Transcutane meting van de zuurstofspanning in de neonatologie

In het laatste decennium heeft men de beschikking gekregen over huidelektroden, waarmee kontinu op niet-invasieve wijze de zuurstofspanning (Po2) gemeten kan worden. Juist bij de behandeling van pasgeboren kinderen met ademhalingsproblemen, bij wie men zo min mogelijk invasieve ingrepen wil verrichten, heeft de toepassing van deze transcutane zuurstofelektroden een grote vlucht genomen. De elektrode bestaat ui t een miniatuur "Clark-eel", waarin een verwarmingssysteern is ingebouwd. Wanneer deze elektrode, die een diameter heeft van slechts enkele centimeters op de huid bevestigd wordt, kan door de huid heen de zuurstofspanning gemeten wordenSkin electrodes have become available during the last ten years, making it possible to continuously measure the oxygen pressure (Po 2 ) in a non-invasive manner. The use of these transcutaneous oxygen electrodes has increased greatly, especially in the treatment of neonates with respiratory problems where invasive techniques are to be avoided as much as possible. The electrode consists of a miniature 11 Clark-cell" and a heating system. The electrode has a diameter of only a few centimeters. The oxygen pressure may be measured through the skin when the electrode is attache

Strabismus in very low birth weight and/or very preterm children: Discrepancy between age of onset and start of treatment

Present medical care is not sufficient for early detection and treatment of strabismus in at-risk children. Our results suggest that the optimal screening age for early detection of persistent strabismus in VLBW children is at 9 months of age. Because strabismus can also develop after this age, it is important to repeat examination of visual functions in at risk-children at regular intervals after 1 year of age

The bilirubin albumin ratio in the management of hyperbilirubinemia in preterm infants to improve neurodevelopmental outcome: A randomized controlled trial - BARTrial

Background and Objective: High bilirubin/albumin (B/A) ratios increase the risk of bilirubin neurotoxicity. The B/A ratio may be a valuable measure, in addition to the total serum bilirubin (TSB), in the management of hyperbilirubinemia. We aimed to assess whether the additional use of B/A ratios in the management of hyperbilirubinemia in preterm infants improved neurodevelopmental outcome. Methods: In a prospective, randomized controlled trial, 615 preterm infants of 32 weeks' gestation or less were randomly assigned to treatment based on either B/A ratio and TSB thresholds (consensus-based), whichever threshold was crossed first, or on the TSB thresholds only. The primary outcome was neurodevelopment at 18 to 24 months' corrected age as assessed with the Bayley Scales of Infant Development III by investigators unaware of treatment allocation. Secondary outcomes included complications of preterm birth and death. Results: Composite motor (100±13 vs. 101±12) and cognitive (101±12 vs. 101±11) scores did not differ between the B/A ratio and TSB groups. Demographic characteristics, maximal TSB levels, B/A ratios, and other secondary outcomes were similar. The rates of death and/or severe neurodevelopmental impairment for th