No abstract

Aim: To evaluate the improvement of feeding intolerance to premature infants by abdominal massage. Method: From January 2018 to January 2020, the basic data of 72 premature infants in the NICU of our hospital were collected by retrospective method, which was divided into an experimental group and control group, 36 cases ineach group. The infants in the experimental group received such intervention of abdominal massage with daily fixed time and fixed frequency, and the control group without abdominal massage. The gestational age, birth weight, sex was not statistically significant in the two groups. The outcome indexes of the two groups were evaluated including the length of stay, the weight beginning oral feeding, the weight reaching total oral feeding, the weight at discharge, transition time, time to recover to birth weight, the daily weight gain, gastric residue. Results: Data analysis by SPSS24.0 showed that the weight beginning oral feeding (P = 0.012), weight reaching total oral feeding (P = 0.014) and the mean times of gastric residue in the experimental group was statistically significant. But there was no significant difference in the length of stay, the weight at discharge, transition time, time to recover to birth weight, and the daily weight gain. Conclusion: Intervention of abdominal massage might promote the weight gain and improve the feeding intolerance in premature infants.

Background: Peripherally inserted central catheter (PICC) is one of the important ways to maintain nutrition in premature infants, especially for very low birth weight infants. There are studies have shown that as premature babies grow up after birth, the tip of the PICC will shift away from the heart. When the catheter remove from the central vein, the risk of complications is suddenly increased. Therefore, it is important to predict the position of catheter tip.Methods: Select the very low birth weight infant (VLBW) infants who used PICC in our hospital from April 2017 to August 2018. And we recorded the birth weight, the weight and the position of the catheter tip of the each filming day, and calculated the rate and speed of weight gain during this period. The correlation was analyzed by the Spearman method.Results: A total of 49 patients and 151 X-rays were enrolled in the study. Of the 49 remaining infants, 40 were in appropriate for gestational age group and 9 were in small for gestational age group. The correlation between weight gain and PICC tip shift in appropriate for gestational ages (AGAs) is statistically significant (P<0.05). But for SGAs group, the correlation between the rate of weight gain and PICC tip shift was −0.588 (P<0.05), but there was no correlation between the speed of weight gain and PICC tip shift.Conclusions: There is a close correction between catheter tip shift and weight gain for those babies. The PICC should be repositioned by X-ray when the rate of weight gain of AGA infants increased to 25%, 50%, 70% [10%, 35%, 55% for small for gestational age (SGA) infants]. For AGAs, when the baby's weight gain speed reaches 1% and 3.5%, the catheter tip had 2 and 3vertebral changes, so if the speed of weight gain is excessive faster, we need to increase the frequency of the positioning.

A tertiary neonatal intensive care unit (NICU) in China has carried out a study investigating the safety and accuracy of intracavitary electrocardiogram (IC-ECG) guidance in PICC tip placement in preterm infants. From October 2015 to September 2018, IC-ECG-guidance was applied in 327 preterm infants in our NICU. The positioning of the PICC was performed under ECG-guidance and subsequently assessed by chest X-ray. The frequency of correct ECG-guided PICC-placement in one single attempt, premature infants gender, weight, weeks' gestational age at PICC insertion was recorded. 327preterm infants(207 male and 120 female)were included in the study with a gestation of 31.3 weeks (25.3 to 36.8) and birth weight of 1498 g (600 to 2560). 327 PICCs tip placement was guided with IC-ECG, all concordant with chest X-ray. 313 (95.7%) were correctly positioned, 228 (72.3%) were correctly positioned on the first attempt, 5 were incorrectly identified to have a short line and 9 were malpositioned. The most commonly punctured vein was the basilic vein (n=228), followed by the superficial temporal vein (n = 31), the axillary vein (n = 25). For 3 years IC-ECG method has proved to be a simple, safe, quick method to assess the correct positioning of the PICC in preterm infants. This is a reliable technique, performing real-time manipulation without any complications.

Limited information exists regarding the correlation between gastric residual volume and gastric fluid pH before feedings in infants with very low birth weight. The purpose of this study was to evaluate this relationship in infants with feeding tolerance compared with that in those with feeding intolerance. A total of 86 infants with very low birth weight were included in the study, including 43 with feeding tolerance (study group) and 43 with feeding intolerance (control group). Gastric residual volume was obtained using a feeding tube and acidity measured using a pH-test paper. The gastric fluid pH was measured before each feeding in both the groups and compared. Demographic and clinical characteristics were similar between very low birth weight infants with and without feeding intolerance. Significant differences were observed in the gastric fluid pH between groups (p < 0.05). The gastric fluid pH value significantly increased with increasing gastric residual volume in a linear fashion (Pearson correlation = 0.543; P < 0.05). There is a positive linear correlation between gastric residual volume and gastric juice pH value in infants with very low birth weight.