[Prospective study of infective complications in newborns with fine silicone catheters used for parenteral nutrition infusion]. / Estudio prospectivo de las complicaciones infecciosas en recién nacidos con catéteres de silicona finos utilizados para infusión de nutrición parenteral.

OBJECTIVE: Percutaneous silastic central venous catheters have contributed to improve the care of neonates. They are quite safe; however, sometimes complications occur, with infections being the most frequent. A prospective study was undertaken in our NICU to know the rate of catheter-related sepsis, the influence of the duration of catheterization, the predominant portal of entry and the microorganisms isolated. PATIENTS AND METHODS: Fifty-two catheters were analyzed. Cultures were obtained once a week by aspiration from the catheter hub, the luer-lock connection and parenteral nutrition solution directly from the bag. If sepsis was suspected, blood cultures were obtained from a different vein. The tip was cultured after catheter withdrawal by the semiquantitative technique of Maki. RESULTS: Nineteen catheters (36.5%), 19 luer-lock connections (21.3%) and 7 parenteral nutrition solutions were colonized. We found a significant increase of the rate of colonization after the catheter had been in place 3 weeks or more (p < 0.05). Coagulase negative Staphylococcus was isolated in 75.7% of the samples. The rate of catheter related sepsis was 15.4% (7/8 caused by coagulase negative Staphylococcus). CONCLUSIONS: Catheter related sepsis may be more frequent than expected it colonization of the catheter were analyzed systematically. Screening catheter colonization allows an earlier diagnosis of pathogens if sepsis develops. Finally, we believe that the use of sterile techniques to handle the catheter and connections will further decrease catheter related infections.

[Coefficient of variation of heart rate in the newborn during the first 2 hours of life. Differences according to type of delivery]. / Estudio del coeficiente de variación de la frecuencia cardiaca en el recién nacido durante las dos primeras horas de vida. Diferencias según el tipo de parto.

A prospective study of continual heart rate monitoring is made in 57 normal newborn infants in the first two hours after birth. They were all divided into three groups according to their type of delivery. We have estimated the coefficient of variation, whose value quantifies the heart rate variability, obtained by continual monitoring. It was significantly lower (p less than 0.05) in newborns whose mothers had received anaesthesia during labour than in infants born by non-induced vaginal delivery. These results support the sensitivity of this method in order to assess neonatal cardiac readaptation.

[Oral clonidine test for growth hormone release (author's transl)]. / "Test" con clonidina oral como estímulo de la hormona del crecimiento.

Serum growth hormone (GH) was determined in 15 children (three with normal height, one with pituitary dwarfism, and eleven with short stature without endocrinological disturb) after oral clonidine load of 0,15 mg/m2 S.A. Significant GH increase was observed, as other authors have reported. Authors findings confirm that clonidine is a potent stimulus for growth hormone release, without relevant side effects. In two children with short stature without endocrinological disturb, there was a partial failure to increase GH in response to clonidine. Authors conclude that confirmation of GH deficiency in the case of failure to respond to oral clonidine test requires one other stimulation test.