Browsing by Subject "Infant, Extremely Low Birth Weight"

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    Cytokine profiles of preterm neonates with fungal and bacterial sepsis.
    (Pediatr Res, 2012-08) Sood, Beena G; Shankaran, Seetha; Schelonka, Robert L; Saha, Shampa; Benjamin, Danny K; Sánchez, Pablo J; Adams-Chapman, Ira; Stoll, Barbara J; Thorsen, Poul; Skogstrand, Kristin; Ehrenkranz, Richard A; Hougaard, David M; Goldberg, Ronald N; Tyson, Jon E; Das, Abhik; Higgins, Rosemary D; Carlo, Waldemar A; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
    BACKGROUND: Information on cytokine profiles in fungal sepsis (FS), an important cause of mortality in extremely low birthweight (ELBW) infants, is lacking. We hypothesized that cytokine profiles in the first 21 d of life in ELBW infants with FS differ from those with bacterial sepsis (BS) or no sepsis (NS). METHODS: In a secondary analysis of the National Institute of Child Health and Human Development Cytokine study, three groups were defined-FS (≥1 episode of FS), BS (≥1 episode of BS without FS), and NS. Association between 11 cytokines assayed in dried blood spots obtained on days 0-1, 3 ± 1, 7 ± 2, 14 ± 3, and 21 ± 3 and sepsis group was explored. RESULTS: Of 1,066 infants, 89 had FS and 368 had BS. As compared with BS, FS was more likely to be associated with lower birthweight, vaginal delivery, patent ductus arteriosus, postnatal steroids, multiple central lines, longer respiratory support and hospital stay, and higher mortality (P < 0.05). Analyses controlling for covariates showed significant group differences over time for interferon-γ (IFN-γ), interleukin (IL)-10, IL-18, transforming growth factor-β (TGF-β), and tumor necrosis factor-α (TNF-α) (P < 0.05). CONCLUSION: Significant differences in profiles for IFN-γ, IL-10, IL-18, TGF-β, and TNF-α in FS, BS, or NS in this hypothesis-generating secondary study require validation in rigorously designed prospective studies and may have implications for diagnosis and treatment.
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    In-hospital outcomes of premature infants with severe bronchopulmonary dysplasia.
    (Journal of perinatology : official journal of the California Perinatal Association, 2017-07) Jackson, W; Hornik, CP; Messina, JA; Guglielmo, K; Watwe, A; Delancy, G; Valdez, A; MacArthur, T; Peter-Wohl, S; Smith, PB; Tolia, VN; Laughon, MM
    OBJECTIVE:To characterize in-hospital outcomes of premature infants diagnosed with severe bronchopulmonary dysplasia (BPD). STUDY DESIGN:Retrospective cohort study including premature infants with severe BPD discharged from 348 Pediatrix Medical Group neonatal intensive care units from 1997 to 2015. RESULTS:There were 10 752 infants with severe BPD, and 549/10 752 (5%) died before discharge. Infants who died were more likely to be male, small for gestational age, have received more medical interventions and more frequently diagnosed with surgical necrotizing enterocolitis, culture-proven sepsis and pulmonary hypertension following 36 weeks of postmenstrual age compared with survivors. Approximately 70% of infants with severe BPD were discharged by 44 weeks of postmenstrual age, and 86% were discharged by 48 weeks of postmenstrual age. CONCLUSIONS:A majority of infants diagnosed with severe BPD were discharged home by 44 weeks of postmenstrual age. These results may inform discussions with families regarding the expected hospital course of infants diagnosed with severe BPD.