[On recommendations, protocols, and clinical guidelines].
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Biomedical subjects
Publications and source records attributed to A Fina Martí.
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OBJECTIVE: We present 12 newborns with acute renal failure (ARF) of different etiologies that were treated with continuous arterio-venous hemofiltration (CAVH). PATIENTS AND METHODS: Gestational age and birth weight ranged from 26-42 weeks and 700-4, 700 grams, respectively. The umbilical artery and vein were most frequently used as vascular accesses. Two types of filters were used: Gambro FH 22 and Amicon Minifilter. RESULTS: Treatment lasted from 8 to 120 hours. We obtained an ultrafiltration median of 25 ml/h ranging from 10.75 mL/h to 82.8 mL/h (4.1-31.8 mL/k/h). The volume balance was negative in all patients. Treatment was well tolerated. Complications included hypotension when the system was started and hypoglycemia. CAVH was stopped because of normalization of renal function in 6 cases and death in the other 6. In the latter, cardiac malformation was the cause of death in 3 cases and multiple organ failure in the other 3. CONCLUSIONS: CAVH is useful is the treatment of ARF in the oligoanuric newborn.
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The clinical records of 137 newborns, diagnosed by cardiac catheterization of aortic coarctation, have been reviewed. According to the presence of associations, three different groups have been established. Group A: isolated coarctation or coarctation associated with patient ductus arteriosus (40 cases); Group B: coarctation associated with ventricular septal defect or atrial septal defect (37 cases); Group C: coarctation associated with other complex congenital cardiac lesions (60 cases). The aortic coarctation has been surgically repaired in 73 cases, by using the following techniques: End-to-end anastomosis in 26 patients, Waldhausen repair in 43 and other procedures in the remaining 4 cases. For the surgically treated patients the survival has been: 88% in group A, 90% in group B and 48% in group C. In non-operated patients the survival has been: 21%, 6% and 14%, respectively.
16 preterm babies with birthweights between 738 and 1,390 g (mean: 1,105. SD: +/- 176.7) and with gestational ages between 27 and 31 weeks (mean: 29.5. SD: +/- 1.32), were fed according to a combined scheme: parenteral nutrition, for a period of 12 days, plus enteral feedings of chemically defined diet, given by nasogastric tube through a continuous infusion, until the 35th week of postconceptional age. All 16 babies had a satisfactory course, with no significant side-effects. Their weight gain was between 9 and 22 g/day (mean: 13.8. SD: +/- 4.2). No significant blood biochemical abnormalities were detected. Our results showed that this combined feeding scheme (enteral & parenteral) worked satisfactorily in this group of newborn premature babies.
Authors present four cases of neonatal necrotizing enterocolitis occurred during an outbreak of acute enteritis. From november 1985 to beginning of february 1986, forty-seven out of 588 newborn infants were involved. In 22 affected infants (46.8%) rotavirus were isolated from stools, whereas no bacterial or viral agent was recovered in 25 (53.2%). Four cases (8.6%) developed necrotizing enterocolitis.