Alterações no Doppler e na espectroscopia associadas à hemorragia intracraniana em recém nascidos de muito baixo peso

Made available in DSpace on 2018-03-12T13:58:50Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) luciene_nacif_iff_mest_2016.pdf: 876670 bytes, checksum: ce8cb4211c5963f6d9669fc570339e54 (MD5)Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.tecnológico permitiu uma maior sobrevida dos recém nascidos de muito baixo peso (RNMBP), mas eles ainda apresentam morbidades relacionadas ao seu grau de imaturidade como a hemorragia peri-intraventricular (HPIV): Nosso trabalho objetivou estudar o comportamento do fluxo sanguíneo cerebral através do Doppler e da rSatO2, através do NIRS nas primeiras horas de vida em recém nascidos de muito baixo peso, na tentativa de verificar alterações que pudessem estar associadas a HIC

Timing of initial surfactant treatment in very low birth weight newborns

ABSTRACT Objective: To correlate the timing of treatment using exogenous surfactant with the main variables related to respiratory distress syndrome or prematurity. Methods: A historic cohort study between January 1, 2004 and June 30, 2007, including very low birth weight newborns (birth weight <1,500 g) admitted to the hospital and who required surfactant therapy. Newborns were divided into three study groups: early (treatment during the first two hours); intermediate (treatment between two and six hours) and late (treatment after six hours). Variables analyzed were: air leak syndrome, mortality, bronchopulmonary dysplasia, intracranial hemorrhage, patent ductus arteriosus, retinopathy of prematurity, duration of oxygen therapy, duration of mechanical ventilation, length of hospital stay and number of surfactant doses. Results: A total of 63 newborns were included (Early Group, n = 21; Intermediate Group, n = 26 and Late Group, n = 16), there was a statistical significance between birth weight and gestational age. Multivariate logistic regression analysis was used to compensate the effects of gestational age, birth weight and other possible interferences over the variables. This analysis revealed a greater incidence of air leak syndrome among newborns of the Early Group compared to the Intermediate Group (OR = 6.98; 95%CI = 1.24-39.37; p = 0.028), with no difference compared to the Late Group (OR = 3.72; 95% CI = 0.28-49.76; p = 0.321). There were no differences regarding the other variables analyzed. Conclusions: In this retrospective, non-randomized study, surfactant administration during the first two hours of life enhanced the risk of air leak syndrome, compared to the treatment between two and six hours after birth, with no reduction of early or late neonatal mortality or bronchopulmonary dysplasia, compared to later treatment after birth