[The therapeutic use of pulmonary surfactant in neonatal hyaline membrane disease]. / Uso terapéutico del surfactante pulmonar en la enfermedad de membrana hialina neonatal.

Preliminary report of our experience with the therapeutic use of pulmonary surfactant in newborn infants of less than 30 weeks gestation with hyaline membrane disease. The use of pulmonary surfactant was held under the "rescue" modality, with up to 36 hours of postnatal life. The blood gas changes are described and the assisted ventilation progress, as well as the general response on the clinical condition of each case. Discussion in centered in the risk of use and in the criteria for prescribing the therapeutic pulmonary surfactant. It is concluded that meeting the recommended requirements for its use, the pulmonary surfactant is a therapeutic alternative in the treatment of hyaline membrane disease in newborn infants of less than 33 weeks gestation, being different the immediate ventilatory response in terms of therapeutic control, with one or other forms of pulmonary exogenous surfactant, without differences in the final result.

[Effects of early multimodal stimulation on preterm newborn infants]. / Efectos de la estimulación multimodal temprana en neonatos pretérmino.

During the last trimester of pregnancy, newborns are deprived of both maternal biorhythms, tactile, kinesthetic and auditory stimulation which characterize the intrauterine environment. The purpose of this study is to determine if supplemental multimodal stimulation improves neurobehavioral performance, increases weight gain and shortens hospital stay. Nine neonates with the following characteristics were included in an early multimodal stimulation program: 1) gestational age less than or equal to 34 weeks, 2) feeding through orogastric tubing, 3) hemodynamically stable, with no signs of hemorrhaging, infections, or any suggestion of neurological damage, convulsions or congenital malformations. A control group with the same characteristics was also included in the study. Risk factors for each patient were evaluated and their evolution was closely watched while still in the hospital. Both the postural reflexes and neurobehavioral performance were assessed at the time the child left the hospital and a month afterwards. Statistically significant differences were found in the neurobehavioral performance and postural reflexes of those included in the study group.

[Clinical characterization of a sample of newborns at risk of presenting with an altered neurologic evaluation]. / Caracterización clínica de una muestra de recién nacidos en riesgo de presentar una evaluación neurológica alterada.

Being the Prachtl's Neurological Sieve a systematic condense analysis of neurologic screening which allows to establish a normal or suspicious neurologic condition at a sensibility of 0.85, and specificity of 0.77 with a predictive value of 0.78 (in our experience), we take it as an axis variable capable to discriminate among the population with and without risk of neurologic injury or sequela. Thirty-five newborn infants with an Apgar score at birth equal or below 6, were taken into study for the purpose of featuring the group of neonates on risk to show an altered neurologic evaluation. The study was held under the hypothesis that: low Apgar score, and morbidity and mortality risk index, need to be complemented with hospital outcome (Casaer) and the estimation of factors affecting physical and mental development (Eggermont), in order to be able to feature those neonates in risk for developing a neurologic injury or sequela. Findings showed that Prechtl's Neurological Sieve is directly influenced by the magnitude of recovery from the one to five minutes Apgar Score, by the Casaer's first or initial score and by the Eggermont's assessment items. It is also related in an indirect way to the birth weight, the gestational age, the morbidity and mortality risk index, the 1 and 5 minutes Apgar score and the final or discharge Casaer evaluation.