Hyperoncotic colloids and acute kidney injury: a meta-analysis of randomized trials.

Introduction: It has been hypothesized that hyperoncotic colloids might contribute to acute kidney injury (AKI). However, the validity of this hypothesis remains unclear.

Methods: A meta-analysis was conducted of randomized controlled trials evaluating AKI after infusion of hyperoncotic albumin and hydroxyethyl starch (HES) solutions.

Use of surfactant for prophylaxis versus rescue treatment of respiratory distress syndrome: experience from an Italian-Bulgarian trial.

Objective: To show if surfactant applied in different social-sanitary realities as prophylaxis of respiratory distress syndrome (RDS) is equally useful and able to reduce mortality and incidence of 3-4 radiological grade RDS.

Methods And Patients: Two neonatal intensive care units (NICU) in Italy, one NICU in Bulgaria and one NICU in Romania were involved in a randomized controlled clinical trial of prophylaxis vs rescue treatment of RDS. Babies with gestational age 26-30 wks were randomized before birth to prophylaxis in the delivery-room with 200 mg/kg of porcine surfactant (prophylaxis) or to routine assistance (control).

[The surgical treatment of fixed aortic subvalvular stenosis].

Over the past 5 years, 45 patients (11 adults and 33 children) have undergone operations for discrete and fixed subaortic stenosis. The resection of the subvalvular membrane or the fibromuscular collar was the procedure of choice. 28 patients underwent myectomy and/or myotomy.

Management of preterm infants receiving surfactant supplementation.

The use of exogenous surfactant in the clinical management of severe neonatal respiratory distress syndrome (RDS) has raised some potential new problems related to the rapid variations in oxygenation and pulmonary compliance occurring after this treatment. We advise a strict monitoring of arterial oxygen tension (Pao2), preferably by a non-invasive technique and rapid resetting of the ventilator as indicated by changes in pulmonary compliance and lung aeration after surfactant administration. The goal should be to minimize the risks of air leakage, left-to-right shunt, and overloading of the pulmonary circulation.

Antenatal prevention of respiratory distress syndrome; a multicentre survey.

Obstetric and neonatal data were collected on 934 preterm deliveries in 11 Italian centres in 1980, 1985 and 1986. Therapeutic regimens for prevention of respiratory distress syndrome (RDS) were applied in 42% of the cases in 1980, 32% in 1985 and 42% in 1986. Prevention was made in most cases with corticosteroids, although their use fell progressively from 94% in 1980 to 74% in 1986.

[Controlled study on the prevention of respiratory distress syndrome with betamethasone in pregnancy and ACTH and cortisol levels in the premature newborn infant].

The influence of maternal corticosteroid administration was studied on the ACTH and cortisol concentrations in neonatal blood of 24 premature infants whose mothers received betamethasone for prevention of RDS, compared with 11 untreated subjects. Cord blood was taken at birth and from venous sample in 5th day. All samples were analyzed for ACTH and Cortisol by radioimmunoassay.

[Prognosis for newborns of very low birthweight (author's transl)].

During the 5 years, 1975-1979, 144 infants weighing less than or equal to 1500 g (ranging from 400 to 1500 g) were admitted to the Neonatal Intensive Care Unit of Mantua. 57 (40%) survived the neonatal period. The principal cause of death was hypoxia and hyaline membrane disease.