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NICU admission hypothermia, chorioamnionitis, and cytokines.

ABSTRACT: OBJECTIVE:To determine whether neonatal intensive care unit (NICU) admission hypothermia is associated with an intrauterine inflammatory response. METHODS:We analyzed a cohort of 309 very low birthweight infants to determine relationships between admission hypothermia, chorioamnionitis, and serum and cerebrospinal fluid (CSF) interleukin (IL)-1?, IL-6, and tumor necrosis factor-?. RESULTS:Admission hypothermia <36°C occurred in 72% of patients <26 weeks and 44% of patients ?26 weeks gestational age. NICU admission hypothermia was not associated with histologic chorioamnionitis or with elevated serum cytokine concentrations. CSF IL-6 concentrations ?6.3 pg/mL were associated with admission hypothermia in infants <26 weeks' gestation. Clinical chorioamnionitis was associated with a lower risk of admission hypothermia, while cesarean section delivery was associated with increased risk. CONCLUSIONS:NICU admission hypothermia is common among preterm infants and is not associated with the fetal inflammatory response syndrome. Hypothermia is less common in the setting of clinical chorioamnionitis and more common in cesarean section deliveries, identifying two groups in whom extra attention to appropriate thermoregulation is warranted.

SUBMITTER: Fairchild KD

PROVIDER: S-EPMC4026090 | biostudies-literature | 2011 Nov

REPOSITORIES: biostudies-literature

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NICU admission hypothermia, chorioamnionitis, and cytokines.

Fairchild Karen D KD Sun Chen-Chih J CC Gross George C GC Okogbule-Wonodi Adora C AC Chasm Rose M RM Viscardi Rose M RM

Journal of perinatal medicine 20110813 6

<h4>Objective</h4>To determine whether neonatal intensive care unit (NICU) admission hypothermia is associated with an intrauterine inflammatory response.<h4>Methods</h4>We analyzed a cohort of 309 very low birthweight infants to determine relationships between admission hypothermia, chorioamnionitis, and serum and cerebrospinal fluid (CSF) interleukin (IL)-1β, IL-6, and tumor necrosis factor-α.<h4>Results</h4>Admission hypothermia <36°C occurred in 72% of patients <26 weeks and 44% of patients ...[more]

PMID: 21838601

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Project description:Objectives: The aim of this study is to explore if manually segmented total brain volume (TBV) from 3D ultrasonography (US) is comparable to TBV estimated by magnetic resonance imaging (MRI). We then wanted to test 2D based TBV estimation obtained through three linear axes which would enable monitoring brain growth in the preterm infant during admission. Methods: We included very low birth weight preterm infants admitted to our neonatal intensive care unit (NICU) with normal neuroimaging findings. We measured biparietal diameter, anteroposterior axis, vertical axis from US and MRI and TBV from both MRI and 3D US. We calculated intra- and interobserver agreement within and between techniques using the intraclass correlation coefficient and Bland-Altman methodology. We then developed a multilevel prediction model of TBV based on linear measurements from both US and MRI, compared them and explored how they changed with increasing age. The multilevel prediction model for TBV from linear measures was tested for internal and external validity and we developed a reference table for ease of prediction of TBV. Results: We used measurements obtained from 426 US and 93 MRI scans from 118 patients. We found good intra- and interobserver agreement for all the measurements. US measurements were reliable when compared to MRI, including TBV which achieved excellent agreement with that of MRI [ICC of 0.98 (95% CI 0.96-0.99)]. TBV estimated through 2D measurements of biparietal diameter, anteroposterior axis, and vertical axis was comparable among both techniques. We estimated the population 95% confidence interval for the mean values of biparietal diameter, anteroposterior axis, vertical axis, and total brain volume by post-menstrual age. A TBV prediction table based on the three axes is proposed to enable easy implementation of TBV estimation in routine 2D US during admission in the NICU. Conclusions: US measurements of biparietal diameter, vertical axis, and anteroposterior axis are reliable. TBV segmented through 3D US is comparable to MRI estimated TBV. 2D US accurate estimation of TBV is possible through biparietal diameter, vertical, and anteroposterior axes.

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NICU admission hypothermia, chorioamnionitis, and cytokines.

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NICU admission hypothermia, chorioamnionitis, and cytokines.

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