[Study of characteristics, risk factors and outcome for ventilator associated pneumonia in neonatal intensive care unit patient]

Ventilator Associated Pneumonia [VAP], developing in mechanically ventilated patients after 48 hours of mechanical ventilation, is the second most common nosocomial infection. Therefore, there is a vital need to study the etiology and risk factors associated with VAP in neonates. Neonates admitted to neonatal intensive care unit [NICU], over a period of one year and who required mechanical ventilation for more than 48 hours were enrolled consecutively into the study. Semi-quantitative assay of endotracheal aspirate was used for microbiological diagnoses of VAP.105CFU/ml was taken as the cut off between evidence of pathological infection and colonization. The primary outcome measure was the development of VAP. Secondary outcome measures were length of mechanical ventilation, NICU length of stay, hospital cost, and death. Thirty eight patients were enrolled [58% were boys and 42% were girls].42% of neonates developed VAP. The most common VAP organisms identified were Acinetobacter baumanni [43%]. On multiple regression analysis, duration of mechanical ventilation was associated with VAP [P=0.00]. Patients with VAP had greater need for mechanical ventilation [18.7 vs 6 median days], longer NICU length of stay [39 vs 21.5 median days] and higher total median hospital costs [79.5 vs 52 million rials] than those without VAP. The mortality rate was not different between two groups. In mechanically ventilated neonates, those with VAP had a prolonged need for mechanical ventilation, a longer NICU stay, and a higher hospital costs. Longer mechanical ventilation was associated with an increased risk of developing VAP in these patients. Developing of VAP didn't increase mortality in patients.

randomized controlled clinical trial of olive oil added to human breast milk for weight gaining in very low birth weight infants

Evaluating the effect of vegetable oil, as a supplement to breast milk in increase the weight gaining of VLBW neonates. In this single blind; Randomized clinical trials, in NICU of Vali-asr Hospital, Tehran University of Medical Sciences, 2005-2006;A total of 48 VLBW neonates referred and admitted to NICU, who did not have any major GI [especially NEC], respiratory or cardiac diseases; participated randomly in two groups: intervention and control.Vegetable oil was added to the milk of 25 neonates [0.5 cc per 30cc of milk] and the other 25neonates with similar conditions that were selected as a control group, did not get any type of supplementary nutrition. Daily feeding volume in both groups was 150-200 cc for each kilogram of body weight. Weight gaining in interventional groups was considerably more than control group. [p<0.04].There were also significant statistical differences in hospitalization period between the two groups, 28.9 days in interventional and 20.33 days in control group, [p<0.03].However, no significant side effects were observed. There is no report regarding contraindication linking the use of vegetable oil intended for appropriate weight gaining or reducing hospitalization period to neonatal chronic diseases