eLetters

635 e-Letters

  • Should we be proactive in reducing exposure of neonates to infected breast milk?
    J McAloon
    Dear Editor

    Reports of microbial contamination of expressed unpasturised breast milk (EBM)[1-3] are not new but the paper from Olver et al[4] again highlights that this routine aspect of neonatal care has the potential to provide a source for bacterial infection in immature neonates.

    Culture or pasturisation of a mother's own non-banked milk is not however routine practice in neonatal units in the UK and may even b...

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  • Osteopetrosis presenting as fractures in preterm neonates
    Anirban Majumdar

    Dear Editor

    The recent report on Malignant Infantile Osteopetrosis (MIOP) presenting with neonatal hypocalcaemia highlights the importance of early recognition of a rare but treatable disorder.[1]

    We would like to point out that recognition in the neonate is difficult, as many of the characteristic manifestations have not had time to develop. The normal sequence of events leading to the diagnosis being ma...

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  • Re: 'PTV': should it be patient triggered and patient terminated ventilation?
    J H Baumer

    Dear Editor

    Visveshwara's eLetter[1] emphasises that the results of the trigger trial should not be interpreted as demonstrating lack of benefit for patient triggered ventilation using other sensors or ventilators. I would concur with this statement, which was emphasised in the paper.

    However, Visveshwara should not be surprised to find different outcome rates in the patients whose results he presents,...

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  • Guidelines for Group B streptococcus
    Kathryn Beardsall
    Dear Editor

    As highlighted in a recent edition of ADC Fetal and Neonatal edition,[1, 2] there is increasing concern about the previously unreported high levels of neonatal group B Streptococcal (GBS) infections in the UK. It is indeed most important that we have national statistics for regional variations in GBS infection, for it is only when we have this information that we can begin to produce evidence based guid...

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  • Weaning from assisted ventilation in RDS
    Mahesh Yadav
    Dear Editor

    I would like to mention two other modes of ventilation used during the immediate post extubation period. They deserve a mention in the excellent article on the current issues in weaning of preterm infants from assisted ventilation.[1] Nasopharyngeal-synchronised intermittent mandatory ventilation (NP-SIMV) and nasal synchronised intermittent positive pressure ventilation (nSIPPV) have been studied in two trials wi...

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  • Premedication before intubation of neonates in The Netherlands
    Harry Molendijk

    Dear Editor

    With great interest we read the paper by Whyte et al regarding the practice of premedication before intubation in UK neonatal units.[1] Their finding that only 37% of the units gave any sedation before intubation is worrysome in view of the known physiologic responses to awake intubation.[2-4] However, one potential bias in their study design was not discussed.

    Since the information regarding...

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  • To trigger or not to trigger?
    M Yadav
    Dear Editor

    International randomised controlled trial by Dr Baumer[1] concluded that there was no benefit of patient triggered ventilation (PTV), but an added risk of increased pneumothorax in those less than 28 weeks gestation. In the same issue Beresford et al[2] concluded in a similar trial (with slightly more mature newborns 29 weeks vs 27), that PTV was feasible with no significant differences noted in medium term outcom...

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  • Guidelines for prevention of neonatal Group B Streptococcal infections
    Yim-Yee Chan
    Dear Editor

    The article by Beardsall et al[1] once again raises awareness of this important and as yet unresolved issue for the UK. We would like to make two related points:

    (1) Although the authors have discussed both early and late onset Group B Streptococcus disease, perinatal intervention is effective in preventing only early onset Group B Streptococcus disease.

    (2) A common related scenario...

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  • 'PTV': should it be patient triggered and patient terminated ventilation?
    Nadarasa Visveshwara
    Dear Editor

    We were surprised at the results of the two studies published in your journal by Baumer[1] and Bersford et al[2]. Our experience with triggered ventilation over 10 years is shown in the table below:

    Complications of prematurity 1991-99

    ...
    1991
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  • Use of antenatal steroids
    HD Dellagrammaticas
    Dear Editor

    We read with interest the excellent review by Dr Ng on the fetal and neonatal hypothalamic-pituitary-adrenal axis.(1) Although the issue of antenatal administration of steroids is addressed in a separate section of the paper it is practically restricted to their antenatal use for the prevention of respiratory distress syndrome and other complications of prematurity.

    We would agree that this is the commonest...

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