Level III neonatal intensive care units at six university or children's hospitals. Patients: Thre... more Level III neonatal intensive care units at six university or children's hospitals. Patients: Three hundred twenty-seven infants receiving conventional IMV for respiratory distress syndrome, pneumonia, or meconium aspiration pneumonitis were randomly assigned at 7.5 ± 6 hours of age to either continue with IMV or change to SIMV. Infants assigned to each mode of ventilation had similar birth weight (BW), gestational age, and Apgar scores at birth, and similar oxygenation indexes at randomization. They received similar surfactant therapy and had similar incidence of sepsis, seizures, secondary pneumonia, and necrotizing enterocolitis. In the infants with BW less than 1000 gm, more infants receiving IMV had surgical ligation of their patent ductus arteriosus than did those receiving SIMV (27 vs 7 %; p = 0.02).
Journal of Pediatric Endocrinology and Metabolism, 2000
Objective: To study the effect of prenatal and postnatal glucocorticoids use on serum leptin and ... more Objective: To study the effect of prenatal and postnatal glucocorticoids use on serum leptin and weight gain in sick preterm infants and its correlation with caloric intake. Methods: Serum leptin was measured in 24 neonates at day 1 (cord), 14 and 28 by radioimmunoassay. Total caloric intake (enteral and parenteral) and weight were measured on days 14 and 28 of life. Results: Mean birth weight and gestational age of study infants were 864 ± 273 g (mean ± SD) (range 520-1755 g), and 26.6 ± 2.4 weeks (23-32 weeks) respectively. Cord blood leptin was greater in infants whose mothers received antenatal steroids (1.98 ± 1.05 ng/ml vs 0.94 ± 0.39 ng/ml, p=0.004). Serum leptin increased postnatally from 1.52 ± 1.0 ng/ml at birth to 2.2 ± 1.3 ng/ml on day 28 of life (p=0.03). Mean serum leptin had an inverse exponential relationship with postnatal weight gain by day 28 of life (R 2 =0.56). Total caloric intake on days 14 and 28 of life did not correlate with postnatal weight gain. Conclusions•. Increased serum concentration of leptin following glucocorticoids may be associated with poor weight gain in sick preterm infants.
Objective-To evaluate the impact of infant-polysomnography studies performed in the NICU on manag... more Objective-To evaluate the impact of infant-polysomnography studies performed in the NICU on management and outcomes. Study design-Retrospective study to collect demographics and data on infantpolysomnography studies between Jan 2010 to Dec 2014. Results-110 premature neonates had polysomnography study performed at 36.9 ± 2.5 weeks post menstrual age. Almost all the studies were read as abnormal and 95% of the studied infants were discharged home on a cardiorespiratory monitor. 20% of the subjects had apnea >20 s, 18% had apnea of 15-20 s and 50% of infants had apnea of 10-15 s. 24.5% infants were discharged home on caffeine, 28% on metoclopramide and 24% on antacids. There were 11 readmissions for apparent life threatening events with no until 6 month-corrected age. There was no association between polysomnography results and readmission. There was a decline in polysomnography studies performed each year. Conclusion-Cardiorespiratory monitoring, medications and polysomnography studies do not predict outcomes.
Journal of perinatology : official journal of the California Perinatal Association
The objective of this study was to correlate the severity of bronchopulmonary dysplasia (BPD) in ... more The objective of this study was to correlate the severity of bronchopulmonary dysplasia (BPD) in infants < or = 28 weeks' gestation with clinical and radiologic scoring and cardiac function as measured by echocardiography. Twenty-five infants with a mean birth weight of 909 gm and gestational age 26 weeks were studied. All infants were categorized with a clinical and radiologic scoring system at 1 and 3 months. All infants were studied with two-dimensional, M-mode, and Doppler echocardiography. A significant correlation was found between clinical and radiologic scores at 1 month (r = 0.42) and between radiologic scorings at 1 and 3 months (r = 0.67). Severe BPD is directly related with mean airway pressure on day 7 of life (p < 0.05), use of intralipids (p < 0.05), and average oxygen exposure (p < 0.05). Left ventricular posterior wall thickness is directly correlated to severity of BPD (p < 0.05), and transmitral flow velocities and early diastolic/atrial contrac...
Level III neonatal intensive care units at six university or children's hospitals. Patients: Thre... more Level III neonatal intensive care units at six university or children's hospitals. Patients: Three hundred twenty-seven infants receiving conventional IMV for respiratory distress syndrome, pneumonia, or meconium aspiration pneumonitis were randomly assigned at 7.5 ± 6 hours of age to either continue with IMV or change to SIMV. Infants assigned to each mode of ventilation had similar birth weight (BW), gestational age, and Apgar scores at birth, and similar oxygenation indexes at randomization. They received similar surfactant therapy and had similar incidence of sepsis, seizures, secondary pneumonia, and necrotizing enterocolitis. In the infants with BW less than 1000 gm, more infants receiving IMV had surgical ligation of their patent ductus arteriosus than did those receiving SIMV (27 vs 7 %; p = 0.02).
Journal of Pediatric Endocrinology and Metabolism, 2000
Objective: To study the effect of prenatal and postnatal glucocorticoids use on serum leptin and ... more Objective: To study the effect of prenatal and postnatal glucocorticoids use on serum leptin and weight gain in sick preterm infants and its correlation with caloric intake. Methods: Serum leptin was measured in 24 neonates at day 1 (cord), 14 and 28 by radioimmunoassay. Total caloric intake (enteral and parenteral) and weight were measured on days 14 and 28 of life. Results: Mean birth weight and gestational age of study infants were 864 ± 273 g (mean ± SD) (range 520-1755 g), and 26.6 ± 2.4 weeks (23-32 weeks) respectively. Cord blood leptin was greater in infants whose mothers received antenatal steroids (1.98 ± 1.05 ng/ml vs 0.94 ± 0.39 ng/ml, p=0.004). Serum leptin increased postnatally from 1.52 ± 1.0 ng/ml at birth to 2.2 ± 1.3 ng/ml on day 28 of life (p=0.03). Mean serum leptin had an inverse exponential relationship with postnatal weight gain by day 28 of life (R 2 =0.56). Total caloric intake on days 14 and 28 of life did not correlate with postnatal weight gain. Conclusions•. Increased serum concentration of leptin following glucocorticoids may be associated with poor weight gain in sick preterm infants.
Objective-To evaluate the impact of infant-polysomnography studies performed in the NICU on manag... more Objective-To evaluate the impact of infant-polysomnography studies performed in the NICU on management and outcomes. Study design-Retrospective study to collect demographics and data on infantpolysomnography studies between Jan 2010 to Dec 2014. Results-110 premature neonates had polysomnography study performed at 36.9 ± 2.5 weeks post menstrual age. Almost all the studies were read as abnormal and 95% of the studied infants were discharged home on a cardiorespiratory monitor. 20% of the subjects had apnea >20 s, 18% had apnea of 15-20 s and 50% of infants had apnea of 10-15 s. 24.5% infants were discharged home on caffeine, 28% on metoclopramide and 24% on antacids. There were 11 readmissions for apparent life threatening events with no until 6 month-corrected age. There was no association between polysomnography results and readmission. There was a decline in polysomnography studies performed each year. Conclusion-Cardiorespiratory monitoring, medications and polysomnography studies do not predict outcomes.
Journal of perinatology : official journal of the California Perinatal Association
The objective of this study was to correlate the severity of bronchopulmonary dysplasia (BPD) in ... more The objective of this study was to correlate the severity of bronchopulmonary dysplasia (BPD) in infants < or = 28 weeks' gestation with clinical and radiologic scoring and cardiac function as measured by echocardiography. Twenty-five infants with a mean birth weight of 909 gm and gestational age 26 weeks were studied. All infants were categorized with a clinical and radiologic scoring system at 1 and 3 months. All infants were studied with two-dimensional, M-mode, and Doppler echocardiography. A significant correlation was found between clinical and radiologic scores at 1 month (r = 0.42) and between radiologic scorings at 1 and 3 months (r = 0.67). Severe BPD is directly related with mean airway pressure on day 7 of life (p < 0.05), use of intralipids (p < 0.05), and average oxygen exposure (p < 0.05). Left ventricular posterior wall thickness is directly correlated to severity of BPD (p < 0.05), and transmitral flow velocities and early diastolic/atrial contrac...
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Papers by Prem Shekhawat