No abstract available.

Blood glucose levels were measured in 89 healthy term neonates during the first 72 hours using the SureStep, a newly developed reagent test strip method by LifeScan. The blood samples were obtained by heel-stick puncture and blood glucose concentrations were monitored at birth(0), 2, 4, 6, 12, 24, 48, and 72 hours after birth. Mean and standard deviation of their measurement were compared according to postnatal hours and type of delivery. Comparison of significance between mean plasma glucose levels were made with the Wilcoxon rank sum test and significance level of 0.05 was used to determine which pair-wise comparisons were significantly different. The mean plasma glucose concentrations of first 6 hours were significantly lower than those of 12, 24, 48, 72 hours. This finding indicates that plasma glucose stabilization in healthy fullterm neonates can be expected with the feedings. The mean plasma glucose concentration at birth in the neonates of cesarean section (64.5+-8.06 mg/dl) was significantly lower than that of vaginal delivery (80.3+-20.7 mg/dl), but there were no significant differences after 2 hours. This may be due to the difference in prenatal care of obstetric department of Horamae hospital (C/S: midnight NPO and Hartmann solution, V/D: NPO with labor pain and 5% dextrose solution intravenously). In summary, the changes in perinatal care, especially prenatal fluid therapy and time of first feeding should be considered in defining neonatal hypoglycemia. Our data suggest that hypoglycemia should he defined as below 40 mg/dl during the first 6 hours and below 55 mg/dl thereafter.
Blood Glucose* ; Cesarean Section ; Female ; Fluid Therapy ; Glucose ; Humans ; Hypoglycemia ; Infant, Newborn* ; Labor Pain ; Parturition ; Perinatal Care ; Plasma* ; Pregnancy ; Prenatal Care ; Punctures ; Reagent Strips*

No abstract available.

No abstract available.
Humans ; Infant, Newborn ; Meningitis, Bacterial*

We analyzed neurodevelopmental outcome data of 36 selected studies. Data of individual studies were pooled by birth weight group: <800g, <1.000g, <1.500g and by time period of birth year: Period I (pre-intensive care era), 1960-67:Period II (beginning period of intensive care), 1968-76: and Period III (established period of intensive care), 1977-87. In all weight groups, survival and intact outcome rates based on live birth have progressively improved over the three period. The major neurodevelopmental handicap rate of the <1,500g decreased in Period III vs. Period I and Period II (66,70, and 45 per 1,000 live births in I, II, and III, respectively). However, the major handicap rate in the <800g and the <1,000g live births increased: in the <800g, from 48 per 1,000 live births in Period II to 101 in Period III and, in the <1000g, from 28 per 1,000 live births in Period I to 67 in Period II and 73 in Period III. Increases in major handicap rate in two lower weight groups were predominantly the effect of increasing number of survivors over these periods and had little to do with the change in handicap rates in the survivors. In the <1,500g, the magnitude of reduction in handicap rate in the survivors was sufficient to overwhelm the effect of increased survival, resulting in a reduction in the number of major handicapped children. We conclude that based on the currently avaiable reports, neonatal intensive care has provided very low birth weight infants with a reduction in mortality, an increase in intact outcome, and decrease in the number of major neurodevelopmentally handicapped children. We try to estimate the trend of major neurodevelopmental handicap and intactoutcome of infants with birth weights <1,500g in Korea and speculate that major handicap rate have progressively increased over the three period in spite of increase in intact outcome.
Birth Weight ; Disabled Children ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal* ; Korea ; Live Birth ; Mortality ; Parturition ; Survivors

No abstract available.
Humans ; Infant, Newborn*

No abstract available.
Animals ; Extracellular Matrix* ; Hyaluronic Acid* ; Hyperoxia* ; Lung Injury* ; Lung* ; Rats*

No abstract available.
Hernia*

PURPOSE: High flow rate (FR) and pressure limit (PL) strategy with time-cycled pressure-limited (TCPL) ventilator is employed routinely in the neonates. Theoretical basis of this strategy is the two-compartment theory that the lung with acute respiratory failure consists of units with different compliance and resistance. But such constant pressure strategy has the risk of ventilator induced lung injury. We compared the ventilatory indices and clinical outcomes of two different strategies, high FR-constant pressure and low FR-constant FR in the ventilator care of the neonates with acute respiratory failure. METHODS: For the neonates born in our hospital and treated with mechanical ventilation from March to August in 1997, two different ventilator strategies were employed randomly with flow control ventilator. In the high-FR group, the FR was fixed at 10 L/ min and the PL was adjusted according to the arterial blood gas analysis (ABGA) results. In the low-FR group, the FR was adjusted to 10 mL/kg of tidal volume. Sixty neonates were enrolled, 32 in high-FR and 28 in low-FR group. Ventilatory indices and clinical outcomes were statistically cornpared in the two groups. RESULTS: Perinatal factors were not different in the two groups. Initial ventilator settings, ABGA results and ventilatory indices were not different. The tidal volume, fraction of inspired oxygen, peak inspired pressure and oxygenation index were higher and dynamic compliance was lower in the high-FR group compared to the low-FR group after 3 to 72 hours of ventilator care. In clinical outcomes, incidences of pulmonary interstitial emphysema, pneumothorax and chronic lung disease were significantly lower in the low-FR group. CONCLUSION: Low-FR with constant FR strategy resulted in better clinical outcomes in the ventilator care of neonates. We conclude that constant FR strategy prevents damage of the better compliant lung units and decreases the incidence of acute and chronic complications of ventilator care.
Blood Gas Analysis ; Compliance ; Emphysema ; Humans ; Incidence ; Infant, Newborn* ; Lung ; Lung Diseases ; Oxygen ; Pneumothorax ; Respiration, Artificial ; Respiratory Insufficiency* ; Tidal Volume ; Ventilator-Induced Lung Injury ; Ventilators, Mechanical

No abstract available.
Humans ; Infant, Newborn* ; Ventilation*