The risks of umbilical vessel catheterization in a neonatal intensive care unit.

Five hundred and fourteen high-risk neonates who had indwelling umbilical catheters at the neonatal intensive care unit of the University of Benin Teaching Hospital were studied. of these 514 neonates, 122 (23.8%) had their catheters in-situ for longer than 24 h. Of the 122, fifty-four (44%) had positive bacterial cultures from their catheter tips. Seven (5.7%) and four (3.2%) of the 122 neonates studied developed septicaemia and necrotizing enterocolitis respectively. Catheterization for periods in excess of 48 h significantly increased the risk of bacterial colonization. Malposition of umbilical catheter tips include: insertion into the right portal vein (thirty-six cases); superior mesenteric vein (three cases) and the left atrium (four cases). The complications related specifically to the malposition were: air collection in the hepatic venous system (two cases); cardiac arrest (one case); necrotising enterocolitis (one case) and a case of blanching of the abdominal wall. Because of these complications, the indications for catheterization should be restricted to carefully selected patients and strict aseptic technique be adhered to during the procedure.

Heat loss in Nigerian newborn infants in the delivery room.

Fifty-three vigorous infants were randomly assigned to six different groups (A-F). The babies in groups A and F were not dried and were either exposed wet to room air or warmed under the radiant heater. The other groups of infants were quickly dried and exposed to room air (group B), wrapped with one sterile sheet (group C), wrapped with two towels (group D) or placed under the radiant heater (group E). The infants exposed to room air lost twice the amount of heat when compared with those insulated with two towels. The amount of heat loss by evaporation could not be demonstrated. The role of high relative humidity as an important determinant of the degree of heat loss by evaporation is stressed.