No abstract

The neurodevelopmental outcome of premature infants with persistent apnea of prematurity (AOP) is reported. Sixty premature infants (birthweight [BW], 1469 +/- 533 gm; gestational age [GA , 31 +/- 3 weeks) with AOP were compared to 47 control infants (BW, 1586 +/- 581 gm; GA, 31 +/- 3 weeks) matched for gestational age and degree of neonatal illness. The infants were enrolled in a multidisciplinary follow-up program, and outcome data between 12 and 24 months are reported. Assessments included the Bayley Scores of Infant Development, neurologic examinations, speech and hearing examinations. There were no significant differences in the cognitive outcome between the premature infants with AOP and the premature control group. In 50 of 60 infants the Bayley Mental Developmental Index was in the normal range (112 +/- 18) as was 39 of 47 of the control group (112 +/- 13). Delays in motor development were seen in both premature groups, although a greater percentage of premature infants with persistent apnea had mild motor delays than did control infants. There was a comparable incidence of cerebral palsy (8% vs 11%), speech delays (20% vs 23%), retinopathy (8% vs 13%), and esotropia (7% vs 4%) between the infants with AOP and the premature control infants. The presence of persistent neonatal apnea without additional adverse perinatal events did not appear to be associated with a higher incidence of significant developmental problems.

. Columbia University College of Physicians and Surgeons, Babies H o s p i t a l , Departments of P e d i a t r i c s , Surgery, Pathology and I n s t i t u t e f o r Human Nutr i t i o n , New York.To t e s t t h e hypothesis t h a t distending p r e s s u r e produced by t h e r e s p i r a t o r y muscles determines p o s t n a t a l growth of lung parenchyma, we s t u d i e d u n i l a t e r a l diaphragmatic p a r a l y s i s i n k i t tens. Twelve 10-12 week o l d k i t t e n s underwent l e f t thoracotomy. In 6 , u n i l a t e r a l phrenectomy was done v i a t h e thoracotomy; t h e o t h e r 6 served a s controls. Five t o 7 weeks l a t e r , body weight had increased by 49% i n the phrenectomized group and by 47% i n t h e c o n t r o l s (NS). However f u n c t i o n a l r e s i d u a l capacity by helium d i l u t i o n under ketamine hydrochloride a n a e s t h e s i a was lower i n t h e phrenectomized group (35 2 4 ml versus 58 + 9 m l i n t h e c o n t r o l s , P C .001). As measured by b i l a t e r a l p l e u r a l balloons, mean transpulmonary p r e s s u r e i p s i l a t e r a l t o t h e phrenectomy was lower than mean transpulmonary pressure c o n t r a l a t e r a l t o t h e phrenectomy (P<.05). I n postmortem s t u d i e s , growth of contral a t e r a l lungs r e l a t i v e t o i p s i l a t e r a l lungs was g r e a t e r i n the phrenectomized animals than i n t h e c o n t r o l s , as shown by r a t i o s of contralateral/ipsilateral wet lung weight (1.44 versus 1.34, P< .005), maximum i n f l a t i o n volume (1.53 versus 1.33, P< .005) and t o t a l p r o t e i n content (1.45 versus 1.26, P< .002). Ratios of t o t a l proteinlDNA and RNA/DNA were unchanged. W e conclude t h a t p o s t n a t a l growth of lung parenchyma by c e l l p r o l i f e r a t i o n i n t h e c a t depends on pulmonary distending pressure. This study was designed to obtain normative data for FRC, dynamic (CLd) and specific lung compliance (CLs) during the first years of life. Thirteen boys and 9 girls f r e e of respiratory disease were studied. Age, height, weight and ventilatory r a t e respectively ranged from 2 -52 months, 55 -96 cm, 4.9 -16 Kg and 22 -55Imin.Studies were performed during chloral hydrate induced sleep. Infants breathed through a mouth piece or a face mask. FRC was determined by the closed circuit helium dilution technique using a 2.2 1 water sealed spirograph.Added dead space was subtracted from the measured volume and values were converted to BTPS. Measurement of tidal flow and volume through a heated pneumotachograph and of esophageal pressure with an air filled balloon catheter allowed for calculation of CLd as A V/ A P a t zero flow. FRC, CLd and CLs respectively ranged from 110 -430 ml, 8.1 -34.7 ml/cm H 0 and .051 -.I10 ml/cm H20/ml FRC. FRC and CLd were signif?cantly correlated with height, age, weight and ventilatory r a t e while CLs was not. CLd was also significantly correlate with FRC. Multiple linear regression analysis showed that: I-the only significant predictive ...