110 e-Letters

published between 2008 and 2011

  • Rationale for managing gastroesophageal reflux in neonates needs more research and sensible use of available evidence.
    Egware B Odeka

    The team from leed have highlighted a very important area of neonatal practice that is still seeking clarification and enlightenment. Neonates do have a high incidence of reflux due to physiologic and iatrogenic causes. These have been clearly highlighted in this review. The choice and rationale for treating these babies clearly shows that more work still needs to done before we can be sure that the doctors and nurses are u...

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  • Low apgar scores following resuscitation do not necessarily mean a dire outcome
    Dominic J Wilkinson

    Dear Editor,

    The paper by Sarkar et al[1] addresses a question of considerable practical and ethical importance for parents and clinicians caring for asphyxiated newborn infants. Which infants are so severely affected that they will not benefit from attempted neuroprotection with therapeutic hypothermia?[2]

    However, it is not clear that their paper answers this question. They focus on risk of mortality...

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  • Could the association between ROP and ethnicity be confounded by growth retardation?
    Hassib Narchi

    Dear Editor,

    In their retrospective observational study of 1960 preterm infants over a 7-year period, Aralikatti et al reported an increased risk of developing threshold retinopathy of prematurity (ROP) in Asian and black infants compared to white infants [1]. The proportion of small for gestational age (SGA), by standard growth charts, was also higher in Asian (36.19%) than in white (29.45%) and black infants (...

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  • Prophylactic surfactant does not improve mortality
    Archana Verma

    We congratulate Sehgal and colleagues for their study (1) that found prophylactic surfactant causes major haemo-dynamic changes in preterm babies. This publication follows close on the heels of a study in the NEJM that found that prophylactic surfactant was no better than continuous positive airway pressure (CPAP)ventilation (2). It is significant that both these papers (1,2) quote a Cochrane meta-analysis in there intro...

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  • Hemodynamics changes in the first hour of life
    Koert A. de Waal

    Dear editor,

    With great interest we read the article by Sehgal et al describing the hemodynamics of surfactant administration in the delivery room. The authors found a low RVO, low LVO, low to normal SVC flow and an increasing RVO:LVO ratio in the first 60 minutes after surfactant administration. Surprisingly, SVC flow is responsible for 62% of RVO in the pre-surfactant measurement and up to 79% of LVO at 1 hour...

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  • Ethinicity can hardly be considered as an independent factor
    Hikmet Basmak

    Dear editor, We read with great interest the recent article by Aralikatti et al.1 The authors conducted a well designed study regarding the effect of ethnicity on developing severe retinopathy of prematurity (ROP). They concluded that asians and black infants have a higher risk of developing threshold ROP compared to white infants. Although ethinicity might be a risk factor, we think that it can hardly be considered as a...

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  • Neonatal Testicular Trauma
    Peter M. Dunn

    The case report by R. Negrine and colleagues(1) is of considerable interest. However, testicular trauma following breech delivery is not extremely rare as they suggest. In 1975 I reported 11 cases of scrotal bruising and significant testicular enlargement among 114 consecutively breech-born male infants over a two year period(2). Those affected tended to be large, first-born, singleton and term or post-term infants. O...

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  • Thiopentone in newborns
    Richard S Taylor

    The swedish observational study on neonatal thiopentone pharmacokinetics provides some interesting data. The authors rightly point out that the duration of anaesthesia following a thiopentone bolus is determined by redistribution rather than metabolism. It is interesting that blood levels in the mother at six minutes following induction with a dose of 5.5mg/kg were three times the average level in the neonate five minute...

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  • Is remifentanil an option as premedication for endotracheal intubation?
    Yerkes Pereira Silva

    Dear Editor,

    It was with great interest that we read the article by Choong et al. - Remifentanil for endotracheal intubation in neonates: a randomised controlled trial. First of all, we would like to congratulate the authors for their relevant RCT. However, there are some aspects that should be pointed out. The premedication protocol for endotracheal intubation of this study includes many classes of drugs besid...

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  • Continuous positive airway pressure following nasal injury in preterm infants
    Daniele Trevisanuto

    Nasal-CPAP (nCPAP) is the most popular system for administering continuous distending pressure to neonatal patients, but this technique may fail due to several problems such as insufficiently applied pressure, insufficient circuit flow, inappropriate prong size or placement, airway obstruction from secretions, and a baby's open mouth creating a large leak and lowering the pharyngeal pressure.1 In addition, severe nasal sk...

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