Vitamin A injections in VLBW preemies!!

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Specializes in NICU, Telephone Triage.

I took care of a 610 gm. preemie the other day who is being given IM injections of Vit. A 3x a week. I've never seen this before, it's a new tx for chronic lung disease...apparently it can't be given IV!!!

This seems so harsh for such a little baby. The baby already has a huge bruise from the injection.

Do the benefits of the drug outweigh the bruising and pain of the injection?

I'm having a hard time with this. Don't most preemies this small get lung disease the majority of the time?

Is Vit. A REALLY that effective?

Has anyone here had to give a 610 gm. baby a SHOT?

I've never had to, didn't have to on this baby either, but the leg loooked so bad and the docs verified no IV administration!

:(

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Specializes in NICU, Telephone Triage.

I'm surprised there aren't any responses about this yet. Is this a weird question? Or maybe nobody has experienced this before?

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Specializes in Palliative Care, NICU/NNP.
I'm surprised there aren't any responses about this yet. Is this a weird question? Or maybe nobody has experienced this before?

Haven't been in NICU since the mid 90s but did not experience vitamin A. I would think since it's a fat soluable vitamin one would need to be very careful with dosing and personally in any age person I find IM injections barbaric unless it can't be given any other route!

I did a search under"premie+vitamin A" and it brought up some abstracts. Not sure it's been researched enough or made enough difference. Hate the thought of jabbing a 600 Gm premie.

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Specializes in NICU, Telephone Triage.
Haven't been in NICU since the mid 90s but did not experience vitamin A. I would think since it's a fat soluable vitamin one would need to be very careful with dosing and personally in any age person I find IM injections barbaric unless it can't be given any other route!

I did a search under"premie+vitamin A" and it brought up some abstracts. Not sure it's been researched enough or made enough difference. Hate the thought of jabbing a 600 Gm premie.

I found some studies online showing that Vit. A helps in preventing CLD, but it has to be given IM...but in such a tiny baby there isn't any "M", so I guess it's really kinda SQ!! OUCH!:(

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Specializes in NICU.

I've never heard of this, we haven't ever given Vitamin A, that I'm aware of.

And yes, we do give micropremies like that shots .... but only Vitamin K, just one injection.

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We've been giving Vit A injections on VLBW babies for quite some time now. We have a nutritionist that researched it and encouraged our physicians to use it. It is supposed to promote healthy lung tissue. We give it Mon-Wed-Fri. At first we all hated it and told the nutritionist that we were going to give HER the shots! Now, we've gotten used to it. Just make sure you have a small gague needle- like a 27 or 30. Go into the leg nice and easy and watch to see how deep you need to go in. You dont want to hit bone. (ugh!) I've seen people "dart" the needle in like you do on adults, and you just dont need to do it like that because their tissue is so much softer.

I hope this helps!

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We've been giving Vit A injections on VLBW babies for quite some time now. We have a nutritionist that researched it and encouraged our physicians to use it. It is supposed to promote healthy lung tissue. We give it Mon-Wed-Fri. At first we all hated it and told the nutritionist that we were going to give HER the shots! Now, we've gotten used to it. Just make sure you have a small gague needle- like a 27 or 30. Go into the leg nice and easy and watch to see how deep you need to go in. You dont want to hit bone. (ugh!) I've seen people "dart" the needle in like you do on adults, and you just dont need to do it like that because their tissue is so much softer.

I hope this helps!

Do your docs feel like it is making a difference? Are they seeing less BPD?

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Specializes in NICU (Level 3-4), MSN-NNP.

We give 5000 units of Vitamin A to kids

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Specializes in NICU, Telephone Triage.
We give 5000 units of Vitamin A to kids

Ok, thanks for the info. I do feel a little better about it all.

Although, this 610 gm baby is already on an oscillator at DOL #3. But, the baby probably didn't receive enough shots to do any good yet. I think my hospital does the same dosing you mentioned.

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That sounds amazing!

I have heard from some of the RT's that we have horrible BPD rates because we over oxygenate. Our docs have changed spo2 limits and hope that it will help us with weaning better. I wonder if this might be something we can try also...

I found a great article on it....

http://pediatrics.aappublications.org/cgi/content/full/104/6/1369

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Specializes in Palliative Care, NICU/NNP.

I took a 26 and 6/7 weeker off of CPAP and put him on a cannula, and he just satted to high heaven in 21% O2.

Why was he on a cannula in room air?

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Specializes in NICU, Telephone Triage.
I took a 26 and 6/7 weeker off of CPAP and put him on a cannula, and he just satted to high heaven in 21% O2.

Why was he on a cannula in room air?

I've had babies on cannulas in room air before, sometimes they just need the liter flow for stimilation to help them breathe.

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