Comparison of Three Different Administration Positions for Intratracheal Beractant in Preterm Newborns with Respiratory Distress Syndrome.

BACKGROUND: The aim of this study was to compare the efficacy and adverse effects of various intratracheal beractant administration positions in preterm newborns with respiratory distress syndrome. METHODS: This study was performed on preterm newborns with respiratory distress syndrome. The inclusion criteria were being between 26 weeks and 32 weeks of gestational age, having a birth weight between 600 g and 1500 g, having received clinical and radiological confirmation for the diagnosis of respiratory distress syndrome (RDS) within 3 hours of life, having been born in one of the centers where the study was carried out, and having fractions of inspired oxygen (FiO2) ≥ 0.40 to maintain oxygen saturation by pulse oximeter at 88-96%. Beractant was administered in four positions to Group I newborns, in two positions to Group II, and in neutral position to Group III. RESULTS: Groups I and II consisted of 42 preterm infants in each whereas Group III included 41 preterm infants. No significant differences were detected among the groups with regards to maternal and neonatal risk factors. Groups were also similar in terms of the following complications: patent ductus arteriosus (PDA), pneumothorax, intraventricular hemorrhage (IVH), chronic lung disease (CLD), retinopathy of prematurity (ROP), necrotising enterocolitis (NEC), death within the first 3 days of life, death within the first 28 days of life, and rehospitalization within 1 month after discharge. Neither any statistically significant differences among the parameters related with surfactant administration, nor any significant statistical differences among the FiO2 levels and the saturation levels before and after the first surfactant administration among the groups were determined. CONCLUSION: In terms of efficacy and side effects, no important difference was observed between the recommended four position beractant application, the two position administration, and the neutral position.

Reference ranges of liver and spleen dimensions in term infants: sonographic measurements.

PURPOSE: To determine reference values of ultrasonographic measurements of the liver and spleen in newborns and to provide a reference chart to use easily in daily practice. METHODS: In this prospective study, spleen and liver dimensions were evaluated in 384 healthy newborns with a gestation age ≥37 weeks in an obstetrics clinic and neonatal intensive care unit with sonography within the first week of life. Relationships of all dimensions with sex, gestational age, height, and weight were statistically analyzed. RESULTS: No statistically significant differences were found between the two sexes in any dimensions of the liver and spleen (p > 0.05). Longitudinal and anteroposterior dimensions of the liver and spleen showed no correlation with the gestational age. All dimensions of the liver and spleen showed a high correlation with the height and weight. Weight was the best correlated with all dimensions. CONCLUSION: The reference values of spleen and liver lengths and diagrams from this study may be useful in the sonographic evaluation of the spleen and liver in newborns.

Reference ranges of kidney dimensions in term newborns: sonographic measurements.

BACKGROUND: Ultrasonographic measurement of kidney dimensions is important in evaluation of renal disease during the neonatal period, when renal abnormalities are common and renal size rapidly changes with age. OBJECTIVE: To determine the reference ranges of kidney dimensions in newborns and to provide a reference chart for daily practice. MATERIALS AND METHODS: In this prospective study, kidney dimensions were evaluated in 385 healthy newborns with a gestational age ≥37 weeks. Each neonate seen at an obstetrics clinic and neonatal intensive care unit was examined with sonography within the first week of life. Relationships of all dimensions with gender, gestational age, height and weight were statistically analyzed. RESULTS: All dimensions of the kidneys were smaller in girls than in boys (P < 0.05). The dimensions of the left kidney were larger than those in the right kidney in both genders (P < 0.01). Longitudinal and anteroposterior dimensions of the right and left kidneys showed no correlation with the gestational age in either gender. The dimensions correlated with the height in boys (P < 0.01), while no correlation was seen between the dimensions and height in girls (P < 0.05). Weight had the best correlation with all dimensions in both genders. CONCLUSION: The reference values of kidney lengths and diagrams from this study may be useful in the sonographic evaluation of kidneys in newborns.