Respiratory Decompensation and Immunization of Preterm Infants

Montague, Edwin Clark; Hilinski, Joseph A.; Williams, Harriet; Giannopoulos, Helen T.; Piazza, Anthony J.

doi:10.1542/peds.2015-4225

Cited by 11 publications

(4 citation statements)

References 28 publications

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“…While efforts to avoid unnecessary vaccination delays are critical, concerns for transient cardiorespiratory deterioration following vaccination may justify brief delays in unstable infants with sBPD. 24,25 These are examples of routinely used medications that would nonetheless benefit from dedicated research to better define best practice.…”

Section: Discussionmentioning

confidence: 99%

Medication use in infants with severe bronchopulmonary dysplasia admitted to United States children’s hospitals

Bamat¹,

Kirpalani²,

Feudtner³

et al. 2019

J Perinatol

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Objective: To identify the number of cumulative medication exposures and most frequently used medications in infants with severe BPD. Study Design: We performed a retrospective cohort study in infants with severe BPD admitted to United States children’s hospitals. We measured cumulative medication exposures in individual subjects and between-center variation after adjustment for infant characteristics. We then identified the specific medications and therapeutic classes with the highest rates of use. Results: In 3252 subjects across 43 hospitals, we identified a median (interquartile range) of 30 (17– 45) cumulative medication exposures per infant. The adjusted mean number of medication exposures varied between centers (p < 0.0001), with a range of 22 – 50. Diuretics and furosemide were the most frequently prescribed therapeutic class and specific medication for the management of severe BPD. Conclusions: Infants with severe BPD are exposed to alarming number of medications of unclear efficacy and safety, with marked variation between center.

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Section: Discussionmentioning

confidence: 99%

Medication use in infants with severe bronchopulmonary dysplasia admitted to United States children’s hospitals

Bamat¹,

Kirpalani²,

Feudtner³

et al. 2019

J Perinatol

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“…Many of these infants present initially with no, or mild, RDS that responds rapidly to surfactant therapy or perhaps require prolonged mechanical ventilation because of apnea and poor respiratory effort. Severe RDS was defined as arterial‐to‐alveolar oxygen (O 2 ) ratio <0.2 [Montague et al, ].…”

mentioning

confidence: 99%

The Improvement of Respiratory Performance After Phototherapy-Induced EPC Mobilization in Preterm Infants With RDS

et al. 2016

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Many infants who develop bronchopulmonary dysplasia (BPD) are born with serious respiratory distress syndrome (RDS), which is associated with impaired vascular and alveolar growth. RDS is a breathing disorder that mostly affects preterm infants and occurs in infants whose lungs have not yet been fully developed. The use of surfactant in RDS treatment does not necessarily prevent BPD. Endothelial progenitor cells (EPCs) may contribute to lung angiogenesis for the prevention and treatment of BPD. The aim of this study was to evaluate the therapeutic efficacy of phototherapy for EPC release in preterm infants born with RDS. Seventy-five RDS preterm infants were divided into two groups: RDS with phototherapy and RDS without phototherapy. Respiratory indices were recorded for each patient. Circulating EPCs were isolated before and after phototherapy and colony forming efficiency, chemotactic, tubulogenic, proliferative, and functional properties of these cells were analyzed. Our results showed that phototherapy increased the release of EPCs into the circulation in RDS preterm infants, with augmentation of cell proliferation, tubulogenic, chemotactic, and proliferative properties of EPCs. Phototherapy-induced EPC release was associated with improved lung function as was recorded by significantly decrease in continuous positive airway pressure (CPAP) days, CPAP plus ventilator days, and PCO along with a significant increase in PO and PaO /FiO , resulting in markedly decreased rate of BPD occurrence in preterm infants with RDS. Overall, phototherapy is touted as a promising modality for the amelioration of respiratory performance and prohibition of BPD occurrence in RDS preterm infants. J. Cell. Biochem. 118: 594-604, 2017. © 2016 Wiley Periodicals, Inc.

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“…Of the 10 infants who received late vaccinations, many of these were unnecessarily delayed. Three infants had no apparent reason for delay and Montague et al showed that respiratory decompensation after vaccination was rare, even amongst infants with BPD and advised that BPD or oxygen dependence should not be a reason to delay vaccines [11].…”

Section: Discussionmentioning

confidence: 99%

A successful preterm vaccination program in a neonatal unit in a developing country

Tooke

Louw

2019

Heliyon

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BackgroundAlthough preterm infants are at a greater risk from vaccine preventable diseases, there are frequent delays in vaccine administration with great variability between units. There is little data from developing countries. Groote Schuur Hospital in Cape Town, South Africa starting vaccinating preterm infants from 2014.ObjectivesTo determine whether vaccines were given at the correct chronological age and whether there were side effects or logistical problems.MethodsFor a six month period, all infants who were still admitted at 6 weeks of age were included. Date of vaccination and side effects were recorded.Results60 infants were included. 57 (95%) received their 6 week vaccines. 68% received the vaccines on time, 10% early and 17% late. Reasons for delay included oxygen dependence and concerns about sepsis. There were no side effects.ConclusionsIt is possible to implement a successful vaccination program for preterm infants in a low resourced setting.

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Respiratory Decompensation and Immunization of Preterm Infants

Abstract: BACKGROUND: Concern for respiratory decompensation after immunization in premature infants, particularly those with bronchopulmonary dysplasia (BPD), may lead to delayed and altered immunization schedules.

Cited by 11 publications

References 28 publications

Medication use in infants with severe bronchopulmonary dysplasia admitted to United States children’s hospitals

Medication use in infants with severe bronchopulmonary dysplasia admitted to United States children’s hospitals

The Improvement of Respiratory Performance After Phototherapy-Induced EPC Mobilization in Preterm Infants With RDS

A successful preterm vaccination program in a neonatal unit in a developing country

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