Management of postoperative pulmonary hypertension by inhaled nitric oxide in a newborn with congenital diaphragmatic hernia

Postero-lateral congenital diaphragmatic hernia [CDH] is a life threatening anomaly characterized by diaphragmatic defect and intrathoracic herniation of abdominal viscera. In patients with CDH, the lungs are hypoplastic and persistent pulmonary hypertension develops in most cases. Although, inhaled nitric oxide [iNO] results in a reduction in pulmonary hypertension with improvement in oxygenation, its benefit in the patients with CDH remains controversial. In this report, the authors present successful management of postoperative pulmonary hypertension by iNO in a newborn with CDH

Blood eosinophil levels in newborns with severe indirect hyperbilirubinemia treated with phototherapy

Newborns who suffer from jaundice and/or receive phototherapy [PT] are at a higher risk of developing asthma. In this study we aimed to investigate the relationship between bilirubin and peripheral eosinophil counts in newborns with severe hyperbilirubinemia needing PT. In this study, a retrospective analysis was performed on 306 newborns with severe hyperbilirubinemia with gestational age >/=35 weeks [Group 1] and the control group consisted of 295 age and gender-matched newborns [Group 2]. Total serum bilirubin, hemoglobin, albumin, leucocyte and eosinophil counts before and after PT were recorded from medical charts. All the patients in Group 1 received phototherapy and 77 [25.2%] of them needed exchange transfusion [ET]. Before receiving PT, the patients in Group 1 had lower levels of Hb and higher levels of total serum bilirubin and lymphocytes than those in Group 2 although there was no statistically significant difference with regard to peripheral eosinophil counts. Eosinophils were detected to be numerically lower in Group 1. Higher bilirubin subgroups had also lower eosinophil counts. The patients in Group 1 had lower levels of Hb, leucocyte, albumin and higher levels of eosinophil following PT. Peripheral eosinophil count may be affected by bilirubin levels and/or phototherapy. There is a need for further clinical research based on different models

Erratum

The radiation dose unit for the scattered radiation in the following sentence, "The measured scattered radiation range at a 2 m distance from the NICU was 11-17 micro Gy per radiograph." passed in the abstract results section and main results section of the Korean J Radiol 2008;9:416-419 should be replaced as 11-17 nGy

Radiation Exposure to Premature Infants in a Neonatal Intensive Care Unit in Turkey

OBJECTIVE: The aim of this work was to determine the radiation dose received by infants from radiographic exposure and the contribution from scatter radiation due to radiographic exposure of other infants in the same room. MATERIALS AND METHODS: We retrospectively evaluated the entrance skin doses (ESDs) and effective doses of 23 infants with a gestational age as low as 28 weeks. ESDs were determined from tube output measurements (ESD(TO)) (n = 23) and from the use of thermoluminescent dosimetry (ESD(TLD)) (n = 16). Scattered radiation was evaluated using a 5 cm Perspex phantom. Effective doses were estimated from ESD(TO) by Monte Carlo computed software and radiation risks were estimated from the effective dose. ESD(TO) and ESD(TLD) were correlated using linear regression analysis. RESULTS: The mean ESD(TO) for the chest and abdomen were 67 micro Gy and 65 micro Gy per procedure, respectively. The mean ESD(TLD) per radiograph was 70 micro Gy. The measured scattered radiation range at a 2 m distance from the neonatal intensive care unit (NICU) was (11-17 micro Gy[corrected to 11-17 nGy]) per radiograph. Mean effective doses were 16 and 27 micro Sv per procedure for the chest and abdomen, respectively. ESD(TLD) was well correlated with ESD(TO) obtained from the total chest and abdomen radiographs for each infant (R2 = 0.86). The radiation risks for childhood cancer estimated from the effective dose were 0.4 x 10(-6) to 2 x 10(-6) and 0.6 x 10(-6) to 2.9 x 10(-6) for chest and abdomen radiographs, respectively. CONCLUSION: The results of our study show that neonates received acceptable doses from common radiological examinations. Although the contribution of scatter radiation to the neonatal dose is low, considering the sensitivity of the neonates to radiation, further protective action was performed by increasing the distance of the infants from each other.