Chorioamnionitis and brain damage in the preterm newborn

Rocha, Gustavo; Proença, Elisa; Quintas, Conceição; Rodrigues, Teresa; Guimarães, Hercília

doi:10.1080/14767050701580515

Cited by 47 publications

(28 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Por outro lado, a extubação tardia, como discutido anteriormente, está associada à piora da lesão pulmonar e ao aumento dos marcadores inflamatórios. O aumento da atividade inflamatória, por sua vez, tem sido associado a uma maior incidência de HIC e à reabertura do canal arterial 22,26,27 .…”

Section: Resultados Secundáriosunclassified

Incidence and main risk factors associated with extubation failure in newborns with birth weight < 1,250 grams

Hermeto

Martins²,

Ramos³

et al. 2009

J Pediatr (Rio J)

View full text Add to dashboard Cite

Objectives: To determine the incidence of extubation failure in preterm newborns with birth weight < 1,250 g extubated to nasal continuous positive airway pressure and to identify the main risk factors associated with the need for reintubation in this population. Methods:A retrospective review of eligible infants admitted and mechanically ventilated between July 2002 and June 2004 was performed. Extubation failure was defined as the need for reintubation within 7 days after the first extubation attempt. Results:Of the 52 patients included in the study, 13 died before the first extubation attempt. Of the remaining 39 patients, only nine had failed extubation (23.1%) Comparing the two groups (failure vs. successful), there was a statistically significant difference regarding birth weight, gestational age and 5-minute Apgar score. After logistic regression, only gestational age was significant. Other secondary outcomes showed significant difference between the groups: intracranial hemorrhage grade III and/or IV, patent ductus arteriosus and death. Conclusions:The incidence of extubation failure in our population was similar to the rate reported in the literature. The main risk factor for extubation failure was prematurity (≤ 28 weeks). In this population of extreme preterm infants, implementation of strategies for early extubation, use of methylxanthines, prevention of patent ductus arteriosus, and use of different modes of assisted ventilation after extubation may improve the outcomes.J Pediatr (Rio J). 2009;85(5):397-402: Prematurity, mechanical ventilation, extubation failure, bronchopulmonary dysplasia. ResumoObjetivos: Determinar a incidência de falha de extubação em recém-nascidos prematuros com peso de nascimento < 1.250 g extubados para pressão positiva contínua nas vias aéreas nasais e identificar os principais fatores de risco que possam estar associados à necessidade de reintubação nessa população.Métodos: Análise retrospectiva dos prontuários de pacientes internados e ventilados mecanicamente durante o período de julho de 2002 a junho de 2004. Falha na extubação foi definida como necessidade de reintubação nos primeiros 7 dias após a primeira tentativa de extubação.Resultados: Entre 52 pacientes estudados, 13 faleceram antes da primeira tentativa de extubação. Do restante, apenas nove falharam na extubação (23,1%). Comparando esses recém-nascidos com aqueles extubados com sucesso, houve diferença estatisticamente significativa em relação a peso de nascimento, idade gestacional e escore de Apgar no 5º minuto. Após a regressão logística, apenas a idade gestacional se manteve significativa. Alguns resultados secundários também foram significativamente diferentes: incidência de hemorragia intracraniana graus III e/ou IV, persistência do canal arterial e óbito. Conclusões:Nosso estudo demonstrou uma incidência de falha na extubação semelhante à da literatura. O principal fator de risco para falha nessa população foi a prematuridade (≤ 28 semanas). Nesses prematuros extremos, a implementação de estrat...

show abstract

Section: Resultados Secundáriosunclassified

Incidence and main risk factors associated with extubation failure in newborns with birth weight < 1,250 grams

Hermeto

Martins²,

Ramos³

et al. 2009

J Pediatr (Rio J)

View full text Add to dashboard Cite

show abstract

“…Moreover, altered cerebral hemodynamics had implications not only in immediate outcome but also farreaching consequences producing IVH and delayed Table 4 Pearson correlation test between interleukin-6 concentrations (pg/mL) and different parameters of cerebral blood flow velocity development in this study. Periventricular-intraventricular hemorrhage is a well-known complication of chorioamnionitis [20]. In experimental animals exposed to high cerebral blood flow, altered cerebral metabolism and microglial activation in the cortex have been found to result in reduction of total and neuronal cell number [22].…”

Section: Discussionmentioning

confidence: 99%

Cerebral blood flow velocity in early-onset neonatal sepsis and its clinical significance

et al. 2012

View full text Add to dashboard Cite

Chorioamnionitis is a known risk factor for neurological damage in newborns. The present study aimed at assessing the changes in cerebral blood flow velocity (CBFV) in early-onset neonatal sepsis (EONS) and determining its predictive value as well as prognostic significance. Inborn neonates with antenatal risk factors for chorioamnionitis were followed up for development of EONS, diagnosed by presence of clinical signs along with positive blood culture and/or elevated interleukin-6 (IL-6) concentrations (≥50 pg/mL) in umbilical cord blood. Comparison group was formed by asymptomatic neonates who had risk factors for chorioamnionitis but did not develop EONS and cord blood IL-6 concentrations were <50 pg/mL. CBFV (resistance and pulsatility indices, peak systolic flow velocity, and vascular diameter) of internal carotid, vertebral, and middle cerebral arteries was assessed by transcranial Doppler ultrasonography within 24 h of birth. The babies were kept under clinical and radiological follow-up for a minimum period of 6 months. Data were analyzed by SPSS 16.0. Final study group contained 55 neonates with sepsis and 35 asymptomatic control neonates. Blood culture was positive in 27 babies of the sepsis group with a preponderance of Gram-negative bacterial isolation. Significantly lower resistance, vasodilatation, and higher blood flow were noted in all the cerebral arteries of the sepsis group. Increase in CBFV was correlated with elevated IL-6 concentrations. CBFV parameters showed significant predictive accuracy as early diagnostic markers of EONS. Among the sepsis group, 14 patients showed signs of intracranial hemorrhage during the hospital stay of which four expired and six showed signs of ventricular dilatation during follow-up. These patients had significantly higher CBFV compared to those who survived. Assessment of CBFV at early hours of birth can be adopted as an additional bedside, non-invasive investigation with immediate diagnostic and late prognostic significance.

show abstract

“…Although a histological diagnosis of chorioamnionitis is more accurate and preferred, the association between histological chorioamnionitis and early IVH remains controversial as Sarkar et al and Rocha et al failed to confirm the association between histological chorioamnionitis and IVH. 32,33 Further studies are required to elucidate the effect of chorioamnionitis on IVH.…”

Section: Discussionmentioning

confidence: 99%

Hypernatremia and grade III/IV intraventricular hemorrhage among extremely low birth weight infants

et al. 2010

View full text Add to dashboard Cite

Objective: To identify the risk factors contributing to intraventricular hemorrhage (IVH) in extremely low birth weight infants during early postnatal life, after appropriate matching for gestational age (GA) and birth body weight (BBW).Study Design: A case-control retrospective study was designed to evaluate preterm infants with a GA p26 weeks and a BBW p1000 g admitted to our hospital during a 7.5-year period. From a cohort of 347 preterm infants, 36 infants (10.7%) had severe IVH (grades III and/or IV). We selected a control group of 36 preterm infants without IVH who were closely matched for GA ( ± 1 week) and body weight ( ± 100 g). Univariate and multivariate logistic regression analyses were performed to identify risk factors for severe IVH. Result:The GA and BBW of the IVH and control groups were 24.6 ± 1weeks and 764.4 ± 118.5 g, and 24.8 ± 0.9 weeks and 771.5 ± 125.9 g, respectively. Vaginal delivery, male sex, resuscitation in the delivery room, high sodium serum levels (meq l À1 ) (162.6 vs 148.8), fluctuation of serum sodium (meq l À1 ) (17.3 vs 6.2), pH, PaCO 2 , hemoglobin and platelet counts were associated with an increased risk of severe IVH. Multivariate logistic regression indicated that sodium fluctuations >13 meq l À1 , vaginal delivery, male sex and hemoglobin fluctuations are strongly associated with the development of severe IVH.Conclusion: Hypernatremia and fluctuations of sodium seem to be related to early severe IVH among preterm infants; however, further studies are required to clarify the causal relationship.

show abstract

Chorioamnionitis and brain damage in the preterm newborn

Abstract: This study confirms the association between histological chorioamnionitis and cystic periventricular leukomalacia, but was unable to confirm the association between histological chorioamnionitis and intraventricular hemorrhage.

Cited by 47 publications

References 37 publications

Incidence and main risk factors associated with extubation failure in newborns with birth weight < 1,250 grams

Incidence and main risk factors associated with extubation failure in newborns with birth weight < 1,250 grams

Cerebral blood flow velocity in early-onset neonatal sepsis and its clinical significance

Hypernatremia and grade III/IV intraventricular hemorrhage among extremely low birth weight infants

Contact Info

Product

Resources

About

Chorioamnionitis and brain damage in the preterm newborn

Abstract: This study confirms the association between histological chorioamnionitis and cystic periventricular leukomalacia, but was unable to confirm the association between histological chorioamnionitis and intraventricular hemorrhage.

Cited by 47 publications

References 37 publications

Incidence and main risk factors associated with extubation failure in newborns with birth weight &lt; 1,250 grams

Incidence and main risk factors associated with extubation failure in newborns with birth weight &lt; 1,250 grams

Cerebral blood flow velocity in early-onset neonatal sepsis and its clinical significance

Hypernatremia and grade III/IV intraventricular hemorrhage among extremely low birth weight infants

Contact Info

Product

Resources

About

Incidence and main risk factors associated with extubation failure in newborns with birth weight < 1,250 grams

Incidence and main risk factors associated with extubation failure in newborns with birth weight < 1,250 grams