Weekly Updates #14

Jiang ZD, Ping LL, Chen C, Wilkinson AR: Brainstem auditory response findings in preterm infants after necrotizing enterocolitis. Acta Paediatrica 2012, 101(12):e531-e534. Auditory brainstem response latencies were longer in preterm infants who had had NEC (when they reached term) compared to term infants. This may be a sign of brainstem dysfunction in this group of infants.

Ivars K, Nelson N, Finnström O, Mörelius E: Nasopharyngeal suctioning does not produce a salivary cortisol reaction in preterm infants. Acta Paediatrica 2012, 101(12):1206-1210. Salivary cortisol did not increase with nasopharyngeal suctioning, whether or not you gave glucose before the intervention, also pain scores did not increase.

van der Laan ME, Verhagen EA, Bos AF, Berger RM, Kooi EM: Effect of balloon atrial septostomy on cerebral oxygenation in neonates with transposition of the great arteries. Pediatr Res 2012. Cerebral oxygen saturations were very low prior to the Rashkind procedure in newborns with transposition. This is not too surprising as systemic oxygenation is poor also. The systemic saturations increased from 72% to 85% within 2 hours, cerebral saturations increased from 42 to 48% in that period, and then continued to increase to 64% 24 hours afterward.

Whitelaw A: Periventricular hemorrhage: A problem still today. Early Human Development 2012, 88(12):965-969. Good review of the state of the art.

Brown SD, Donelan K, Martins Y, Burmeister K, Buchmiller TL, Sayeed SA, Mitchell C, Ecker JL: Differing attitudes toward fetal care by pediatric and maternal-fetal medicine specialists. Pediatrics 2012. This questionnaire study compared the attitudes of obstetric maternal fetal medicine specialists and pediatricians who are involved in fetal counseling. They asked whether and when pregnant women should be seen by pediatricians when the fetus was affected by (1) maternal alcohol abuse, (2) maternal cocaine abuse, (3) maternal use of seizure medications, and (4) maternal diabetes. We asked whether such counseling should occur (1) before a decision about continuing or terminating the pregnancy, (2) only if the decision has been made to continue the pregnancy, (3) only after delivery, or (4) never. MFMs and the pediatricians had very different opinions, 40 to 50% of the MFMs didn’t think that a pediatric consultation was ever necessary for each of these indications, and when they did think they were necessary, it was mostly after the woman had decided to continue the pregnancy. Pediatricians in contrast thought that most women should be seen by a pediatrician before they make any decision. The also asked the respondents about the appropriateness of seeking court intervention to compel adherence when a pregnant woman has decided to continue a pregnancy but refused to comply with recommendations regarding the following: (1) a program to discontinue cocaine use at 25 weeks; (2) azidothymidine (AZT) therapy to prevent perinatal transmission of HIV at term; and (3) percutaneous transfusion for fetal anemia secondary to Rh isoimmunization at 25 weeks. Pediatricians were far more likely to want court orders than the MFMs.

About Keith Barrington

I am a neonatologist and clinical researcher at Sainte Justine University Health Center in Montréal
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