INTENSIVE CARE OF SMALL PREMATURE INFANTS: I. Clinical findings and results of treatment

Abstract

Summary Clinical findings and results of treatment in a series of 49 premature infants with birth weights between 850 and 1250 g are presented. The “intensive care” included nursing in incubators with high environmental humidity maintaining skin temperature at 36.5°C, umbilical catheterisation (both arterial and venous), intravenous glucose infusions, correction of metabolic acidosis by rapid sodium bicarbonate infusions, oxygen therapy and finally endotracheal intubation and mechanical ventilation. The series was divided into 3 categories according to the severity of respiratory symptoms. There was only one survivor out of 12 cases in the category of severe RD, whereas 14 of 21 with moderate RD and 9 of 16 with slight or no RD survived. The overall survival rate was 45%. The correlation between clinical findings, arterial blood gases and pH, chest X‐rays, response to treatment and outcome in each of the 3 categories is discussed. The preliminary data from our follow‐up studies indicate that there are only a few cases showing signs of permanent brain injury at the age of two years.

Intensive Care of Small Premature Infants

“…(IPPR) (31). This report concerns the clinicalpathological correlation in the 27 infants who died; such a specific study has not been reported before.…”

“…The clinical definitions, symptomatology, the diagnoses and the chest roentgenograms have been given previously (31).…”

“…The material was divided into three categories: severe respiratory distress (RD), moderate R D and slight or no R D (31).…”

Newborn Intensive Care and Long‐term Prognosis

“…Documenration of the benefits derived from intensive care of newborns has been difficult to obtain, but data are now appearing which indicate that neonatal mortality has improved (Swyer 1970, Vapaavuori and Raiha 1970, Rawlings et al 1971, Carrier et al 1972, Ellis et al 1972, and that survivors have a better outlook for central nervous system development (Stahlman 1969, Vapaavuori and Raiha 1970, Phibbs and Tooley 1971, Rawlings et al 1971, Alden et al 1972, Dweck et al 1972, Hunt and Tooley 1973.…”

Review article

“…DWECK, et al [29] reported an 18% survival rate for infants under 1100 grams managed during 1968-1970, and ALDEN and colleagues [2] found that 13% of neonates under 1000 grams survived during 1965-1970. The 45% survival rate for 49 infants 850-1250 grams managed during 1966-1967 in the NICU at University Central Hospital, Helsinki, Finland included only three who were both appropriate for gestational age (AGA) and under 1000 grams at birth[83]. Mortality rates for neonates äs relatedto gestational age are outlined in Tab.…”