Neonatology
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Comparative Study
Bruising at birth: antenatal associations and neonatal outcome of extremely low birth weight infants.
Early studies have identified severe cranial bruising as a risk factor for intraventricular hemorrhage (IVH) in premature infants but the nature of this association has not been evaluated. ⋯ Antenatal exposure to steroids and increasing gestational age are associated with a lower incidence of bruising at birth in extremely low birth weight infants. Severe bruising at birth is associated with increased incidence of severe intraventricular hemorrhage and mortality.
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Transient tachypnea of the newborn (TTN) is a mild form of neonatal respiratory distress which early in its course needs to be differentiated from other severe respiratory disorders. At present the diagnosis is based on radiological findings and clinical course. Lung sonography in TTN has not yet been assessed. ⋯ We found lung sonography reliable for the early diagnosis of TTN. We suggest that it should become the first approach for imaging of neonatal respiratory distress although further prospective studies with good blinding need to be performed.
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Treatment with surfactant (S) decreases lung injury in paralyzed, mechanically ventilated animals. The use of nasal continuous positive airway pressure (CPAP) as an alternative to mechanical ventilation may further improve acute pulmonary outcomes. ⋯ Animals treated with surfactant prior to CPAP or SIMV had less acute lung injury. SIMV+S animals had less open air space in nondependent regions. This suggests, during early ventilatory support, surfactant administration may modulate pulmonary inflammation. CPAP alone without surfactant may not provide optimal pulmonary protection. The addition of mechanical breaths may alter and add to injury.
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Apnea and bradycardia of prematurity (ABP) are possible risks towards damage of the developing brain. ⋯ ABP is an age-specific phenomenon. However, more severe courses than expected for PMA or the resolution at a later PMA indicated an increased risk of neurodevelopmental disturbances at a corrected age of 13 months.
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To evaluate the relation between cerebral tissue oxygenation index (TOI), measured with spatially resolved spectroscopy (SRS), and the different oxygenation parameters. To evaluate the relation between a new parameter named fractional tissue oxygen extraction (FTOE) and the cerebral fractional oxygen extraction (FOE). ⋯ The measurement of TOI and FTOE by SRS correlated well with the cerebral venous saturation and FOE, respectively.