ABSTRACT
When a newborn infant presents with high intestinal atresia, the proximal segment of the bowel is usually grossly distended and atonic. The anastomosis of this segment to the smaller and unused distal segment will usually result in little or no propulsion of contents distally. Many techniques have been employed to correct this problem. A common surgical approach is immediate end-to-end anastomosis, followed by parenteral alimentation until return of normal function. This can take many weeks, and requires special attention to fluid loss and complications associated with parenteral alimentation. In this paper we report two infants in whom we utilized a new technique to circumvent these problems. The technique involves continuous drip ileostomy feedings through the distal ileostomy, while basic nutritional needs are being met parenterally. In addition, the secretions from the proximal stoma are collected and infused with the elemental feeding. The distal bowel, now being fully utilized, is stimulated to accommodate, and when the two ends are joined at a second operation, nearly normal anatomical bowel is present.
Subject(s)
Enteral Nutrition , Ileostomy , Malabsorption Syndromes/therapy , Short Bowel Syndrome/therapy , Combined Modality Therapy , Female , Humans , Infant, Newborn , Parenteral Nutrition, TotalABSTRACT
Fifty-six premature infants with a mean gestational age at birth of 30 weeks were randomly assigned to a transfusion group, for whom the hemoglobin level was kept above 10.0 g/dL, and a nontransfusion group, who were transfused only for specific clinical indications. The groups were followed up longitudinally with weekly determinations of reticulocyte count, the partial pressure of oxygen at which 50% of hemoglobin is saturated, and hemoglobin F percentage, as well as weight gain, length of stay, hospital cost, and frequency and severity of apnea. At birth, there was no significant difference in birth weight, gestational age, and hemoglobin level between the two groups. At discharge, laboratory differences were noted between the two groups, but there was no clinical difference. We found no clinical advantage to the use of "booster" RBC transfusions in growing premature infants.
Subject(s)
Blood Transfusion , Erythrocyte Transfusion , Infant, Premature , Age Factors , Birth Weight , Body Weight , Erythrocyte Count , Fetal Hemoglobin/analysis , Follow-Up Studies , Gestational Age , Hospitalization/economics , Humans , Infant, Newborn , Intensive Care Units, Neonatal , Length of Stay , Random Allocation , ReticulocytesSubject(s)
Fetal Diseases/diagnosis , Neoplasms/congenital , Prenatal Diagnosis/methods , Adult , Edema/etiology , Female , Humans , Neoplasms/diagnosis , Polyhydramnios/etiology , PregnancyABSTRACT
An analysis of pharmacokinetic parameters of digoxin was carried out in six premature infants after the administration of a single total digitalizing dose of 20 microgram/kg. The data was analyzed using both a 2 and 3 exponential model. In the premature infant, the plasma half-life of digoxin is prolonged, while the volume of the central compartment, total body clearance, volume of distribution and volume of distribution at steady state are reduced compared to other aged patients.
Subject(s)
Digoxin/metabolism , Infant, Premature , Digoxin/blood , Half-Life , Heart Failure/congenital , Heart Failure/drug therapy , Humans , Infant, Newborn , Injections, Intravenous , KineticsSubject(s)
Infant, Newborn, Diseases/diagnosis , Thrombosis/diagnosis , Ultrasonography , Female , Gangrene/diagnosis , Gangrene/diagnostic imaging , Gangrene/surgery , Humans , Infant, Newborn , Infant, Newborn, Diseases/diagnostic imaging , Infant, Newborn, Diseases/surgery , Male , Radionuclide Imaging , Sodium Pertechnetate Tc 99m , Technetium , Thrombosis/diagnostic imaging , Thrombosis/surgerySubject(s)
Colon, Sigmoid/abnormalities , Intestinal Atresia/genetics , Adolescent , Child , Humans , Infant, Newborn , MaleABSTRACT
A relatively common complication in preterm infants is intracranial hemorrhage, which is often followed by increased intracranial pressure and hydrocephalus. Shunt procedures must often be delayed because CSF protein and RBCs are increased. Since vomiting often precludes gasric feeding of these infants, we attempted nasojejunal feedings while awaiting the optimal time for shunt insertion. Favorable results were obtained in three infants in whom nasojejunal feedings were utilized.
