Abstract
Objective: To test the hypothesis that three changes in the early management of extremely low birth weight (ELBW) neonates would decrease the incidence of extra-uterine growth restriction (EUGR) by 25%. The three early management practice changes (EMPC) included surfactant at delivery followed by immediate extubation to nasal continuous positive airway pressure (CPAP), decreased oxygen exposure and early parenteral amino acids. Study Design: Historical cohort study of preterm infants ≤ 1000g birth weight (BW) born at the University of Texas Medical Branch between January 2001 and June 2002 (pre-EMPC, before changes, n=87) and July 2004 to December 2005 (post-EMPC, after changes, n=76). Outcomes measured included feeding and growth parameters, morbidities and interventions. Statistical analysis included χ2-analysis, Student's t-test, and analysis of variance. Result: Infants in the post-EMPC cohort regained BW more quickly, maintained appropriate size for weight at 36 weeks and had less morbidity associated with poor long-term outcome. Predictors of EUGR included BW <750g and surgical necrotizing enterocolitis. Conclusion: The introduction of surfactant at delivery followed by immediate extubation to CPAP, decreased oxygen exposure and early parenteral amino acids in ELBW infants is possible, safe and associated with improvements in growth and morbidity.
Original language | English (US) |
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Pages (from-to) | 347-353 |
Number of pages | 7 |
Journal | Journal of Perinatology |
Volume | 28 |
Issue number | 5 |
DOIs | |
State | Published - May 2008 |
Keywords
- Delivery room CPAP
- Early amino acids
- Extra-uterine growth restriction
- Neonatal nutrition and growth
- Neurodevelopmental delay
- Surfactant
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Obstetrics and Gynecology