[Medication errors in a neonatal unit: One of the main adverse events].

Introduction: Neonatal units are one of the hospital areas most exposed to the committing of treatment errors. A medication error (ME) is defined as the avoidable incident secondary to drug misuse that causes or may cause harm to the patient. The aim of this paper is to present the incidence of ME (including feeding) reported in our neonatal unit and its characteristics and possible causal factors.

[Towards a safety culture in the neonatal unit: Six years experience].

Introduction: A safety culture is the collective effort of an institution to direct its resources toward the goal of safety.

Material And Methods: An analysis is performed on the six years of experience of the Committee on the Safety of Neonatal Patient. A mailbox was created for the declaration of adverse events, and measures for their correction were devised, such as case studies, continuous education, prevention of nosocomial infections, as well as information on the work done and its assessment.

Combination of vancomycin and rifampicin for the treatment of persistent coagulase-negative staphylococcal bacteremia in preterm neonates.

Unlabelled: Coagulase-negative staphylococci are the most common cause of late-onset sepsis in premature neonates. The optimal approach in persistent coagulase-negative staphylococcal bacteremia, despite adequate treatment with glycopeptides, is not well established. A retrospective study was conducted on preterm neonates with persistent coagulase-negative staphylococcal bacteremia treated with the combination of vancomycin-rifampicin.

Trends in survival among extremely-low-birth-weight infants (less than 1000 g) without significant bronchopulmonary dysplasia.

Objective: The aim of this study was to analyze the evolution from 1997 to 2009 of survival without significant (moderate and severe) bronchopulmonary dysplasia (SWsBPD) in extremely-low-birth-weight (ELBW) infants and to determine the influence of changes in resuscitation, nutrition and mechanical ventilation on the survival rate.

Study Design: In this study, 415 premature infants with birth weights below 1000 g (ELBW) were divided into three chronological subgroups: 1997 to 2000 (n = 65), 2001 to 2005 (n = 178) and 2006 to 2009 (n = 172).Between 1997 and 2000, respiratory resuscitation in the delivery room was performed via a bag and mask (Ambu®, Ballerup, Sweden) with 40-50% oxygen.

Impact of chorioamnionitis on exhaled nitric oxide and endotracheal aspirate levels of nitrites-nitrates and interleukin-8 in mechanically ventilated preterm neonates.

Objectives: To assess the influence of maternal chorioamnionitis on early exhaled nitric oxide (NO) and levels of nitrites-nitrates and interleukin (IL)-8 in endotracheal aspirate fluid in mechanically ventilated preterm neonates.

Study Design: Cross-sectional study. PATIENT-SUBJECT SELECTION: Between September 2007 and August 2009, 54 mechanically ventilated preterm neonates were included.

Intravenous immunoglobulin and necrotizing enterocolitis in newborns with hemolytic disease.

Objective: The objective of this study was to assess whether the use of high-dose intravenous immunoglobulin (IVIG) in late-preterm and term newborns with severe isoimmune hemolytic jaundice caused by Rh and ABO incompatibility was a risk factor for necrotizing enterocolitis (NEC).

Methods: An observational, retrospective study that encompassed 16 years was conducted. A total of 492 liveborn infants who were of >or=34 weeks' gestation and had severe isoimmune hemolytic jaundice caused by Rh (n = 91) and ABO (n = 401) incompatibility and were treated with phototherapy were included in the study.

Attempt to normalize simulated exhaled nitric oxide according to ventilatory settings.

Background: Simulated exhaled nitric oxide (eNO) depends on ventilatory settings used in different experimental conditions.

Objectives: To normalize the simulated minute exhaled nitric oxide according to different ventilatory settings.

Working Hypothesis: Different ventilatory settings influence the concentrations of exhaled nitric oxide and these results can be normalized.

Serum soluble ICAM-1, VCAM-1, L-selectin, and P-selectin levels as markers of infection and their relation to clinical severity in neonatal sepsis.

Adhesion molecules may play a role in the evolution and severity of neonatal sepsis. The purposes of this study were to determine whether serum soluble intercellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule (VCAM)-1, L-selectin, and P-selectin levels are useful tools in the diagnosis of proven sepsis in newborn infants, and whether their levels are related to the clinical severity of the disease. A cohort of 25 consecutive newborns meeting criteria for clinical sepsis, 10 hemoculture-negative (HC - ) and 15 hemoculture-positive (HC + ), were prospectively followed and compared with 12 healthy newborns (six /= 39 weeks).

Severe hypernatremic dehydration secondary to undetected lactation failure: usefulness of sodium levels in breast milk.

There is a concern that lactation failure and neonatal morbidity might be more common than previously thought. Maybe the early discharge, the lack of timely follow-up, or poor information during pregnancy or after delivery play important roles. A case of severe hypernatremic dehydration secondary to lactation failure is reported and we analyze recent recommendations.

Nonimmune hydrops fetalis due to congenital xerocytosis.

Hereditary xerocytosis is a rare hemolytic anemia in which erythrocytes are dehydrated due to a loss of potassium and water through their cell wall membrane. In adults, this condition leads to a mild-to-moderate hemolysis. We report a case of hydrops fetalis secondary to hereditary xerocytosis.

Plasma endothelin-1 and clinical manifestations of neonatal sepsis.

Aim: To determine whether plasma endothelin-1 (ET-1) relates to clinical manifestations of sepsis in the newborn, especially with systemic hypotension, acidosis, severe hypoxemia (which may represent pulmonary hypertension) and oliguria.

Methods: Prospective study of 35 consecutive newborns with clinical sepsis: 22 with hemoculture-positive (HC+) sepsis and 13 hemoculture-negative (HC-). Plasma ET-1 concentrations were measured within 2 days of the diagnosis of sepsis.

Energy intake, metabolic balance and growth in preterm infants fed formulas with different nonprotein energy supplements.

Objective: To study metabolic and energy balances, growth and composition of increased body mass in healthy preterm infants fed control formula or control formula with three different nonprotein energy supplements.

Patients And Methods: Growing preterm infants (birth weight < 1,500 g and gestational age < 31 weeks) were fed standard preterm formula (control group) or the same formula enriched with three different nonprotein energy supplements. An energy supplement of 23 kcal/kg/day was achieved by adding medium-chain triglyceride and dextrinomaltose in three different caloric ratios: 33:66 in group A, 66:33 in group B, and 85:15 in group C.

Efficacy of three treatment schedules in severe meconium aspiration syndrome.

Aim: To compare three different schedules in severe meconium aspiration syndrome (MAS) treatment: standard, bronchoalveolar lavage (BAL) with diluted surfactant, and diluted surfactant BAL plus a single early dexamethasone dose.

Methods: Twenty-four full-term newborns with severe MAS (needing mechanical ventilation and with oxygenation index > or = 15) were divided into three groups: group I (historical control group; n = 6) treated with standard therapy; group II (n = 7) treated in the first hours of life with one BAL using diluted surfactant (beractant 5 mg/mL) in a volume of 15 mL/kg in four aliquots; and group III (n = 11) treated with one diluted surfactant BAL and a previous single dose of intravenous dexamethasone (0.5 mg/kg).

Plasma nitrite/nitrate and endothelin-1 concentrations in neonatal sepsis.

Aim: To determine the changes in plasma nitrite/nitrate (NOx) and endothelin-1 (ET-1) concentrations during neonatal sepsis.

Methods: In a prospective study, 60 consecutive newborns meeting the criteria for sepsis and without receiving exogenous nitric oxide (25 haemoculture-positive [HC+] and 35 haemoculture-negative [HC-]) were compared with 68 healthy newborns (46 full-term and 22 preterm). NOx and ET-1 concentrations were measured in each newborn within 48 h of diagnosis of sepsis and then every third day up to three determinations.

[Neonatal morbidity and mortality in very low birth weight infants according to exposure to chorioamnionitis].

Objectives: To study differences in the incidence of neonatal morbidity and mortality among newborns weighing less than 1,500 g according to exposure to chorioamnionitis (CA).

Patients And Methods: A case-control study of 135 newborns weighing less than 1,500 g at birth and born between 1988 and 1998 was performed. The case group was composed of 45 newborns exposed to clinical or subclinical levels of maternal CA.

[Neonatal varicella: report of a case of bronchopneumonia and hemorrhagic pulmonary edema].

We describe the case of a male newborn infant, whose mother developed varicella 20 days before delivery. At 2 hours of life the infant's general state suddenly deteriorated and he presented cyanosis, respiratory distress and emission of pink foam in his mouth. The infant was diagnosed with bilateral bronchopneumonia, of probable varicellosus etiology, with a component of hemorrhagic pulmonary edema.

[Analysis of a case of severe congenital toxoplasmosis].

Background: To describe a case of severe congenital toxoplasmosis because of inadequate surveillance of a seronegative pregnant woman and to evaluate the usefulness of different microbiological diagnostic methods after birth.

Methods: We applied serology, DNA amplification by one-tube semi-nested PCR, cell culture and mice inoculation analysis.

Results: Anti.

[Neurological and growth follow-up of cardiac patients operated on before 45 days of life].

Objective: Our aim was to study the neurological and growth disorders in patients undergoing cardiac surgery during the neonatal period.

Patients And Methods: Ninety clinical records of newborns with congenital heart disease that were operated between 1985 and 1996 and were under the age of 45 days with a minimum follow-up period of 12 months were reviewed.

Results: Of the 37 patient records considered, 33 (89.