Probiotics for promoting feed tolerance in very low birth weight neonates — <Emphasis Type="Italic">A randomized controlled trial</Emphasis>

Objective

To measure the efficacy of a probiotic formulation on time to reach full enteral feeds in VLBW (very low birth weight) newborns.

Design

Blinded randomized control trial.

Setting

A tertiary care neonatal intensive care unit (NICU) in Southern India between August 2012 to November 2013.

Participants

104 newborns with a birth weight of 750–1499 g on enteral feeds.

Intervention

Probiotic group (n=52) received a multicomponent probiotic formulation of Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium longum and Saccharomyces boulardii once a day at a dose of 1.25×10⁹ CFU from the time of initiation of enteral feeds till discharge and the control group (n=52) received only breast milk.

Outcome measure

Time to reach full enteral feeds (150 mL/kg/day).

Results

The mean (SD) time to reach full enteral feeding was 11.2 (8.3) days in probiotic vs. 12.7 (8.9) in no probiotic group; (P=0.4), and was not significantly different between the two study groups. There was a trend towards lower necrotizing enterocolitis in the probiotic group (4% vs. 12%).

Conclusion

Probiotic supplementation does not seem to result in significant improvement of feed tolerance in VLBW newborns.

     

Effect of recorded maternal voice on child’s cooperation during cardiac catheterization – A randomized controlled trial

Objective

To assess the effect of recorded maternal voice on child’s cooperation during cardiac catheterization.

Design

Randomized placebo controlled trial.

Setting

Cardiac catheterization laboratory at a tertiary care hospital.

Participants

90 children with congenital heart disease scheduled for cardiac catheterization between July 2014 and Dec 2014 randomized to maternal voice group and control group.

Intervention

During cardiac catheterization, children in maternal voice group listened to a 3-min audio-recording of their mother’s voice, played in loop, using head-phones. Children in the other group wore headphones without auditory stimuli.

Main outcome measures

Child’s cooperation during cardiac catheterization as assessed by Child Emotional Manifestation Scale.

Results

Children in the maternal voice group showed lower mean (SD) distress scores [13.2 (4.6) vs. 16 (5.6), P=0.01]. The requirement of sedative agents during the procedure was not different (P=0.09).

Conclusion

Allowing children to listen to recorded voice of their mother is an effective strategy to improve cooperation during cardiac catheterization.

     

Comparative efficacy and safety of caffeine and aminophylline for apnea of prematurity in preterm (≤34 weeks) neonates: A randomized controlled trial

Objective

To compare the efficacy and safety of standard doses of Caffeine and Aminophylline for Apnea of prematurity.

Study design

Randomized controlled trial.

Setting

Tertiary-care referral centre and a teaching institution in Southern India. Trial was conducted from February 2012 to January 2015.

Participants

240 preterm (≤34 wk) neonates with apnea of prematurity.

Interventions

Neonates randomized into two groups: Caffeine group received loading dose of caffeine citrate (20 mg/kg) followed by 5 mg/kg/day maintenance dose every 24 hour. Aminophylline group received loading dose of Aminophylline–5 mg/kg and maintenance dose of 1.5 mg/kg 8-hourly.

Outcome measures

Difference in apneic spells, associated respiratory morbidity, and acute adverse events were assessed. Association of efficacy with therapeutic drug levels was also evaluated.

Results

Infants on aminophylline experienced less apnea spells in 4-7 days of therapy (P=0.03). Mean apnea rate and isolated desaturations were similar in 1-3, 4-7 and 8-14 days of therapy. No difference was noted in duration of Neonatal Intensive Care Unit stay and hospital stay. Mean heart rate was significantly high in Aminophylline group (P<0.001). Risk of developing tachycardia was less (RR 0.30; 95% CI range 0.15 to 0.60; P<0.001) in Caffeine- over Aminophylline-treated infants.

Conclusion

Aminophylline is as effective as caffeine for prevention of apneic spells in preterm neonates; however, dosage optimization needs to be done to reduce toxicity.

     

Effect of albumin administration prior to exchange transfusion in term neonates with hyperbilirubinemia — <Emphasis Type=Italic>A randomized controlled trial</Emphasis>

Objective  

To determine the role of intravenous administration of human albumin prior to blood exchange in term neonates for reduction of total serum bilirubin (TSB).