RESUMO
Urinary ascites in a newborn infant is unusual and most commonly indicates a disruption to the integrity of the urinary tract. The following report describes a case of urinary ascites, probably due to bladder rupture caused by umbilical artery catheterization, associated with hyponatremia, hyperkalemia and elevated serum creatinine. This unusual biochemical profile is characteristic of urinary 'autodialysis' and was corrected by bladder drainage.
Assuntos
Anuria/etiologia , Ascite/etiologia , Bexiga Urinária/lesões , Cateterismo Urinário/efeitos adversos , Ascite/diagnóstico , Ascite/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Recém-Nascido , Paracentese , Ultrassonografia , Artérias Umbilicais/lesõesRESUMO
AIM: To assess the efficacy of cisapride in reducing the time required to establish enteral feeds in preterm infants. METHODS: A randomised, double blind, placebo controlled trial was conducted of 34 infants of < or = 32 weeks of gestation, assigned to receive either cisapride 0.2 mg/kg/dose four times daily (n = 18) or placebo (n = 16). RESULTS: The time taken by the babies to tolerate full enteral feeds was not significantly different between the groups (median 9.5 days vs 10 days). There was a significantly lower incidence of large gastric residuals and regurgitation in the treated group compared with the placebo group. The number of episodes of large gastric residuals per infant was also significantly less. No adverse effects were noted. CONCLUSION: The routine use of cisapride in preterm infants cannot be recommended to decrease the time to establish enteral feeds. Its use may be justified for clinically significant gastric stasis or regurgitation.
Assuntos
Cisaprida/uso terapêutico , Nutrição Enteral , Recém-Nascido Prematuro , Simpatomiméticos/uso terapêutico , Método Duplo-Cego , Feminino , Motilidade Gastrointestinal/efeitos dos fármacos , Humanos , Recém-Nascido , MasculinoRESUMO
Six very low birthweight neonates with terminal respiratory failure due to severe hyaline membrane disease who failed to respond to conventional ventilation were offered a trial of high frequency jet ventilation using the volumetric diffusive respirator (VDR). All neonates showed improvement in pulmonary function. Two neonates were weaned successfully from high frequency ventilation. The results of this initial trial suggest that the volumetric diffusive respirator is a safe and effective method of ventilation in neonates with respiratory failure and that the survival rate in such neonates might be enhanced if treatment is introduced earlier in the disease.
