Category Archives: Prematurity

Tip 150: oxygen and ROP

Giving supplemental oxygen in preterm infants with incompletely vascularised retina causes hyperoxia and vasoconstriction. This in turn may lead to local hypoxia, up‐regulation of vascular endothelial growth factor, and excessive proliferation of new vessels and fibrous tissue that invades the … Continue reading

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Tip 149: preterm infant nutrition

Preterm infants <1kg require 4.0 – 4.5 g/kg/day protein compared to 2 g/kg/day for a term infant. Reference: ESPGHAN, (2010). Enteral Nutrient Supply for Preterm Infants: Commentary from European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition. JPGN; 50: … Continue reading

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Tip 146: NEC risk factors (2)

Other risk factors for NEC include: Hypoxic insult – especially in the more mature infant with NEC Anaemia / need for transfusion Polycythaemia Dehydration Use of non-human milk or hyperosmolar feeds (e.g. fortifier additives) Rapid introduction and escalation of enteral … Continue reading

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Tip 145: NEC risk factors

The aetiology of NEC is multifactorial. The most important risk factors include: Prematurity – median gestation of 29/40 Low birth weight, especially <1500g (found in 65% of cases in one study) In-utero growth restriction (IUGR) Patent ductus arteriosus (PDA) Formula … Continue reading

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Tip 140: cortisol

Very preterm neonates are at increased risk for cortisol insufficiency in acute illness and stress because of immaturity of the adrenal gland. The adrenal neocortex generally does not synthesize cortisol until ~ 30/40. Before this, the fetus uses progesterone from the placenta to … Continue reading

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Tip 131: RDS 2

Respiratory distress syndrome (pulmonary surfactant deficiency) is seen almost exclusively in preterm infants, especially <34 weeks gestation. It is difficult to assess true incidence due to the use of prophylactic surfactant. Coding data from the Vermont Oxford Network for 2015 … Continue reading

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Tip 130: ranitidine in preterm babies

There is a strong statistical evidence to suggest that ranitidine increases the risk of both NEC and infection in preterm infants, but none of the data so far comes from an RCT. References: Chandrasekaran M., Fleming P. (2014). Question 1: does … Continue reading

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