Tolazoline-assisted Doppler echocardiography confirming normal pulmonary venous return in a neonate with severe persistent pulmonary hypertension.

In a critically ill neonate, pulsed and color-flow Doppler echocardiography was able to document normal pulmonary venous return after an intravenous dose of tolazoline hydrochloride. Differential diagnosis was between persistent pulmonary hypertension of the newborn and obstructed total anomalous pulmonary venous return. Once normal pulmonary venous return was clearly documented, all therapeutic efforts were directed at the infant's lung disease.

Early discontinuation of antibiotic treatment in newborns admitted to rule out sepsis: a decision rule.

We developed a decision rule to define a group of newborns eligible for discontinuation of antibiotic treatment 24 hours after initiation. The decision rule is based on two clinical assessments, three demographic variables, four maternal risk factors and six laboratory studies. The rule was created by retrospective analysis of all admissions to rule out sepsis at 10 Kaiser Permanente Northern California Region nurseries during a 2-month period in 1990.