Comparison of effectiveness and safety of different concentration of sucrose analgesia in newborn infants undergoing minor painful procedures

Background: Sick preterm and term neonates experience many daily painful procedures during stay in neonatal intensive care units. Recognition and treatment of pain in these babies remains a challenge. Oral sucrose is the most studied pain intervention in newborn

Aim: This study attempted to compare the efficacy and safety of the analgesic effect of different concentrations of sucrose in minor painful neonatal procedures such as heel pricks, intravenous insertion, and wound care, suctioning and bladder catheterization

Methods: A total of 90 newborn babies admitted to El Shatby neonatal intensive care unit were included in this study [gestational age above 34 weeks] undergoing minor painful procedures such as arterial puncture, heel pricks, venous puncture and intravenous insertion

Results: The newborn infants included in this study were divided into 3 groups according to the method of sucrose administration each group subdivided equally into full term and late preterm. The overall pain score was significantly lower among newborn who received sucrose in either concentrations than placebo. However no statistical significant difference was found between sucrose 12% and 24% concentrations [p=0.734], Also no significant difference was found in behavioral and physiologic responses in both full term and later preterm babies

Conclusion: Sucrose is safe and effective for reducing procedural pain from single events. Further investigation on repeated administration of sucrose in neonates and the use of sucrose in combination with other non-pharmacological and pharmacological interventions is needed. Sucrose use in extremely preterm, unstable and ventilated [or a combination of these] neonates needs to be addressed

Evaluation of the role of interleukin-2 receptor in the diagnosis of neonatal septicemia

The role of IL-2R as a predictor of neonatal sepsis was evaluated in 20 newlyborn infants admitted to the neonatal intensive care unit of Alexandria University Children's Hospital. Ten healthy neonates served as a control group. The study showed that PROM, prior use of antibiotics, insertion of umbilical catheters and the use of endotracheal tubes were the common risk factors of infection. Hypothermia, lethargy, tachypnea and poor feeding were the significant presentation associated with infection. Gram negative bacteria were isolated from 85% and 30% of blood and CSF of newly born infants respectively. The mean value of mini-ESR was significantly higher in the septic group than the control group. As regard the expression of IL-2R, there was a statistically high significant difference between the septic and the control group. Moreover, there was a significant difference between the mean value of IL-2R expression of the first and second blood sample. IL-2 = Interleukin-2; IL-2R = Interleukin-2 receptor; PROM = Premature rupture of membranes CSF = Cerebro Spinal Fluid; ESR = Erythrocyte Sedimentation Rate; sIL-2R = Soluble Interleukin-2 receptor

Hemoglobin patterns in healthy infants

The post-neonatal changes in the level of hemoglobin A,F and A[2] have been studied by different workers. Although there is general agreement about the pattern of these changes, still some controversy exists regarding the mean values at certain ages. The present study aimed at determining the levels of the different types of hemoglobin during the first two years of life in Egyptian infants. The tabulated and graphically presented results have been discussed and compared with the results given in the literature

myocardial status in neonatal hypothermia

The literature lacks information about the state of myocardium in neonatal hypothermia. This work aimed at clarifying the impact of cold on the myocardium of hypothermic neonates. The total serum CPK, LDH and LDH isoenzymes, the ECG tracing as well as the serum sodium, potassium and calcium levels have been studied in a group of cold injured neonates. The significant elevation of the total CPK, total LDH and 2 in sever hypothermia and LDH[1] in mild hypothermia suggests cold induced myocardial damage. The increased levels of the other LDH isoenzymes reflects the wide spread tissue damage incured by cold. The cold injured myocardium and /or the significant elevation of the serum potassium are probably responsible for the observed ECG anomalies