Reducing medication errors in the neonatal intensive care unit.

Background: Medication errors are common in the neonatal intensive care unit (NICU). Various strategies to reduce errors have been described in adult and paediatric patients but there are few published data on their effect in the NICU.

Aim: To describe the medication errors occurring within an NICU, and assess the impact of a combined risk management/clinical pharmacist led education programme on these errors.

Uniparental isodisomy for chromosome 16 in a growth-retarded infant with congenital heart disease.

We report a growth-retarded infant with congenital heart disease and maternal isodisomy for chromosome 16. Non-mosaic trisomy 16 was detected at mid-trimester chorionic villus sampling, performed because biochemical screening indicated an increased Down's syndrome risk. Further karyotyping analysis of the placenta, after delivery, showed a 50 per cent mosaic trisomy 16.

Randomised trial of continuous nasogastric, bolus nasogastric, and transpyloric feeding in infants of birth weight under 1400 g.

Forty three infants under 1400 g were fed by a bolus nasogastric, continuous nasogastric, or transpyloric route. There were more complications with transpyloric feeding and no identifiable benefits in the growth rate, oral energy input, or chosen biochemical indices of nutrition. Bolus or continuous nasogastric feeds rather than transpyloric are better routine methods in infants of low birth weight.

Thyrotropin receptor antibodies associated with post-operative relapse of thyrotoxicosis in a pregnancy complicated by neonatal thyrotoxicosis.

This case describes the clinical, biochemical and immunological features associated with relapse of thyrotoxicosis during pregnancy in a patient who had recently undergone a subtotal thyroidectomy for Graves' disease. The baby, shortly after birth, showed clinical and biochemical features of thyrotoxicosis which responded to carbimazole therapy. Thyrotropin receptor antibodies and thyroid stimulating antibodies were present in the blood of the mother and baby.

Maternal narcotic abuse and the newborn.

In 50 infants born to women who continued to take heroin during all or part of their pregnancy the drug withdrawal symptoms were mild and were noted in 21 infants (42%). Only nine infants required treatment. Sudden infant death syndrome occurred in two infants at 4 and 6 months.

Central venous catheterisation in very low birthweight infants.

Forty two premature babies (mean birth weight 980 g, mean gestation 27.6 weeks) had central venous lines inserted at a mean age of 10 days through the internal jugular vein because of poor peripheral venous access and for purposes of parenteral feeding and minimal handling. Eight babies died from complications of prematurity and four from septicaemia with a central line in situ, but the other 30 babies had lines in place for a mean of 20 days.

Renal vein renin measurement and arteriography in the investigation and management of severe childhood hypertension.

Forty-two children aged one to sixteen years with persistent and severe hypertension were investigated by renal vein renin measurements. There were no serious complications in the 49 procedures performed and technical failure occurred on three occasions. Arteriography was performed in 35.