I haven’t done one of these for a while, getting too verbose I guess, but here is a selection of interesting recent articles with just a few sentences about them.
Mola-Schenzle E, Staffler A, Klemme M, Pellegrini F, Molinaro G, Parhofer KG, et al. Clinically stable very low birthweight infants are at risk for recurrent tissue glucose fluctuations even after fully established enteral nutrition. Archives of Disease in Childhood – Fetal and Neonatal Edition. 2014. VLBW and ELBW babies continue to have unstable blood sugars, with low and high values even when you think it was safe to stop monitoring them so closely. What do we do about this? I sure don’t know.
Okumus N, Beken S, Aydin B, Erol S, Dursun A, Fettah N, et al. Effect of Therapeutic Hypothermia on C-Reactive Protein Levels in Patients with Perinatal Asphyxia. American journal of perinatology. 2014(EFirst). Asphyxiated babies under hypothermia have elevated CRP. Asphyxia, and/or cooling is one of the many things that makes your CRP rise.
Hauglann L, Handegaard BH, Ulvund SE, Nordhov M, Rønning JA, Kaaresen PI. Cognitive outcome of early intervention in preterms at 7 and 9 years of age: a randomised controlled trial. Archives of Disease in Childhood – Fetal and Neonatal Edition. 2014. At 7 to 9 years of age the authors could find no benefit of their early intervention program on cognitive outcomes. I do not think this means that we should ditch the programs. They will be harder to justify, but I think we should still be helping families to learn how to help out their premies at home, and we need to focus on subgroups that have ore benefit, which in other studies are those with lower socio-economic status.
Meyer MP, Hou D, Ishrar NN, Dito I, te Pas AB. Initial Respiratory Support with Cold, Dry Gas versus Heated Humidified Gas and Admission Temperature of Preterm Infants. The Journal of Pediatrics. 2014. We don’t use cold dry gases to ventilate our premies at any other time, so why in the delivery room? This is a multi-center RCT examining the question. Using Warmed humidified gases resulted in more infants being normotthermic on admission to the NICU, especially the very preterm babies. With 100 babies in each group there were no other significant differences in clinical outcomes, but most differences were in the direction of a beneficial effect of warming and humidifying the gases. A larger study is worth doing I think but will be hard to fund with these modest differences between groups.