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1.
Pediatr Res ; 87(4): 683-688, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31493775

RESUMO

AIM: To investigate the effect of kangaroo care (KC) and its duration on neurobehavioral performance, stress response, breastfeeding success, and vital signs in premature infants. METHODS: One hundred and twenty premature infants were randomized to receive either KC for 60 min daily, KC for 120 min daily or conventional care (controls) for at least 7 days. Salivary cortisol was measured before and after the first KC session and then after 7 days. Temperature, respiration rate, heart rate, and oxygen saturation were recorded, before and after KC. Neonates were evaluated by the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS). RESULTS: Both KC groups demonstrated higher scores for attention, arousal, regulation, nonoptimal reflexes, and quality of movements and lower scores for handling, excitability, and lethargy, compared to controls (p < 0.05). Both KC groups had higher infant breastfeeding assessment tool score and reached full enteral feeds faster than controls (p < 0.05). After the first KC session, improvement in O2 saturation and temperature was observed in KC 120-min group compared with the KC 60-min group (p < 0.05). Salivary cortisol decreased in both KC groups compared with controls after 7 days (p < 0.05). CONCLUSION: Preterm neonates who receive KC for long durations reach full enteral feeds faster, have better breastfeeding success, neurobehavioral performance, thermal control, and tissue oxygenation.


Assuntos
Aleitamento Materno , Desenvolvimento Infantil , Comportamento Alimentar , Comportamento do Lactente , Recém-Nascido Prematuro/psicologia , Método Canguru , Sistema Nervoso/crescimento & desenvolvimento , Fatores Etários , Extração de Leite , Método Duplo-Cego , Egito , Feminino , Estado Funcional , Idade Gestacional , Humanos , Hidrocortisona/metabolismo , Recém-Nascido , Recém-Nascido Prematuro/metabolismo , Masculino , Nascimento Prematuro , Estudos Prospectivos , Saliva/metabolismo , Fatores de Tempo , Resultado do Tratamento
2.
Pediatr Res ; 87(1): 74-80, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31216566

RESUMO

OBJECTIVE: We assessed oxidant-antioxidant status and evaluated the role of lipid peroxidation, oxidative DNA damage, and protein oxidation in the development and severity of neonatal respiratory distress syndrome (RDS). METHODS: Forty preterm neonates with RDS were compared with another 40 preterm neonates without RDS enrolled as controls. Total antioxidant capacity (TAC), malondialdehyde (MDA), advanced oxidation protein products (AOPPs), 8-hydroxy-2-deoxyguanosine (8-OHdG), and trace elements (copper and zinc) were measured in cord blood (day 0) for all neonates and repeated on day 3 for the RDS group. RESULTS: Day 0 serum levels of MDA, AOPPs, and 8-OHdG were significantly higher in neonates with RDS than controls with a further increase on day 3. Days 0 and 3 levels of TAC, copper, and zinc were significantly lower in the RDS group compared with controls. Elevated serum levels of 8-OHdG and AOPPs were associated with severe RDS, invasive mechanical ventilation, and high mortality rate. 8-OHdG and AOPPs were positively correlated with MDA, oxygenation index, duration of ventilation, and duration of hospitalization. CONCLUSIONS: Increased lipid, protein, and DNA oxidation is accompanied by alterations in the antioxidant defense status, which may play a role in the pathogenesis and severity of RDS.


Assuntos
8-Hidroxi-2'-Desoxiguanosina/sangue , Produtos da Oxidação Avançada de Proteínas/sangue , Dano ao DNA , Peroxidação de Lipídeos , Estresse Oxidativo , Carbonilação Proteica , Síndrome do Desconforto Respiratório do Recém-Nascido/sangue , Biomarcadores/sangue , Peso ao Nascer , Estudos de Casos e Controles , Feminino , Idade Gestacional , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Malondialdeído/sangue , Estudos Prospectivos , Síndrome do Desconforto Respiratório do Recém-Nascido/diagnóstico , Síndrome do Desconforto Respiratório do Recém-Nascido/genética , Índice de Gravidade de Doença , Fatores de Tempo
3.
Pediatr Res ; 84(2): 261-266, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29907848

RESUMO

BACKGROUND AND OBJECTIVES: Sepsis leads to systemic inflammatory response with cerebral blood flow (CBF) alteration and blood-brain barrier disruption that contribute to sepsis-associated encephalopathy (SAE). We aimed to evaluate cord blood neuron-specific enolase (cNSE) and CBF in early-onset neonatal sepsis (EONS) as predictors of SAE and to define short-term neurodevelopmental outcomes among survivors. METHODS: cNSE was measured in 200 neonates with antenatal risk factors for EONS, stratified into two groups: sepsis (n = 96) and no-sepsis (n = 104). Trans-cranial Doppler of peak systolic velocities (PSV), end diastolic velocities (EDV) and resistive indices (RI) of anterior (ACA) and middle (MCA) cerebral arteries recorded on day 1 postnatal. Griffiths mental developmental scale (GMDS) was assessed at 6 months. RESULTS: Increased cNSE, PSV, EDV, and decreased RI of both ACA and MCA were found in sepsis group compared to no-sepsis group (p < 0.001 for all). Patients with SAE (n = 34) had higher NSE, PSV, and EDV as well as lower RI of ACA and MCA compared to those without (p < 0.01 for all). SAE neonates had lower GMDS than those without. ACA RI of ≤0.61 was the best predictor of SAE. CONCLUSION: High CBF and cNSE could be useful markers for prediction of SAE. SAE impairs neurodevelopmental scales at 6 months.


Assuntos
Circulação Cerebrovascular , Sepse Neonatal/sangue , Fosfopiruvato Hidratase/sangue , Adulto , Artéria Cerebral Anterior/patologia , Biomarcadores/sangue , Velocidade do Fluxo Sanguíneo , Artérias Cerebrais/fisiopatologia , Diástole , Feminino , Sangue Fetal , Humanos , Recém-Nascido , Doenças do Recém-Nascido , Inflamação , Masculino , Artéria Cerebral Média/patologia , Estudos Prospectivos , Fatores de Risco , Sístole , Ultrassonografia Doppler , Ultrassonografia Doppler em Cores , Adulto Jovem
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