China
Africa
Explore chapters and articles related to this topic
Care of the Premature and Ill Neonate
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Ting Ting Fu, Kera McNelis, Carrie Smith, Jae H. Kim
Trace elements and vitamins should be included in PN solutions. For infants receiving full EN, trace minerals such as zinc, copper, selenium, and iodine are provided by formulas or HMFs, and vitamin D can be initiated. Preterm infants are at risk for anemia of prematurity as iron stores are obtained during the last trimester of pregnancy (Chapter 4). Iron supplementation should be given to promote erythropoiesis. Zinc and sodium supplementation may also be provided to premature infants.
An Updated Overview of the Medical Management of Necrotizing Enterocolitis
Published in David J. Hackam, Necrotizing Enterocolitis, 2021
Lila S. Nolan, Martin Goree, Misty Good
Symptomatic anemia in NEC is commonly associated with hemolysis, acute blood loss, and iatrogenic blood loss from frequent serial laboratory monitoring. Premature infants experience an insufficient erythropoietin response to anemia, and infants with anemia of prematurity remain at higher risk for NEC (24, 26). Notably, in a study of 598 infants of less than 1500 grams in birth weight, 18% developed severe anemia (defined as hemoglobin level ≤8 g/dL) and had a significant association with the development of NEC (hazard ratio 4.13, 95% confidence interval [CI] 1.61 to 10.6) (26). Infants with anemia require supportive management with packed red blood cell transfusions. Strategic management of anemia during an episode of NEC is necessary to ensure adequate tissue perfusion and oxygen delivery to sites of mucosal damage (27). Various trials have studied restrictive and liberal hemoglobin or hematocrit thresholds for which preterm infants should receive red blood cell transfusions, but with no current consensus established (24, 28).
Haematology and oncology
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
Premature infants grow very rapidly and increase their blood volume. The bone marrow is unable to produce enough red blood cells to maintain the haemoglobin. Anaemia in premature infants also occurs because of 'physiological hypoplasia' of the marrow. Iron deficiency anaemia of prematurity does not appear until the age of 3-6 months. Although the blood of premature infants may contain larger amounts of fetal haemoglobin, which may cause slightly increased fragility of the red cells, it does not account for the anaemia. Absorption of iron is normal compared with full-term infants.
The residual blood from segmental umbilical cord milking in preterm delivery
Published in Journal of Obstetrics and Gynaecology, 2020
Woraphot Chaowawanit, Pruk Koovimon, Adjima Soongsatitanon
Anaemia in preterm infant are caused by the reduced production of red blood cell (anaemia of prematurity) and loss from repeated blood testing. DCC was associated with fewer infants requiring transfusions for anaemia (Rabe et al. 2012; McDonald et al. 2013). UCM was confirmed for its efficacy and safety in preterm infants (Al-Wassia and Shah 2015). UCM increases foetal haemoglobin level without changes in mortality rate as compared to delayed cord clamping method. Many randomised clinical trials reported various lengths of umbilical cords (20–30 cm) and different gestational age (Hosono et al. 2008; Rabe et al. 2011; Erickson-Owens et al. 2012; March et al. 2013; Upadhyay et al. 2013; Alan et al. 2014; Katheria et al. 2014). A small volume transfusion (10–20 m/kg) is commonly used for replacement in preterm neonates (Norfolk 2013; New et al. 2016). Top-up transfusions in excess of 20 mL/kg are not recommended because of the risk of transfusion-associated circulatory overload, retinopathy of prematurity, bronchopulmonary dysplasia, NEC, IVH, and mortality (Cooke et al. 1996; Inder et al. 1997; Christensen et al. 2009; Baer et al. 2011; dos Santos et al. 2011; Norfolk 2013; New et al. 2016).
Micafungin injection for the treatment of invasive candidiasis in pediatric patients under 4 months of age
Published in Expert Review of Anti-infective Therapy, 2022
Nahed Abdel-Haq, Stephanie M. Smith, Basim I. Asmar
Anemia was commonly noted in the treatment emergent adverse event (TEAE) analysis [66]. However, other contributing factors such as anemia of prematurity, blood draws, sepsis, and concurrent medications are difficult to assess. There was one serious adverse event (SAE) of neutropenia. No SAEs, deaths or discontinuations were attributed to leukopenia or thrombocytopenia [66].