[Evaluation of treating neonates with surfactants for respiratory distress syndrome. I. Importance of gas exchange]. / Ocena leczenia surfaktantem noworodków z zespolem zaburzen oddychania. I. Wplyw na wymiane gazowa.

Twenty seven preterm babies enrolled in a European Multicentre Trial (Curosurf 4) were treated with surfactant Curosurf (Chiesi Farmaceutici, Italy). Mean gestational age was 30.7 weeks (range 26-36), and mean birthweight 1617 g (960-2790 g). Curosurf was given as a rescue therapy in babies with severe RDS between 2-72 hours after birth. Indications for treatment were: clinical and radiological diagnosis of RDS, need for mechanical ventilation and arterial to alveolar oxygen tension ratio < 0.22. Umbilical arterial catheterisation and written parental consent were obtained before trial entry. The results are given for all treated babies and have not been analysed according to the dose of Curosurf. In the first hour after treatment there were mean increases in PaO2 of 27.4 mm Hg (3.6 kPa), and oxygen saturation of 8.2%, a mean decrease in PaCO2 of 15.0 mm Hg (3.3 kPa) and mean increases a/A ratio of 0.1. It was possible to reduce mechanical ventilation one hour after Curosurf instillation: inspired oxygen concentration was decreased by a mean of 12.3%, peak inspiratory pressure by 4.3 cm H2O, and frequency by a mean of 5.6 per minute. It is concluded that there are immediate beneficial effects of Curosurf in preterm babies with severe RDS.

E1Intensive therapy and prevention of epilepsy in newborn infants. / Intensywna terapia i zapobieganie napadom u noworodków

On the basis of an analysis of the material from the Department of Neonatology, Institute of Gynaecology and Obstetrics, Medical Academy in Poznan the authors evaluated clinical seizures and their electroencephalographic correlates in the perinatal period. Attention is called to scant clinical symptoms despite frequent seizure activity in EEG. The authors describe the principles of comprehensive treatment in the first days of life.