[The effect of phenobarbital on the severity of intraventricular hemorrhage]. / Efecto del fenobarbital sobre la gravedad de la hemorragia intraventricular.

During an eight-months period, we studied every newborns under 34 gestation weeks who needed mechanical ventilation (MV) from the moment they were born and whom had an ultrasonogram without intraventricular hemorrhage in the first six hours after birth. Patient were separated in two groups: the first, a group of 30 patients received phenobarbital 20 mg/kg IV in the first 6 hours of life and then 2.5 mg/kg, I.V., every 12 hours for the next five days. Blood levels were measured 24 and 96 hours after the initial dose was given. The second group of 30 patients was not treated with phenobarbital. In both groups a brain ultrasonogram was made every 48 hours until 15 days of life. There were no difference in weight, gestational age, Apgar score, way of birth, initial diagnosis, incidence of pneumothorax, mortality and days with MV between the two groups. During the first three days were measured blood glucose, blood pressure, mean airway pressure, PCO2, PO2 and found no significant difference between both groups. The blood pH showed statistically significant difference, with better values at 48-72 hours in the group treated with phenobarbital. The global incidence of intraventricular hemorrhage was 16 (53%) in the group treated and 14 (46%) in the not treated, this difference was not statistically significant. The degree of hemorrhage, found was: I and II degree, eleven (69%) in the treated group and four (28%), in the control group; III and IV degree five (31%), in the treated group and ten (71%), in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

[Nosocomial infection in newborn infants on mechanical ventilation]. / Infección nosocomial en recién nacidos con ventilación mecánica.

During a two-year period (1988-1989), were studied newborns treated with intermittent mandatory ventilation (IMV). The goal was to know incidence of infections in these patients and characteristics of these process. Of 187, 40 (21.3%) were infected. For these neonates the mean gestational age was 33 +/- 3 weeks and average for birth weight was 1755 +/- 644 g. In 32 the infecting agent was isolated, being the most common coagulase negative Staphylococcus, it was found in 18 (45%), Klebsiella sp in 7 (17%), Escherichia coli in 1 and Candida albicans in 1. In the remaining 8 (20%) with negative cultures, postmortem confirmation was made in 5 and in 3 by clinical, radiologic or hematologic evidence. Of the 17 positive blood cultures and 3 spinal fluid culture, the same bacteria grew as in the bronchial aspirate. Were found, thrombocytopenia in 22 (55%) and leucocytosis in 19 (47%) as the most common blood changes. Pneumonia was the most common form of infection; it was found in 30 (75%); 22 of 40 died (55%). We concluded that 21.3% of neonates under IMV without infections, may get infected later in the hospital. S. epidermidis is the etiologic agent that predominates through the whole year, except during epidemics caused by others agents.