VLBW Flashcards
VLBW how many kg?
<1500g
Primary causes of VLBW
IUGR
Prematurity
Prematurity is at what range of weeks?
22-37
borderline 23-24w
Risk factors VLBW
Afro-american
Age <16 and >35
Twins,…
Maternal health: socioeconomic status, health before pregnancy, health during pregnancy
Consequences of VLBW for baby?
Hypothermia: large body surface:weight, skin barrier immature, metabolism 1/3 of needed
CV: PDA and hypotension
Hypoglycemia: low glycogen/fat stores
Perinatal asphyxia: suffered from hypoxia in utero (mother health, placental health) can cause or be consequence of!
Respiratory distress (surfactant deficiency), apnea
Electrolyte and fluid disorders: water loss, renal insufficiency, dehydration/overload, hypo/pernatremia,….
Hyperbilirubinemia: unconjugated- due to hepatic immaturity, delayed enteral feeding, infection, polycythemia,…
conjugated: complication of parenteral nutrition
Neuro: IV hemorrhage, periventricular leukomalacia, incr. risk cerebral palsy, learning difficulties
ROP
Hearing deficit: due to LBW itself or ototoxicity drugs given,…
Anemia
Impaired nutrition
Infection
Management of VLBW
CV- give dopamine 5mcg/kg/min
Resp- 02 takes 10 mins to reach extrauterine levels- maintain this at 90-95%, CPAP, IT, surfactant
Fluids- 1st day low @ 60-80ml/kg/d +Ca
RBC- transfusion or EPO
Nutrition: usually needs early aggressive TPN <12h of life with aa +lipids and within 5 days of life initiate trophic feedings with breast milk or formula, then start enteric
Glycemia: >45mg/dL
AB: if risk factors like strep B no prophylaxis, chorioamnionitis, PROP,…
Hyperbili: phototherapy prophylaxis
Retinopathy: screen @4w of life
US: PVL and IV hemorrhage