Prophylactic Administration of Surfactant in Extremely Premature Infants

Objective. To investigate whether prophylactic surfactant administration is superior over selective treatment in preterm infants with respiratory distress syndrome (RDS). Methods. In our retrospective analysis, we compared premature infants (23 + 0 to 26 + 6 weeks) receiving 200 mg/kg surfactant (curosurf®) within five minutes after birth (prophylactic group, N = 31) with those infants who received surfactant therapy for established RDS (selective group, N = 34). Results. Prophylactic therapy significantly decreased the need for mechanical ventilation (74 hours per patient versus 171 hours per patient, resp.). We observed a reduced incidence of interstitial emphysema (0% versus 9%, resp.), pneumothoraces (3% versus 9%, resp.), chronic lung disease (26% versus 38%, resp.), and surfactant doses per patient (1.3 versus 1.8, resp.), although those variables did not reach significance. Conclusion. We conclude that infants under 27 weeks' gestation profit from prophylactic surfactant administration by reducing the time of mechanical ventilation. This in turn could contribute to reduce the risk for mechanical ventilation associated complications, without any detrimental short-term side effects

Preparations for the Evaluation of a Speech Recognition System in Neonatology (U2)

Background: before using a speech recognition system for the neonatal documentation, the underlying neonatal information has to be specified and structured. Up to now, the pre-structuring the first comprehensive examination of newborn (U2) and the respective data set entries has not been described in literature, yet. The common booklet for the documentation of the German U2 does not contain all examinations required nor does it show the choice of all respective finding statements. Objectives: to set up a documentation standard for the U2 distinguishing the most important diseases/disorders at a limited level of detailing. Methods: the finding scheme of the U2 has been specified based on the German national recommendation for the U2. Here, the U2 is the first exhaustive examination of the newborn. Due to a lack of detailed descriptions, the U2 has been formalized and arranged in cooperation with experienced medical experts, which carry out the U2 in daily routine. Results: if all possible finding statements are presented in a hierarchical structure, – even with a small font size – it would cover more than 20 pages. Hence, a more condensed structure has been set up for presentation. If the general practitioner (GP) is to see (a) the finding statements necessary but (b) no more, additional rules can be set up for the masking of finding statements excluded by the results of the prior investigation. Conclusions: the proposed structure for neonatal documentation serves as a basis for statistical analysis. On its basis, investigation can be carried out about (a) problems during the individual examination, (b) problem with the documentation and (c) the benefits of automated speech recognition systems