Parameters In Preterm Infants Research Articles

A clinical study on the optimal placement depth for peripherally inserted central catheter through the great saphenous vein in preterm infants

To investigate the correlation between optimal placement depth (OPD) and physical measurement parameters in preterm infants receiving placement of peripherally inserted central catheter (PICC) through the great saphenous vein (GSV), and to establish a predictive formula for OPD during the placement of PICC through the GSV. A retrospective analysis was performed for the preterm infants who received the placement of PICC through the GSV in the Neonatal Intensive Care Unit of the Third Xiangya Hospital of Central South University from December 2022 to February 2024. According to the site of puncture [GSV of the knee joint (KJ) or the ankle joint (AJ)], they were divided into a GSV-KJ placement group (n=38) and a GSV-AJ placement group (n=33). The infants were measured in terms of body weight (BW), body length, the length of the upper and lower parts of the body, head circumference, and abdominal circumference at the time of placement. The Pearson correlation analysis was used to investigate the correlation between the above variables and OPD. A predictive formula was established for OPD in the placement of PICC via the GSV in preterm infants, and the predicted residual between the predicted depth and the ideal OPD was compared between the conventional predictive formula and the new predictive formula. The Pearson correlation analysis showed that PICC OPD was significantly positively correlated with BW, body length, the length of the upper and lower parts of the body, head circumference, and abdominal circumference in both the GSV-KJ placement group and GSV-AJ placement group (P<0.05), with the highest degree of correlation between OPD and BW. The univariate linear regression analysis showed a linear relationship between PICC OPD and BW in both groups. The predictive formulas for OPD were as follows: GSV-KJ PICC OPD (cm) = 13.1 + 2.7 × BW (kg) and GSV-AJ PICC OPD (cm) = 13.4 + 6.0 × BW (kg), and the new predictive formulas had a significantly lower predicted residual than the conventional predictive formula (P<0.05). OPD for PICC through the GSV is positively correlated with BW, and the prediction results of the new predictive formula based on BW are closer to the ideal OPD.

Efficacy of facilitated tucking position and Reiki given to preterm infants during orogastric tube insertion: A randomised controlled trial.

This research was conducted to evaluate the effects of Reiki and facilitated tucking position on pain, stress and physiologic parameters in preterm infants during orogastric tube (OGT) insertion. The study used a single-blind, parallel-group randomised controlled experimental design. It was carried out in the neonatal intensive care unit of a hospital in Niğde/Turkey between February 2022 and January 2023. A total of 45 preterm infants, who met the study criteria and whose sample size was determined according to power analysis, were randomly divided into three groups. As an intervention, the facilitated tucking position was applied to the first group, and Reiki was applied to the second group during OGT insertion. Routine application continued in the control group. The Infant Introductory Information Form, Physiological Parameter Follow-up Chart, Infant Stress Scale (ISS) and Premature Infant Pain Profile Scale-Revised (PIPP-R) were used for data collection. Significance was accepted as P < 0.05 in the statistical analysis. It was determined that the infants were homogeneously distributed between the experimental and control groups (P > 0.05). Infants who received the facilitated tucking position and Reiki intervention had better physiological stability compared to the control group (P < 0.05). The group with the lowest average stress (1.53 ± 0.99) and pain scores (4.06 ± 1.22) during OGT insertion was the facilitated tucking group (P < 0.001). After the procedure, stress and pain scores in both the facilitated tucking group and the Reiki group were found to be significantly lower than those in the control group (P < 0.001). The results of the study showed that the facilitated tucking position during OGT insertion was especially effective in reducing the pain and stress of infants. Both the facilitated tucking position and Reiki were determined to be effective interventions in reducing the pain and stress of infants more quickly after the procedure. The results of study contribute to the recommendation that NICU nurses should include non-pharmacological methods to decrease the pain of preterm infants during procedural pain.

Tidal Breathing Analysis as a Prognostic Index for Airway Obstruction Trajectory and Asthma in Preterm Infants.

An easy-to-implement and accurate lung function assessment tool for preterm infants is crucial to manage lifelong respiratory morbidities. We aimed to determine which pulmonary function parameters in preterm infants can predict the trajectory of airway obstruction and asthma development after 4years of age. We evaluated 52 preterm infants who had undergone both tidal breathing flow-volume loop (TBFVL) and multiple-breath washout (MBW) analyses in infancy and spirometry after the age of 4years. We evaluated the association between pulmonary function parameters in infancy and childhood and the pulmonary function trajectory until 13years of age and compared the changes in this trajectory according to pulmonary function parameters in infancy. Time to peak expiratory flow/expiratory time (TPEF/TE) in infancy was associated with FEV1, FEF25-75, and dysanapsis ratio in childhood and differed according to level of airway obstruction assessed by FEV1, FEV1/FVC, and FEF25-75, an asthma development. TPEF/TE was a significant predictive factor for airway obstruction and asthma after 4years of age, after adjusting for sex, extreme prematurity, duration of supplementary oxygen and mechanical ventilation, and recurrent wheezing during infancy. In premature infants with lower TPEF/TE, subsequent pulmonary function parameters remained low until 13years of age. In preterm infants, TPEF/TE could be useful to predict airway obstruction and asthma after 4years of age and even a lower pulmonary function trajectory until 13years of age. This information may help clinicians to provide lifelong care for pulmonary morbidity in children and adolescents born preterm.

Effects of endotracheal suctioning duration cerebral oxygenation in preterm infants.

This study evaluates the effects of endotracheal suctioning duration on cerebral oxygenation and physiological parameters in preterm infants in intensive care. Prospective and observational s tudy. In this study, 51 preterm infants born at 28-34 weeks of gestation in NICU were evaluated. Cerebral oxygenation was measured before, during, and after endotracheal suctioning with near-infrared spectroscopy. Pain levels of the infants were with N-PASS scale. A negative correlation was found between the lowest cerebral oxygenation value during endotracheal suctioning and the duration of endotracheal suctioning. Cerebral oxygenation levels during endotracheal suctioning were lower than pre- and post-endotracheal suctioning levels. Higher cerebral oxygenation was observed in infants whose endotracheal aspiration time was less than 13 s. The duration of endotracheal suctioning was positively correlated with pain and cerebral oxygenation stabilization time. Prolonged endotracheal suctioning duration negatively affects cerebral oxygenation in preterm infants. The study suggests an optimal endotracheal suctioning duration under 13 s. Properly executed endotracheal suctioning, with the correct technique and knowledge, can alleviate the adverse physiological effects observed in preterm infants and contribute to routine nursing care in intensive care units. This study has been reported in line with STROBE checklists. No patient or public contribution was required to design or undertake this research. Patients contributed only to the data collection. This study contributes to defining the ideal endotracheal aspiration duration, as there is not enough data so far. It showed the effect of prolonged endotracheal aspiration time on cerebral oxygenation, pain and physiological parameters in preterm infants.

The effect of music on pain, comfort, and physiological parameters during premature retinopathy examination

AimTo determine the effect of music applied during the ROP examination on pain, comfort, and physiological parameters in preterm infants. MethodsThe sample of this prospective randomized controlled double-blind experimental study consisted of 28 preterm infants who were examined for ROP of a tertiary hospital in the Neonatal Unit. Data were collected with a Questionnaire, Physiological Parameters Observation Form (PPOF), Revised-Premature Infant Pain Profile (PIPP-R), and Premature Infant Comfort Scale (PICS). ResultsThe results revealed that the crying times of the infants in the experimental group were shorter than the infants in the control group. The preterm infants in the experimental group had statistically lower PIPP-R scores during and after the procedure than the PIPP-R scores of the infants in the control group (p < 0.001) and the music applied to the preterm infants resulted in a mean decrease of 3.857 in the post-procedure and pre-procedure PIPP-R scores (p < 0.05). While there was no statistical difference between the pre-procedure and pre-procedural PICS scores of the preterm infants in the experimental and control groups (p = 0.599; p = 117), the post-procedure PICS values of the preterm infants in the experimental group were found to be lower than those of the control group (p < 0.001). It was found that the music applied to preterm infants during the ROP examination resulted in a mean decrease of 1.286 in PICS scores after the procedure and before the procedure (p < 0.05). ConclusionIt was determined that the music listened to during the ROP examination decreased the PIPP-R pain scores of preterm infants, had a positive effect on the PICS scores after the procedure, but did not affect the physiological parameters positively.Trial Registration: ClinicalTrials.gov Identifier: NCT05263973

Hemodynamic evaluation in preterm infants using ultrasonic cardiac output monitor (USCOM).

We aimed to establish reference ranges for USCOM parameters in preterm infants, determine factors that affect cardiac output, and evaluate the measurement repeatability. This retro-prospective study was performed at Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy. We included infants below 32weeks of gestational age (GA) and/or 1500g of birth weight (BW). We excluded infants with congenital heart diseases or hemodynamic instability. Measurements were performed at 3 ± 1, 7 ± 2, and 14 ± 2 postnatal days. We analyzed 204 measurements from 92 patients (median GA = 30.57weeks, BW = 1360g). The mean (SD) cardiac output (CO) was 278 (55) ml/min/kg, cardiac index (CI) was 3.1 (0.5) L/min/m2, and systemic vascular resistance (SVRI) was 1292 (294) d*s*cm-5/m2. CO presented a negative correlation with postmenstrual age (PMA), while SVRI presented a positive correlation with PMA. The repeatability coefficient was 31ml/kg/min (12%). Conclusion: This is the first study describing reference values for USCOM parameters in hemodynamically stable preterm infants and factors affecting their variability. Further studies to investigate the usefulness of USCOM for the longitudinal assessment of patients at risk for cardiovascular instability or monitoring the response to therapies arewarranted. What is Known: • The ultrasonic cardiac output monitoring (USCOM) has been widely used on adult and pediatric patients and reference ranges for cardiac output (CO) by USCOM have been established in term infants. What is New: • We established reference values for USCOM parameters in very preterm and very-low-birth-weight infants; the reference ranges for CO by USCOM in the study population were 198-405 ml/kg/min. • CO normalized by body weight presented a significant negative correlation with postmenstrual age (PMA); systemic vascular resistance index presented a significant positive correlation with PMA.

The effect of the simulated intrauterine sound on behavioral and physiological indices of pain during capillary blood sampling for screening preterm infants: a randomized clinical trial study

IntroductionDue to medical procedures, preterm infants are at high risk for side effects of pain. In this regard, heel lancing for capillary blood sampling is a common painful procedure. The present study was conducted to assess the effectiveness of a simulated intrauterine sound on behavioral and physiological indices of pain due to heel-prick blood sampling in preterm infants.MethodsA double‑blind randomized clinical trial (RCT) was conducted. The data were collected from September 23 to December 22, 2019. We measured the effect of a simulated intrauterine sound on changes in the behavioral and physiological parameters of pain (heart rate, SPO2) caused by heel lance that was measured 5 min before the intervention, during the sampling, and 5 min after the procedure. We measured behavioral pain by video recording the infants’ faces and then the scoring neonatal infant pain scale (NIPS). Heart rate and SPO2 were measured using a pulse oximeter device. The data were analyzed using analysis of variance (ANOVA) and independent t‑test in SPSS software version 20.0.ResultsEighty infants were randomized (40 in each group). Mean scores NIPS during and after intervention were in the intervention group (3.55 ± 0.84, 95% CI: 3.30–3.80(, and (1.15 ± 0.84, 95%: 0.95–1.35) and in the control group (5.57 ± 0.95, 95% CI:5.30–5.85) and (3.00 ± 0.98) respectively. There were significant differences in scores of NIPS between the two study groups during (p < 0.001) and five min after heel lancing (p < 0.001). Mean scores of heart rate in the three phases of before, during, and five min after the intervention were respectively in the intervention group (127.57 ± 4.45, 95% CI:126.27-128.99), (131.07 ± 6.54, 95% CI:129.20-133.22), (128.45 ± 5.15, 95% CI:127.02-130.07) and in the control group (128.67 ± 4.57, 95% CI:127.32-130.07), (136.07 ± 7.24, 95% CI:133.90-138.37), and (132.42 ± 6.47, 95% CI:130.37-134.49). There were significant differences in heart rate between the intervention and the control group during (p = 0.002) and five min after the heel lance (p = 0.003). Mean scores of SPO2 in the three phases of baseline, during, and five min after the intervention were respectively in the intervention group (96.72 ± 0.93, 95% CI:96.42-97.00), (91.47 ± 1.46, 95% CI:91.05–91.92), (94.17 ± 1.03, 95% CI:93.22-94.00) and in the control group (96.6 ± 0.84, 95% CI:96.35–96.85), (91.5 ± 1.24, 95% CI:91.12–91.87), and (93.60 ± 1.27, 95% CI:93.85–94.50).ConclusionThis study showed that the simulated intrauterine sound reduces the behavioral pain and heart rate in the intervention group during and after heel lance. These results suggest using the method during the painful heel lancing to reduce pain parameters in preterm infants.

The effects of massage and white noise on physiological parameters of preterm infants: A randomized controlled research

PurposeThe present research was conducted to find out the effects of massage and white noise on physiological parameters in preterm infants. Material-methodWhile each preterm infant in the massage group was given massage by the researcher in the morning and evening for three days, the infants in the white noise group listened to white noise in the morning and evening for three days. Standard nursing care was provided for three days in the control group. Physiological parameters of the preterm infants in all of the groups on the first, second and third days were recorded by the researcher before the procedure. Following the interventions to preterm infants by the researcher, peak heart rate, respiratory rate and oxygen saturation data were recorded. ResultsSignificant difference was found between the first, second and third day peak heart rate, respiratory rate and oxygen saturation values of the preterm infants in the massage and white noise group when compared with the control group. No significant difference was found between the white noise and massage group. In the temporal analysis of the massage and white noise group, a decrease was found in peak heart rate and respiratory rate, while an increase was found in oxygen saturation values. ConclusionMassage and white noise were found to be effective on physiological parameters of preterm infants. It was found that in the neonatal intensive care unit, nurses can prefer massage or white noise methods in healing physiological parameters of preterm infants.

Coagulation parameters in very preterm infants.

The aim of this study was to define normal percentile values of coagulation parameters in preterm infants below 32 weeks of gestational age. This retrospective cohort study was conducted at Istanbul Medical Faculty. Preterm infants who were born prior to 32 weeks of gestation, between 2011 and 2021 were included and evaluated for coagulation parameters. Blood samples obtained through umbilical catheters prior to administration of heparinized flushes/fluids, vitamin K or fresh frozen plasma (FFP). Infants with a major bleeding disorder, intrapartum asphyxia or a history of familial bleeding disorders were excluded. Infants were grouped according to their gestational ages and birth weights: less than 24, 25-26, 27-28, 29-30, 31-32 weeks and <500, 500-749, 750-999, 1000-1249, 1250-1499, more than 1500 g. Third to 97th percentile values of both prothrombin time (PT) and activated partial thromboplastin time (aPTT) were defined. A total of 420 preterm infants were included. The median value and range of gestational age and birth weight of the infants were 29 (22.3-32.9) weeks and 1150 (395-2790) g, respectively. PT values were similar between subgroups according to gestational age but longer in infants with a birth weight less than 1000 g. aPTT values in infants born less than 24 weeks of gestation were found significantly longer. As maturation of the coagulation system increases by gestational age, very preterm infants (<32 gestational week (GW)) are under increased risk of bleeding. Determination of normal percentile distribution of coagulation parameters for preterm infants will shed light on the interpretation of coagulation parameters of these infants and minimize unnecessary FFP administrations.

Assessment of lung ventilation of premature infants with bronchopulmonary dysplasia at 1.5 Tesla using phase-resolved functional lung magnetic resonance imaging.

The most common chronic complication of preterm birth is bronchopulmonary dysplasia (BPD), widely referred to as chronic lung disease of prematurity. All current definitions rely on characterizing the disease based on respiratory support level and do not provide full understanding of the underlying cardiopulmonary pathophysiology. To evaluate a rapid functional lung imaging technique in premature infants and to quantitate pulmonary ventilation using 1.5 Tesla magnetic resonance imaging (MRI). We conducted a prospective MRI study of 12 premature infants in the neonatal intensive care unit (NICU) using the phase resolved functional lung MRI technique to calculate pulmonary ventilation parameters in preterm infants with and without BPD grade 0/1 (n = 6) and grade 2/3 (n = 6). The total ventilation defect percentage showed a significant difference between groups (16.0% IQR (11.0%,18%) BPD grade 2/3 vs. 8.0% IQR (4.5%,9.0%) BPD grade 0/1, p = 0.01). Phase-resolved functional lung MRI is feasible for assessment of ventilation defect percentages in preterm infants and shows regional variation in localized lung function in this population.

Investigation of the effect of early and late breast milk enrichment on growth parameters in preterm infants: A randomized clinical trial

Background and aims: This study aimed to investigate and compare the effect of early and late breast milk fortification on growth parameters in preterm infants. Methods: In this clinical trial, 90 preterm infants (28-32 weeks) admitted to the neonatal intensive care unit (NICU) of Hajar Hospital in Shahrekord, Iran were randomly divided into three groups. The fortification was performed when the milk intake reached 30 (group A), 70 (group B), and 100 cc/kg (group C). The height, weight, and head circumference of newborns were measured at the beginning of birth and 4 weeks after the birth. The incidence of sepsis and necrotizing enterocolitis, and milk tolerance were investigated as well. All analyses were conducted with Stata software, and P values&lt;0.05 were considered statistically significant. Results: The value changes in the height, weight, and head circumference in all three groups at 4 weeks were significant (P&lt;0.001). The mean weight changes in the A, B, and C groups were 727.33±163.85, 947.33±155.38, and 808.66±168.82, indicating a statistically significant difference (P&lt;0.001). Further, the mean change of weight after 4 weeks showed statistically significant differences (P&lt;0.001) among the A, B, and C groups. The weight gain in the B group was significantly higher than that of the A and C groups (P&lt;0.05); however, no significant difference was observed in the mean weight gain between the A and C groups (P=0.264). Conclusion: The breast milk fortification when the milk intake reached 70 cc/kg had better efficiency on neonatal weight gain compared with the early and delayed fortification.

Impact of Physical Contact on Preterm Infants' Vital Sign Response to Live Music Therapy.

Evidence that music therapy stabilises vital parameters in preterm infants is growing, but the optimal setting for therapy is still under investigation. Our study aimed to quantify the effect of physical contact during live music therapy in preterm infants born < 32 weeks’ gestational age (GA) on post-therapy vital sign values. Live music therapy was delivered twice-weekly until discharge from hospital to 40 stable infants < 32 weeks’ GA. Baseline and post-therapy heart rate, respiratory rate, oxygen saturation and physical contact during each session were recorded. 159 sessions were performed with, and 444 sessions without, physical contact. Descriptive and multivariable regression analyses based on directed acyclic graphs were performed. The mean GA was 28.6 ± 2.6 weeks, and 26 (65%) infants were male. Mean absolute values for heart and respiratory rates lowered during music therapy regardless of physical contact. The mean post-therapy SaO2 was higher compared to baseline values regardless of physical contact (mean differences −8.6 beats/min; −13.3 breaths/min and +2.0%). There were no clinically relevant changes in vital sign responses between therapy sessions, with or without physical contact, or adjusted post-therapy values for any of the studied vital signs. Physical contact caused better baseline and post-therapy vital sign values but did not enhance the vital sign response to music therapy. Thus, the effect of music therapy on preterm infants’ vital signs is independent of physical contact and parents’ presence during music therapy in the neonatal intensive care unit.

Coagulation parameters and Apgar score are associated with severity in preterm infants.

Coagulation parameters are used to diagnose hematological diseases. The correlation between the coagulation parameters and Apgar score at 5 min is yet to be elucidated. The present study aimed at describing the neonatal coagulation parameters in preterm infants with a low Apgar score at 5 min. In this case-control study, 32 serious preterm infants were compared with 20 preterm infants, according to the Apgar score at 5 min. The prothrombin time (PT), thrombin time (TT), fibrinogen (Fbg), activated partial thromboplastin time (APTT), calculated international normalized ratio (INR), D-dimer (D2), fructose diphosphate sodium (FDP), and procalcitonin (PCT) values were recorded. The linear correlation between coagulation parameters and Apgar score at 5 min was analyzed by linear regression. The two groups were compared using GraphPad Prism 8 (LaJolla, CA, USA). In the study, the mean coagulation parameters were significantly higher in the serious preterm infants with low the Apgar score at 5 min compared to the preterm infants with normal Agar scores at 5 min (p<0.05). The correlation between coagulation parameters and Apgar score at 5 min was recorded (PT: R=0.3984; APTT: R=0.3165; INR: R=0.4139). The coagulation parameters were significantly higher in serious preterm infants with a low Apgar score at 5 min. Also, the coagulation parameters and Apgar score at 5 min are associated with severity in preterm infants.

Preterm Births: Obstetric Features and Neonatal Outcomes at University Hospital Mostar

Background: The aim of this study was to determine and analyze the frequency and obstetric features of preterm birth and neonatal outcomes of infants born before 37 completed weeks of pregnancy. Methods: The retrospective study included 470 premature births. The following data on preterm births were collected from hospital records and analyzed: gestational age, type of preterm birth, multiple pregnancy and maternal parity. The parameters of preterm infants were: Apgar score, intrauterine growth restriction (IUGR), perinatal asphyxia, respiratory distress syndrome (RDS), sepsis, necrotizing enterocolitis, intracranial hemorrhage, neonatal convulsions, hypoglycemia, blood transfusion, the need for surfactant, the need for mechanical ventilation, the length of stay in an Intensive Care Unit and early and late neonatal mortality.Main findings: The frequency of preterm births was 6.48%. The most common type of premature birth was spontaneous premature birth. Most complications occurred in neonates with a gestational age of 28-34 weeks. The most common respiratory complication was RDS (8.1%). Early neonatal mortality was 1.49% and late neonatal mortality was 0.85%.Principal conclusion: Neonatal outcomes of premature infants are directly proportional to their gestational age. The neonatal mortality rate of premature infants at Clinical Hospital Center Mostar (CHC) Mostar is comparable to other developing countries.Key words: preterm birth, gestational age neonatal outcome, perinatal care, neonatal mortality

The effect of gentle human touch on pain, comfort and physiological parameters in preterm infants during heel lancing

ObjectiveThis research was conducted to evaluate the effects of gentle human touch (GHT) on pain, comfort, and physiologic parameters in preterm infants during heel lancing. MethodThis prospective, assessor-blind, randomized controlled study was performed between August 10, 2021 and September 10, 2021 in the Neonatal Intensive Care Units (NICU) of a tertiary hospital in the Central Anatolia Region of Turkey. Fifty preterm infants were randomly appointed to GHT and control groups. The researcher applied GHT to the infants in the GHT group by placing one hand on the infant's head and the other hand on the lower abdomen covering the waist and hips for 15 min. Data were collected with a Questionnaire, Physiological Parameters Observation Form, Newborn Infant Pain Scale (NIPS), The Comfort Scale (COMFORT), and Pulse Oximeter. ResultsThe NIPS and COMFORT mean scores of preterm infants in the GHT group were lower during (p < 0.001, p < 0.05, respectively) and after heel lancing (p < 0.05, p < 0.001, respectively). There was no difference between the preterm infants' peak heart rate, respiratory rate, and SPO2 values in the GHT and control groups during and after heel lancing (p > 0.05). The study found that preterm infants in the GHT group had less crying time during the heel lancing (p < 0.001). ConclusionIt could recommend using in painful procedures because GHT may positively affect preterm infants' pain, comfort, and physiologic parameters. The results of this study will contribute to NICU nurses should include non-pharmacological methods such as GHT to decrease pain of preterm infants in procedural pain. Trial registrationClinicalTrials.gov (NCT05001191).

Effect of zinc supplementation on growth of preterm infants

Background and objectives: Nutritional deficits are almost universal in low-birth weight babies. This study aimed to show the effect of zinc supplementation on growth and certain hematological parameters in preterm infants. Methods: The current case-control study was carried out on 80 healthy preterm infants below 37 weeks of age divided into two groups. The first group was a zinc-supplemented group fed with breast milk exclusively and supplemented with zinc (2 mg/kg/day) since the first day of life. The second group was a non-zinc-supplemented group fed with breast milk exclusively (without zinc supplementation). Both groups were followed up at the age of 4 months for monitoring growth and determining serum zinc and hemoglobin levels. Results: With the beginning of the study; there was no significant statistical difference between the zinc supplemented &amp; non zinc supplemented groups in weight (2.4±0.2 kg vs 2.5±0.4kg), length (45.0±1.6 cm vs 45.2±1.5 cm) and occipitofrontal circumference (31.5±1.2 cm vs 31.5±1.1cm) respectively, but there was statistical significant difference at 4 months follow up with regard to weight (6.2±0.3 kg vs 6.0±0.2 kg) and length (63.2±2.1 cm vs 61.1±2.0 cm). Also, there was a highly significant increase in serum hemoglobin levels (11.7±1.6 gm/dl vs 10.6±1.5 gm/dl) and serum zinc level (101.2±8.1 µg/dl vs 84.1±7.0 µg/dl) in the zinc-supplemented group compared to the non-zinc-supplemented group at 4 months follow up. Conclusion: Zinc supplementation was found to be effective to enhance the growth as well as increasing serum zinc and hemoglobin levels in early months of life of preterm infants.

Baseline Values of Left Ventricular Systolic Function in Preterm Infants With Septic Shock: A Prospective Observational Study.

Background and AimGuidelines recommended that cardiac index (CI) of term infants with septic shock should reach the target level of 3.3–6.0L/(min⋅m2). However, there are still no standard values for preterm infants with septic shock. Herein, we investigated the functional echocardiographic baseline values of left ventricular (LV) systolic functional parameters at the onset of septic shock in preterm infants and possible correlations between baseline values and poor outcomes.Materials and MethodsThis was a prospective, observational, and longitudinal single-center study. Eligible infants were monitored for LV systolic functional parameters using functional echocardiography at the onset of septic shock. The primary study outcome was the difference in the baseline value of LV systolic functional parameters in preterm infants with septic shock with different gestational age (GA) and birth weight (BW). The secondary outcome was septic shock-associated death or severe brain injury (including grade 3–4 intraventricular hemorrhage or periventricular leukomalacia).ResultsIn total, 43 subjects met the criteria, with a median GA of 321/7 weeks and BW of 1800 grams. No difference was observed in baseline values of LV systolic functional parameters among infants with different GA and BW. Infants were assigned to good and poor outcomes groups based on septic shock-associated death or severe brain injury. Out of 43 infants, 29 (67.4%) had good outcomes vs. 14 (32.6%) with poor outcomes. Stroke index (SI) [18.2 (11.1, 18.9) mL/m2 vs. 23.5 (18.9, 25.8) mL/m2, p = 0.017] and cardiac index (CI)[2.7 (1.6, 3.5) L/(min⋅m2) vs. 3.4 (3.0, 4.8) L/(min⋅m2), p = 0.015] in infants with poor outcomes were significantly lower (P < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the cut-off values of SI and CI for predicting poor outcomes in preterm infants with septic shock were 19.5 mL/m2 (sensitivity, 73.9%; specificity, 81.8%) and 2.9L/(min⋅m2) (sensitivity, 78.3%; specificity, 72.7%), with area under the ROC curve (AUC) value of 0.755 and 0.759, respectively.ConclusionThere were no differences in baseline LV systolic functional values among preterm infants with septic shock with different GA and BW. However, preterm infants with SI<19.5mL/m2 and/or CI<2.9L/(min⋅m2) at the onset of septic shock were at high risk of having poor outcomes.

The effect of white noise and classical music on pain and physiologic parameters in preterm infants during retinopathy of prematurity examinations: a randomized controlled trial

ABSTRACT This study was designed as a prospective, randomized controlled trial. A total of 90 preterm infants who underwent retinopathy of prematurity (ROP) examinations were categorized into three groups, a control group, a white noise group (WN), and a classical music group (CM), each comprising 30 preterm infants. The study data were obtained using an information form and the Premature Infant Pain Profile. During (WN: 9.70±3.02; CM: 11.2±2.28) and after the examination (WN: 3.60±2.11; CM: 3.77±1.83), the preterm infants in the WN and CM groups had lower mean pain scores and heart rates (181.17±15.76 and 3150.10±17.03 vs. 173.30±20.66 and 146.67±18.17, respectively; p<0.001) and higher mean oxygen saturation values (93.60±3.87 and 97.83±1.93 vs. 95.73±2.52 and 98.27±1.82, respectively; p<0.05) than those in the control group; the differences were statistically significant. The WN and CM listened to by the preterm infants during ROP examinations had positive effects on pain and heart rate and oxygen saturation values.

Association of Serum Zinc and Copper with Clinical Parameters in Preterm Infants

Association of Serum Zinc and Copper with Clinical Parameters in Preterm Infants

A Neonatal Phantom for Vital Signs Simulation.

Neonatal intensive care units provide vital medical support for premature infants. The key aspect in neonatal care is the continuous monitoring of vital signs measured using adhesive skin sensors. Since sensors can cause irritation of the skin and lead to infections, research focuses on contact-free, camera-based methods such as infrared thermography and photoplethysmography imaging. The development of image processing algorithms requires large datasets, but recording the necessary data from studies brings tremendous effort and costs. Therefore, realistic patient phantoms would be feasible to create a comprehensive dataset and validate image-based algorithms. This work describes the realization of a neonatal phantom which can simulate physiological vital parameters such as pulse rate and thermoregulation. It mimics the outer appearance of premature infants using a 3D printed base structure coated with several layers of modified, skin-colored silicone. A distribution of red and infrared LEDs in the scaffold enables the simulation of a PPG signal by mimicking pulsative light intensity changes on the skin. Additionally, the body temperature of the phantom is individually adjustable in several regions using heating elements. In the validation process for PPG simulation, the feasibility of setting different pulse frequencies and the variation of oxygen saturation levels was obtained. Furthermore, heating tests showed region-dependent temperature variations between 0.19 °C and 0.81 °C around the setpoint. In conclusion, the proposed neonatal phantom can be used to simulate a variety of vital parameters of preterm infants and, therefore, enables the implementation of image processing algorithms for the analysis of the medical state.