1455 TRANSCUTANEOUS BILIRUBINOMETRY IN BLACK & HISPANIC INFANTS

Abstract

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...

A Prospective Comparison of Serum and Transcutaneous Bilirubin in Indian Neonates

“…Nevertheless, most of the previous studies have tested the validity of transcutaneous bilirubinometry almost solely by comparing the degree of exact correlation with the serum value. 10 11 12 13 14 15 But the studies which show the effect of phototherapy on correlation of TcB and TSB are mostly from outside India. 9 16 17 18 19…”

“…Nevertheless, most of the previous studies have tested the validity of transcutaneous bilirubinometry almost solely by comparing the degree of exact correlation with the serum value. [10][11][12][13][14][15] But the studies which show the effect of phototherapy on correlation of TcB and TSB are mostly from outside India. 9,[16][17][18][19] As there is more prevalence of neonatal hyperbilirubinemia in developing countries like India, but still there is paucity of data regarding correlation of TcB and TSB.…”