Neonatal Updates

Hyland R, Komlósi K, Alleman B, Tolnai M, Wood L, Bell E, Ertl T: Infantile hemangiomas and retinopathy of prematurity: Clues to the regulation of vasculogenesis. Eur J Pediatr 2013, 172(6):803-809. This observational study in 3 different NICUs shows that if a preterm infant has a hemangioma, their risk of retinopathy is much higher. I’m not sure what this means, but maybe it shows differing regulation of vascular development in those babies (which I guess is exactly what the 2nd part of the title says!)

Hayakawa M, Ito M, Hattori T, Kanamori Y, Okuyama H, Inamura N, Takahashi S, Nagata K, Taguchi T, Usui N et al: Effect of hospital volume on the mortality of congenital diaphragmatic hernia in japan. Pediatrics International 2013, 55(2):190-196. Hospitals with higher volumes of diaphragmatic hernia cases have lower mortality. Regionalisation!

Vinall J, Grunau RE: Impact of repeated procedural pain-related stress in infants born very preterm. Pediatric Res 2014. Fairly brief review article about the long term effects of pain in preterm infants. Well worth the read, it hits the high points.

Bates ML, Farrell ET, Eldridge MW: Abnormal ventilatory responses in adults born prematurely. Prestigious New England Journal of Medicine 2014, 370(6):584-585. I don’t usually bother with letters, but this is actually a brief report of a research study, and it is very interesting, especially to someone with a history of doing respiratory control research. 13 VLBW newborns who were now about 21 years of age and had normal respiratory function at rest had hypoxic and hyperoxic challenges. 12 control adults born at full term were compared. The preterm born adults had very reduced hypoxic responses, some even had paradoxical respiratory depression, they also had reduced effects of hyperoxia, with smaller decreases in ventilation. The letter could have done with a bit of editing though, in the first section they talk about ‘preterm infants being treated with hyperoxia’! which is a strange thing to write. I think what they mean is that for several weeks of their early postnatal life preterm infants have much higher arterial PO2 than a fetus at the same post-menstrual age. That looks like it has a very long-lasting effect on respiratory regulation.

About Keith Barrington

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