Variability in human milk composition: benefit of individualized fortification in very-low-birth-weight infants.
de HALLEUX, Virginie ; Rigo, Jacques
in The American journal of clinical nutrition (2013), 98(2), 529-35
BACKGROUND: Preterm infants fed fortified human milk (HM) grow more slowly than those fed preterm formulas. These differences could be related to the variability in the macronutrient composition of ... [more ▼]
BACKGROUND: Preterm infants fed fortified human milk (HM) grow more slowly than those fed preterm formulas. These differences could be related to the variability in the macronutrient composition of expressed HM, resulting in inadequate nutrient intake in relation to the estimated needs of the preterm infants. OBJECTIVES: The aim of this article was to show the variability in HM composition from an infant's own mother's milk (OMM) or pooled HM from the milk bank. The second objective was to evaluate the advantages of individual fortification on nutritional intakes over standard fortification. DESIGN: The macronutrient composition of 428 OMM, 138 HM pools from single donors, 224 pools from multiple donors, and 14 pools from colostral milk was determined by using a mid-infrared analyzer. Individualized fortification was performed after analysis of the milk samples in 2 steps: adjustment of fat content up to 4 g/dL, followed by the addition of an HM fortifier to provide 4.3 g . kg(-1) . d(-1) according to the daily prescribed volume of feeding. Nutritional intakes resulting from the individualized fortification were compared with calculated intakes resulting from standard fortification (HM fortifier: 4 packets/dL). RESULTS: The variability in contents of fat, protein, and energy was high for all types of HM samples. Compared with standard fortification, individual fortification significantly reduced the variability in nutritional intakes, allowing the maintenance of protein intake and the protein:energy ratio in the range of the nutritional recommendations. CONCLUSIONS: The variability in expressed HM with respect to its protein and energy content is high. This variability persists after standard fortification, possibly resulting in under- or overnutrition. Because both over- and undernutrition confer risks in later development, individualized fortification optimizes protein and energy intake. [less ▲]Detailed reference viewed: 17 (0 ULg)
Automated respiratory cycles selection is highly specific and improves respiratory mechanics analysis.
RIGO, Vincent ; Graas, Estelle ; Rigo, Jacques
in Pediatric Critical Care Medicine (2012), 13(4), 234-9
OBJECTIVE:: Selected optimal respiratory cycles should allow calculation of respiratory mechanic parameters focusing on patient-ventilator interaction. New computer software automatically selecting ... [more ▼]
OBJECTIVE:: Selected optimal respiratory cycles should allow calculation of respiratory mechanic parameters focusing on patient-ventilator interaction. New computer software automatically selecting optimal breaths and respiratory mechanic derived from those cycles are evaluated. DESIGN:: Retrospective study. SETTING:: University level III neonatal intensive care unit. SUBJECTS:: Ten mins synchronized intermittent mandatory ventilation and assist/control ventilation recordings from ten newborns. INTERVENTION:: The ventilator provided respiratory mechanic data (ventilator respiratory cycles) every 10 secs. Pressure, flow, and volume waves and pressure volume, pressure flow, and ventilator volume flow loops were reconstructed from continuous pressure/volume recordings. Visual assessment determined assisted leak-free optimal respiratory cycles (selected respiratory cycles). New software graded the quality of cycles (automated respiratory cycles). Respiratory mechanic values were derived from both sets of optimal cycles. We evaluated quality selection and compared mean values and their variability according to ventilatory mode and respiratory mechanic provenance. To assess discriminating power, all 45 "t" values obtained from interpatient comparisons were compared for each respiratory mechanic parameter. MEASUREMENTS AND MAIN RESULTS:: A total of 11,724 breaths are evaluated. automated respiratory cycle/selected respiratory cycle selections agreement is high: 88% of maximal kappa with linear weighting. Specificity and positive predictive values are 0.98 and 0.96, respectively. Averaged values are similar between automated respiratory cycle and ventilator respiratory cycle. C20/C alone is markedly decreased in automated respiratory cycle (1.27 +/- 0.37 vs. 1.81 +/- 0.67). Tidal volume apparent similarity disappears in assist/control: automated respiratory cycle tidal volume (4.8 +/- 1.0 mL/kg) is significantly lower than for ventilator respiratory cycle (5.6 +/- 1.8 mL/kg). Coefficients of variation decrease for all automated respiratory cycle parameters in all infants. "t" values from ventilator respiratory cycle data are two to three times higher than ventilator respiratory cycles. CONCLUSIONS:: Automated selection is highly specific. Automated respiratory cycle reflects most the interaction of both ventilator and patient. Improving discriminating power of ventilator monitoring will likely help in assessing disease status and following trends. Averaged parameters derived from automated respiratory cycles are more precise and could be displayed by ventilators to improve real-time fine tuning of ventilator settings. [less ▲]Detailed reference viewed: 12 (2 ULg)
Precision of continuous neonatal ventilator respiratory mechanics is improved with selected optimal respiratory cycles.
RIGO, Vincent ; ; RIGO, Jacques
in European journal of pediatrics (2012), 171(4), 689-96
Given their high apparent variability, bedside continuous respiratory mechanics (RM) parameters (excepting tidal volume (VT)) remain infrequently used for adjustment of neonatal ventilatory settings. RM ... [more ▼]
Given their high apparent variability, bedside continuous respiratory mechanics (RM) parameters (excepting tidal volume (VT)) remain infrequently used for adjustment of neonatal ventilatory settings. RM parameters provided by ventilator (VRC) from 10 recordings of newborns (10 minutes in synchronized intermittent mandatory ventilation and Assist/control (A/C)) were compared to those computed from visually selected assisted leak-free optimal respiratory cycles (SRC). Mean values, variability and ability to distinguish patients were compared between VRC and SRC. Dynamic resistances were more correlated (r²=0.95) than compliances (r²=0.42). VT’s were correlated only in A/C (r²=0.78). C20/C was significantly higher in VRC (1.81±0.67) than in SRC (1.23±0.36) and frequently out of neonatal reference range. In A/C ventilation, VT was higher in VRC (5.6 ±1.8 ml/kg) than in SRC (4.8 ±1.0 ml/kg) (p<0.05). Displayed VT’s don’t reflect those found in optimal assisted breaths and therefore have incomplete value in assessing adequacy of ventilator settings. The variability of RM parameters provided by the ventilator is large, and coefficients of variation were significantly lower with optimal respiratory cycles (for Resistance, Compliance, VT and C20/C: 27, 26, 18, 24% in SRC, 36, 35, 40, 33% in VRC). Selecting optimal cycles yields RM with a 2-3 times higher discriminating power between patients. Conclusion: Current ventilator’s RM parameters have limited clinical use. Using optimal breaths to calculate RM parameters improves precision and discriminating power. For integration to ventilatory care, automation of this selection must be implemented first. [less ▲]Detailed reference viewed: 19 (1 ULg)
Calcium and Phosphorus Homeostasis: Pathophysiology
RIGO, Jacques ; PIELTAIN, Catherine ; VIELLEVOYE, Renaud et al
in BUONOCORE, Giuseppe; BRACCI, Rodolfo; WEINDLING, Michael (Eds.) Neonatology. A practical approach to neonatal diseases. (2012)Detailed reference viewed: 13 (3 ULg)
Neuroprotection par hypothermie contrôlée dans l'encéphalopathie anoxo-ischémique du nouveau-né
GARSPARD, Valérie ; VIELLEVOYE, Renaud ; RIGO, Jacques
in Revue Médicale de Liège (2012), 67(4), 186-191
Neonatal hypoxic, ischemic encephalopathy is a major cause of death and neurodevelopmental delay. Brain cooling by mild controlled hypothermia is currently the most promising therapy.Detailed reference viewed: 24 (8 ULg)
Optimizing early nutritional support based on recent recommendations in VLBW infants and postnatal growth restriction
SENTERRE, Thibault ; Rigo, Jacques
in Journal of Pediatric Gastroenterology and Nutrition (2011), 53(5), 536-542Detailed reference viewed: 14 (1 ULg)
L’allo-immunisation fœto-maternelle ABO peut être sévère
SENTERRE, Thibault ; ; Rigo, Jacques
in Archives de Pédiatrie (2011), 18Detailed reference viewed: 22 (2 ULg)
Influence of HIV-1 and placental malaria co-infection on newborn biometry and Apgar scores in Kinshasa Democratic Republic of Congo
; Foidart, Jean-Michel ; RIGO, Jacques
in Journal de Gynécologie, Obstétrique et Biologie de la Reproduction (2011), 40(5), 460-4
Objective The aim of this study was to assess the impact of HIV-1 and placental malaria co-infection on newborn biometry and Apgar scores. Methods 146 HIV-1 infected and 149 HIV-1 uninfected consent ... [more ▼]
Objective The aim of this study was to assess the impact of HIV-1 and placental malaria co-infection on newborn biometry and Apgar scores. Methods 146 HIV-1 infected and 149 HIV-1 uninfected consent mothers and their newborns were recruited. Placental biopsies examination confirmed the presence or absence of placental malaria. Birth weight (BW), placental weight, cranial circumference, brachial perimeter, height, Body Mass Index (BMI) and Apgar scores at 1’, 5’, 10’ were taken. The Chi2 test and t -Student test were used for data statistical analysis. Results The global placental malarial infection prevalence was 72% but was 91% in HIV-1 infected vs. 53.7% in HIV-1 uninfected mothers (p <0.0001). The mean BW of HIV-1 co-infected mother’s newborns was slightly inferior to that of HIV-1 uninfected mother’s babies (3,033±524g vs. 3,236±565g) but this difference was not statistically significant (p >0.05). No other significant biometric differences were noted (p >0.05). But, the co-infection influenced negatively Apgar scores at 5’ (p <0.05). Conclusion HIV-1 co-infected mothers were more frequently exposed to placental malaria infection. The co-infection reduced the Apgar scores taken at the fifth minute. [less ▲]Detailed reference viewed: 19 (1 ULg)
Postnatal growth restriction may be limited in very-low-birth-weigth infants.
Senterre, Thibault ; ; Rigo, Jacques
in Journal of Maternal-Fetal & Neonatal Medicine (2010, May), 23(S1), 325-326Detailed reference viewed: 1 (1 ULg)
Automated respiratory cycles selection improves the variability of respiratory mechanics monitoring.
Rigo, Vincent ; ; Rigo, Jacques
in Rimensberger, Peter (Ed.) 10th European Conference on Pediatric and Neonatal Ventilation program (2010, April)Detailed reference viewed: 22 (4 ULg)
Macronutrients supply during Lactation and Infant Growth
Senterre, Thibault ; Rigo, Jacques
in Symonds, M.; Ramsay, M. (Eds.) Maternal-Fetal Nutrition during Pregnancy and Lactation (2010)Detailed reference viewed: 22 (3 ULg)
Immunoglobulines intraveineuses et maladie hémolytique allo-immune du nouveau-né.
Senterre, Thibault ; Viellevoye, Renaud ; Rigo, Jacques
in Archives de Pédiatrie (2010), 17(3), 299-300Detailed reference viewed: 57 (10 ULg)
Nutrition du prématuré après la sortie: lait, vitamines, fer, diversification
Rigo, Jacques ; ; Senterre, Thibault et al
in Archives Françaises de Pédiatrie (2010), 17Detailed reference viewed: 17 (1 ULg)
Amélioration de la variabilité des paramètres continus de mécanique ventilatoire en sélectionnant les respirations de bonne qualité.
Rigo, Vincent ; Rigo, Jacques
in Storme, Laurent (Ed.) JFRN 2009 (2009, November 23)Detailed reference viewed: 23 (2 ULg)
Newborns need another tune: « I will survive » sets neonatal resuscitation rhythm.
Rigo, Vincent ; Rigo, Jacques
in Annals of Emergency Medicine (2009), 53(6), 837Detailed reference viewed: 65 (14 ULg)
Le programme national nutrition santé (PNNS) : quels effets sur la santé des enfants ?
in Archives de Pédiatrie (2009), 16
Le programme national nutrition santé (PNNS) est un plan de santé publique mis en place en janvier 2001 par le ministère de la Santé. Son but est d'améliorer l'état de santé de la population, en ... [more ▼]
Le programme national nutrition santé (PNNS) est un plan de santé publique mis en place en janvier 2001 par le ministère de la Santé. Son but est d'améliorer l'état de santé de la population, en particulier dans les domaines de l'obésité...Il repose sur l'amélioration de la consommation alimentaire et la promotion de l'activité physique. Deux des objectifs du plan concernent la promotion de l'allaitement maternel et la prévention de l'obésité. [less ▲]Detailed reference viewed: 79 (11 ULg)
Intérêt de la consommation de produit laitier et de la supplémentation en vitamine D au cours de la croissance.
Pieltain, Catherine ; Vervoort, Anne ; Senterre, Thibault et al
in Journal du Pédiatre Belge (2009), 11(3), 24-27Detailed reference viewed: 22 (1 ULg)
On-line respiratory mechanic monitoring in newborns: reproducibility and effect of ventilatory mode
Rigo, Vincent ; Rigo, Jacques
in Archives of Disease in Childhood (2008, November), 93(suppl II), 483
Objectives: Neonatal ventilator softwares provide information on respiratory mechanics (RM). Integration of those values with clinical variables could improve ventilation management. We investigated ... [more ▼]
Objectives: Neonatal ventilator softwares provide information on respiratory mechanics (RM). Integration of those values with clinical variables could improve ventilation management. We investigated accuracy and reproducibility of those variables in Assist Control (AC) and Synchronised Intermittent Mandatory Ventilation (SIMV) modes. [less ▲]Detailed reference viewed: 48 (11 ULg)