Newborns admitted to the Neonatal Intensive Care Unit (NICU) require increased attention regarding neurological assessment and monitoring, due to immaturity or certain conditions that occur during the perinatal and neonatal period. Hypoxic-ischemic encephalopathy (HIE) following perinatal asphyxia is one of the most studied clinical conditions due to the risk of medium-and long-term neurobehavioral outcome. We studied 43 newborns with HIE, for all 3 degrees of impairment, performed amplitude-integrated electroencephalography (aEEG) in the first hours of life and collected common laboratory tests, following serum glycemia at admission and creatinine, creatine kinase (CK) and lactate dehydrogenase (LDH) at admission and in the 3rd day of life. Newborns with mild HIE presented normal aEEG pattern and slightly elevated CK. A total of 80.9% of the newborns with moderate HIE had seizure patterns in aEEG, while among those with severe HIE, 71.4% had seizure patterns in aEEG and 28.5% burst suppression. CK and LDH were mean elevated in those with moderate HIE, and the newborns with severe HIE had also high creatinine values at admission and in the 3rd day of life. Statistically significant differences between the 3 degrees of HIE were noted in terms of creatinine (P=0.009) and CK (P=0.008) at admission and LDH in the 3rd day of life (P=0.036). Hypoglycemia was common in our study group. In conclusion, common blood tests in association with aEEG monitoring and rigorous neurological assessment can predict short-term outcome of HIE and multiorgan dysfunction and can help clinicians predict even long-term outcomes in severe HIE.
Background Congenital gastrointestinal (GI) malformations are developmental disorders that can result in secondary intestinal failure. Nutrient intakes must be adapted according to the newborn’s nutritional requirements based on frequent anthropometric and biochemical assessments. Deficiencies or excess of a macronutrient can hinder the growth of the newborn. Material/Methods To assess the clinical condition of newborns with GI malformations, together with the postoperative nutritional status of newborns who underwent surgery due to congenital GI malformations, we performed a case-control study. The study group comprised newborns with digestive malformations (n=51) and the control group consisted of newborns without digestive pathologies (n=102), matched by sex, gestational age, and weight at admission. Results Bivariate comparisons and multiple logistic regression analyses were performed. A P value <0.05 was considered to be statistically significant; these were observed in abdominal distension, gastric residue, and vomiting. The duration of hospitalization was shorter in the case group, as on average, they were transferred to the Pediatric Surgery Department on the 6 th day, where they further remained admitted to treat the underlying cause. Differences between groups in administration of breast milk versus formula were not statistically significant. Conclusions We concluded that the clinical examination had a major role in early detection of digestive malformations and in the effective management of specific necessary nutrition. Proper evaluation of when to start enteral feeding can help post-surgical cases to recover faster, minimizing complications. Further studies are required to assess how financial factors affect implementation of the standardized guidelines of nutrition in children and to find possible solutions to financial constraints.
Obiectiv. Scopul principal al lucrării este acela de a evalua factorii predispozanţi, evoluţia şi patologia asociată pneumotoraxului în perioada neonatală. Material şi metodă. S-a efectuat un studiu retrospectiv, pe o perioadă de doi ani, pe 11 pacienţi internaţi în Spitalul Clinic de Urgenţă pentru Copii „Louis Ţurcanu“, Timişoara, secţia Neonatologie – Prematuri, diagnosticaţi cu pneumotorax în peiroada 2014-2015. Rezultate. Din 1.689 de nou-născuţi internaţi, 11 pacienţi au dezvoltat pneumotorax, incidenţa fiind de 0,65%. 8 pacienţi (73%) au fost de sex masculin şi 3 pacienţi (27%) de sex feminin. Din cei 11 pacienţi, 4 au fost nou-născuţi la termen cu VG (vârsta de gestaţie) peste 37 de săptămâni şi 7 au fost nou-născuţi prematuri cu VG sub 37 de săptămâni. În funcţie de greutatea la naştere, 4 au avut greutatea peste 2.500 g şi 7 sub 2.500 g. Cauza cea mai frecventă a pneumotoraxului în grupul studiat a fost reprezentată de sindromul de detresă respiratorie, cu un procent de 45,4%. Concluzii. Pneumotoraxul reprezintă o afecţiune importantă în patologia neonatală. Este esenţială recunoaşterea şi iniţierea tratamentului încă din fazele iniţiale, pentru reducerea apariţiei complicaţiilor secundare.
IntroductionThe introduction of early enteral feeding at extremely low birth weight newborns has many advantages and should be started as soon as possible if a premature is clinically stable. Also is important to fortify human milk when feeding volume reaches 100 ml/kg/day.AimsAuthors aim to determine the effect of early trophic feeding on digestive tolerance improvement, and to determine the effect of formula milk compared with human breast milk on growth and development in preterm infants.Material and methodThe study was carried out in the Premature and Neonatology Department on a group of 60 premature newborns with birth weight under 1000 grams (800–1000 grams) without severe asphyxia.ResultsAll the newborns received early trophic feeding associated with parenteral nutrition. Once premature receive exclusively enteral feeding the newborns in both groups (formula milk – group I, human breast milk with breast milk fortifier- group II) have received the same type of milk (breast milk or formula) and they were monitored for any evidence of digestive intolerance and the growth curves were followed. Body weight was measured at the same time each day.ConclusionsImplementing minimal enteral nutrition leads to several clinical benefits that include: increased postnatal growth and shorter hospitalisation period.Enteral feeding with fortified human milk compared with enteral feeding with formula milk improved weight gain at premature in the studied lot.
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