The Incubator and the Medical Discovery of the Premature Infant

Baker, Jeffrey P.

doi:10.1038/sj.jp.7200377

Cited by 464 publications

(54 citation statements)

References 28 publications

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“…Although the spectacular successes of preterm outcomes are usually attributed to technological advances, far more has been contributed by generations of clinicians who applied available technology to the care of critically ill infants and basic scientists who studied the pathophysiology of preterm complications [Baker, 2000]. The trial and error approach to innovative treatments required feedback regarding preterm outcomes.…”

Section: Historical Perspectivementioning

confidence: 99%

Preterm outcomes research: A critical component of neonatal intensive care

Allen

2002

Ment. Retard. Dev. Disabil. Res. Rev.

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While early preterm outcome studies described the lives of preterm survivors to justify the efforts required to save them, subsequent studies demonstrated their increased incidence of cerebral palsy, mental retardation, sensory impairments, minor neuromotor dysfunction, language delays, visual-perceptual disorders, learning disability and behavior problems compared to fullterm controls. Because infants born at the lower limit of viability require the most resources and have the highest incidence of neurodevelopmental disability, there is concern that resources have gone primarily to neonatal intensive care and are not available for meeting the followup, health, educational and emotional needs of these fragile infants and their families. Despite many methodological concerns, preterm outcome studies have provided insight into risk factors for and causes of CNS injury in preterm infants. Nevertheless, it remains difficult to predict neurodevelopmental outcome for individual preterm infants. Perinatal and neonatal risk factors are inadequate proxies for neurodevelopmental disability. Recent randomized controlled trials with one to five year neurodevelopmental followup have provided valuable information about perinatal and neonatal treatments. Recognizing adverse longterm neurodevelopmental effects of pharmacological doses of postnatal steroids is a sobering reminder of the need for longterm neurodevelopmental followup in all neonatal randomized controlled trials. Ongoing longterm preterm neurodevelopmental studies, analysis of changes in outcomes over time and among centers, and evaluation of the longterm safety, efficacy and effectiveness of many perinatal and neonatal management strategies and proposed neuroprotective agents are all necessary for further medical and technological advances in neonatal intensive care.

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Section: Historical Perspectivementioning

confidence: 99%

Preterm outcomes research: A critical component of neonatal intensive care

Allen

2002

Ment. Retard. Dev. Disabil. Res. Rev.

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“…In the 1890s, the Lion incubator was developed, which was more sophisticated and was subsequently used in many of the incubator baby shows. 6 Subsequent incubator development is described by Hess 7 in his text, Premature and Congenitally Diseased Infants, published in 1922 (Chapter IX, Incubators) and by Baker 4 in his book, The Machine in the Nursery.…”

Section: Lowered Thermal Environmentmentioning

confidence: 99%

“…50 The 1930s had seen great progress in the study of vitamins. In 1934, Gyorgy used the term B 6 to describe a substance in crude feed supplements that cured a florid dermatitis in rats fed purified feed with only vitamins B 1 and B 2 added. In 1938, five research groups purified crystalline B 6 ; in 1939, its chemical formula was elucidated and the name pyridoxine given.…”

Section: Sma Formula Changementioning

confidence: 99%

Reflections on Errors in Neonatology: I. The “Hands-Off” Years, 1920 to 1950

Robertson

2003

J Perinatol

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“…At this point, it is probably not necessary to detail the development of the modern incubator (17)(18)(19). Suffice it to say that at the end of the 19th century, infant and neonatal mortality was alarmingly high and temperature regulation improved survival.…”

Section: Thermoregulationmentioning

confidence: 99%

“…This acronym stood for toxoplasmosis, other, rubella, cytomegalovirus, and herpes simplex; chief among "other" was congenital syphilis (138,139). Later, we were introduced to parvovirus B 19 , which can cause profound anemia and hydrops of the fetus (140), and on a global basis, perinatal transmission of HIV-1 has had a devastating effect on millions of infants who became HIV positive or acquired AIDS. Although perinatal transmission may now be prevented in many cases, availability of appropriate drug therapy remains a problem (141).…”

Section: Neonatal Infectionmentioning

confidence: 99%

The Evolution of Neonatology

Philip

2005

Pediatr Res

540

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In 1960, the terms "neonatology" and "neonatologist" were introduced. Thereafter, an increasing number of pediatricians devoted themselves to full-time neonatology. In 1975, the first examination of the Sub-Board of Neonatal-Perinatal Medicine of the American Board of Pediatrics and the first meeting of the Perinatal Section of the American Academy of Pediatrics were held. One of the most important factors that improved the care of the neonate was the miniaturization of blood samples needed to determine blood gases, serum electrolytes, glucose, calcium, bilirubin, and other biochemical measurements. Another factor was the ability to provide nutrition intravenously, and the third was the maintenance of normal body temperature. The management of respiratory distress syndrome improved with i.v. glucose and correction of metabolic acidosis, followed by assisted ventilation, continuous positive airway pressure, antenatal corticosteroid administration, and the introduction of exogenous surfactant. Pharmacologic manipulation of the ductus arteriosus, support of blood pressure, echocardiography, and changes in the management of persistent pulmonary hypertension, including the use of nitric oxide and extracorporeal membrane oxygenation, all have influenced the cardiopulmonary management of the neonate. Regionalization of neonatal care; changes in parent-infant interaction; and technological changes such as phototherapy, oxygen saturation monitors, and brain imaging techniques are among the important advances reviewed in this report. Most remarkable, a 1-kg infant who was born in 1960 had a mortality risk of 95% but had a 95% probability of survival by 2000. However, errors in neonatology are acknowledged, and potential directions for the future are explored. Abbreviations AAP, American Academy of Pediatrics BPD, bronchopulmonary dysplasia CPAP, continuous positive airway pressure ECMO, extracorporeal membrane oxygenation ELBW, extremely low birth weight HMD, hyaline membrane disease iNO, inhaled nitric oxide IUGR, intrauterine growth restriction IVH, intraventricular hemorrhage L/S, ratio of lecithin, phosphatidyl choline, to sphingomyelin NICU, neonatal intensive care unit PDA, patent ductus arteriosus PEEP, positive end expiratory pressure PPHN, persistent pulmonary hypertension of the newborn PVH, periventricular hemorrhage RDS, respiratory distress syndrome ROP, retinopathy of prematurity SIDS, sudden infant death syndrome VLBW, very low birth weight VON, Vermont-Oxford Network "There is need for specialization in neonatal medicine. This applies to doctors and nurses as well as teaching and construction of hospitals. The specialist in neonatal diseases and the nurse intensively trained and expert in the management of delicate newborns will be commonplace ere long." J.W. Ballantyne, 1923 (1) "In previous times the problems of the newborn child have been the province of the obstetrician, a field in which he has taken comparatively little interest and to which he has contributed little. As pediatricians we have but s...

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The Incubator and the Medical Discovery of the Premature Infant

Cited by 464 publications

References 28 publications

Preterm outcomes research: A critical component of neonatal intensive care

Preterm outcomes research: A critical component of neonatal intensive care

Reflections on Errors in Neonatology: I. The “Hands-Off” Years, 1920 to 1950

The Evolution of Neonatology

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