Repeated, low-dose, recombinant human erythropoietin treatment reduced the risk of disability for infants with moderate HIE, without apparent side effects.

No abstract

SUMMARY Transcutaneous Po2, heart rate, and aortic blood pressure were measured in 10 mechanically-ventilated newborn infants to assess the degree and course of hypoxaemia, and to monitor the cardiovascular and respiratory changes during tracheal toilet. Five infants weighed < 1250 (mean 994) g, and 5 infants weighed >1750 (mean 2216) g. During tracheal suction the TcPo2 fell from 68 ± 27 (x ± SD) to 43 ± 23 mmHg, and the heart rate from 144 ± 8 to 123 ± 25 beats/minute, but the blood pressure increased from 44 ± 24 to 49 ± 24 mmHg. Hypoxaemia (TcPo2 <50 mmHg) occurred in 7 of 8 initially well-oxygenated infants when suctioned. The decrease in TcPo2 was similar for both groups of infants. It was greater in infants with controlled ventilation and an F0o2 >0.8 than in infants with intermittent mandatory ventilation and an F1o2 <0X8. The TcPo2 fall correlated well with the TcPo2 during the control period but not during the time that the infants were disconnected from the respirator. A critical re-evaluation of routine tracheal toilet is needed.

Systemic hypothermia reduced the risk of disability in infants with moderate HIE, in accordance with earlier studies. Hypothermia was induced within 6 hours in most infants, but delaying the onset to 6 to 10 hours after birth did not negatively affect primary outcome. Further studies with a large number of patients are needed to confirm that delayed cooling is equally effective.

Adverse effects of mild hypothermia induced for 3 days in asphyxiated newborns were significantly less than expected from previous reports on neonates with accidental hypothermia.