712 e-Letters

  • 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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  • ROP and survival of premature infants
    David A Todd

    Dear Editor,

    We were interested to read the article of Vyas et al (1) on the incidence of severe retinopathy of prematurity (ROP) in 11 neonatal units (NUs) from five cities in England in 1994. We have published similar data from 8 NUs in New South Wales (NSW) Australia in 1993 and 1994.(2) These data were prospectively collected in the NSW Neonatal Intensive Care Unit's data collection and is stored and maintai...

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  • Follow up of Bereaved Parents
    Madeleine White

    Dear Editor,

    I read with interest the paper by McHaffie [1] et al on the follow up of bereaved parents after treatment withdrawal from newborns. They comment how they could find no evidence in the literature to support the recommendations for timing of follow up given by the Stillbirth and Neonatal Death Society and how bereavement care is largely an "intuitive response". I wish to offer the following comments:...

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  • Image inversion
    Ian Bernard
    Dear Editor,

    Long lines are commonplace but putting them in the appropriate place is not so common. The article [1] advocates the use of contrast to position long lines. In a e-letter, Dr Yadav [2] argues against the use of contrast medium until safety is validated. We, at Glan Clwyd Hospital, have found that using the picture archiving and communication system (PACS), line tips are simpler to identify. We use software MedVi...

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  • Extra-thoracic complications of central lines
    Nilesh M Mehta

    Dear Editor, We read the article by Reece et al [1] and followed the subsequent correspondence with interest. In light of the recent review commissioned by The Chief Medical Officer for England, physicians must be aware of potential complications of peripherally inserted central catheters (PICC).[2] While the true incidence of such events will only be known with prospective data collection, retrospective studies s...

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  • Birth order and RDS : Some controversy in the literature
    N Naor

    I read with interest the article by D Hacking et al.
    In their article they stress the significantly increased risk of RDS in the second twin. Our experience presented in the study 'Comparative outcome study between triplet and singleton preterm newborns' [1], differ from their findings. Birth order of the triplets did not influence the incidence or severity of Respiratory distress syndrome(RDS), Tr...

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  • Re: Birth order and RDS : Some controversy in the literature
    Doug Hacking

    Dear Sir,

    We noted with interest Noar et al's letter of 20th July 2001 describing their as yet unpublished work on outcomes of infants from multiple gestation pregnancies. We look forward to seeing the data and methods of analysis on which their conclusions were based.

    We discussed Nielsen et al's work in our paper where we noted that 'the sample size and analytical approach may explain discrepancies...

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  • Foot length and neonatal intubation
    Stephen W Hancock

    Dear Editor

    We were interested to read Embleton et al's study in which they presented a well researched argument for using foot length as a predictor of nasotracheal tube length in neonates [1]. While we do not doubt the accuracy of this method we question some of the intubation techniques described, particularly in an emergency situation.

    It is generally recommended that emergency intubation should be or...

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  • Case for ANNPs not yet proven
    Cliona Ni Bhrolchain
    Dear Editor,

    Lee et al compare routine neonatal examinations by SHOs and ANNPs. They claim that ANNPs were more sensitive and equally specific at detecting all three conditions examined. The study proves this however only for hip abnormalities, referred directly by the ANNPs and SHOs for specialist assessment.

    Referrals for eye and heart abnormalities were routed through senior paediatricians in both hospi...

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  • Weighing breastfed babies
    Anthony F Williams
    Dear Editor,

    Harding et al state that the problem of hypernatraemic dehydration in breastfed babies is attributable to: "the reluctance of midwives to weigh breastfed infants". They imply that weighing between 72 and 96 hours would be an effective intervention, but provide no evidence to support this claim.

    It does not surprise me that the views of midwives and consultant neonatologists differ on this point. Whe...

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