Iloprost instillation in two neonates with pulmonary hypertension

Pulmonary hypertension may coexist with certain diseases in neonates. Iloprost inhalation is one of the treatments which cause selective pulmonary vasodilatation. Inhalation is not an easy way of drug administration in mechanically ventilated infants; as some exhibit desaturations during inhalation. Moreover, inhalation of drug requires cessation of mechanical ventilation, if patient is on high frequency oscillatory ventilation. We presented two patients with pulmonary hypertension; term baby with congenital diaphragmatic hernia and preterm baby with respiratory distress syndrome; who had iloprost instillation during mechanical ventilation treatment. Iloprost instillation was well tolerated with no side effects in the term patient with diaphragmatic hernia; whereas severe blood pressure fluctuations were observed in the preterm infant. This report may courage administration of iloprost in term neonates with resistant pulmonary hypertension

Ileo-Ileal intussusception in a premature neonate: an unusual cause of NEC in premature babies

Intussusception is a rare entity in neonates. It may present with non-specific signs including abdominal distension, feeding intolerance, vomiting and bloody stools. Symptomatology is similar to Necrotizing Entero-Colitis [NEC]. Ultrasound can help to establish early diagnosis in neonate. A 27-week preterm newborn was initially suspected as NEC based on abdominal distention, bilious vomiting, worsening clinical condition and dilated loops of bowel on X-ray, which turned out to be ileo-ileal intussusception. Diagnosis was made by ultrasound obtained for a palpable mass to rule out intra abdominal abscess and lack of improvement in clinical condition despite 5 days of conservative treatment. Surgery was performed consisting of removal of the necrotic intussusception area and end-to-end anastomosis and patient was discharged from hospital on day 60 of life. As a conclusion, pathological abdominal findings in preterm newborns can also be due to conditions other than NEC and ultrasound may be a useful tool for timely and accurate diagnosis

effects of surfactant on oxygenation in term infants with respiratory failure

The objective of the study was to evaluate the effects of exogenous surfactant on respiratory indices in term infants with respiratory failure. Consecutive 18 mechanically ventilated term infants, who received a single dose of exogenous surfactant were retrospectively included into the study. The respiratory outcome of surfactant rescue therapy was evaluated by comparing respiratory indices before and six hours after surfactant administration. Median oxygenation index [OI], mean alveolar pressure [MAP] and fraction of inspired oxygen [FiO[2]] values were significantly decreased [P<0.001]; median arterial oxygen partial pressure [PaO[2]], arterial oxygen saturation [SaO[2]] and PaO[2]/FiO[2] values were significantly increased six hours after surfactant treatment [P<0.001]. Rescue therapy with surfactant was found to be effective in the improvement of early respiratory indices in term infants with respiratory failure

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.