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At least 37 records · Page 2Linked to original sources
PubMed1997

Necrotizing funisitis: clinical significance and association with chronic lung disease in premature infants.

OBJECTIVES: Our purpose was to analyze the clinical significance of necrotizing funisitis, an unusual type of chronic inflammation of the umbilical cord, and to determine whether necrotizing funisitis is associated with chronic lung disease in premature infants. STUDY DESIGN: A total of 52 perinatal factors were prospectively assessed in 18 pregnant women and their fetuses in cases of chorioamnionitis at delivery occurring at 22 to 30 gestational weeks; a statistical comparison between the necrotizing funisitis group (n = 5) and the group without necrotizing funisitis (n = 18) was carried out. RESULTS: Significant correlations were found between necrotizing funisitis and the following factors: maternal serum C-reactive protein level on admission (p = 0.014), fetal distress (p = 0.044), umbilical artery blood pH value (p = 0.037) and polynuclear neutrophilic leukocyte count at birth (p = 0.014), chronic lung disease (p = 0.035), need for dexamethasone therapy for chronic lung disease (p = 0.029), duration of oxygen supplementation (p = 0.026), and length of hospital stay (p = 0.026). CONCLUSIONS: There was a significant association between necrotizing funisitis and development of chronic lung disease, suggesting that necrotizing funisitis is an important risk factor for the development of chronic lung disease.

Chorioamnionitis↗
PubMed1981

Acquired lobar emphysema in premature infants with bronchopulmonary dysplasia: an iatrogenic disease?

Five premature infants in whom bronchopulmonary dysplasia developed following prolonged neonatal respiratory support are presented. In all five patients, right middle and/or lower lobe emphysema related to focal obstructing endobronchial masses of granulation tissue subsequently developed. It is speculated that the granulation tissue formed in response to the repeated mechanical trauma of endotracheal tube suctioning.

Female↗
PubMed1982

Osteomyelitis in the neonate. Clinical aspects and the role of radiography and scintigraphy in diagnosis and management.

Based on experience with 22 cases of neonatal osteomyelitis in 10 years, the authors suggest these patients can be divided into two groups depending on severity of disease. Premature infants requiring umbilical catheterization and severely ill full-term infants constitute a high-risk group; signs are more overt, multifocal infection and joint involvement more frequent, and severe skeletal deformities more common. The patients in the low-risk group had much milder disease but also presented more difficulty in diagnosis because of the vagueness of the presenting signs. Radiographic examination is essential for diagnosis and follow-up of osteomyelitis, particularly limb deformities. Bone scans should be reserved for situations in which the clinical and radiographic findings are equivocal.

Diphosphonates↗
PubMed1993

Effect of early initiation of intravenous lipid administration on the incidence and severity of chronic lung disease in premature infants.

OBJECTIVE: To investigate whether intravenous administration of lipid nutrition (Intralipid) within 12 hours of birth to ventilator-dependent premature infants would decrease the incidence or severity, or both, of chronic lung disease. METHOD: We randomly assigned 133 infants to Intralipid or control groups, using two weight strata: 42 Intralipid versus 37 control subjects in the 600 to 800 gm stratum, and 28 Intralipid versus 26 control subjects in the 801 to 1000 gm stratum. The Intralipid group received 20% Intralipid at < 12 hours after birth, starting at a dose of 0.5 gm/kg and increasing to a maximum of 1.5 gm/kg, maintained through day 7. Control infants received no lipid until after day 7. Neither group received enteral feedings until after day 7. RESULTS: No significant differences in mortality rates were present in the total population (23/70 = 32.9% vs 16/63 = 25.4%; p = 0.35, Intralipid vs control); however, the mortality rate increased significantly in 600 to 800 gm infants receiving Intralipid versus the control infants (20/41 = 47.5% vs 9/37 = 24.3%; p = 0.032). No significant differences were found in the number of infants in whom chronic lung disease developed (requiring oxygen for > or = 28 days), proportion requiring oxygen for > or = 60 days, number of survivors without chronic lung disease, or total oxygen and ventilation requirements. However, 600 to 800 gm infants receiving Intralipid had significantly more pulmonary hemorrhage, and greater numbers of infants receiving Intralipid in both weight categories required supplemental oxygen at day 7. The incidence of other complications of prematurity, time required to regain birth weight, and duration of hospital stay did not differ between groups. CONCLUSION: Intralipid administration initiated at < 12 hours after birth failed to protect very low birth weight premature infants from chronic lung disease. Some of the results raise questions about possible deleterious effects of Intralipid when administered early in the first week of life.

Chronic Disease↗
PubMed2004

Free radicals and diseases in premature infants.

Free radicals have been implicated in the pathogenesis of a wide spectrum of human diseases. Premature infants are probably developmentally unprepared for extrauterine life in an oxygen-rich environment and exhibit a unique sensitivity to oxidant injury. Diseases associated with premature infants, including bronchopulmonary dysplasia, periventricular leukomalacia, intraventricular hemorrhage, retinopathy of prematurity, and necrotizing enterocolitis, have been linked to free radical-mediated cell and tissue injury. With the advent of therapies designed to combat the injurious effects of free radicals, the role of these highly reactive chemical molecules in the pathogenesis of neonatal diseases needs to be fully determined.

Animals↗
PubMed2005

Management of infants with chronic lung disease of prematurity in China.

With improved survival of very low birth weight infants in China over the last decade, chronic lung disease of prematurity (CLD) is only now becoming prevalent. As a result the management of CLD in China is only now beginning. In this paper, we describe the practice of managing these infants with as much evidence base as possible but often the management is based on other published papers in China and elsewhere and other people's personal experience. It appears that oxygen therapy is important to the survival of CLD infants but blood oxygen concentrations must be monitored closely in infants needing oxygen supplementation. We aim for a target range for oxygen saturation range of between 90%-95% to prevent retinopathy of prematurity. Although dexamethasone is effective in the treatment of CLD particularly extubation of preterm infants from mechanical ventilation, we restrict its use in severe infant due to their side effects. We have little experience of home oxygen and are only now setting up management protocols for oxygen use for CLD in both hospital and at home. We hope that the survival and outlook for these infants with CLD will improve over the next few years.

Adrenal Cortex Hormones↗
PubMed1995

Role of elevated plasma soluble ICAM-1 and bronchial lavage fluid IL-8 levels as markers of chronic lung disease in premature infants.

BACKGROUND: Pulmonary neutrophilia characterises both the relatively transient inflammation associated with infant respiratory distress syndrome (IRDS) and the persistent inflammation of chronic lung disease. The possibility that persistently raised markers of inflammation indicate the development of chronic lung disease in low birth weight (< 1730 g) preterm (< 31 weeks) infants was therefore investigated. METHODS: Soluble ICAM-1 (sICAM-1) levels in plasma, and interleukin (IL)-8 and myeloperoxidase (MPO) levels in bronchial lavage fluid (BLF) obtained from 17 infants on days 1, 5, and 14 following birth were measured and correlations with the number of neutrophils in BLF sought. Peripheral neutrophils were isolated on Polymorphoprep and chemotactic responsiveness to IL-8 was assessed using micro Boyden chambers. RESULTS: Sixteen infants developed IRDS and, of these, 10 infants subsequently developed chronic lung disease. Levels of IL-8 in BLF at 14 days of age correlated with the long term requirement for intermittent positive pressure ventilation (IPPV). Interleukin 8 levels in BLF correlated with neutrophil numbers and MPO concentration, suggesting both recruitment and activation in response to this cytokine. Antibody depletion studies showed that approximately 50% of total neutrophil chemotactic activity in BLF was due to IL-8. No difference in peripheral neutrophil chemotactic responsiveness at any age was observed for infants with IRDS or chronic lung disease. Plasma soluble intercellular adhesion molecule (sICAM-1) was higher at 14 days of age in infants who developed chronic lung disease than in those with resolving IRDS, and correlated with severity of disease, as indicated by duration of IPPV. CONCLUSIONS: The results indicate that high levels of plasma sICAM-1 and IL-8 in BLF at day 14 correlate with the development of chronic lung disease and indicate the severity of disease.

Biomarkers↗
PubMed2002

[Value of prenatal corticotherapy in the prevention of hyaline membrane disease in premature infants. Randomized prospective study].

OBJECTIVE: The aim of the study was to determine the feasibility, the cost and the effects of antenatal maternal corticosteroid treatment on preventing respiratory distress syndrome in premature neonates of our population. SUBJECTS AND METHODS: Between January, 1, 1998 and June, 31, 1999, 118 pregnant women at 26-34 weeks' gestation and at a high risk of premature delivery, were prospectively randomized in 2 groups: group 1 received intramusculary 24 mg of betamethasone (12 mg every 24 hours), group 2 didn't receive antenatal corticosteroids. At birth, premature neonates were systematically examined by a neonatologist. RESULTS: 131 premature neonates were born (63 from group 1, 68 from group 2). The incidence and the degree of severity of respiratory distress syndrome, appeared substancially reduced (4.8% vs 27.9%) by the use of antenatal corticosteroids. Moreover, neonatal mortality due to respiratory distress syndrome was statistically less in group 1 than in group 2 (22.9% vs 57%). There was no significant difference in the occurrence of maternal or neonatal corticosteroid complications such as infection between treated group and control subjects. We estimated a potential annual savings of 21 thousands tunisian dinars, when the cost implications for antenatal corticosteroid therapy were estimated to 2 thousands tunisian dinars. CONCLUSION: Maternal administration of corticosteroids before preterm delivery results in a decrease in the incidence and severity of respiratory distress syndrome and a decrease in neonatal mortality rate among premature neonates born to treated versus untreated mothers at 26-34 weeks' gestation; added to an annual savings estimated to 21 thousands tunisian dinars.

Anti-Inflammatory Agents↗