ABSTRACT
OBJECTIVE: The objective of the study was to compare thoracic fluid content (TFC) between newborn infants with and without respiratory distress. We tested the hypothesis that TFC would be higher in infants with respiratory distress. STUDY DESIGN: A total of 96 newborn infants, gestational age 37.9 (2.6) weeks, were enrolled at birth. TFC by electrical bioimpedance was recorded within 3 h after birth (TFC1) and at 24 h of life (TFC2). RESULTS: TFC1 was higher in infants with respiratory distress at birth (76.8 (24.9) versus 61.6 (16.1) 1 KOhm-1, P<0.0005). The association was independent from gestational age and mode of delivery. TFC2 was independently associated with respiratory distress at 24 h of life (adjusted coefficient b=0.5 (s.d. 0.02), P=0.02). CONCLUSION: TFC by electric bioimpedance independently correlated with the presence of respiratory distress at birth and at 24 h of life in late preterm and term newborn infants.
Subject(s)
Body Fluids/physiology , Electric Impedance/therapeutic use , Respiratory Distress Syndrome, Newborn/diagnosis , Respiratory Distress Syndrome, Newborn/therapy , Thoracic Cavity/physiopathology , Betamethasone/administration & dosage , Biomarkers/analysis , Body Composition , Cardiac Output/physiology , Case-Control Studies , Female , Gestational Age , Glucocorticoids/administration & dosage , Humans , Infant, Newborn , Infant, Premature , Male , Prospective Studies , Radiography , Respiratory Distress Syndrome, Newborn/complications , Thoracic Cavity/diagnostic imagingABSTRACT
Aspiration of uncontaminated amniotic fluid as a cause of neonatal respiratory distress is scarcely documented. A term neonate who presented with early onset respiratory distress with a radiographic appearance of an aspiration syndrome is therefore reported. Differential diagnosis and implication of this diagnosis in the management of neonatal respiratory distress are discussed. This case highlights amniotic fluid aspiration as a possible cause of severe respiratory distress even in the absence of meconium stained fluid.
Subject(s)
Amniotic Fluid , Respiratory Aspiration/complications , Respiratory Distress Syndrome, Newborn/etiology , Diagnosis, Differential , Humans , Infant, Newborn , Inhalation , Radiography , Respiratory Aspiration/diagnostic imagingSubject(s)
Arthritis, Juvenile/diagnosis , Collagen/metabolism , Fibroma/diagnosis , Finger Joint , Adolescent , Diagnosis, Differential , Humans , Male , Treatment OutcomeABSTRACT
AIM: The aim of this paper was to evaluate usefulness and safety of Meropenem in severe infections in neonatal intensive care unit (NICU) patients. New broad spectrum carbapenem class of -lactam antibiotics has been investigated for the treatment of a wide range of infections, including nosocomial infections with cephalosporin-resistant pathogens, an emergent problem in NICU, and meningitis. Meropenem represents the first cabapenem-class that has received Food and Drug Administration (FDA) approval for use in children 3 months of age and older. The pharmacokinetics of Meropenem has been well studied in preterm neonates. METHODS: We report the use of Meropenem in 26 neonates with median gestational age (GA) of 27 weeks (25-32) and median birth weight of 940 g (510-1900), with severe infections due to Gram-negative or Gram-positive organisms, from 2001 to 2004. The median postnatal age was 21 days (4-75). Meropenem was administrated intravenously in 30 min at dosage of 20 mg/kg every 12 h (every 8 h in Pseudomonas Aeruginosa infections). RESULTS: In all cases Meropenem has been used as second choice. No adverse effects (eosinophilia, trombocytosis or thrombocytopenia, increase in liver enzyme, increase in creatinine, diarrhea, vomiting and seizures) were observed. Clinical and bacterial response was ontaine in all cases but one. CONCLUSIONS: This report suggests that Meropenem may be a useful and safe antimicrobial agent in neonatal infections caused by resistant organisms and in meningitis. Further studies are needed to confirm these results.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Cross Infection/drug therapy , Thienamycins/therapeutic use , Cross Infection/microbiology , Humans , Infant, Newborn , Infant, Newborn, Diseases , Infant, Premature , Intensive Care Units, Neonatal , Liver Function Tests , Meropenem , Severity of Illness Index , Treatment OutcomeABSTRACT
AIM: The aim of this study was to evaluate retrospectively the incidence and etiology of connatal pneumonia and ventilator-associated pneumonia (VAP) in preterm newborns who had birth weight = or < 1250 g and required intubation for at least 12 h. METHODS: We have reported data about preterm newborns who had birth weight = or < 1250 g and required intubation for at least 12 h with diagnosis of connatal pneumonia and VAP, admitted to the neonatal intensive care unit from 1994 to 2004. We divided these 11 years into 4 periods. For each period we determined etiology associated with connatal pneumonia or VAP. RESULTS: A total of 417 patients were studied; 311 (74.6%) required mechanical ventilation (MV) for more than 48 h (the least for the diagnosis of VAP). Connatal pneumonia occurred in 35/417 patients (8.4%). VAP incidence did not change over time showing a slight increase in the last 2 years (from 27% to 33%). Mycoplasma and Chlamydia as causative organisms of connatal pneumonia dissapear during years. Gram-negative micro-organisms were isolated more frequently in last years in VAP episodes. CONCLUSIONS: The incidence of VAP does not decrease over time although length of MV was reduced. Additional studies are needed to improve criteria for the diagnosis and prevention of VAP in NICU patients.
