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CC BY-NC-ND 4.0 · AJP Rep 2022; 12(01): e89-e95
DOI: 10.1055/a-1678-3755
Case Report

Respiratory and Gastrointestinal Management of an Infant with a Birth Weight of 258 Grams

Ryo Itoshima 
1   Division of Neonatology, Nagano Children's Hospital, Nagano, Japan
2   Department of Pediatrics, University of Turku, Turku, Finland
,
Arata Oda
1   Division of Neonatology, Nagano Children's Hospital, Nagano, Japan
,
Ryo Ogawa 
1   Division of Neonatology, Nagano Children's Hospital, Nagano, Japan
,
Toshimitsu Yanagisawa 
1   Division of Neonatology, Nagano Children's Hospital, Nagano, Japan
,
Takehiko Hiroma
1   Division of Neonatology, Nagano Children's Hospital, Nagano, Japan
,
Tomohiko Nakamura
1   Division of Neonatology, Nagano Children's Hospital, Nagano, Japan
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Abstract

Today, more infants weighing less than or equal to 300 g are born, and they survive because of the improvements in neonatal care and treatment. However, their detailed clinical course and neonatal intensive care unit management remain unknown due to their low survival rate and dearth of reports. A male infant was born at 24 weeks and 5 days of gestation and weighed 258 g. The infant received 72 days of invasive and 92 days of noninvasive respiratory support, including high-frequency oscillatory ventilation with volume guarantee and noninvasive neurally adjusted ventilatory assist. Meconium-related ileus was safely treated using diatrizoate. Although the infant was diagnosed with severe bronchopulmonary dysplasia and retinopathy of prematurity requiring laser photocoagulation, he had no other severe complications. He was discharged 201 days postdelivery (3 months of corrected age) with a weight of 3.396 kg. Although managing infants weighing less than or equal to 300 g is difficult, our experience shows that it is possible by combining traditional and modern management methods. The management of such infants requires an understanding of the expected difficulties and adaptation of existing methods to their management. The management techniques described here should help improve their survival and long-term prognosis.

Keywords

tiny infant - extremely low birth weight - small for gestational age - high-frequency oscillatory ventilation with volume guarantee - noninvasive neurally adjusted ventilatory assist - meconium-related ileus - transpyloric tube feeding - cow milk–based fortifier - medium-chain triglyceride oil


Publikationsverlauf

Eingereicht: 20. September 2021

Angenommen: 20. Oktober 2021

Accepted Manuscript online:
25. Oktober 2021

Artikel online veröffentlicht:
09. Februar 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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