The Effect of Midazolam on Oxidative Stress and Apoptosis in Preterm Infants.

OBJECTIVE: Our study aimed to investigate the effect of caffeine and midazolam on oxidative stress and neuronal apoptosis markers in preterm neonates. Methods: Sixty infants between 27-32 weeks of gestational ages were enrolled for this prospective study. Group 1 included patients (n = 23) receiving only early caffeine treatment; group 2 included patients (n = 22) receiving early caffeine treatment with midazolam. Serum levels of total antioxidant capacity (TAC), total oxidative status (TOS) and oxidative stress index (OSI) as oxidative stress markers and serum levels of caspase-3 as an apoptosis indicator were compared in both groups. Results: TAC levels were found significantly higher (p = 0.015) and caspase-3 levels were significantly lower (p = 0.008) in the serum samples of group 2 after treatment. Conclusion: Our study indicated that the treatment with midazolam and caffeine increased TAC and decreased apoptosis markers in preterm infants.

Acute Peritoneal Dialysis in Premature Infants.

OBJECTIVE: This study aimed to investigate the underlying causes and outcomes of less than 1500 g birth weight infants who underwent acute peritoneal dialysis (PD). METHODS: Case records of infants with birthweight less than 1500 g from January 2015 to June 2018 were reviewed. RESULTS: The median (range) birth weight and gestational age of the patients were 720 g (555-1055) and 26 weeks (23-27.5), respectively. Underlying factors for the development of acute kidney injury (AKI) were patent ductus arteriosus (PDA) (15 patients), necrotizing enterocolitis (NEC) (10 patients), sepsis (7 patients), asphyxia (2 patients) and hydrops fetalis (2 patients). Multifunctional 10 F flexible catheter was used for the procedure. Median PD onset time was 7 days (4.5-13.5) and median PD duration was 3 days (1.5-3.5). Overall mortality rate was 81 % (n=17). CONCLUSIONS: Despite high overall mortality, PD is technically feasible in very low birthweight (VLBW) and extremely low birthweight (ELBW) neonates using a multifunctional catheter.