Restrictive RBC transfusion thresholds in VLBW infants may be utilised without incurring clinically important increases in the risk of death or major short-term neonatal morbidities.

Dexmedetomidine for analgesia and sedation in newborn infants receiving mechanical ventilation.

Key Clinical MessageWe report a case of an infant with congenital diaphragmatic hernia (CDH) and hydrops fetalis who died from hypoxic respiratory failure. Autopsy revealed type B interrupted aortic arch (IAA). Microarray revealed a female karyotype with deletion of chromosome 1p21.1p12. There may be an association between 1p microdeletion, CDH, and IAA.

Introduction:The incidence of chickenpox in Singapore is steadily increasing despite the availability of effective preventive measures. To address the need for improvement in public education, a survey was conducted to establish if differences exist amongst parents and medical students with regards to their knowledge, attitudes, and practices regarding chickenpox and its prevention.

necessary. In 21/82 cases INSURE was not successful. In the unsuccessful group patients were not significantly younger and smaller. Procalcitonin levels at the age of one day were significantly higher the group of unsuccessful cases. III-IV Gr. IVH occurred in 6/82 necrotizing enterocolitis in 7/82 and bronchopulmonary dysplasia in 7/82 cases. Complications were more frequent in those cases whose INSURE therapy was unsuccessful. Background and aims Current definitions for bronchopulmonary dysplasia (BPD) lack objectivity. A physiological definition for BPD where the level of shunt and the reduction in ventilation-perfusion ratio serve as an objective grading of severity has been suggested. Shunt and reduced VA:Q can be measured noninvasively by determining the relationship of arterial oxygen saturations (SpO2) to the fraction of inspired oxygen (FiO2). Our aims were to: 1. quantify shunt and reduced VA:Q in infants with BPD and in preterm infants without BPD. 2.correlate shunt and VA:Q to clinical grading of severity where possible Methods The group study population consisted of 10 infants (two with 'No BPD', two with 'Mild BPD' and six with 'Severe BPD') based on the NIH grades of BPD severity. Stepwise alterations in FiO2 were made, whilst ensuring infants stayed within the Monash Newborn SpO2 alarm limits. A two compartmental model of gas exchange was used to derive the SpO2 vs. FiO2 curves and values for shunt and VA:Q. Results Five out of six infants with 'Severe BPD' and one infant with 'Mild BPD' had VA:Q well below normal, range 0.34 to 0.56. Two infants with 'No BPD' and two infants with BPD, had SpO2 vs. FiO2 curves suggesting no impairment in gas exchange. The level of shunt and reduction in VA:Q did not consistently reflect the clinical grading of BPD. Conclusions Our results reinforce the need for a more objective definition of BPD as the possibility of misclassification using the clinical definition occurred on three occasions.