Journal of neonatal-perinatal medicine最新文献

{"title":"POCUS using the neo-ECHOTIP protocol plus the retract, advance, and position (RAP) technique to improve lower extremity catheter positioning in neonates.","authors":"M Ostroff, J Abu-Ali, V DeBari, F Kiblawi, A Zauk, S Datta-Bhutada, Z Pua","doi":"10.1177/19345798251318585","DOIUrl":"https://doi.org/10.1177/19345798251318585","url":null,"abstract":"<p><strong>Background: </strong>International guidelines recommend point-of-care ultrasonography (POCUS) in neonatology for diagnostic, therapeutic, and procedural purposes. However, there are few standard protocols for using POCUS to confirm lower extremity catheter tip positioning.</p><p><strong>Methods: </strong>In this prospective study, subcutaneously tunneled femorally inserted central catheters (ST-FICCs) were placed in eligible neonates according to physician orders. In line with the Neo-ECHOTIP (NE) protocol, a subcostal longitudinal view was used to identify the catheter, and saline flush test (SFT) was performed to confirm catheter tip placement below the right atrium. During the study, a novel \"retract, advance, and position (RAP)\" technique was added to the existing NE-SFT protocol to improve catheter positioning. Two-view radiographs of the chest and abdomen were obtained to verify catheter tip position for all subjects. The agreement rate with post-procedural radiographs and the total number of radiographs needed to achieve proper catheter positioning were assessed.</p><p><strong>Results: </strong>The agreement rate of POCUS with radiographs for catheter terminal tip position was 75% (39/52) for the NE-SFT group compared to 100% (48/48) for the NE-SFT + RAP group (<i>p</i> < 0.001). Catheters in the NE-SFT group required repositioning (25%); no malpositioned catheters were observed in the NE-SFT + RAP group. Repositioning of the catheter in the NE-SFT group resulted in 22 repeat radiographs in the NE-SFT group; none were required in the NE-SFT + RAP group (<i>p</i> < 0.0001).</p><p><strong>Conclusions: </strong>This single-center study demonstrated that applying the RAP technique to the Neo-ECHOTIP protocol improved the ease and accuracy of lower extremity catheter tip position localization in neonates, thus eliminating the use of radiography.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251318585"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National variation in delayed cord clamping implementation - A survey of the challenges in universal adoption of DCC in the United Kingdom.","authors":"Ahmed Marya, Claudia Chetcuti Ganado","doi":"10.1177/19345798251318596","DOIUrl":"https://doi.org/10.1177/19345798251318596","url":null,"abstract":"<p><strong>Background: </strong>Evidence shows that allowing the umbilical cord to pulsate for 1-3 minutes before clamping greatly improves newborn outcomes. In preterm infants, DCC reduces mortality by a third, reduces sepsis, bowel inflammation, and severe brain bleeds yet uptake has been variable in the latter cohort. Our survey aimed to understand the challenges faced when implementing DCC.</p><p><strong>Methods: </strong>Survey questions were designed and user tested prior to dissemination. An electronic and word format of the questionnaire were sent through emails to units in England and Wales. The survey was also disseminated via social media.</p><p><strong>Results: </strong>A total of 116 responses were obtained with 44% being from level three units and 50% from level two and the remainder from Level one. Although all but 1 respondent said they implemented DCC in their hospital, 30% respondents said they only apply DCC for stable term babies. The remaining 70% implement DCC for both preterm and term stable babies. While 21% of respondents said they implemented cord intact stabilisation for planned deliveries, only 3% implemented it in emergency scenarios. 71% of respondents undertaking cord intact stabilisation use the Lifestart TM trolley. Respondents highlighted several challenges when using Lifestart particularly the lack of familiarity with its use, need for advance planning and ineffective heating surface.</p><p><strong>Conclusion: </strong>The survey highlights that challenges in adopting DCC in extreme preterm and sick infants remain unaddressed. More research is required to enable delivery of placental transfusion safely allowing the needs of all newborns to be met.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251318596"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of dexmedetomidine during hypothermia on initiation of enteral feeding in newborns with hypoxic-ischemic encephalopathy.","authors":"Kimberly R Marsh, Eric S Peeples","doi":"10.1177/19345798251318601","DOIUrl":"https://doi.org/10.1177/19345798251318601","url":null,"abstract":"<p><strong>Background: </strong>After early studies suggested safety and potential for benefit of dexmedetomidine use in neonatal hypoxic-ischemic encephalopathy (HIE), our neonatal intensive care unit (NICU) decided to transition from morphine to dexmedetomidine as our standard sedative during therapeutic hypothermia (TH). The primary aim was to monitor the possible side effects of transitioning from morphine to dexmedetomidine with a primary goal of reducing the days to initiation of enteral feeds to less than 3 days, with the hypothesis that the gastrointestinal motility effects of morphine may have been hindering feeding progress during TH. The secondary aim was to determine rates of hemodynamically significant bradycardia.</p><p><strong>Methods: </strong>This was a prospective quality improvement study using a retrospective comparison group to determine the comfort, hemodynamic, and early feeding effects of a clinical change in sedation management from morphine to dexmedetomidine. We included infants born at ≥35 weeks of gestation receiving hypothermia for hypoxic-ischemic encephalopathy (HIE) from 2017 to 2023.</p><p><strong>Results: </strong>Data were collected from 107 infants: 48 morphine, 35 dexmedetomidine, and 24 neither. Heart rate was lower in the morphine and dexmedetomidine groups compared to no sedation. Blood pressures, pain scores, and blanket temperatures were not different between groups. Infants receiving dexmedetomidine initiated enteral feeds earlier than either of the other groups and reached full enteral feeds earlier than the no treatment group but not the morphine group.</p><p><strong>Conclusions: </strong>This study supports a growing body of literature suggesting dexmedetomidine is a well-tolerated alternative to opioids during hypothermia for HIE.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251318601"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ratio of non-protein calories to grams of amino acids and amino acid blood levels in preterm infants receiving parenteral nutrition.","authors":"Robert K Huston, Reese H Clark, Donald H Chace","doi":"10.1177/19345798251318605","DOIUrl":"https://doi.org/10.1177/19345798251318605","url":null,"abstract":"<p><strong>Background: </strong>Studies evaluating the optimal intake of amino acids for preterm infants have often not considered the effect of the non-protein calorie to grams of amino acids ratio (NPKcal:g AA) in parenteral nutrition solutions. The objectives of this study were to document the ratio in a group of preterm infants and explore any associations of the ratio to AA and acylcarnitine levels.</p><p><strong>Methods: </strong>This was descriptive cohort study of data collected from a previously published prospective study evaluating the influence that gestational age had on amino acid and acylcarnitine profiles in preterm infants ≤31 weeks postmenstrual age. Acylcarnitine and AA levels on day of life 7 of three study groups, based upon terciles of the NPKcal:g AA, who were receiving minimal enteral feedings and an enterally fed comparison group were measured. Growth velocities and changes in z-scores were also evaluated.</p><p><strong>Results: </strong>NPKcal:g AA terciles were: 6.3-17.6:1 (low, <i>N</i> = 153), 17.7-21.2:1 (mid, <i>N</i> = 150), and 21.3-36.2:1 (high, <i>N</i> = 159). Higher levels of ornithine, citrulline, blood urea nitrogen, isovalerylcarnitine + methylbutyrylcarnitine, and octenoylcarnitine were found in the low versus the high group. From day 1-42 of life, the low group had a lower head circumference (HC) growth velocity and the low and mid groups had more negative HC changes in z-scores versus the enteral group.</p><p><strong>Conclusions: </strong>This study suggests that preterm infants may receive parenteral nutrition solutions containing inadequate energy to prevent oxidation of administered AA. The impact of inadequate non-protein caloric intake needs to be considered when evaluating growth and outcomes in nutritional studies of VLBW infants.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251318605"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive values of prognostic nutritional index and systemic immüne- inflammatory index in the follow-up newborns of preeclamptic mothers.","authors":"Seda Aydoğan, Caner Köse, Eda Tüfekçioğlu, Meltem Aksu, Hasan Akduman, Ferit Kulalı","doi":"10.1177/19345798251318599","DOIUrl":"https://doi.org/10.1177/19345798251318599","url":null,"abstract":"<p><p><b>Background</b>: Preeclampsia (PE) is among the causes of serious morbidity and mortality for the mother and fetus. The most common consequences of intrauterine hypoxemia in the newborn are intrauterine growth retardation (IUGR), premature labor, respiratory distress syndrome (RDS), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), and perinatal death. The systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI), which is used as an indicator of inflammation, can be used to examine the effect of the immune status of babies of PE mothers on their prognosis.<b>Methods</b>: A retrospective cohort study was conducted on 148 newborns of PE mothers who received treatment in our NICU between November 2022 and July 2024. Hematological indices including neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, SII, and PNI were calculated for all patients. Subgroups were created for complications and analyses were performed.<b>Results</b>: For all preeclamptic mothers' babies, the mean SII and PNI were 387.69 ± 348.13 and 49.08 ± 7.59, respectively. The SII for prematurity produced an area under the curveReceiver operating characteristic (ROC) of 0.76 (0.59-0.92) (88.4% sensitivity, 70% specificity). The PNI for prematurity produced an area under the curve ROC of 0.72 (0.57-0.86) (63% sensitivity, 70% specificity). That was found that the SII has more sensitivity than the PNI for detecting prematurity in preeclamptic mothers' babies. Low PNI and SII were independent predictors of mortality (<i>p</i> < 0.01).<b>Conclusion</b>: We found that it is significant for SII and NLR to be low at the time of admission to predict mortality in infants of preeclamptic mothers.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251318599"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical NEC-associated cerebellar underdevelopment and PDA: Call for close monitoring and action.","authors":"Parvesh Mohan Garg","doi":"10.1177/19345798251317986","DOIUrl":"https://doi.org/10.1177/19345798251317986","url":null,"abstract":"<p><p>Necrotizing enterocolitis (NEC) is a systemic inflammatory disease of very low birth weight infants and is associated with brain injury and poor neurodevelopmental outcomes. The cerebellar injury is seen in one third of cases with surgical cases. The association between patent ductus arteriosus (PDA) and necrotizing enterocolitis, cerebral and gut hemodynamics in preterm infants is well documented. The cerebellum is at the high risk of underdevelopment and injury in preterm infants with surgical NEC and PDA. The combined exposure of NEC and PDA most likely affect the normal cerebellar development further due to inflammatory and hypoperfusion insults. There is a need to develop the targeted monitoring and therapeutic approach for cerebellum in preterm infants with surgical NEC and PDA.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251317986"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infantile myofibromatosis: Small bumps pose big problems.","authors":"Hillary C Lee, Amee A Amin, Kudakwashe R Chikwava, Valeria R Smith, Caraciolo J Fernandes","doi":"10.1177/19345798251318587","DOIUrl":"https://doi.org/10.1177/19345798251318587","url":null,"abstract":"<p><strong>Background: </strong>Infantile myofibromatosis (IM) is a disorder characterized by proliferation of benign myofibroblastic tumors that typically manifest as solitary or multiple nodules in the skin, muscle, bone, subcutaneous tissues, and visceral organs and can pose significant morbidity and mortality risks, particularly in cases involving visceral organs or causing functional impairment. These soft tissue lesions are the most prevalent benign fibrous tumors that present before age two and can undergo spontaneous regression or are amenable to surgical resection.</p><p><strong>Case: </strong>A preterm, male infant was born via Caesarean section to a mother with a trichorionic, triamniotic pregnancy following preterm labor. Within the first week of life, several well-circumscribed, smooth, non-tender, and soft nodules with some mobility were noticed along the border of the ribs, across the trunk, back, and lower extremities. Ultrasound imaging confirmed well-circumscribed hypoechoic, intramuscular nodules, and biopsy evaluation showed atypical spindle cell proliferation. The biopsied lesion was <i>PDGFRB</i>-mutated on molecular genetic studies, confirming a diagnosis of myofibromatosis. The infant developed mixed lytic and sclerotic deformities of a variety of bones, necessitating treatment given disease progression.</p><p><strong>Conclusion: </strong>Successful clinical management with low-dose metronomic chemotherapy (methotrexate and vinblastine) is possible and can treat extensive disease, as seen in our patient.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251318587"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal inpatient stays longer than one year: Who was admitted, what happened, and how much did it cost?","authors":"Nihaal Shah, Angel Sunny, Fredrick Dapaah-Siakwan","doi":"10.1177/19345798251315153","DOIUrl":"https://doi.org/10.1177/19345798251315153","url":null,"abstract":"<p><strong>Background: </strong>Anecdotal evidence suggests that some preterm infants remain hospitalized for more than a year, but little is known about this population. We aimed to describe the characteristics, the hospital course, and the hospital costs for preterm hospitalizations with length of stay (LOS) ≥365 days.</p><p><strong>Methods: </strong>This was a retrospective, descriptive cohort study of the 2016 and 2019 Kids Inpatient Database. ICD-10 codes were used to identify preterm infants, their comorbidities, and surgical interventions. The study population was dichotomized into LOS ≤364 days (PT364) and LOS ≥365 days (PT365) and compared using Chi-square or Mann-Whitney U test as appropriate. The exposure was PT365, and the outcomes were the characteristics, comorbidities, discharge disposition, and inflation-adjusted hospital costs.</p><p><strong>Results: </strong>Among 688,995 preterm infants, 111 had LOS ≥365 days (0.016%). Compared to PT364, PT365 were more likely to be males (74.6% vs 53.2%), of gestational age ≤27 weeks (71.5% vs 4.7%), and <1000 gm birthweight (64.2% vs 4.0%). PT365 were more likely to have a higher prevalence of comorbidities in each organ system, surgical and procedural interventions, and neonatal chronic complex conditions (872% vs 13.3%). PT365 were less likely to be discharged home (45.7% vs 93.4%) and more likely to be discharged to home healthcare (28.0% vs 5.7%) or to a skilled nursing facility (16.0% vs 0.8). The median hospital cost per surviving PT365 was $1,616,336.</p><p><strong>Conclusion: </strong>PT365 was rare but was associated with complex chronic conditions, increased morbidity and surgical burden, and high inflation-adjusted hospital costs.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251315153"},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of predelivery Rotational Thromboelastometry readings with the risk of postpartum hemorrhage during delivery: The ROTEM Study.","authors":"Joaquin A Calderon, Ahmed M Ebeid, Sean M Lee, Homa K Ahmadzia","doi":"10.1177/19345798241291327","DOIUrl":"10.1177/19345798241291327","url":null,"abstract":"<p><p>BackgroundInconsistency in defining postpartum hemorrhage (PPH), and the inability of current tools and approaches to accurately predict PPH have led to the exploration of innovative methods. Rotational thromboelastometry (ROTEM) point-of-care technology provides real-time assessment of the clotting process facilitating time-efficient hemostatic interventions. Our study investigates the utility of ROTEM parameters for predicting individual risk of PPH.MethodsThis multi-site, prospective observational cohort study recruited 92 women who underwent scheduled cesarean delivery and normal spontaneous vaginal delivery at university-affiliated hospitals from 2018 to 2023. We included women between 18 and 50 years old at ≥34 weeks of gestation. Subjects were approached in the hospital pre-admission testing unit during their routine pre-operative blood draws, typically at least 72 h in advance of their planned cesarean delivery. Participants were also enrolled at the hospital once they arrived for admission a few hours before their procedure. ROTEM parameters EXTEM clotting time (CT), clot formation time (CFT), alpha angle, A10, A20, maximum clot formation (MCF), maximum lysis, were measured preoperative.ResultsWe found significant effects of age, blood loss type, delivery mode, gestational age, and maximum lysis on blood loss. The reduced model predicted that every one-percent increase in maximum lysis was associated with a 44-milliliter increase in blood loss and every one-year increase in age was associated with a 19-milliliter increase in blood loss. On average, cesarean deliveries resulted in 522 more milliliters of blood loss than normal spontaneous vaginal delivery.ConclusionThe ROTEM EXTEM maximum lysis parameter has a significant effect on blood loss. Larger prospective clinical trials in conjunction with a prompt definition of the ranges of reference values will strengthen these advances to provide a rapid assessment and guide early interventions to prevent severe obstetric bleeding.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"18-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does oral care with mother's colostrum reduce the risk of late-onset sepsis in preterm infants? A randomized clinical trial.","authors":"Marwa Taha, Mai Mohamed Mostafa, Fifi Helmy, Sohaila Ali Abd El-Halim","doi":"10.1177/19345798241310739","DOIUrl":"10.1177/19345798241310739","url":null,"abstract":"<p><p>BackgroundOral care with mother's colostrum (OCC) for very-low-birth-weight (VLBW) preterm newborns may provide immune-protective effects that potentially reduce the risk of late-onset sepsis (LOS) and death. Our objective was to assess the effect of OCC on the risk of LOS and mortality in VLBW premature neonates.MethodsA single-center randomized clinical trial was conducted on 65 VLBW preterm neonates. The intervention was oral care administrated every 6 hours, starting in the first 24 hours of life and lasting for 5 days, using either own mother's colostrum (colostrum group) or sterile water (placebo group).ResultsNeonates in the colostrum group were significantly less likely to have LOS (62.5% vs 93.9%, RR = 0.66, <i>p</i> = 0.002), ventilator-associated pneumonia (VAP) (21.9% vs 48.5%, RR = 0.45, <i>p</i> = 0.025), feeding intolerance (56.3% vs 84.3%, RR = 0.66, <i>p</i> = 0.01), and mortality (18.8% vs 57.6%, RR = 0.3, <i>p</i> = 0.001). The time to start enteral nutrition in the colostrum group was shorter (<i>p</i> = 0.04) than in the placebo group. In multivariate analysis, OCC decreased the risk of LOS (OR = 0.12, <i>p</i> = 0.01) and death (OR = 0.14, <i>p</i> = 0.004). Moreover, OCC practice was associated with a faster time to regain birth weight (<i>p</i> = 0.027) and a shorter duration of hospitalization (<i>p</i> = 0.04) in surviving preterm infants.ConclusionOCC is a simple and safe practice that may yield a significant impact in reducing the risk of LOS, VAP, feeding intolerance, and mortality; can shorten time to start enteral feeding with faster regain to birth weight; and can shorten the length of hospital stay in VLBW preterm infants.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"79-85"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}