SUMMARY Seventy three preterm infants weighing less than 1500 g or less than 32 weeks' gestation, or both, were allocated randomly to treatment (fresh frozen plasma 10 ml/kg on admission and at 24 hours of age) or control groups. Fifteen (41%) out of 37 control patients sustained intraventricular haemorrhage compared with five (14%) of 36 patients receiving treatment (X2=5-24, P=0-022). No difference was found in coagulation factors measured at birth or at 48 hours of age in both groups. Fresh frozen plasma appears to have a beneficial effect in the prevention of intraventricular haemorrhage.Intraventricular haemorrhage is the most common neurological disorder in preterm infants, occurring in 30-40% of babies weighing less than 1500 g.1-3
SUMMARY Twenty five of 106 preterm infants of 34 weeks' gestation or less developed intraventricular haemorrhage within the first 48 hours of life. A comparison of infants with and without intraventricular haemorrhage showed no significant differences in their haemostatic parameters at birth. At age 48 hours the group with intraventricular haemorrhage showed a prolonged activated partial thromboplastin time and reduced factor II, VII, and X activity. There was a significant correlation between the severity of intraventricular haemorrhage and the degree of haemostasis abnormality both in cord blood and in blood obtained at age 48 hours. Those infants sustaining grade IV intraventricular haemorrhage had a significantly prolonged activated partial thromboplastin time, reduced factor II, VII, and X activity; and a decreased fibrinogen concentration at birth. At age 48 hours these defects were accompanied by reduced platelet counts and an increased megathrombocyte index. Although intraventricular haemorrhage is multifactorial, we postulate that correction of haemostasis abnormalities at birth may prevent progression to more severe grades of haemorrhage. The birthweight of the study population was mean (SD) 1-67 (0.58) kg (range 0-6 to 3-49 kg) and the gestational age was mean (SD), 31-2 (3-12) weeks (range 24 to 34 weeks). Infants were excluded if there was a maternal history of ingestion of drugs such as aspirin and warfarin that might have altered the coagulation studies. Infants weighing less than 1500 g and those weighing 1500 g or more received vitamin K1 intramuscularly in doses of 0 5 mg and 1 mg respectively shortly after birth. None of the infants received indomethacin during the study period. Blood products including fresh frozen plasma, albumin, and whole blood were given according to the infants' clinical status. When arterial catheters were used the infusion fluid contained 1 U/ml heparin and infusion rates did not exceed 1 ml/hour. Detection of intracranial haemorrhages. Intraventricular and periventricular haemorrhages were detected using a Diasonics 20S ultrasound detector (Diasonics, Canada) fitted with a 7-5 mHz transducer. Serial craniosonograms were performed at 8 hour intervals in the first 24 hours of life, at 12 hour intervals in the second 24 hours, and weekly thereafter. Haemorrhages were graded according to 444 on 11 May 2018 by guest. Protected by copyright.
in a gelatin capsule that dissolves in the stomach. The pancreatin in the released microspheres is protected from acid/pepsin digestion by a pH sensitive coat that does not dissolve until the pH exceeds roughly 5-5. Thus the granules mix with the gastric contents and enzymes are not released until the pH of the chyme exceeds 5-5 within the duodenum. In this study we compared the efficacy of Pancrex V Forte tablets (Paines and Byrne) with three microsphere systems-namely, Pancrease (Ortho-Cilag), Creon (Duphar), and a new pancreatin product, Pancreatin Merck (Merck Pharmaceuticals) (Table). Patients and methodsPatients. Nineteen patients who were currently receiving treatment at our unit were enrolled in the study. Their median age was 12 years 1 month, with a range of 6 years 2 months to 20 years 1 month, and their most recent Shwachman clinical scores and Chrispin Norman x ray scores were 80 (60-95) and 6 (0-21), respectively. All children had symptoms of cystic fibrosis and all had had at least two raised sweat sodium and chloride concentrations. At the time of entry into the trial all patients were on an unrestricted normal diet that contained a median of 3-14 (1-38-4-48) g of fat/kg/day and were receiving as their pancreatic supplement a median of 18 (6-40) capsules of Pancrease each day.
Patients and methodsSt Joseph's Hospital, London, Ontario is a regional referral unit for high-risk pregnancies. Of
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.