The annual incidence of bronchopulmonary dysplasia (BPD) is presently 1.3 case p. 1,000 alive births. The most severe forms of BPD are characterized by a prolonged oxygen-dependence and a spontaneous evolution marked by numerous complications which could be life-threatening. We studied retrospectively 65 premature infants with BPD who underwent ventilation for one month or more during the first weeks of life. Comparison between survivors and children deceased during the first year of life allowed for discerning 5 prognostic criteria: the nature and severity of initial respiratory disease, the respiratory improvement during the first trimester, the results of hematosis by age 3 months, the ability of maintaining and increasing the respiratory improvement while reducing the therapeutic management, the weight and head circumference gains. The respective parts and conditions of oxygen therapy and prolonged mechanical ventilation in severe cases of BPD are discussed.

Age Factors↗

PubMedDate not supplied

[Breast feeding and hypernatremic dehydration. 3 case studies].

Despite the well-recognized advantages of breast-feeding, a rare but life-threatening complication may occur with failure to thrive resulting in severe malnourishment or hypernatremic dehydration. We report 3 more cases. Two of them with severe hypernatremic dehydration and cachexia were treated using peritoneal dialysis rather than intravenous fluids in order to rapidly correct the severe metabolic acidosis but slowly the serum osmolarity. Although insufficient breast-milk volume appears to prevail over positive sodium balance in the pathway to hypernatremic dehydration, high sodium concentrations were found in breast milk as previously reported. However, the discovery of a low lactose content inversely related to that of sodium in breast-milk, suggests more complex disturbances in lactation and may draw up new hypothesis in the pathogenesis of this challenging syndrome.

Breast Feeding↗