151 e-Letters

published between 2005 and 2008

  • Inotropes and cyanotic skin rash: worrisome side effects of dopamine.
    Stefano Maccario

    Editor, We read with great interest the article published by Filippi et al. (1) regarding the usefulness of dopamine in the treatment of hypotension in preterm, very low birth weight (VLBW) infants. Recently Dempsey and Barrington (2) reported how there are marked variations between neonatologists in interventions and treatments for neonatal hypotension. In medical literature is well reported how dopamine should be cons...

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  • Giving vancomycin as a continuous infusion
    Nicholas D Embleton

    The recent paper advocating “a new dosage schedule” for giving vancomycin in early infancy [1] confirms what others have long said is usually the most appropriate total daily dose for babies of less than 34 weeks gestation who are more than a week old, and focuses on the time- dependent rather than concentration-dependent mode of vancomycin killing. Continuous infusion may prevent the risks of high peaks and low troughs...

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  • Support transition by keeping the placental circulation intact .
    David Hutchon

    Support transition by keeping the placental circulation intact – even in newborns apparently requiring resuscitation.

    Detecting ‘fetal distress’ in labour allows timely delivery, followed by effective resuscitation, if required, to restore or maintain adequate circulation with oxygenated blood to the baby. This should prevent or minimise brain damage from hypoxaemia or hypovolaemia. Nielso...

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    Carlos Zaconeta

    The interesting article written by Gunlemez and Isken relates a complication case of nasal CPAP in a low resource country. Unaware, the expiratory tubing was submerged besides the wished, causing an excessive pressure and propitiating a pneumothorax 1. Bublle CPAP is simple, cheap and as efficient as the other systems, but it requires trained professionals in the device installation, as any CPAP System2. There is no evide...

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  • Safe solution
    Elisa Smit

    Jamalpuri et al reported on the problems drawing up surfactant following recommendations from the National Patient Safety Agency (NPSA) to replace nasogastric tubes (1). They suggest using the old method of syringe and needle to draw up surfactant and transferring the content into a Penta syringe (Pentaferte, Campli, Italy) that can then be attached to the nasogastric tube. In response to this CM Kissack and Y Freer (2)...

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  • The Management of Babies born Extremely Preterm at less than 26 weeks of gestation
    Giuseppe Paterlini

    Sir, the paper of Wilkinson and colleagues describes an approach to resuscitation of extremely preterm newborn we believe excessively schematic, based only on gestational age and parental expectations. In the same document intensive therapies are suggested only for newborns of 23-24 weeks who show capability of survival, therefore the burden of proof for obtaining intensive care is put on children who have to demonstrate...

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  • Management of babies born extremely preterm at less than 26 weeks of gestation.
    Mario De Curtis

    Dear Editor, I have read with great interest the article by Wilkinson et al (1) discussing one of the most challenging aspects of perinatal medicine. These authors most appropriately point out that treatment of ELBW newborns needs to be customized and that any intervention should be performed in the patient’s best interest. The authors also emphasise the important role parents have in deciding whether to start and/or co...

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  • A response to "The new nasogastric tubes: implications for neonatal practice"
    Christopher M Kissack

    We write in response to the letter from Jamalpuri et al (1) concerning the potential implications of the introduction of new nasogastric tubes in response to the National Patient Safety Agency Alert (2). This alert referred to the oral/enteral and intravenous routes but not to the tracheal route. It is likely that the NPSA were completely unaware of the impact of the alert on the administration of surfactant by this rou...

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  • Help for GI slowing by morphine?
    Douglas P. Derleth

    Opiate drugs can affect the function of the gastrointestinal tract of premature babies, as confirmed by Menon et al. A new development in palliative care medicine may someday help us with this problem.

    Methylnaltrexone is an opiate antagonist that does not cross the blood-brain barrier. In theory, giving methylnaltrexone along with opiates would allow the opiates to give the desired analgesia while maintaining...

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    Karel Allegaert


    We enjoyed reading the paper of Hoellering et al. on the impact of closed versus open endotracheal suctioning on lung volume and cardiorespiratory changes in ventilated newborns.1 We fully agree that the respiratory and cardiovascular response during and following different suctioning techniques should be evaluated. However, in addition to these variables and similar to the observations on the difference b...

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