eLetters

462 e-Letters

published between 2013 and 2016

  • Response to Dr D'Amore
    Eric S. Shinwell

    Dear Editor

    We thank Dr Amore for her instructive comments on our article. [1] Dr Amore correctly points out that our study population was limited to high- risk VLBW infants. However, the point of our article seems to have been missed.[2] Our large population-based study showed that VLBW triplets, when compared with singletons and twins, have increased risk for RDS and mortality, even after detailed correction...

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  • Techniques for insertion of percutaneous central venous catheters in neonates
    Peter A. Dargaville

    Dear Editor

    We wish to amend and supplement the information supplied by Bayley [1] regarding the technique of insertion of central venous catheters in newborn infants. The report implied that the prescribed method for long line insertion in neonates at the Royal Children’s Hospital, Melbourne is that using a 19 FG butterfly needle. This is incorrect; no particular technique is stipulated as the preferred method, a...

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  • Risks of treating infected neonatal lines
    Kiran Nistala

    Dear Editor

    Hodge and Puntis[1] suggest that "up to 80 % of coagulase negative staphylococcus infection... in young children can be eradicated with antibiotics". The study referenced, Raad et al.[2] was carried out in adults (mean age 43 yr) with underlying malignancy, most of whom had non-tunnelled subclavian lines. It may not be appropriate to apply Raad et al.’s results to children with long term...

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  • Re: A novel way of inserting a percutaneous central venous catheter: The Townsville Method.
    Dr Naharmal Soni

    Dear Editor

    We read Dr Bayley's letter with interest, as we use a similar but probably safer technique to insert 27 guage lines (medex, vygon ). I was surprised at the author`s technique where the hub of the 24 guage canula was cut and then the long line passed through the plastic sleeve of the canula. We think this can be very dangerous as sometimes the thin plastic sleeve in front of the hub can be easily dislodge...

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  • Catheter related blood stream infection in children receiving long term parenteral nutrition
    John W Puntis

    Dear Editor

    We thank Drs Nistala and Nichol for their comments on our leading article concerned with management of catheter related blood stream infection in chldren receiving long term parenteral nutrition. The points they make with regard to neonates may well have some validity, but our paper relates to children on parenteral nutrition for many months, and sometimes years. The balance of risk and benefits when tre...

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  • Re: A novel way of inserting a percutaneous central venous catheter: The Townsville Method
    T.H Koh

    Dear Editor

    We have inserted over 150 lines using the Townsville technique [1] (for babies as small as 500 gram birth weight) and had no problems with the 24 G cannula segment slipping into the vein. The disadvantage of leaving the hub is the possibility of a blood pool in it during the procedure. Another important reason is that it is easier and neater to secure the central line with Tegaderm without the potenti...

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  • SIDS, smoking and arousal thresholds: conclusions not supported by data
    Tom Blyth

    Dear Editor

    The investigation of the effect of maternal tobacco smoking on arousal in healthy infants[1] concluded that maternal tobacco smoking increases arousal thresholds (i.e. impairing arousal) in infants of 2-3 months of age, in quiet sleep, in the supine position. It is suggested that this may provide an explanation for the association between smoking and sudden infant death syndrome (SIDS).

    This con...

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  • Hyponatraemia associated with treatment of post-haemorrhagic hydrocephalus
    Richard W Cooke

    Dear Editor

    I read with interest Tenbrock and colleagues account of hyponatraemia following cerebrospinal fluid drainage for hydrocephalus in preterm infants.[1] The fact that they were draining the fluid via a reservoir device probably enabled large amounts of fluid to be drained daily. Even using direct ventricular needle tap or spinal taps to drain cerebrospinal fluid in preterm infants can lead to hyponatraemia a...

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  • Author's Reply
    Rosemary SC Horne

    Dear Editor

    In response to the letter from Tom Blyth and Sheila McKenzie[1] we wish to clarify the following points. Our study is the first to examine the effects of both sleeping position and maternal smoking, both factors which are associated with an increased risk for Sudden Infant Death Syndrome (SIDS), on arousal from sleep. We had hypothesised that the effects of these two risk factors might be additive. O...

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  • Reply to Ovaly and Cleary
    R Gottstein

    Dear Editor

    We are grateful to our colleagues for their interest and responses to our paper.[1] In response to Dr Ovaly’s comments we agree that late anaemia can be a problem in these babies who receive intravenous immunoglobulin (IVIG), as also demonstrated in our systematic review. Even when infants have received exchange transfusions (XTs) top-up red cell transfusions may be required. In a recent local audit of XTs, 3...

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