Clinical practice: The care of children with Down syndrome

Down syndrome (DS) is one of the most common chromosomal abnormalities. Because of medical advances and improvements in overall medical care, the median survival of individuals with DS has increased considerably. This longer life expectancy requires giving the necessary care to the individual with DS over their total longer lifespan. DS medical guidelines are designed for the optimal care of the child in whom a diagnosis of DS has been confirmed. We present an overview of the most important issues related to children with DS based on the most relevant literature currently available

Effect of balloon atrial septostomy on cerebral oxygenation in neonates with transposition of the great arteries

<p>BACKGROUND: The aim of this study was to determine the effect of balloon atrial septostomy (BAS) on cerebral oxygenation in neonates with transposition of the great arteries (TGA).</p><p>METHODS: In term neonates with TGA, regional cerebral tissue oxygen saturation (r(c)SO(2)) was measured using, near-infrared spectroscopy (NIRS) for a period of 2 h, before BAS, after BAS, and 24 h after BAS. In neonates who did not require BAS on clinical,grounds, r(c)SO(2) was measured within 24h of admission and 24h later.</p><p>RESULTS: BAS was performed in 12 of 21 neonates. r(c)SO(2) increased from a median of 42% (before) to 48% at 2 h after BAS (P <0.05), as did transcutaneous arterial oxygen saturation (spO(2)) (from 72% to 85%, P <0.01). r(c)SO(2) increased further during the next 24 h (from 48% to 64%, P <0.05), whereas spO(2) remained stable. Although beginning from a lower baseline (42 vs. 51%, P <0.01), r(c)SO(2) Was higher in neonates treated with BAS, as compared with neonates not treated with BAS, 24h after the procedure (64 vs. 58%, P <0.05); spO(2) was, however, similar between the two groups.</p><p>CONCLUSION: BAS improves cerebral oxygen saturation in neonates with TGA. Complete recovery of cerebral oxygen saturation occurred only 24h after BAS.</p>