Effect of Silicon Gel Sheeting in Nasal Injury Associated with Nasal CPAP in Preterm Infants.

We conducted this study to investigate the efficacy of the silicon gel application on the nares in prevention of nasal injury in preterm infants ventilated with nasal continuous positive airway pressure (NCPAP). Patients (n=179) were randomized into two groups: Group 1 (n=87) had no silicon gel applied to nares, and in Group 2 (n=92), the silicon gel sheeting was used on the surface of nares during ventilation with NCPAP. Nasal injury developed in 13 (14.9%) neonates in Group 1 and 4 (4.3%) newborns in Group 2 (OR:3.43; 95% CI: 1.1-10.1; P<0.05). The incidence of columella necrosis was also significantly higher in the Group 1 (OR: 6.34; 95% CI: 0.78-51.6; P<0.05). We conclude that the silicon gel application may reduce the incidence and the severity of nasal injury in preterm infants on nasal CPAP.

Does early erythropoietin therapy decrease transfusions in anemia of prematurity?

OBJECTIVE: To investigate the effect of early erythropoietin treatment on induction of erythropoiesis and the need for transfusion in Very Low Birth Weight (VLBW) infants with acute neonatal problems. METHODS: The study group consisted of 14 VLBW prematures with gestational ages less than 32 weeks who were given subcutaneous erythropoietin (600 U/kg per week) and oral iron (3 mg/kg per day) during the first 7-8 weeks of their life, while 13 other VLBW prematures that were given placebo constituted the control group. Weekly hematocrit, (Hct) reticulocyte (Ret) values and the volume of blood drawn and transfused were recorded in the both groups. RESULTS: The groups were comparable regarding with birth weights and gestational ages. The volume of the blood drawn (76.8 +/- 42.5 and 37.0 +/- 15.2) was higher and the volume of the transfusions (51.84 +/- 49.30 and 68.84 +/- 41.2) was lower in the study group but the differences between the groups were not significant (p>0.05). The hematocrit, the reticulocyte and the ferritin values were similar in both the groups at the end of the therapy. CONCLUSION: Under the neonatal intensive care circumstances of developing countries where blood volumes needed for laboratory analysis are still very high, phlebotomy losses can not be avoided. Thus early erythropoietin and iron therapy at these doses are not effective in decreasing the need for transfusion and induction of endogenous erythropoiesis.