[Cerebral oxygenation and near-infrared rays spectrophotometry]. / Ossigenazione cerebrale e spettrofotometria a raggi vicino all'infrarosso.

Near infrared spectroscopy (NIRS) is a new technique which allows non invasive bedside monitoring of cerebral oxygenation and hemodynamics by measuring relative changes in cerebral oxy- and deoxyhaemoglobin and cytochrome aa3. We have applied this technique to evaluate the possible effects on cerebral oxygenation and hemodynamics of clinical procedures usually performed on preterm infants:--endotracheal suctioning, and we have demonstrated that the magnitude and the duration of the negative effects of open system are significantly reduced using closed endotracheal suctioning system;--withdrawal and infusion through umbilical vein and artery cause significant changes in cerebral hemodynamics: these effects are significantly reduced after administration of ibuprofen;--treatment of patent ductus arteriosus with ibuprofen does not significantly reduce cerebral perfusion and oxygen availability compared to indomethacin and ibuprofen administration also does not affect cerebral vasoreactivity to arterial carbon dioxide tension;--administration of different types and doses of natural surfactant causes different changes in cerebral hemodynamics and these effects seem to be dose-related. Therefore NIRS is an useful device to investigate cerebral oxygenation state of preterm infants and new possibilities could derive from the introduction of a new NIRS method which allows to measure the tissue oxygenation index.

A case of hemolytic disease of the newborn due to anti-Kpa.

A patient with hemolytic disease of the newborn (HDN) due to maternal anti-Kpa alloimmunization is described. Although there are few reports in the literature, it appears that HDN due to anti-Kpa is often mild and transfusion therapy is rarely required. However, in this case, the baby's hemoglobin progressively decreased and on day 18 a blood transfusion was administered, but jaundice was not severe enough for exchange transfusion.

Ultrasonic evaluation of kidney volume in term and preterm infants.

Kidney volume in relation to gestational age, birthweight, and height was determined in 121 infants, 58 females and 63 males, with gestational ages from 23 to 43 weeks (mean, 33.3) and birthweight from 430 to 4600 gm (mean, 1982 gm). The kidney volume was measured using a real-time linear computed ultrasound scanner, with a 5 MHz transducer. The renal volume was calculated from outer kidney diameters using the volume formula for an ellipsoid. In the infants studied, mean volume of the right kidney was 6.0 ml (range, 1.4 to 13.8 ml), and of the left kidney 6.6 ml (range 1.5, to 15.6 ml), with no significant difference. A highly significant correlation was found between the volume of both kidneys and either gestational age, or birthweight, or height, with r values ranging from 0.81 to 0.92. The best correlation was observed with birthweight. No significant difference was found between males and females.

Ultrasonic evaluation of kidney length in term and preterm infants.

Kidney length was evaluated by ultrasound in 132 healthy neonates with gestational ages from 27 to 42 weeks and birth weights from 790 to 4200 g. A highly significant correlation was found between the length of the kidneys and gestational age or birth weight.