• Journal of Cardiovascular Imaging
• /
• v.30 no.2
• /
• pp.112-122
• /
• 2022

BACKGROUND: Few studies have utilized right atrial (RA) strain to evaluate right ventricular (RV) diastolic dysfunction in preterm infants with bronchopulmonary dysplasia (BPD). We aimed to evaluate the associations of RA strain with BPD severity and respiratory outcomes in preterm infants with BPD. METHODS: We retrospectively studied 153 infants with BPD born before 32 weeks of gestational age at CHA Bundang Medical Center. Peak longitudinal right atrial strain (PLRAS) was obtained using velocity vector imaging and compared among infants across BPD severity. Conventional echocardiographic parameters and clinical characteristics were also evaluated. RESULTS: In infants with severe BPD, mean gestational age (27.4 ± 2.1 weeks) and mean birth weight (971.3 ± 305.8 g) were significantly smaller than in those with mild BPD (30.0 ± 0.9 weeks, 1,237.3 ± 132.2 g) and moderate BPD (29.6 ± 1.3 weeks, 1,203.2 ± 214.4 g). PLRAS was significantly lower in infants with severe BPD (26.3 ± 10.1%) than in those in the moderate BPD group (32.4 ± 10.9%) or mild BPD group (31.9 ± 8.3%). Tricuspid E/e' and maximum RA volume index were similar across BPD severity. A decrease in PLRAS was significantly correlated with increased duration of mechanical ventilation duration; however, tricuspid E/e' and maximum RA volume index were not. CONCLUSIONS: Evaluating PLRAS with other parameters in infants with BPD might detect RV diastolic dysfunction. Longer follow-up and larger study populations may elucidate the association between PLRAS and respiratory outcomes in infants with BPD.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.19 no.6
• /
• pp.343-351
• /
• 2019

Background: Preterm labor and miscarriage may occur in stressful situations, such as a surgical operation or infection during pregnancy. Pharyngeal and buccal abscess and facial bone fractures are inevitable dental surgeries in pregnant patients. Remifentanil is an opioid analgesic that is commonly used for general anesthesia and sedation. Nonetheless, no study has investigated the effects of remifentanil on amniotic epithelial cells. This study evaluated the effects of remifentanil on the factors related to uterine contraction and its mechanism of action on amniotic epithelial cells. Methods: Amniotic epithelial cells were preconditioned at various concentrations of remifentanil for 1 h, followed by 24-h lipopolysaccharide (LPS) exposure. MTT assays were performed to assess the cell viability in each group. The effects of remifentanil on factors related to uterine contractions in amniotic epithelial cells were assessed using a nitric oxide (NO) assay, western blot examinations of the expression of nuclear factor-kappa B (NF-κB), cyclooxygenase 2 (COX2), and prostaglandin E2 (PGE₂), and RT-PCR examinations of the expression of the proinflammatory cytokines interleukin (IL)-1β and tumor necrosis factor-alpha (TNF-α). Results: Remifentanil did not affect viability and nitric oxide production of amniotic epithelial cells. Western blot analysis revealed that remifentanil preconditioning resulted in decreased expressions of NF-κB and PGE2 in the cells in LPS-induced inflammation, and a tendency of decreased COX2 expression. The results were statistically significant only at high concentration. RT-PCR revealed reduced expressions of IL-1β and TNF-α. Conclusions: Preconditioning with remifentanil does not affect the viability of amniotic epithelial cells but reduces the expression of factors related to uterine contractions in situations where cell inflammation is induced by LPS, which is an important inducer of preterm labor. These findings provide evidence that remifentanil may inhibit preterm labor in clinical settings.

• Neonatal Medicine
• /
• v.18 no.2
• /
• pp.228-233
• /
• 2011

Purpose: The aim of our study was to compare the efficacy and safety of ibuprofen and indomethacin in the prophylaxis of patent ductus arteriosus (PDA) in preterm infants and to determine whether ibuprofen could be an alternative agent in prophylactic use. Methods: A retrospective study including 37 preterm infants <1,500 g of birth weight, <34 weeks of gestation, whom were administrated indomethacin (n=17; January 2009-December 2009) or ibuprofen (n=20; January 2010-February 2011) within 24 hr after birth was conducted. The rate of ductal closure, need for surgical ligation, clinical outcomes such as necrotizing enterocolitis, intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity (ROP) and death rate were compared. Results: There were no statistically significant differences between the two groups in mean gestational age, mean birth weight, Apgar score, sex, type of delivery, maternal dexamethasone treatment, frequency and duration of ventilator and surfactant treatment. The closure of PDA on day 7 of life was in 19 of 20 infants of the ibuprofen group and 13 of 17 infants of the indomethacin group (P=0.159). Between the two groups, there were no significant differences with respect to clinical outcomes. Conclusion: Ibuprofen has similar effects to indomethacin in the rate of PDA closure. Our study demonstrates that prophylactic ibuprofen is relatively effective without significant differences with respect to clinical outcomes compared with indomethacin. Therefore, ibuprofen may be used as an alternative agent in the prophylaxis of PDA in preterm infants.

• Clinical and Experimental Pediatrics
• /
• v.52 no.8
• /
• pp.888-892
• /
• 2009

Purpose : To evaluate the risk factors for hospital readmission during the neonatal period among late preterm infants who were discharged after nursery care. Methods : In this retrospective study, we reviewed medical records of 135 late preterm infants readmitted to the neonatal intensive care unit (NICU) during the neonatal period, after discharge from nursery of IL Sin Christian Hospital from January 2003 to December 2008. We compared the risk factors of the hospital readmission group with the control group. Results : The gestational age and birth weight of 135 study infants were $36^{+1}{\pm}0.5$ weeks and $2,718.4{\pm}296.9gm$, respectively. Identified risk factors of hospital readmission were breastfeeding (71.9% vs. 44.4%), short duration of nursery stay ($3.3{\pm}1.6$ days vs. $4.1{\pm}2.0$ days), firstborn (60.0% vs. 45.3%), and maternal pregnancy complication (31.9% vs. 18.8%). Jaundice accounted for the majority of hospital readmissions (83.7%), and the age at hospital readmission was $6.2{\pm}3.6$ postnatal days, mostly at 5-6 postnatal days (40.7%). Identified risk factors of hospital readmission due to jaundice were spontaneous normal vaginal delivery (43.4% vs. 1.8%), younger maternal age ($29.8{\pm}3.4$ yrs vs. $32.1{\pm}4.2$ yrs), and lower maternal pregnancy complication (28.3% vs. 50%). Conclusion : Identified risk factors of hospital readmission were breastfeeding, short duration of nursery stay, firstborn, and maternal pregnancy complication. Jaundice accounted for the majority of hospital readmissions, and the age at hospital readmission was $6.2{\pm}3.6$ postnatal days.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.12
• /
• pp.128-137
• /
• 2016

This study aimed to investigate the effect of kangaroo care on physical development adaptation of external environment of prematurity, and maternal role confidence of those who delivered preterm infants. The subjects were 38 preterm infants and mothers with cesarean section delivery in the hospital, located at B city. Eighteen premature infants were assigned to the kangaroo care (KC) group or the control group (CG). Data were collected between June 2013 and June 2015. KC was given 3 times a day (60 min at a time) and performed a total of 10 times. The physical development indicator (weight, height, and head circumference) as well as the adaptation of external environment (temperature, heart rate, oxygenation) of preterm infants were checked before the start of the program. Following the initial measurement, the program was performed, and measurements were taken again at the end of the program. For measurement of maternal role confidence, structured self-reported questionnaires were performed. The results showed that the KC group had a lower oxygenation compared with the CG (t=2.27, p=.02); however, the physical development indicator (weight t=-0.83, p=.21, height t=-0.34, p=.37, head circumference t=1.29, p=.10) and maternal role confidence (t=-0.41, p=.34) were not significantly compared with the CG. The results of this study suggest that the practice of KC helps the adaptation of external environment of preterm infants

• Child Health Nursing Research
• /
• v.20 no.1
• /
• pp.20-29
• /
• 2014

Purpose: The purpose of this study was to develop a feeding protocol for premature infants and to evaluate the effects of protocol. Methods: The feeding protocol was developed through a literature review and discussions of an expert group. The developed feeding protocol was tested with 85 preterm infants in one neonatal intensive care unit in B city. A non-equivalent control group non-synchronized design was used. Data were collected from January 1 to April 30, 2013 for the control group and from June 1 to September 30, 2013 for the experimental group. The experimental group (n=38) received the feeding protocol, whereas the control group (n=47) had routine feeding care. Collected data were analyzed by t-test and -test using SPSS/WIN version 18.0. Results: First feeding time (t=2.22, p=.029) and full enteral feeding time (t=2.28, p=.026) were significantly decreased in the experimental group compared to the control group. There was no difference in incidence of complications (p>.05). Also no significant differences in weight reduction rate between the two groups were observed at the 7th postnatal day (t=-1.23, p=.222). Conclusion: The results indicate that the feeding protocol for preterm infants is effective in decreasing first feeding time and full enteral feeding time.

• Obstetrics & gynecology science
• /
• v.61 no.6
• /
• pp.647-648
• /
• 2018

• Journal of Yeungnam Medical Science
• /
• v.14 no.1
• /
• pp.77-84
• /
• 1997

We measured the blood flow velocity of the anterior cerebral artery via anterior fontanelle approach of fifty five preterm neonates with duplex Doppler sonography and analyzed the waveform and calculated pulsatility index, resistive index. Intracranial velocities and pulsatility indexes were increased with increasing gestational age, birth weight, and age of the neonate, but resistive indices decreased. In sick babies, characteristic resistive index increment were seen in patients with intraventricular hemorrhage, but no statistical difference was seen in patients with respiratory distress syndrome. Our results suggest that duplex Doppler sonography is a useful noninvasive means of monitoring cerebrohemodynamics in normal preterm neonates and flow change of sick babies.

• Child Health Nursing Research
• /
• v.26 no.3
• /
• pp.376-384
• /
• 2020

Purpose: This study aimed to determine the influence of a breastfeeding coaching program (BCP) for mothers of late preterm infants (LPIs) on the breastfeeding rate and neonatal morbidity within 1 month after discharge. Methods: This was a non-randomized quasi-experimental study with a time series design. The participants were 40 LPIs and their mothers who were hospitalized in a neonatal intensive care unit at a university hospital. Nineteen LPIs were assigned to the control group, and 21 to the experimental group. The mothers of the LPIs in the experimental group received the BCP once on the discharge day and then once a week for 1 month. Neonatal morbidity was defined as an outpatient department or emergency room visit due to an LPI's health problem. Results: The breastfeeding rate in the experimental group was significantly higher than in the control group at the fourth week after discharge (χ²=7.17, p=.028). Five and two LPIs in the control group and the experimental group, respectively, visited a hospital due to neonatal jaundice. Neonatal morbidity was not significantly different between the two groups (χ²=1.95, p=.164). Conclusion: The BCP was useful for improving the breastfeeding rates of LPIs and may have potential to reduce neonatal morbidity.

• Journal of Korean Academy of Nursing
• /
• v.37 no.6
• /
• pp.949-956
• /
• 2007

Purpose: The purpose of this study was to examine the effects of Kangaroo Care(KC) on anxiety, maternal role confidence, and maternal infant attachment of mothers who delivered preterm infants. Methods: The research design was a nonequivalent control group pretest-posttest. Data was collected from September 1. 2006 to June 20. 2007. The participants were 22 mothers in the experimental group and 21 in the control group. KC was applied three times per day, for a total of ten times in 4 days to the experimental group. Results: The degree of anxiety was statistically significantly different between the two groups but maternal role confidence and maternal infant attachment was statistically insignificant. Conclusion: This data suggests that KC was effective for mothers anxiety relief but it was not effective for maternal role confidence and maternal infant attachment of mothers. The implications for nursing practice and directions for future research need to be discussed.