding, and routinely listened to music daily. (4) Conclusions: When recruiting parents and preterm infants for music therapy intervention studies, one should highlight potential contributions to the child’s health, future children’s health and medical knowledge. Stressing music as a potential tool for brain development and augmenting bonding is important. The best time to recruit is when improvements are still anticipated.

Recommendations to promote breast milk feeding and enhance nutritional care for preterm infants in the Asia-Pacific region: highlights from a roundtable discussion of key opinion leaders

Introduction: Preterm infants are vulnerable to nutritional deficiencies, thus optimal nutrition is crucial in promoting growth among these infants. However, socio-cultural complexities and limited resources in the Asia-Pacific demands a judicious approach in implementing nutritional care that is pragmatic to align with current evidence-based recommendations. Methods: A roundtable meeting was held in Jakarta in 2017 for key opinion leaders in neonatology from the AsiaPacific to discuss issues when delivering nutritional care in this region and the unique circumstances encountered. Results: Priority areas discussed include: (i) breast milk feeding, (ii) donor milk bank/sharing, (iii) human milk fortification, and (iv) nutrient-enriched breast milk substitutes. Socio-cultural practices impeding breastfeeding, insufficient maternity leave, the religious issue of milk kinship, and limited availability of specialty nutritional care products were among the most challenging factors. Conclusion: The group proposed recommendations to enhance breastfeeding uptake, accessibility to a complete portfolio of specialty nutritional care products, and encouraging more active collaborations to engage policy makers in addressing these contemporary issues.

Early Enteral Feeding in Preterm Infants: A Narrative Review of the Nutritional, Metabolic, and Developmental Benefits.

Enteral feeding is the preferred method of nutrient provision for preterm infants. Though parenteral nutrition remains an alternative to provide critical nutrition after preterm delivery, the literature suggests that enteral feeding still confers significant nutritional and non-nutritional benefits. Therefore, the purpose of this narrative review is to summarize health and clinical benefits of early enteral feeding within the first month of life in preterm infants. Likewise, this review also proposes methods to improve enteral delivery in clinical care, including a proposal for decision-making of initiation and advancement of enteral feeding. An extensive literature review assessed enteral studies in preterm infants with subsequent outcomes. The findings support the early initiation and advancement of enteral feeding impact preterm infant health by enhancing micronutrient delivery, promoting intestinal development and maturation, stimulating microbiome development, reducing inflammation, and enhancing brain growth and neurodevelopment. Clinicians must consider these short- and long-term implications when caring for preterm infants.

Mothers’ Knowledge of Kangaroo Mother Care for Premature Infants and Related Factors

This study aims to describe premature infants’ mothers’ knowledge of kangaroo mother care (KMC) and related factors to identify methods for improving maternal and child health programs. This descriptive cross-sectional research was carried out at Bach Mai Hospital from October 2019 to March 2020 to interview 60 mothers with premature babies on KMC and some related factors. The research results show that 94.8% of the interviewed mothers were aware of KMC’s necessity; 91,78% of them knew about KMC, of which, only 8.3% without prior knowledge of KMC. In terms of sources of knowledge, 58.2% of the mothers learned about KMC from relatives or friends; via the Internet - 45.5% and 18.2% through health workers. The number of mothers -university graduates having prior knowledge about KMC was with p &lt;0.05. The study recommends promotion of mothers’ education on the role and effect of KMC for premature infants, especially among those with a modest education level.&#x0D; Keywords&#x0D; Kangaroo mother care, preterm delivery, premature infants.&#x0D; References&#x0D; [1] R. Dawar, S. Nangia, A. Thukral et al., Factors Impacting Practice of Home Kangaroo Mother Care with Low Birth Weight Infants Following Hospital Discharge, J Trop Pediatr, Vol. 65, No. 6, 2019, pp. 561-566, https://doi.org/10.1093/tropej/fmz007.[2] A. C. Agudelo, J. L. D. Rossello, Kangaroo Mother Care to Reduce Morbidity and Mortality in Low Birthweight Infants, Cochrane Database Syst Rev, No. 8, 2016, pp. 111-116, https://doi: 10.1002/14651858.CD002771.[3] Y. Takubo, T. Nemoto, Y. Obata et al., Effectiveness of Kangaroo Care for a Patient with Postpartum Depression and Comorbid Mother-Infant Bonding Disorder, Vol. 2019, 2019, pp. 1-6, https://doi.org/10.1155/2019/9157214.[4] E. Akbari, N. B. Erez, M. Rodrigues et al., Kangaroo Mother Care and Infant Biopsychosocial Outcomes in The First Year: A Meta-Analysis, Early Hum Dev, Vol. 25, No. 122, 2018, pp. 22-31, https://doi.org/10.1016/j.earlhumdev.2018.05.004.[5] N. T. Nam, N. T. Dung, D. T. Anh et al., Characteristis Structure of Diseases in Neonatal at Pediatric of Department of Bachmai Hospital, Bachmai Clinical Jounral, Vol. 112, 2019, pp. 28-37 (in Vietnamese).[6] D. Kommers, M. Broeren, G. Oei et al, Oxytocin Levels in the Saliva of Preterm Infant Twins During Kangaroo care, Biol Psychol, Vol. 137, 2018, pp. 18-23. https://doi.org/10.1016/j.biopsycho.2018.06.009.[7] R. B. Garcia, A. Spilker, D. Goyal, Skin to Skin Contact: Newborn Temperature Stability in the Operating Room, MCN Am J Matern Child Nurs, Vol. 43, No. 3, 2018, pp. 158-163, https://doi.org/10.1097/NMC.0000000000000430.[8] F. Cavallin, G. Segafredo, D. Pizzol et al, Thermal Effect of a Woolen Cap in Low Birth Weight Infants During Kangaroo Care, Pediatrics, Vol. 141, No. 6, 2018, pp. 156-159, https://doi.org/ 10.1542/peds.2017-3073.[9] M. Evereklian, B. Posmontier, The Impact of Kangaroo Care on Premature Infant Weight Gain, J Pediatr Nurs, Vol. 34, 2017, pp. 10-16, https://doi.org/ 10.1016/j.pedn.2017.02.006.&#x0D; &#x0D;

The BabySaver: Design of a New Device for Neonatal Resuscitation at Birth with Intact Placental Circulation.

The initial bedside care of premature babies with an intact cord has been shown to reduce mortality; there is evidence that resuscitation of term babies with an intact cord may also improve outcomes. This process has been facilitated by the development of bedside resuscitation surfaces. These new devices are unaffordable, however, in most of sub-Saharan Africa, where 42% of the world’s 2.4 million annual newborn deaths occur. This paper describes the rationale and design of BabySaver, an innovative low-cost mobile resuscitation unit, which was developed iteratively over five years in a collaboration between the Sanyu Africa Research Institute (SAfRI) in Uganda and the University of Liverpool in the UK. The final BabySaver design comprises two compartments; a tray to provide a firm resuscitation surface, and a base to store resuscitation equipment. The design was formed while considering contextual factors, using the views of individual women from the community served by the local hospitals, medical staff, and skilled birth attendants in both Uganda and the UK.

Nurses' Knowledge and Practice Regarding Developmental Supportive Care for Preterm and Low Birth Weight Infants

Background: Developmental supportive carerecognizes the physical, psychological and emotional vulnerabilities of premature and low birth weight infants. The aim of this study was to assess knowledge and practice of nurses regarding developmental supportive care for preterm and low birth weight infants in Neonatal Intensive Care Unit (NICU). Subjects and method: design: A descriptive designwas used, the study was carried out on 180 nurses at the governmental hospitals at Mansoura City. Tools: Tool (1) Structured interview for nurses' personal characteristics and their knowledge about preterm infant and developmental supportive care. Tool (2) an observational checklist for nurses' practice of developmental supportive care for preterm and low birth weight infants during daily nursing care procedures. Results revealed that most of the studied nurses had satisfactory level of knowledge regarding developmental supportive care for preterm and low birth weight infants while of them had inadequate practice of developmental supportive care for preterm and low birth weight infants, there were no statistically significant relation between nurses' knowledge and their actual practice (p < 0.05). Conclusion: 64.4% of the studied nurses had satisfactory level of knowledge regarding developmental supportive care for preterm and low birth weight infants, while more than half of studied nurses (56.7%) had inadequate level of practicing developmental supportive care for preterm and low birth weight infants. Recommendations. Setting training and educational programs for nurses to improve their knowledge and their performance regarding developmental supportive care for preterm and low birth weight infants.

Parents, healthcare professionals and other stakeholders’ experiences of caring for babies born too soon in a low-resource setting: a qualitative study of essential newborn care for preterm infants in Kenya

ObjectivesPrematurity is the leading cause of global neonatal and infant mortality. Many babies could survive by the provision of essential newborn care. This qualitative study was conducted in order to...

Multichannel Esophageal Heart Rate Monitoring of Preterm Infants.

Autonomic dysregulation in preterm infants requires continuous monitoring of vital signs such as heart rate over days to months. Unfortunately, common surface electrodes are prone to electrocardiography (ECG) signal artifacts and cause serious skin irritations during long-term use. In contrast, esophageal ECG is known to be very sensitive due to the proximity of electrodes and heart and insensitive to external influences. This study addresses if multichannel esophageal ECG qualifies for heart rate monitoring in preterm infants. We recorded esophageal leads with a multi-electrode gastric feeding tube in a clinical study with 13 neonates and compared the heartbeat detection performance with standard surface leads. A computationally simple and versatile ECG wave detection algorithm was used. Multichannel esophageal ECG manifested heartbeat sensitivity and positive predictive value greater than 98.5% and significant less false negative (FN) ECG waves as compared to surface ECG due to site-typical electrode motion artifacts. False positive bradycardia as indicated with more than 13 consecutive FN ECG waves was equally expectable in esophageal and surface channels. No adverse events were reported for the multi-electrode gastric feeding tube. Heart rate monitoring of preterm infants with multiple esophageal electrodes is considered as feasible and reliable. Less signal artifacts will improve the detection of bradycardia, which is crucial for immediate interventions, and reduce alarm fatigue. Due to the possibility to integrate the multichannel ECG into a gastric feeding tube and meanwhile omit harmful skin electrodes, the presented system has great potential to facilitate future intensive care of preterm infants.

Underdiagnosis of obesity in pediatric clinical care settings among children born preterm: a retrospective cohort study.

Neonatal care of preterm infants may include dietary approaches such as high calorie formulas to promote physical growth. However, continuing growth-promoting strategies beyond the point of necessity, coupled with poverty and food insecurity which are more common among families of children born preterm, may increase the risk of obesity. Because children born preterm tend to have more pressing health conditions that require ongoing care, obesity may go undiagnosed by providers. This retrospective cohort study included 38,849 children (31,548 term, 7301 preterm) born from 2010 to 2015, who received clinical care at a large pediatric medical center (Ohio, USA). Electronic medical record data, linked to Ohio birth certificates, were used to identify children with measured obesity (≥2 weight-for-length values ≥95th percentile before 24 months of age or BMI values ≥95th percentile at or after 24 months of age). Children were considered to have diagnosed obesity if their medical record had an obesity-related phrase or billing code recorded. Modified Poisson regression was used to compare risk of obesity undiagnosis among obese children born preterm versus at term. In total, 13,697 children had measured obesity, 10,273 (75%) of which were undiagnosed. Children born preterm with measured obesity were 8% more likely to be undiagnosed compared to children born at term (adjusted relative risk = 1.08 95% CI 1.05, 1.11). The risk was slightly higher for preterm children born to white women or born to women with higher educational attainment. For both groups, Primary Care and subspecialist clinics were the most common settings for undiagnosed obesity (74.9% and 16.8% of undiagnosed cases, respectively). Preterm birth was associated with increased risk of undiagnosed obesity in early childhood. This highlights the need to enhance obesity screening in the preterm population and to further explore reasons for this disparity.

Soins précoces mère-enfant, définition et efficacité : revue de la littérature

ObjectiveProfessionals agree on the need for early joint mother-baby care, but its effectiveness remains poorly studied. The aim of our work is to propose a review of the literature on this subject. MethodsWe included randomized or non-randomized controlled clinical trials of interventions targeting the mother-baby dyad which can begin during pregnancy or during the first three years of life. ResultsForty-one studies met the inclusion criteria and focused on mother-baby psychotherapy, educational or guidance programs, care for premature infants, infant massage, and home visits. The results show an improvement of the quality of the interactions whatever the type of approach, but according to different indications or modalities. The heterogeneity of intervention methods and indications make the comparison of results almost impossible. ConclusionThis work highlights the lack of consensus on mother-child care methods, both for their indications and their effectiveness. The isolated evaluation of interactions is an insufficient criterion for judging the effectiveness of care. Finally, whatever the theoretical models, the interventions must take into account the environment of the child.

Human milk bank in Ukraine – relities and perspectives

Premature birth complicates 5 to 8% of pregnancies worldwide. The efforts of the medical world are aimed at improving the care of premature infants, which is much more successful – increasing the proportion of extremely premature surviving infants, improving the health and quality of life of premature infants. Such measures include, in particular, the early start of enteral feeding. It is its early initiation that is complicated by the delay in establishing lactation in the mother. To overcome this contradiction, it is proposed to use donor breast milk, for the procurement and storage of which human milk banks have been created. The objective: to analyze the activities of the human milk bank of the Kyiv Perinatal Center in 2020. Materials and methods. To evaluate the activity of the breast milk bank the main indicators of its work for 2020 were analyzed – the total number of donors, their distribution by age, total milk volume, average milk volume per woman, duration of donor milk to newborns. Results. During 2020, 65 donors took part in the breast milk donation program, who received 8,603 portions of milk and 8,220 portions were given to recipients for consumption. It is established that the main source of information for breast milk donors is the staff of the Perinatal Center, and therefore – the main motivation to participate in the program is the desire to help in the care of premature infants. The main pool of recipients (67.1%) are patients of the intensive care unit. A small part of the donor milk was consumed by patients of the postnatal care department and the second stage of nursing. Among patients receiving donor breast milk in the intensive care unit, preterm weight categories of 1000–1499 g (49.3%) and 1500–1999 g (32.7%) dominated. Conclusions. 1. The main source of information about the breast milk donation program is the staff of the Perinatal Center of Kyiv (32.3%), which determines the main motivation of the study participants. The prospect of developing the idea of ​​breast milk donation in Ukraine is popularization in the media in order to expand the audience and encourage women who have given birth in other obstetric facilities. 2. The main pool of DHM recipients in the Perinatal Center of Kyiv are premature patients of the intensive care unit. The largest proportion of patients receiving DGM were in the weight category of 1000–1499 g. The average duration of consumption of DGM by patients in this department is 6.5±0.9 days.

MicroRNA 29 Family Serves a Key Role in Lung Development and the Prevention of Lung Pathology

Even with remarkable advances in the care of preterm infants, chronic lung disease in the form of bronchopulmonary dysplasia (BPD) continues to be a significant pathologic consequence of prematurity. BPD is caused by the interruption of physiologic lung development and exposure of the immature newborn lung to high O2 tensions. BPD is characterized by a simplified alveolar structure, arrested lung growth, impaired vascular development and lung fibrosis (1). To identify effective treatment strategies for BPD, it is important to understand the molecular mechanisms underlying this disorder. MicroRNAs (miRNA, miR) are known to regulate growth, development and repair of the developing lung; whereas, dysregulation of miRNA expression has been associated with pulmonary disease. Specifically, members of the miR-29 family have been linked to pulmonary cancers, fibrosis, and BPD. Previous studies from our laboratory indicate that developmental induction of miR-29 expression in the fetal lung near term serves a key role in promoting surfactant-producing type II cell differentiation and function through repression of TGF-β2 signaling (2). To understand the role of miR-29 in protection against BPD, in the present study, we created mice in which the entire miR-29 family (miR-29a/b1 and miR-29b2/c) (miR-29 dKO) was disrupted. Upon exposure of miR-29 dKO and WT neonatal mice to hyperoxia (95% O2) for 5 days immediately after birth, expression levels of the proinflammatory cytokines and chemokines, IL-1 β, TGF-β1, CXCL2 and IL-6, were significantly increased in the lungs of miR-29 dKO mice, compared to WT. Furthermore, lungs of miR-29 dKO adult mice manifested increased expression of their direct targets, TGF-β2 and TGF-β3. This was associated with increased collagen deposition, as evidenced by enhanced trichrome staining, suggesting the development of lung fibrosis. HDAC4 (a direct target of miR-29) and proinflammatory TNF-α, which have been implicated in pulmonary fibrosis, also were upregulated in the lungs of miR-29 dKO mice. Overall, our studies suggest a key role of the miR-29 family and its targets in prevention of inflammatory and profibrotic signaling in the neonatal lung leading to lung pathology.Supported by: NIH R01-HL050022 (C.R.M.)

Development of an educational module for mothers of premature infants admitted to the neonatal intensive care unit in Iran: a narrative review

Introduction: Mothers of preterm infants, as the primary caregiver, need to learn more about their infants and the complex environment of neonatal intensive care. This study aimed to develop and evaluate the educational module for the mothers of premature infants admitted to the neonatal intensive care unit (NICU) in Iran.Method: The online databases (SID, Magiran, Google Scholar, ScienceDirect, PubMed, Elsevier, and Scopus) were accessed from 2009 to 2019, using the keywords ‘mother’, ‘neonatal intensive care’, ‘program’, ‘intervention education,’ and ‘empowerment’. In general, 275 articles were retrieved and a total of 12 studies was retained for appraisal, after screening the titles, abstracts, and full-text reviews. Finally, the qualitative module validity and face validity were determined, using the opinions of 11 experts and 10 mothers of premature infants, respectively.Results: Eight themes were identified based on thematic analysis, including orientation with the NICU, characteristics of premature infants, premature infants’ problems, needs of premature infants, preparation of premature infant’s environment, behavioral symptoms of premature infants, the positioning of premature infants, and preparation for discharge and measures were developed after the discharge of the premature infant. Considering all acquired interventions for all items, a content validity ratio of 0.59 and content validity index of 0.79 based on the opinions of experts at two levels of specialists and mothers.Conclusion: Due to the lack of enough nursing staff and a high workload in the NICU, this review offers nurses to spend less time educating mothers and focusing more on premature infants. Moreover, supporting mothers can help to provide better care. The educational module can help nurses and mothers have more effective care for premature infants.

Consecutive daily administration of intratracheal surfactant and human umbilical cord-derived mesenchymal stem cells attenuates hyperoxia-induced lung injury in neonatal rats

BackgroundSurfactant therapy is a standard of care for preterm infants with respiratory distress and reduces the incidence of death and bronchopulmonary dysplasia in these patients. Our previous study found that mesenchymal stem cells (MSCs) attenuated hyperoxia-induced lung injury and the combination therapy of surfactant and human umbilical cord-derived MSCs (hUC-MSCs) did not have additive effects on hyperoxia-induced lung injury in neonatal rats. The aim is to evaluate the effects of 2 consecutive days of intratracheal administration of surfactant and hUC-MSCs on hyperoxia-induced lung injury.MethodsNeonatal Sprague Dawley rats were reared in either room air (RA) or hyperoxia (85% O2) from postnatal days 1 to 14. On postnatal day 4, the rats received intratracheal injections of either 20 μL of normal saline (NS) or 20 μL of surfactant. On postnatal day 5, the rats reared in RA received intratracheal NS, and the rats reared in O2 received intratracheal NS or hUC-MSCs (3 × 104 or 3 × 105 cells). Six study groups were examined: RA + NS + NS, RA + surfactant + NS, O2 + NS + NS, O2 + surfactant + NS, O2 + surfactant + hUC-MSCs (3 × 104 cells), and O2 + surfactant + hUC-MSCs (3 × 105 cells). The lungs were excised for histological, western blot, and cytokine analyses.ResultsThe rats reared in hyperoxia and treated with NS yielded significantly higher mean linear intercepts (MLIs) and interleukin (IL)-1β and IL-6 levels and significantly lower vascular endothelial growth factors (VEGFs), platelet-derived growth factor protein expression, and vascular density than did those reared in RA and treated with NS or surfactant. The lowered MLIs and cytokines and the increased VEGF expression and vascular density indicated that the surfactant and surfactant + hUC-MSCs (3 × 104 cells) treatment attenuated hyperoxia-induced lung injury. The surfactant + hUC-MSCs (3 × 105 cells) group exhibited a significantly lower MLI and significantly higher VEGF expression and vascular density than the surfactant + hUC-MSCs (3 × 104 cells) group did.ConclusionsConsecutive daily administration of intratracheal surfactant and hUC-MSCs can be an effective regimen for treating hyperoxia-induced lung injury in neonates.