ABSTRACT
Indomethacin was given by suppository to 18 neonates for the treatment of patent ductus arteriosus. The plasma levels of the drug were measured by high pressure liquid chromatography. Permanent closure of the ductus was achieved in 12 of 21 treatments and took up to 48 h. Successful treatment was strongly associated with a plasma indomethacin level greater than 0.5 micrograms/ml in the 8 h after a dose. Decreased urinary output was more likely at the same level, but was also found with substantially lower figures. It is suggested that indomethacin therapy for patent ductus should be rationalized by measurement of the plasma level.
Subject(s)
Ductus Arteriosus, Patent/drug therapy , Indomethacin/therapeutic use , Infant, Premature, Diseases/drug therapy , Humans , Indomethacin/blood , Infant, NewbornABSTRACT
This study is an evaluation of different methods of PO2 monitoring in newborn infants. These were an intravascular PO2 electrode (Searle Life Support Systems); transcutaneous monitoring (Kontron and Hewlett-Packard); and arterialized capillary blood samples. Values of each were compared with simultaneous aortic sample values and their correlation compared. The Searle electrode and TCM were found to be of equivalent accuracy overall, although the Searle was less reliable. Searle catheters were more difficult to insert than normal catheters, with a high wastage. Arterialized capillary PO2 values did not correlate with arterial. Transcutaneous monitoring is the most reliable and cheapest method.
Subject(s)
Infant, Newborn , Monitoring, Physiologic/methods , Oxygen/blood , Cost-Benefit Analysis , Electrodes , Humans , Respiratory Distress Syndrome, Newborn/bloodABSTRACT
A baby admitted to a special care baby unit with profuse watery diarrhoea was found to have a rotavirus infection. A total of 196 babies were admitted to the unit over the next year. Routine stool samples were taken weekly from all babies and additional samples were taken from all babies who developed clinical signs suggesting sepsis. A total of 76 babies excreted rotavirus; 32 of these developed a diarrhoeal illness, 12 of whom were severely ill with bloody diarrhoea and abdominal distension; and two had perforations. The smaller, sicker babies who stayed in hospital longer were more likely to acquire infection; colostrum did not confer protection against rotavirus or symptomatic infection. The outbreak of rotavirus declined independently of the measures taken to eradicate it. Our findings suggest that neonatal rotavirus infection may occasionally cause severe gastrointestinal problems.
