ObjectiveTo evaluate the height and weight development of children with congenital heart disease undergoing surgery with the goal of determining when they reach the threshold of normal development and whether there are differences between patients with developmental pattern below the level of normality preoperatively (z-score<-2 for the analyzed parameter) in comparison to the total group of cardiac patients.MethodsWe prospectively followed up 27 children undergoing operation into five time periods: preoperatively and at four subsequent outpatient appointments: 1st month, 3rd month, 6th month and 12th month after hospital discharge. The anthropometric parameters used were median z-score (MZ), weight (WAZ), height (HAZ), subscapular skinfold (SSFAZ), upper arm circumference (UAC) and triceps skinfold (TSFAZ). The evolution assessment of the parameters was performed by analysis of variance and comparison with the general normal population from unpaired t test, both in the total group of cardiac patients, and in subgroups with preoperative parameters below the normal level (Zm<-2).ResultsIn the total group there was no significant evolution of MZ of all parameters. WAZ was statistically lower than the normal population until the 1st month of follow-up (P=0.028); HAZ only preoperatively (P=0.044), SSFAZ in the first month (P=0.015) and at 12th month (P=0.038), UAC and TSFAZ were always statistically equal to the general population. In patients whose development was below the level of normality, there were important variation of WAZ (P=0.002), HAZ (P=0.001) and UAC (P=0.031) after the operation, and the WAZ was lower than the normal population until the 3rd month (P=0.015); HAZ and UAC, until the first month (P=0.024 and P=0.039 respectively), SSFAZ, up to the 12th month (P=0.005), the TSFAZ only preoperatively (P=0.011).ConclusionThe operation promoted the return to normalcy for those with heart disease in general within up to three months, but for the group of patients below normal developmental pattern of the return occurred within 12 months.
Purpose: to verify the hospital discharge rate in breastfeeding and speech-language practice during implementation of the kangaroo method in a tertiary-level teaching hospital. Methods: a retrospective and documentary study, whose data were collected from electronic medical records of all preterm and/or low birth weight newborns, born at or admitted to a teaching hospital, from August 2016 to August 2017, and who had received care by the speech-language team. Data were collected regarding sample characterization (gender, Apgar, gestational age, birth weight, and orotracheal intubation time); speech-language therapy time; description of the procedures used, such as weight to start breastfeeding, empty breast technique, translactation, and feeding method at the time of speech-language therapy and hospital discharge. Appropriate statistical tests were applied, adopting a significance level lower than 0.05%. Results: there was a higher rate of breastfeeding in moderately preterm infants, born in a gestational age of 30 to 34 weeks, and in low birth weight newborns. Conclusion: breastfeeding was the prevalent feeding method for newborns. The results show that the speech-language stimulation of newborns was adapted from the conventional model to that proposed by the Kangaroo Method, corroborating with humanized care guidelines.
Late pulmonary tomography assessment in premature infants with bronchopulmonary dysplasia submitted to patent ductus arteriosus managemnent Abstract Objective: To assess through high-resolution computed tomography, the pulmonary parenchyma of children born prematurely with both very low birth weight and patent ductus arteriosus, undergoing medical or surgical treatment who developed bronchopulmonary dysplasia.Methods: Between December 2006 and January 2007, 14 children born prematurely with a birth weight of less than 1500 g with bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA) were submitted to high-resolution computed tomography (HRCT). Patients were divided into two groups (Group A = medical [n=6] and Group B = surgical [n=8]) and all of them underwent surgical closure of the ductus arteriosus. The pool of patients was comprised of 9 baby boys and 5 baby girls who were 36.5±4.3 month-old. The HRCT were analyzed by two independent observers and quantified in each patient. The statistical analyses were assessed using the Mann-Whitney test and p<0.05 was considered statistically significant. Results:Three patients presented normal tomography; two of group A and one of B. In Group A, the most frequent finding was multifocal ground-glass opacity. In Group B, multifocal ground-glass opacity, atelectasis, and low attenuation areas with relatively decreased number and caliber of vessels were prevalent (62.5%). There was a statistically significant difference between both groups. Group B presented higher averages in intubation time, use of oxygen, and admission. However, as to the number of injuries found on HRCT there was no statistically significant difference (p=0.0787).Conclusion: The lately use of HRCT has shown no significant difference between both medical and surgical treatment aiming at to occlude the PDA in pulmonary parenchyma injuries of premature infants with PDA who developed bronchopulmonary dysplasia.Descriptors: Tomography. Patent ductus arteriosus. Bronchopulmonary dysplasia. 401BEANI, L ET AL -Late pulmonary tomography assessment in premature infants with bronchopulmonary dysplasia submitted to patent ductus arteriosus managemnent Bras Cir Cardiovasc 2007; 22(4): 400-406 Rev
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