Neonatology
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Early identification and prevention of hypoxic-ischemic encephalopathy (HIE) in newborns may reduce neonatal mortality and neurological dysfunction. ⋯ These data suggest that early measurement of both S100B level and lactate/creatinine ratio in the urine of newborns with HIE is a practical convenient and sensitive way to improve diagnosis on the third day of life and prognostic prediction of HIE.
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Hyperlactatemia in neonates admitted to the cardiac intensive care unit with critical heart disease.
Neonates with critical heart disease are at risk of significant deficiencies in systemic oxygen delivery. The incidence and clinical pattern of hyperlactatemia in neonates presenting with critical heart disease has not been described. We reviewed the lactate pattern of neonates transferred to our cardiac intensive care unit for surgical management of their heart disease over a 1-year period. ⋯ Hyperlactatemia is frequently present in neonates admitted to a tertiary care center for management of congenital heart disease. Blood lactate levels normalize within 36 h. The presence of preoperative hyperlactatemia, even when moderate-to-severe, does not have significant adverse effect on postoperative mortality.
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It remains a great challenge to measure systemic blood flow in critically ill newborns. In a former study we validated the modified carbon dioxide Fick (mCO(2)F) method for measurement of cardiac output in a newborn lamb model. In this new study we studied the influence of a left-to-right shunt on the accuracy of the mCO(2)F method. ⋯ Cardiac output measurement with the mCO(2)F method is reliable and easily applicable in ventilated newborn lambs, also in the presence of a significant left-to-right shunt.
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Historical Article
History of neonatal resuscitation. Part 2: oxygen and other drugs.
Oxygen was used in neonatal resuscitation from 1780, within 5 years of its detection. It rapidly gained general acceptance and infiltrated delivery rooms and, a century later, neonatal special care units. ⋯ Continuous distending airway pressure for oxygen administration was available at the beginning of the 20th century, but was not widely accepted. Alkali and analeptic drugs gained widespread but short-lived use after the Second World War.