cardiovascular-agents and Urinary-Tract-Infections

Extremely preterm infants are peculiar in regard to their risk of retinopathy of prematurity (ROP). In this study, we aim to study insults that may affect extremely preterm infants, including prenatal, at birth, and postnatal insults and their effect on the development of ROP.. This study used the data from Prematurity and Respiratory Outcomes Program (PROP). All included infants with a gestational age of 23 0/7 to 28 6/7 weeks using best obstetrical estimate. We included stressful events and/or modifiable variables that may affect the normal development. We used multiple regression analysis in our statistical analysis.. We included a total of 751 infants in our study. The mean birth weight for the included sample was 915.1 (±232.94) grams. 391 (52.1%) Infants were diagnosed with ROP. We found a significant negative correlation between ROP development and birth weight (p < 0.001), with a correlation coefficient of - 0.374. We found that the need for prophylactic indomethacin (OR 1.67), the occurrence of air leaks (OR: 2.35), ventilator-associated pneumonia (OR: 2.01), isolated bowel perforations (OR: 3.7), blood culture-proven sepsis (OR: 1.5), other infections (OR: 1.44), and receiving ventricular shunt (OR: 2.9) are significantly associated with the development of ROP.. We believe this study included the largest number of factors studied in the largest sample of extremely premature infants. We recommend a screening program for extremely preterm infants that takes into account a scoring system with higher scores for complicated condition.

Topics: Birth Weight; Cardiovascular Agents; Cellulitis; Cerebrospinal Fluid Shunts; Continuous Positive Airway Pressure; Ductus Arteriosus, Patent; Embolism, Air; Female; Humans; Indomethacin; Infant, Extremely Low Birth Weight; Infant, Extremely Premature; Infant, Newborn; Infant, Very Low Birth Weight; Intestinal Perforation; Male; Mediastinal Emphysema; Meningitis; Neonatal Sepsis; Pneumonia, Ventilator-Associated; Pneumopericardium; Pneumoperitoneum; Pneumothorax; Protective Factors; Retinopathy of Prematurity; Subcutaneous Emphysema; Urinary Tract Infections

To determine the association between fluid resuscitation volume following pediatric burn injury and impact on outcomes.. A retrospective chart review of pediatric patients (0-18 years) sustaining ≥15% TBSA burn, admitted to an American Burn Association verified pediatric burn center from 2010 to 2015.. Twenty-seven patients met inclusion criteria and had complete data available for analysis. Fifteen (56%) patients received greater than 6ml/kg/total body surface area burn in first 24h and twelve (44%) patients received less than 6ml/kg/percent total body surface area burn in first 24h. There were no differences between groups in median number of mechanical ventilator days (4 vs 8, p=0.96), intensive care unit length of stay (10 vs 13.5, p=0.75), or hospital length of stay (37 vs 37.5, p=0.56). Secondary analysis revealed that patients with a higher mean cumulative fluid overload (>253ml/kg, n=16) had larger burn size, higher injury severity scores, and were more likely to receive mechanical ventilation and invasive support devices. Controlling for burn size, odds of longer PICU length of stay and duration of mechanical ventilation were 20.33 [95% CI (1.7-235.6) p=0.02] and 27.9 [95% CI (2.1-364.7) p=0.01], respectively, among patients with a high cumulative fluid overload on day 3 compared to low cumulative fluid overload.. Resuscitation volume in the first 24h was not associated with adverse outcomes. Persistent cumulative fluid overload at day 3 and beyond was independently associated with adverse outcomes.

Topics: Adolescent; Bacteremia; Burns; Cardiovascular Agents; Catheterization, Central Venous; Child; Child, Preschool; Female; Fluid Therapy; Humans; Infant; Infant, Newborn; Injury Severity Score; Intensive Care Units; Length of Stay; Logistic Models; Male; Prognosis; Respiration, Artificial; Respiratory Insufficiency; Retrospective Studies; Time Factors; Trauma Severity Indices; Urinary Tract Infections; Water-Electrolyte Balance; Wound Infection

Topics: Acute Disease; Brain Edema; Brain Ischemia; Cardiovascular Agents; Case Management; Combined Modality Therapy; Decompression, Surgical; Fever; Humans; Hyperglycemia; Hypertension; Hypoxia; Intracranial Hypertension; Pneumonia; Thrombolytic Therapy; Urinary Tract Infections; Water-Electrolyte Imbalance

Topics: Cardiovascular Agents; Disease; Humans; Male; Muscle Relaxants, Central; Muscle Spasticity; Neoplasms; Parasympatholytics; Prostate; Prostatic Neoplasms; Ureter; Ureteral Diseases; Urinary Tract Infections