ABSTRACT
The effects of 0.1 mg, 0.25 mg, 0.50 mg, and 1.0 mg of nebulized furosemide per kilogram of body weight on pulmonary functions were studied in eight preterm infants with bronchopulmonary dysplasia who were supported by mechanical ventilation. Doses of 1 mg/kg significantly improved lung compliance (51% at 2 hours after nebulization), pulmonary resistance (28% at 1 hour), and tidal volume (43% at 1 hour), starting as early as 30 minutes after the dose; the effect lasted for at least 4 hours in many of the infants and was not associated with diuresis or renal side effects.
Subject(s)
Bronchopulmonary Dysplasia/drug therapy , Furosemide/therapeutic use , Infant, Premature, Diseases/drug therapy , Respiration, Artificial , Airway Resistance/drug effects , Body Weight , Bronchopulmonary Dysplasia/physiopathology , Bronchopulmonary Dysplasia/urine , Dose-Response Relationship, Drug , Female , Furosemide/pharmacology , Humans , Infant , Infant, Newborn , Infant, Premature, Diseases/physiopathology , Infant, Premature, Diseases/urine , Lung Compliance/drug effects , Male , Nebulizers and Vaporizers , Respiratory Function Tests , Tidal Volume/drug effects , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVE: To determine the prevalence of measles seronegativity among infants younger than 6 months and to ascertain their serologic response to measles vaccine. DESIGN: Cross-sectional measles antibody survey during the 1989 measles epidemic in Chicago, Ill. SETTING: Inner-city perinatal center. PARTICIPANTS: Two hundred three infants younger than 6 months who had been admitted to the neonatal intensive care unit at birth; 130 (64%) of these infants were premature. Transplacental antibody transfer was evaluated in a subset of 89 mother-newborn pairs. INTERVENTION: Administration of measles monovalent vaccine to seronegative infants. MEASUREMENTS/RESULTS: Measles IgG antibody was measured using indirect fluorescent assay. At birth, 19 (38%) of 50 neonates born at less than 37 weeks' gestation had antibody titers that were twofold to fourfold lower than those of their mothers compared with three (8%) of 39 neonates born at more than 37 weeks' gestation (P < .01). Of the 203 study infants, fewer than 4% were seronegative at birth, while 74% of these infants aged 4 to 5 months were seronegative. Univariate logistic regression analysis indicated that the independent variables related to seronegativity were as follows: gestational age at birth (P = .007), chronological age (P < .001), history of having received three or more packed red blood cell transfusions (P < .001), and maternal age at delivery (P = .001). Multiple logistic regression analysis confirmed the association of seronegativity with chronological age (P < .001), gestational age (P < .02) and maternal age at delivery (P < .001). Seroconversion following administration of the measles vaccine was documented in 11 (79%) of 14 infants. CONCLUSION: A significant proportion of 4- to 5-month-old infants who had been admitted to the neonatal intensive care unit at birth lack measurable measles antibody; this population should be taken into account when strategies to control measles are considered.
