Quantitative studies of faecal bacterial flora were carried out during the week preceding the clinical onset of 12 episodes of neonatal necrotising enterocolitis. There were considerable quantitative changes in the faecal flora preceding the clinical onset of both definite and possible episodes of necrotising enterocolitis. There was a decline in the numbers of some species from up to 72 hours before the clinical onset of the disease. Enterobacteriaceae were isolated from samples collected during the 48 hours preceding the clinical onset of ali four definite episodes of necrotising enterocolitis. These were 'new' isolates in two episodes, and considerably increased numbers in another.The changes that we found are probably the result of changes in intralunal conditions that precede the clinical onset of necrotising enterocolitis.

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Aim-To evaluate the role of recombinant human erythropoietin (R-HuEpo) in reducing iron infusion, which may exacerbate free radical damage, leading to chronic lung disease. Methods-A multicentre, randomised, placebo controlled, double blind study was carried out in four neonatal intensive care units in Yorkshire. Infants were randomly allocated and received either R-HuEpo (480 U/kg/wk) or placebo by twice weekly subcutaneous injection. The primary outcome measure was the number of days on respiratory support and a secondary outcome the number of blood transfusions required. Results-Forty two very low birthweight (VLBW) infants were randomly allocated. There was little diVerence in the need for respiratory support one month after randomisation, but subsequently there was a trend towards a reduction in the proportion requiring respiratory support in the R-HuEpo group (diVerence at three months −0.50, 95% confidence interval −1.00, 0.17). During stay in hospital, the median number of blood transfusions was lower for infants in the R-HuEpo group (diVerence in medians −2, 95% CI −4, 0). The study was stopped early because of failure to recruit babies at the expected rate. Conclusions-R-HuEpo seems to reduce the number of days in oxygen for ill VLBW infants. These data could be used to construct a larger multicentre study to evaluate this eVect further. (Arch Dis Child 1997;76:F190-F192)

ABSTRACT. The development of the transdermal electrical potential (TDP) with postnatal age was studied in neonates born at gestational ages of 25 to 42 wk. The TDP of neonates born at less than 28 wk gestational age was of similar magnitude over the whole skin surface when measured in the first 5 d of life (mean value -5.4 mV; skin surface negative with respect to s.c. tissues). The TDP increased progressively with increasing gestational and postnatal age. The rate of increase of the TDP with postmenstrual age was not accelerated in neonates born prematurely. TDP values of infants born at term were lower than those of adults, but the sites of high and low TDP were similar in both term infants and adults. (Pediatr Res 29: 78-81, 1991) Abbreviations TDP, transdermal electrical potential An electrical potential difference exists across many epithelia. It results from the balance of active transport of ions across the epithelium and the permeability of the epithelium to the passive diffusion of ions along the electrochemical gradients produced by the active transport processes. The magnitude of the potential is dependent on the structure and function of the epithelium and may be altered in disease states, as in cystic fibrosis, where epithelial cells have decreased passive permeability to chloride ions. This causes decreased reabsorption of chloride from sweat, resulting in increased negativity of the transdermal potential and abnormally high sweat chloride concentration.In adult humans, the TDP is generated largely in the sweat glands. Its magnitude depends on the activity and density of distribution of the glands, the hydration of the epidermis, and the integrity and permeability of the living cell layers of the epidermis (1). All of these factors are altered in premature infants.We studied the evolution of the TDP in premature infants compared to that of term infants and of adults. SUBJECTS A N D METHODSThe TDP was measured in three groups of subjects over a 3-month period. from the dorsum of the hand, the flexor and extensor aspects of the forearm, the chest and the back (when the baby was able to be turned safely), the dorsum of the foot, and the middle of the plantar surface of the foot.The results were grouped into 5-d periods of postnatal age. When more than one set of observations was collected during one time period from one individual, only the result nearest the median day of the time period was considered. This resulted in analysis of 86 sets of observations from 49 premature infants.All infants required i.v. cannulas for their medical management. Thirty-three (67.3%) of the 49 infants had respiratory distress syndrome.Group 2. Nine sets of observations from nine term infants aged 0-5 d were analyzed. Each set of observations consisted of TDP measurements from 30 skin sites, which were obtained while the infants were asleep.All of the infants were asymptomatic at the time of observation but were receiving antibiotics through peripheral i.v. cannulas for suspected perinatal infection. No pathogens we...

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