Early human development
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Early human development · Jul 2005
Clinical TrialDevelopmental changes in serum half-life of (EZ)-cyclobilirubin.
Phototherapy has been a standard treatment for neonatal hyperbilirubinemia for more than 40 years, but it has remained sub-optimal. ⋯ Serum (EZ)-C excretion followed a first-order kinetic model in most of the neonates. The half-life of (EZ)-C becomes more prolonged in the very low birth weight infant and early gestational age.
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Early human development · Mar 2005
Randomized Controlled Trial Clinical TrialPrior pain induces heightened motor responses during clustered care in preterm infants in the NICU.
Acute pain is a significant stressor for preterm infants in neonatal intensive care units (NICU); however, little is known about the effects of acute pain on subsequent motor responses during clusters of tactile handling. ⋯ Prior pain induces heightened biobehavioral reactivity in preterm infants during subsequent tactile procedures. In addition, clustering care is particularly stressful for infants born at earlier GA.
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Early human development · Feb 2005
ReviewManagement of infants with bronchopulmonary dysplasia in North America.
The in-hospital management of infants with BPD includes minimizing the duration of mechanical ventilation and avoiding the use of high inspired oxygen concentrations while maintaining adequate oxygenation. Fluid restriction, bronchodilators, and diuretic therapy can improve lung function and reduce the need for supplemental oxygen and high ventilator settings, but do not change the ultimate course of these infants. Corticosteroids also improve lung function and accelerate weaning from oxygen and mechanical ventilation, but their use during the first weeks of life is associated with worse neurological outcome. ⋯ Home oxygen and mechanical ventilation therapy are used frequently after discharge and require specialized staff and equipment. Maintenance of oxygenation and proper nutritional support are critical aspects in the post-discharge management of these infants. Immunizations and RSV prevention are also important to prevent infections in these vulnerable immunocompromised patients.
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Early human development · Feb 2005
ReviewManagement of infants with chronic lung disease of prematurity in Chile.
Despite advances in the prevention and management of respiratory distress syndrome, chronic lung disease of prematurity (CLD) remains a major cause of morbidity and mortality in preterm babies in Chile. Its incidence varies from 10% to 60% in different regions of Chile. Since 1998, the management of CLD after discharge from neonatal unit follows national guidelines. ⋯ Inhaled steroids and bronchodilators may reduce asthma-like symptoms in established CLD. Prevention of RSV infection in CLD babies is paramount. The preterm infant population has been maintained under surveillance nationally since 1998.
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Studies in encephalopathic infants have demonstrated a brief phase of normal cerebral energetics following hypoxia-ischaemia prior to development of delayed energy failure. In experimental models, mild hypothermia has shown a consistent neuroprotective action, although its efficacy is critically dependent on the severity of the primary insult, the delay in initiating cooling, and the duration and depth of hypothermia. ⋯ Preliminary results from a large randomised trial of selective head cooling suggest that early intervention can lead to significantly improved outcome in a subgroup of encephalopathic infants with intermediate electroencephalographic abnormalities. Further research in established experimental models is essential to improve the identification of suitable infants for treatment, to investigate the importance of variations in regional brain temperature, and to examine the therapeutic potential of hypothermia combined with other neuroprotective agents.