<b><i>Introduction:</i></b> Macrolides have anti-inflammatory and immunomodulatory properties that give this class of antibiotics a role that differs from its classical use as an antibiotic, which opens new therapeutic possibilities. <b><i>Objective:</i></b> The aim of this study was to evaluate the anti-inflammatory effect of azithromycin in preventing mechanical ventilation (MV)-induced lung injury in very-low-birth-weight preterm neonates. <b><i>Methods:</i></b> This is a randomized, double-blind, placebo-controlled trial of preterm neonates who received invasive MV within 72 h of birth. Patients were randomized to receive intravenous azithromycin (at a dose of 10/mg/kg/day for 5 days) or placebo (0.9% saline) within 12 h of the start of MV. Two blood samples were collected (before and after intervention) for measurement of interleukins (ILs) and PCR for <i>Ureaplasma</i>. Patients were followed up throughout the hospital stay for the outcomes of death and bronchopulmonary dysplasia defined as need for oxygen for a period of ≥28 days of life (registered at ClinicalTrials.gov, No. NCT03485703). <b><i>Results:</i></b> Forty patients were analyzed in the azithromycin group and 40 in the placebo group. Five days after the last dose, serum IL-2 and IL-8 levels dropped significantly in the azithromycin group. There was a significant reduction in the incidence of death and O<sub>2</sub> dependency at 28 days/death in azithromycin-treated patients regardless of the detection of <i>Ureaplasma</i> in blood. <b><i>Conclusions:</i></b> Azithromycin has anti-inflammatory effects, with a decrease in cytokines after 5 days of use and a reduction in death and O<sub>2</sub> dependency at 28 days/death in mechanically ventilated preterm neonates.
The incidence of late-onset neonatal sepsis indicates a vulnerability in preterm infants due to immunological immaturity. These results reveal that knowledge of the profile of newborn infants admitted to the NICU and the risk factors to which they are exposed are central to the planning of nursing care for these patients. Future studies should address strategies for preventing nosocomial infection.
The aim of this retrospective cohort study was to investigate clinical outcomes of the first year of life of premature infants discharged from the Neonatal Intensive Care Unit (NICU) based on mortality and readmission data, and the motor development of the children. The sample consisted of 170 children with gestational age under 37 weeks and who survived hospitalization in neonatal intensive care unit (NICU). Data were collected from medical records, the hospital IT system and telephone interview with the caregiver. The authors found 100% survival during the study period and that 39.4% of the infants were often readmitted (26.5%) due to respiratory conditions. Their development was considered as expected, when using the corrected age. In conclusion, the premature infants from this study showed good clinical evolution of the proposed observation. Descriptors:Intensive care units, neonatal. Infant, premature. Infant, very low birth weight. RESUMO O estudo investigou desfechos clínicos do primeiro ano de vida de prematuros egressos da Unidade de
Objetivo: avaliar as evidências científicas disponíveis sobre as intervenções de enfermagem no atendimento aorecém-nascido submetido à terapia de oxigenação por membrana extracorpórea. Método: Pesquisa bibliográfica utilizandocomo fonte de pesquisa plataformas online como Ovid MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials ePubmed, SCOPUS, Scielo nos últimos 15 anos, realizada no período de junho de 2019 à outubro de 2020. Resultado: a utilizaçãoda membrana de oxigenação extracorpórea é uma terapia de alta complexidade, cabendo ao enfermeiro, privativamente, aresponsabilidade pela assistência direta ao paciente submetido a esta intervenção. É primordial que o enfermeiro possua amploconhecimento técnico-científico sobre o procedimento a fim de garantir a qualidade da assistência de enfermagem e a segurançado paciente em uso da tecnologia em estudo. Conclusão: O conhecimento científico e a capacitação profissional são vistos comofatores determinantes para o êxito na implantação e manutenção da oxigenação por membrana extracorpórea.
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