Continuous monitoring of v i t a l s i g n s , e . g . temperature, blood pressure, heart and r e s p i r a t i o n r a t e s , and E C G , f o r the care of c r i t i c a l l y s i c k infants has become an established hospital routine. W e have compared various non-invasive and invasive continuous Pa02 monitors with a r t e r i a l blood Pa02 levels and find t h a t there i s a considerable c o r r e l a t i o n between the values obtained by d i f f e r e n t procedures. Continuous monitoring procedures permit b e t t e r evaluation of the p a t i e n t than skin c o l o r , ECG monitoring o r c l i n i c a l observation.I t s immediate a v a i l a b i l i t y a t bedside and the capacity t o detect i r r e g u l a r i t y in oxygen supply i s of major c l i n i c a l advantage. These devices help in preventing t h e e f f e c t s of hyperoxemia and hypoxemia. S t a b i l i z a t i o n of s i c k infants can be achieved rapidly without repeated a r t e r i a l blood sampling f o r Pa02 determinations. The r e s u l t s suggest t h a t these continuous Pa02 monitors (invasive o r non-invasive) may be a b l e t o eliminate or minimize conditions l i k e bronchopulmonary dysplasia, r e t r o l e n t a l f i b r o p l a s i a and brain damage due t o lack of oxygen during neonatal development. INTRAUTERINE FETAL RESUSCITATION WITH TERBUTALINENer esh A. Te a n i , Uma L. Verma, S amali Chatter ee.1451 Spo:. by P l a t i n J. Collipp. NassavlCty Med C t r , i l t h S c i C t r , SUNY a t Stony Brook, Dept. of Ob/Gyn, East Meadow, NY Cases of i n t r a p a r t a l f e t a l d i s t r e s s from any cause s u s t a i n f u r t h e r hypoxia during u t e r i n e contractions due t o t h e concomit a n t reduction i n u t e r i n e blood flow during u t e r i n e a c t i v i t y . Therapeutic reduction of u t e r i n e a c t i v i t y should, t h e r e f o r e , res u l t i n recovery of f e t a l h e a r t r a t e (FHR) and f e t a l a c i d o s i s , and t h e b i r t h of a neonate i n a b e t t e r s t a t e of owgenation and acid-base balance. Towards t h i s , t e r b u t a l i n e 250 Ug subcutaneously was i n j e c t e d i n p a t i e n t s with evidence of f e t a l d i s t r e s s . A l l 1 1 p a t i e n t s showed ominous FHR changes. I n 2 of t h e s e , f e t a l s c a l p blood pH (FSB-pH) was not t e c h n i c a l l y possible. I n 2 , t h e FSB-pH was b 7.25. The remaining 7 p a t i e n t s showed FSB-pH 4 7.25.Results: Where adequate FHR t r a c e was a v a i l a b l e , 9/10 pat i e n t s showed marked reduction t o cessation of u t e r i n e a c t i v i t y , and complete o r p a r t i a l recovery of ominous FHR changes. FSB-pH was compared t o t h e mid-point of t h e umbilical vein and a r t e r y pH's. I n t h e 2 cases where t h e o r i g i n a l FSB-pH was b 7.25, no change was seen. However, i n cases with FSB-pH 5 7.25, a s i gn i f i c a n t improvement from a mean of 7.180 + .038 t o 7.270 2 .066 (P = 4 .005) was seen. No major s i d e e f f e d s were noted. ST of AP l i p . e x t . meas...

Forty low r i s k newborn infants were studied w i t h conceptual ages between 28 and 42 weeks. They were distinguished from high r i s k i n f a n t s on the basis o f neonatal medical complications. Brainstem auditory evoked p o t e n t i a l s (BAEP) were recorded from v e r t e x -i p s i l a t e r a l and contralateral ear reference s i t e s . Monaural 70 dBHL r a r e f a c t i o n c l i c k s were presented a t a r e p e t i t i o n r a t e o f 11 per second. Both ears were tested. The peak and i nterpeak latencies o f waves I, 111 and V were measured i n term and preterm infants. These i n t e r v a l s were analyzed i n r e l a t i o n s h i p t o conceptual age i n order t o assess the r e l a t i v e contributions o f the pertpheral and central portions o f the auditory system t o the process o f i n f a n t development.Since i t i s expected t h a t BAEPs w i l l have increasing diagnost i c and prognostic significance f o r the neurologic and otologic outcome o f newborns, a short term study o f these responses i n rel a t i o n s h i p t o r i s k f a c t o r s i s underway i n our laboratory. This data forms, i n part, a basis f o r comparison o f auditory brainstem function i n low and high r i s k infants. (Supported by USPHS Grant NS15254). Franklin ~e h r l e ) CMDNJ-NJ Med. School, Dept. Neonatolo@y,N.J. WNG TERM FOLLOW UP OF NEONATAL S E I Z m S DUEControversy e x i s t s a s t o whether neonatal s e i z u r e s due t o mode r a t e degree of p e r i n a t a l asphyxia requires long term anticonvuls a n t Rx. W e reviewed a l l cases of neonatal seizures due t o perin a t a l asphyxia from 1972-79. A l l . were t r e a t e d uniformly with Phenobarbital 10-20mg/kg I . V . & maintained a t lOmg/kg/day f o r 3 days. I f s e i z u r e s recurred, p a t i e n t s were discharged on maintenance Phenobarbital. I f seizures did not r e c u r , p a t i e n t s were s e n t home without medication. A l l p a t i e n t s were seen a t follow up c l i n i c a t r e g u l a r i n t e r v a l s u n t i l presently. 2587 records were reviewed, 47 i n f a n t s (35-43 wks GA) f i t t e d t h e c r i t e r i a of perin a t a l asphyxia ( 5 min Apgar score < 5(17), f e t a l d i s t r e s s ( 6 ) , meconiwn a s p i r a t i o n (20) prolapsed cord ( 8 ) d i f f i c u l t delivery (6) ; o t h e r causes of s e i z u r e s excluded). Infants l e s s than 35 wks GA were excluded t o avoid inclusion of I V H . Of a l l t h e 47 i n f a n t s , 7 were l o s t t o follow up, 12 required maintenance Rx. The remaini n g 28 i n f a n t s who had no s e i z u r e s beyond t h e 3rd day of l i f e & discharged without medication, were found t o our s u r p r i s e t o be s e i z u r e f r e e f o r t h e follow up period ( 6 mos-8yrs, av. 42.5 nos) except f o r 2 i n f a n t s who had seizures a s s o c i a t e d with fever, one a t 9 mos, t h e o t h e r a t 15 mos of age. These 2 i n f a n t s had no recurrence of s e i z u r e s and a r e not on therapy. From t h e s e d a t a we concluded t h a t p e r i n a t a l a...