Parvin Akbari Asbagh , Mohammad Reza Zarkesh , Firoozeh Nili , Fatemeh Sadat Nayeri , Azam Tofighi Naeem ,
Volume 73, Issue 2 (May 2015)
Abstract
Background: The incidence of Patent Ductus Arteriosus (PDA) in premature infants whose birth weight is less than 1500 grams is approximately 30-60%, most of them need medical or surgical interventions. The purpose of this study is to determine the efficacy of prophylactic treatment with oral paracetamol (Acetaminophen- Hakim® Oral Drops 100 mg/ml, Hakim Pharmaceutical Co., Tehran, Iran) for PDA in preterm infants.
Methods: A randomized clinical trial conducted from March 2012 to March 2013. Thirty-two preterm newborns whose gestational age was under 32 weeks and birth weight was 1500 grams or less, admitted in neonatal intensive care unit (NICU) of Vali-Asr Hospital, Tehran were studied prospectively. They were randomly assigned in two groups. The prophylaxis group received oral paracetamol for a period of two days starting during first 24 hours of life. No placebo was given to the control group. Echocardiography was performed 24-36 hours after the last given dose in prophylaxis group and on the 4th and 5th day in control group. A p-value less than 0.05 are considered significant.
Results: There were 16 newborns in each group (20 boys and 12 girls). In 12 newborns of prophylaxis group the ductus arteriosus was closed although in control group in 8 newborns the duct was closed. No significant difference was observed in sex, gestational age, birth weight, mode of delivery, multifetal gestation and birth order between two groups. The rate of ductal closure was 75% and 50% in prophylaxis group and control group respectively (P=0.27).
Conclusion: Our study demonstrated that prophylactic paracetamol is ineffective in PDA closure, although the rate of ductal closure between two groups seems remarkable. Paracetamol as a new strategy for PDA closure because of cost effectiveness and harmlessness may be used in future. However, we presume larger sample size studies are needed to show the efficacy of paracetamol, side effects, and complications in PDA prophylaxis treatment.
Seyedeh Zohreh Jalali, Sadroddin Mahdipour, Reza Sharafi, Fariborz Torkipour, Afagh Hassanzadeh Rad , Babak Moqtader, Marjaneh Zarkesh ,
Volume 79, Issue 10 (January 2022)
Abstract
Background: one of the leading clinical problems for premature neonates especially with very low birth weight is the type and amount of feeding. The authors aimed to compare outcomes of slow versus rapid feeding in premature neonates hospitalized in Al-Zahra hospital, Rasht.
Methods: This is a clinical trial that was conducted on 62 premature neonates aged less than 35 weeks of gestation who were referred to Al-Zahra Hospital from April 2015 to April 2016. They weighed 1000-2000 gr at birth. Samples were randomly assigned to intervention or control groups. The intervention included neonatal feeding with breast milk or formula with feeding advancement of 30 cc/kg/day which was compared with the routine method of slow feeding (20 cc/kg/day). Neonates were assessed until discharge or the occurrence of Necrotizing enterocolitis. Data were reported by descriptive statistics including mean, standard deviation, frequency, and percent, and analyzed by independent samples t-test and chi-square test in SPSS software, version 22 (IBM SPSS, Armonk, NY, USA).
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Results: All 62 patients finished the study including 31 neonates weighing 1000-2000 gr at birth in the intervention group and 31 neonates weighing 1000-2000 gr at birth in the control group. Neonates in the intervention group reached to full milk feeding of 150 cc/kg/day sooner (6.06±1.34 versus 9.45±2.39), return to birth weight faster (9.89±3.57 versus 12.9±6.46), had a lower duration of needing parenteral fluids (5.10±1.61 versus 8.86±3.81), and had a lower duration of hospitalization (9.97±4.03 versus 16.87±9.13) compared to controls. Results showed that there was no necrotizing enterocolitis in the intervention and control groups.
Conclusion: The results of this study showed that initiating feeding by 30 cc/kg/day method shortened the duration of access to intravenous line and hospitalization and caused sooner discharge. Also, no adverse complication was noted. Therefore, it seems that further investigations assessing these methods can be help manage preterm neonates.
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