[Continuous arteriovenous hemofiltration in the newborn infant]. / Hemofiltración arterio-venosa continua en el recién nacido.

OBJECTIVE: We present 12 newborns with acute renal failure (ARF) of different etiologies that were treated with continuous arterio-venous hemofiltration (CAVH). PATIENTS AND METHODS: Gestational age and birth weight ranged from 26-42 weeks and 700-4, 700 grams, respectively. The umbilical artery and vein were most frequently used as vascular accesses. Two types of filters were used: Gambro FH 22 and Amicon Minifilter. RESULTS: Treatment lasted from 8 to 120 hours. We obtained an ultrafiltration median of 25 ml/h ranging from 10.75 mL/h to 82.8 mL/h (4.1-31.8 mL/k/h). The volume balance was negative in all patients. Treatment was well tolerated. Complications included hypotension when the system was started and hypoglycemia. CAVH was stopped because of normalization of renal function in 6 cases and death in the other 6. In the latter, cardiac malformation was the cause of death in 3 cases and multiple organ failure in the other 3. CONCLUSIONS: CAVH is useful is the treatment of ARF in the oligoanuric newborn.

[Granulocyte colony-stimulating factor in the newborn neutropenic patient]. / Factor estimulante de colonias granulocíticas en el recién nacido neutropénico.

OBJECTIVE: To assess the therapeutic effect of G-CSF in newborns with neutropenia. METHODS: Newborn with evidence of both peripheral neutropenia and decreased granulocytic precursors in tibial bone marrow aspirate were included in the study. G-CSF was perfused intravenously over 2 hours at dose of 10 micrograms/kg/day, during 4-8 days. CBC were obtained immediately before each dose of G-CSF. RESULTS: Neutropenia followed neonatal sepsis in four cases and maternal pre-eclampsia in three. Prior to treatment, peripheral blood granulocyte (PMNL) counts ranged from 420 to 1,073/mm3. Once G-CSF infusion was started, counts returned to normal within 24-48 hours. No adverse effects related to G-CSF administration were noticed. CONCLUSIONS: G-CSF induces a significant increase in peripheral PMNL counts in newborn with neutropenia, in the absence of significant toxic effects. Our date suggest a potential role for G-CSF in the prophylaxis and treatment of sepsis in the neutropenic newborn, although widespread recommendation must await further, controlled studies.

[Umbilical colonization in normal newborns. A comparative study of 4 methods for umbilical antisepsis]. / Colonización umbilical en recién nacidos normales. Estudio comparativo de cuatro métodos de antisepsia umbilical.

We report the results of a prospective study in which the effectiveness of 70% alcohol (A), mercurochrome (M), a solution of alcohol and mercurochrome (AM) and 1% chlorhexidine (C) as umbilical antiseptics was tested on 311 normal newborn infants. Similar results were obtained by using A, M, or AM; however, when C was used umbilical colonization was significantly reduced as compared to when the other three antiseptic agents were used. The umbilical cords that had been scrubbed with A, M or AM were detached by the 8th day after birth, whereas those treated with C took 14 days to fall off. The use of chlorhexidine resulted in a marked increase in pure cultures positive for Gram negative bacteria (Proteus spp. and Pseudomonas spp.) which was not the case with the other three antiseptics tested.

[Nutritional support of premature newborn infants with birthweight below 1.500 g]. / Aporte nutritivo en recién nacidos prematuros de peso inferior a 1.500 g.

16 preterm babies with birthweights between 738 and 1,390 g (mean: 1,105. SD: +/- 176.7) and with gestational ages between 27 and 31 weeks (mean: 29.5. SD: +/- 1.32), were fed according to a combined scheme: parenteral nutrition, for a period of 12 days, plus enteral feedings of chemically defined diet, given by nasogastric tube through a continuous infusion, until the 35th week of postconceptional age. All 16 babies had a satisfactory course, with no significant side-effects. Their weight gain was between 9 and 22 g/day (mean: 13.8. SD: +/- 4.2). No significant blood biochemical abnormalities were detected. Our results showed that this combined feeding scheme (enteral & parenteral) worked satisfactorily in this group of newborn premature babies.

[Epidemic outbreak of necrotizing enterocolitis coincident with an epidemic of neonatal rotavirus gastroenteritis]. / Brote epidémico de enterocolitis necrotizante, coincidiendo con una epidemia de gastroenteritis neonatal a rotavirus.

Authors present four cases of neonatal necrotizing enterocolitis occurred during an outbreak of acute enteritis. From november 1985 to beginning of february 1986, forty-seven out of 588 newborn infants were involved. In 22 affected infants (46.8%) rotavirus were isolated from stools, whereas no bacterial or viral agent was recovered in 25 (53.2%). Four cases (8.6%) developed necrotizing enterocolitis.