RESUMO
The objective of this study is to assess the safety and preventative effects of aminophylline on the incidence of chronic lung disease [CLD] in very premature infants. This was a long follow-up randomized clinical trial. The prophylactic effect of aminophylline on the incidence of CLD was investigated in very premature infants. The study group received aminophylline for the 1[st] 10 days of life and control infants received no aminophylline during the 1st 10 days of life. Fifty-two infants participated [26 aminophylline, 26 controls]. Premature infants on aminophylline had clearly shorter oxygen dependency time than those in the control group. Median time of oxygen dependency was 3 [0-9.5] days and 14 [3-40.5] days in group A and C, respectively [P: 0.001]. Incidence of CLD was significantly different between the two groups. Only two infants [8.7%] on aminophylline developed CLD, when compared to 11 infants [44.0%], who did not receive aminophylline [P: 0.006]. No side-effects were reported in the neonates [P: 1]. This study supports the preventative effects of aminophylline on the incidence of CLD in very premature infants. In other words, the more premature the infants, the greater will be the preventative effect of aminophylline on the incidence of CLD
RESUMO
Necrotizing enterocolitis [NEC] is one of the most destructive diseases associated with conditions of neonatal prematurity. Supplementation with enteral prebiotics may reduce the incidence of NEC, especially in infants who fed exclusively with breast-milk. Therefore, we compared the efficacy and safety of enteral supplementation of a prebiotic mixture [short chain galacto-oligosaccharides/long chain fructooligosaccharides [SCGOS/LCFOS]] versus no intervention on incidence of NEC in preterm infants. In a single-center randomized control trial 75 preterm infants [birth weight [BW] = 1500 g, gestational age = 34 weeks and were not fed with formula] on 30 ml/kg/day volume of breast-milk were randomly allocated to have enteral supplementation with a prebiotic mixture [SCGOS/LCFOS; 9:1] or not receive any prebiotic. The incidence of suspected NEC, feeding intolerance, time to full enteral feeds, duration of hospitalization were investigated. Differences in demographic characteristics were not statistically important. SCGOS/LCFOS mixture significantly reduced the incidence of suspected NEC, [1 [4.0%] vs. 11 [22.0%]; hazard ratio: 0.49 [95% confidence interval: 0.29-0.84]; P = 0.002], and time to full enteral feeds [11 [7-21] vs. 14 [8-36] days; P - 0.02]. Also duration of hospitalization was meaningfully shorter in the prebiotic group [16 [9-45] vs. 25 [11-80]; P - 0.004]. Prebiotic oligosaccharides were well tolerated by very low BW [VLBW] infants. Enteral supplementation with prebiotic significantly reduced the incidence of NEC in VLBW infants who were fed exclusively breast-milk. This finding suggests that it might have been the complete removal of formula which caused a synergistic effect between nonhuman neutral oligosaccharides [prebiotic] and human oligosaccharides
RESUMO
Neonatal respiratory distress syndrome [RDS] in premature infants who survived and its complications are a common problem. Due to high morbidity and mechanical ventilation [MV] nowadays researchers in interested minimizing MV. To determine, in very low birth weight [BW] preterm neonates with RDS, if initial treatment with nasal intermittent mandatory ventilation [early NIMV] compared with early nasal continuous positive airway pressure [early NCPAP] obtains more favorable outcomes in terms of the duration of treatment, and the need for endotracheal tube ventilation. In this single-center randomized control trial study, infants [BW = 1500 g and/or gestational age = 34 weeks] with respiratory distress were considered eligible. Forty-four infants were randomly assigned to receive early-NIMV and 54 comparable infants to early-NCPAP. Surfactants were given, when FIO[2] requirement was of >30%. Primary outcomes were failure of noninvasive respiratory support, that is, the need for MV in the first 48 h of life and for the duration of noninvasive respiratory support in each group. 98 infants were enrolled [44 in the NIMV and 54 in the NCPAP group]. The Preventive power of MV of NIMV usage [95.5%] was not lower than the NCPAP [98.1%] strength [hazard ratio: 0.21 [95% confidence interval: 0.02-2.66]; P: 0.23]. The duration of noninvasive respiratory support in the NIMV group was significantly shorter than NCPAP [the median [range] was 24 [18.00-48.00] h versus 48.00 [22.00-120.00] h in NIMV versus NCPAP groups; P < 0.001]. Similarly, the duration of dependency on oxygen was less, for NIMV [the median [range] was 96.00 [41.00-504.00] h versus144.00 [70.00-1130.00] h in NIMV versus NCPAP groups; P: 0.009]. Interestingly, time to full enteral feeds and length of hospital stay were more favorable in the NIMV versus the NCPAP group