1,721,020 research outputs found
Umbilical cord blood as a source for red-blood-cell transfusion in neonatology: a systematic review
No full textThe prevention and treatment of anaemia in newborn patients made tremendous progress in the last decades. However, red-blood-cell (RBC) transfusions remain unavoidable in many neonates candidate to surgery and especially in preterm infants. In particular, anaemia occurring in neonates born at extremely low gestational age is actually severe and frequently requires transfusions. Several approaches have been explored to prevent or even to reduce the threshold and the frequency of RBC transfusions. Among these, umbilical cord blood (UCB) collection and processing to obtain RBC components for autologous or allogeneic transfusion have been extensively investigated. In this systematic review, we revised the literature concerning the use of UCB for either autologous or allogeneic transfusion purposes and we illustrated the rationale for a transfusion therapy tailored to extremely preterm neonates, based on RBC concentrates from allogeneic UCB donations
Studio per la realizzazione di una cartella clinica computerizzata nel nido: nove mesi di esperienza clinica.
No full textStudio per la realizzazione di una cartella clinica computerizzata nel nido: nove mesi di esperienza clinica
[Type of diet and "ambulatory" pathology in the first 6 months of life]
No full textThis work is a contribution to the investigation that mainly in the last year have been widely performed to evaluate the protecting action of breast feeding against some typical pathological occurrences in the first months of life. Authors studied, for six months, 117 babies. The respiratory and intestinal illness have been found (in progress or anamnestically) during pediatric monthly or occasionally visits. 33% of the babies were fed with milk formula since the first life months; the remainder 67% were breastfed during one month at least. By statistic correlation of type of feeding and disease frequency, there is evidence of the following: 1) Babies, breastfed during 6 months, have lower frequency of respiratory pathology, when compared (p 0.05) with 6 months bottle fed ones. 2) Babies, breastfed during 2 months have lower frequency of intestinal pathology when compared (p 0.05) with bottle fed ones. Therefore, it seems that the most interesting results coming out from this study is that the protective action of breast feeding concerns not only the intestinal disease, but the respiratory ones too, when, however, the breast feeding period is enough extended
Renal Failure of the Surviving Fetus After Intrauterine Death of the Co-Twin
No full textTwin pregnancies are considered at a higher risk for fetal mortality than singleton pregnancies. The antenatal death of one of the twins is associated with an increasing rate of cerebral impairment and lesions in other organs in the surviving fetus, especially if the pregnancy is monochorionic. We describe a case of isolate renal failure becoming evident gradually after birth in a surviving twin after the antenatal death of the co-twin. Considering the deleterious effects of vascular disruption in a surviving twin, our findings suggest careful investigation of renal function, even if no intrauterine signs of diminished renal function were previously detected
Adrenocortical function and chronic lung disease of prematury: an unsolved problem?
No full textno abstract availabl
Cardiac adverse effects of early dexamethasone treatement in preterm infants: a randomized clinical trial
No full textThis study evaluates the effects of early administration of dexamethasone on left ventricle dimensions and their clinical significance in preterm infants. Fifty preterm infants with birth weight < or = 1250 g and gestational age < or = 30 weeks were randomly assigned after 72 hours of life to the dexamethasone group (n = 25) or to the control group (n = 25). The treated infants received dexamethasone intravenously from the 4th day of life for 7 days (0.5 mg/kg/day for the first 3 days, 0.25 mg/kg/day for the next 3 days, and 0.125 mg/kg/day for the 7th day). Serial echocardiographic measurements of end systolic interventricular septum thickness, end diastolic interventricular septum thickness, end systolic left ventricle posterior wall thickness, end diastolic left ventricle posterior wall thickness, left ventricle end diastolic diameter, and left ventricle end systolic diameter were taken before starting dexamethasone, on days 3 and 7 of treatment, 7 days after the interruption of treatment, and at the 28th day of life. Five infants of each group were excluded by the final analysis because of the lack of a complete cardiac evaluation, leaving 20 treated and 20 control infants. Infants receiving dexamethasone had a significantly larger increase in mean septal and left posterior wall thickness during the treatment and 7 days after the dexamethasone weaning. The mean left ventricle diameter of treated infants was significantly lower than that of control infants from the 7th day of treatment to the 28th day of life. Four neonates (20%) in the dexamethasone group developed left ventricular myocardial hypertrophy without left ventricle outflow tract obstruction, showing signs of decreased cardiac output and ischemic changes on ECG. The daily fluid intake was increased to 200 ml/kg to ensure an adequate preload volume, and the complete resolution of left ventricle hypertrophy was obtained within the 2nd to 3rd week after dexamethasone weaning. Preterm infants receiving an early (< 96 hours of life) short course of dexamethasone develop a left ventricular myocardial hypertrophy that can be symptomatic and clinically significant. Preterm infants included in future studies with the goal to find the minimum dose and duration of dexamethasone treatment should be strictly monitored echocardiographically for this side effec
Foetal haemoglobin, blood transfusion, and retinopathy of prematurity
No full textStutchfield et al. have recently demonstrated that low foetal
haemoglobin (HbF) levels predict retinopathy of prematurity
(ROP) . There is an increasing awareness that
red blood cell (RBC) transfusions are independent risk
factors for all prematurity-associated diseases (PAD).
Since adult haemoglobin (HbA) releases oxygen more
efficiently than HbF, autologous cord blood (CB) transfusion
has been attempted, with limited results due to the low
volume of CB collected. We have shown that allogeneic
CB RBC concentrates obtained from healthy full-term
babies can fulfil transfusion requirements of preterm neonates
(PNs) with gestational age ≤30 weeks and/or birth
weight ≤1500 g, in their first 28 days of life. At first
transfusion episode, PNs received ABO-Rh(D) matched
CB-RBCs if available, or adult RBCs if CB units were not
available. At subsequent transfusions, the same regimen
was adopted, unless CB-RBCs were unavailable. Overall, 9
patients received CB-RBCs and 11 adult-RBCs; 6 patients
(3 in each group) died before ROP assessment. Table 1
illustrates ROP findings in 14 surviving patients. All PNs
receiving adult-RBCs developed ROP, while two of six
patients in the CB-RBC group did not. Stage 3 ROP was
observed in four heavily transfused extremely PNs: three of
them were transfused only or mainly with adult-RBCs
(patients 8,10 and 14, respectively; Table 1).
Transfusions contribute to the overwhelming oxidative
burden caused by infections, oxygen therapy and
inflammatory diseases in PNs. Unfortunately, to monitor in
these patients lipid peroxidation products or other biomarkers
of the oxidative stress, requires sophisticated
methodologies and exceeding volume of biologic samples.
Hence, these investigations are so far confined to the
research field. In this regard, the study of Stutchfield
et al. suggests that monitoring HbF levels in PNs might be a
feasible and reliable tool to figure out to what extent
transfusions might favour PAD developmen
Early postnatal dexamethasone for the prevention of chronic lung disease in high-risk preterm infants
No full textno abstract availabl
Severe sepsis in a premature neoante: protein C replacemnet therapy
No full textTreatment with activated protein C has been shown to reduce mortality in adult patients with severe sepsis but also to increase risk of bleeding. In patients with predisposition to bleeding, as in preterm infants, the inactivated form of protein C could serve as a safe therapeutic option. We report the case of a preterm neonate who developed severe sepsis on the 28th day of life, who was successfully treated with the inactivated form of protein C for a period of 96 hours
Early visual assessment in preterm infants with and without brain lesions: correlation with visual and neurodevelopmental outcome at 12 months.
No full textBACKGROUND: Several studies have reported the development of various aspects of visual function in infancy and early childhood in both preterm and term-born infants, but only a few studies have focused on the predictive power of neonatal visual findings in infants with brain lesions.
AIMS: To explore visual findings at term age, and at 3 and 12 months corrected age in preterm infants (gestational age <33 weeks) with and without brain lesions; to compare the assessment at term age and at 12 months; and to assess the relationship between visual findings and neurodevelopmental outcome at 12 months.
STUDY DESIGN: Cranial ultrasound scans (US) were classified in normal, mild or major abnormalities. One-hundred and forty-five infants were assessed with age specific tests for visual function at term age, and at 3 and 12 months. Neurodevelopmental assessment (Griffiths' Scales) was performed at 12 months.
RESULTS: A good correlation was found between early and late visual assessment and neurodevelopment outcome. Of the 121 infants with normal neonatal visual assessment, 119 were also normal at 12 months and 116 had normal developmental quotient. Of the 24 infants with abnormal neonatal visual assessment, 12 were also abnormal at 12 months. All the false positives had normalised by 3 months. Of the 35 infants with major US abnormalities, 20 had normal and 15 abnormal scores on the neonatal assessment. At 1 year 17 had normal and 18 abnormal scores.
CONCLUSION: A normal visual assessment at term age is a good predictor of normal visual and neurodevelopmental outcome at 12 months. An abnormal visual examination in the neonatal period was a less reliable prognostic indicator, infant should be reassessed at 3 months
- …
