Complications associated to percutaneous catheter in preterm and term born children / Complicaciones asociadas al catéter percutáneo en recién nacidos pretérmino y a término

Objective: Identify percutaneous catheter-related complications in preterm and term newborns. Methods: Comparative cross-section. Were included newborns whit percutaneous catheter insertion, blood culture results and distal catheter segment. Were formed two groups: Preterm and term. Results: Were analyzed the data of preterm (n = 50) and term (n = 50) newborn, the gestational age was 30 ± 3 and 40 ± 2 (p = 0.01). The frecuency in preterm and term newborn was respectively, sepsis catheter 36 and 18% (p = 0.02; OR: 2.56; 95% CI: 1.02-7.17), infected catheter 50 and 22% (p = 0.01; OR: 5.92; 95% CI: 1.66-23.12), colonized catheter of 24 and 14% (p = 0.01; OR: 3.58; 95% CI: 1.32-9.90), local infection 14 and 8% (p = 0.03; OR: 1.87; 95% CI: 1.45-8.29), infiltration 18 and 4% (p = 0.02; OR: 5.27; 95% CI: 1.17-59), accidental removal 6 and 22% (p = 0.02; OR: 0.23; 95% CI: 0.05-0.87) and catheter rupture 10 and 28% (p = 0.02; OR: 0.29; 95% CI: 0.08-0.98). Conclusions: We found a higher association of infections and infiltrations by percutaneous catheter in preterm and term prevailed in accidental removal and catheter rupture.

Objetivo: Identificar las complicaciones asociadas al catéter percutáneo en recién nacidos pretérmino y a término. Método: Estudio transversal comparativo. Se incluyeron recién nacidos que tenían insertado un catéter percutáneo, con resultados de cultivo de sangre y segmento distal del catéter. Se formaron dos grupos: pretérmino y a término. Se calcularon la razón de momios (RM) y el intervalo de confianza del 95% (IC 95%). Resultados: Se analizaron datos de 50 recién nacidos por grupo. En los pretérmino y a término se encontró un valor de la media de edad gestacional de 30 ± 3 y 40 ± 2, respectivamente (p = 0.01), y unos porcentajes de sepsis por catéter del 36 y el 18% (p = 0.02; RM: 2.56; IC 95%: 1.02-7.17), de catéter infectado del 50 y el 22% (p = 0.01; RM: 5.92; IC 95%: 1.66-23.12), de catéter colonizado del 24 y el 14% (p = 0.01; RM: 3.58; IC 95%: 1.32-9.90), de infección local del 14 y el 8% (p = 0.03; RM: 1.87; IC 95%: 1.45-8.29), de infiltración del 18 y el 4% (p = 0.02; RM: 5.27; IC 95%: 1.17-59), de retiro accidental del 6 y el 22% (p = 0.02; RM: 0.23; IC 95%: 0.05-0.87) y de rotura del catéter del 10 y el 28% (p = 0.02; RM: 0.29; IC 95%: 0.08-0.98). Conclusiones: Se encontró mayor asociación de infecciones e infiltraciones por catéter percutáneo en los pretérmino, y de retiro accidental y rotura del catéter en los nacidos a término.

[Clinical risk index for babies II (CRIB II) and weight to predict mortality in preterm infants less than 32 weeks treated with surfactant]. / Índice de riesgo clínico para bebés II (CRIB II) y peso para predecir mortalidad en recién nacidos pretérmino menores de 32 semanas tratados con surfactante.

OBJECTIVE: To determine the usefulness of the Clinical Risk Index for Babies II (CRIB II) and weight to predict mortality in preterm infants < 32 weeks treated with exogenous surfactant. MATERIAL AND METHODS: Design: cohort for diagnostic test. Preterm babies < 32 weeks who received exogenous surfactant in a third level of care were included. The cutoff for CRIB II was evaluated and considered as score > 10 and weight < 750 grams; monitoring was performed until discharge or death. RESULTS: RNP data analyzed 105 babies; 55/105 (52%) were female, the mean value ± 1.4 weight 2 grams and 29 + 2 weeks gestational age. Mortality was found in 16/105, of which 15/16 had a score > 10 on the CRIB II index. Survival was found in 89/105 and index > 10 points in 2/89. Based on these results we found: sensitivity 93%, specificity 98%, positive predictive value 88 "/o, negative predictive value 98"/o . With weight < 750 grams, mortality occurred in 10/16 and survival in 17189; sensitivity 62 "/o, specificity 81 "/o, positive predictive value 37%, and negative predictive value 92%. CONCLUSIONS: The CRIB II index is more useful than weight for predicting mortality in preterm infants less than 32 weeks treated with surfactant.

[Assessment of prenatal, perinatal, and postnatal factors for intraventricular hemorrage in premature newborns less than 33 weeks of gestational age]. / Evaluación de factores prenatales, perinatales y posnatales para hemorragia intraventricular en prematuros menores de 33 semanas de edad gestacional.

OBJECTIVE: Evaluation of risk factors for intraventricular hemorrhage in preterm less than 33 weeks gestational age (RNP). METHODS: CASE-control study. We included RNP from a tertiary care center classified by the results of transfontanellar sonography. CASE: presence of intraventricular hemorrhage. CONTROL: absence of intraventricular hemorrhage. We investigated prenatal history perinatal and postnatal. Logistic regression was used to adjust the variables associated with intraventricular hemorrhage; we calculated odds ratios (OR) with confidence intervals of 95% (95% CI). RESULTS: We analyzed the medical records of RNP 64; of these 32 were cases. The risk factors associated with intraventricular hemorrhage were: sepsis (OR: 18.45; 95% CI: 4.01-32.82; p = 0.01), respiratory distress syndrome (OR: 2.24; 95% CI: 1.07-4.95; p = 0.04), use with mechanical ventilation (OR: 3.60; 95% CI: 1.46-8.91; p = 0.01), and exogenous surfactant (OR: 2.32; 95% CI: 1.05-6.14; p = 0.03). CONCLUSIONS: The postnatal factors were associated with higher risk for intraventricular hemorrhage in RNR The transfontanellar sonography should be taken at different times to know with precision the risk factors for this pathology and try to avoid them.