eLetters

191 e-Letters

published between 2020 and 2023

  • A simple practice to increase red cell transport in newborns
    Cory Mermer

    The finding of Pladys et al (1), that preterm infants are able to compensate for deficiencies in hematocrit by increasing cardiac output is reassuring. However, it would seem to be a good idea to attempt to minimize the need for such efforts, which are another added stress to an already overburdened newborn’s system.

    There is a simple procedure with little, if any risk that can increase red cell transport or...

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  • Perinatal cortical infarction with no obvious cause
    Péter Temesvari

    Sir,

    In a recent, elegant study Govaert et al published their ultrasonographical observations in newborn infants with perinatal cortical infarctions (1). Like many others before them, they could not find a cause for stroke in a high proportion in (25%) of cases. They also confirmed an association between stroke and pulmonary hypertension requiring assisted ventilation (2).

    We have previously published...

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  • Unit Specific Antibiotic Policies
    Laura Stewart

    Sir, We read with interest the article by Isaacs on the rationing of antibiotic use in neonatal units.(1) This encourages the use, where possible, of flucloxacillin and an aminoglycoside as empiric therapy of late onset sepsis.

    While this represents a valid approach to the empiric therapy of late onset infection, the epidemiology of bacterial sepsis will vary from unit to unit. In our unit we use a combination...

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  • Premedication for neonatal intubation - current practice in Australia and the UK
    Stephen Hancock

    The paper by Bhutada et al (1) adds to the growing body of evidence that premedication for tracheal intubation in neonates both improves physiological stability and makes the procedure easier to perform. The results of the telephone survey of premedication use in UK neonatal units by Whyte et al (2) helps to define current practice. In a similar study, we recently tried to define the routine use of premedication for trac...

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  • Premedication before procedures in neonates
    Shabih Manzar

    Editor,

    Neonates are exposed to many procedures, including intubation, IV access, central line placement, chest tube insertion, lumber puncture, catheterisation, suprapubic aspiration etc. These procedures are associated with pain and stress. No clear guidelines are available for alleviating the distress by premedication before such procedures. Researchers are looking for methods to minimise the pain and distre...

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  • Hydrocortisone:Early treatment of hypotension in preterm infants
    A Soe

    Dear Editor

    We note with interest the paper by Ng et al[1]. Their study concluded that corticosteriod treatment could be lifesaving in severely hypotensive preterm infants who do not respond to conventional treatment with volume expanders and inotropes. The use of steroids in the management of hypotension in very low birthweight has already been shown to be effective [2].

    We wrote to this Journal in 199...

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  • Cut-off for normal serum creatinine levels in preterm infant.
    Shabih Manzar

    Editor,

    I read with interest the article by Marlow et al(1) on sensorineural hearing loss and prematurity. In their study of preterm infant of less that 33 weeks gestation, they put the cut-off value of serum creatinine (as one of the variables) as 60 mmol/l. My comment is regarding the cut- off of 60. In a recent study from Leeds, UK, Miall et al(2) have shown that preterm babies have higher serum creatinine an...

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  • Treatment decisions and survival data
    Malcolm Battin

    Dear Editor,

    Evans and Levene have endeavoured to review the published survival data for infants born at less than 28 weeks, to identify bias and to make recommendations facilitating more accurate comparison of the published survival rates [1].

    Practices regarding resuscitation vary between institutions and may change over time. In one study from a large regional centre in British Columbia, not includ...

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  • Need for prospective studies
    Elpis Mantadakis

    This review on alloimmune thrombocytopenic purpura (ATP) by OUWEHAND et al is excellent and describes the current knowledge on ATP. Regarding the management of this condition, since no randomised trials have been performed using IVIg or intravenous corticosteroids during pregnancy, no evidence-based guidelines for the use of either treatment exist. I believe it is necessary for a multi-institutuional trial on the preventio...

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  • Where should the long line tip lie?
    M Yadav

    Dear Editor,

    I read with interest the recommendation of Reece and colleagues regarding the positioning of long lines in preterm neonates. [1] In their methods the authors state that they aimed to place the tip of the line up to 10 mm into the right atrium (upper limb insertions). Manufacturer and standard text book of neonatology recommend that the line tip should not be sited in the right atrium as there are potenti...

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