The Journal of pediatrics
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The Journal of pediatrics · Mar 1994
Management and outcome of low birth weight neonates with congenital heart disease.
In 100 consecutive neonates with birth weights < or = 2500 gm (range, 540 to 2500 gm; median, 2200 gm), major congenital heart disease (excluding patent ductus arteriosus, isolated atrial septal defect, and ventricular septal defect) was diagnosed between January 1987 and January 1991; 46 had ductus-dependent lesions. Of the 100 neonates, 30 had genetic aberrations or significant associated congenital anomalies. The four most common cardiac diagnoses were tetralogy of Fallot with or without pulmonary atresia (n = 16); coarctation of the aorta (n = 12); transposition of the great arteries (n = 11); and common atrioventricular canal (n = 11). ⋯ The remaining 12 patients (group 3) had complicating features that precluded intervention; none survived. On the basis of these results, we conclude that early intervention, even with corrective surgery, can be performed in low birth weight neonates with an acceptable mortality rate. Prolonged medical therapy to achieve further weight gain did not appear to improve the survival rate.
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The Journal of pediatrics · Feb 1994
Comparative StudyGanciclovir therapy for symptomatic congenital cytomegalovirus infection in infants: a two-regimen experience.
The efficacy of two regimens of ganciclovir therapy was evaluated in 12 infants with symptomatic congenital cytomegalovirus (CMV) infection. Virologic investigations included culture from urine, saliva, and cerebrospinal fluid, detection of CMV DNA by polymerase chain reaction, and detection of CMV class-specific antibodies (IgG, IgA, IgM) by enzyme immunoassays. Six infants were given ganciclovir, 5 mg/kg twice daily for 2 weeks (group 1); the other six infants were given 7.5 mg/kg twice daily for 2 weeks and 10 mg/kg three times weekly for 3 months (group 2). ⋯ In group 2, all infants had negative CMV-culture and CMV DNA results; clinical improvement was evident in five infants, one of whom had later development of mild psychomotor retardation. In another infant, severe psychomotor retardation and hearing loss developed after transient improvement developed. These preliminary data indicate that a ganciclovir regimen including a higher dose and more prolonged therapy might be more effective in infants with symptomatic congenital CMV infection.
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The Journal of pediatrics · Jan 1994
Comparison of oxygenation measurements in pediatric patients during sickle cell crises.
Measurements of the saturation of arterial blood with oxygen (SaO2) were compared in 24 children during sickle cell crises. Simultaneous pulse oximetry (Nellcor N-100 pulse oximeter) and arterial blood analysis showed that SaO2 measured by pulse oximetry overestimated cooximeter-measured SaO2 (mean bias, 6.9%; p < 0.001). The blood gas machine-calculated SaO2 also overestimated cooximeter-measured SaO2 (p < 0.001). The bias increased with increasing age (p = 0.002) and carboxyhemoglobin level (p = 0.005) but was not related to methemoglobin, total hemoglobin, percentage of hemoglobin S, or percentage of hemoglobin F.