Caffeine is the most commonly used medication for treatment of apnea of prematurity. Its effect has been well established in reducing the frequency of apnea, intermittent hypoxemia, and extubation failure in mechanica...Caffeine is the most commonly used medication for treatment of apnea of prematurity. Its effect has been well established in reducing the frequency of apnea, intermittent hypoxemia, and extubation failure in mechanically ventilated preterm infants. Evidence for additional short-term benefits on reducing the incidence of bronchopulmonary dysplasia and patent ductus arteriosus has also been suggested. Controversies existamong various neonatal intensive care units in terms of drug efficacy compared to other methylxanthines, dosage regimen, time of initiation, duration of therapy, drug safety and value of therapeutic drug monitoring. In the current review, we will summarize the available evidence for the best practice in using caffeine therapy in preterm infants.展开更多
Sacral dimples are the most common cutaneous anomaly detected during neonatal spinal examination. Congenital dermal sinus tract, a rare type of spinal dysraphism, occurs along the midline neuraxis from occiput down to...Sacral dimples are the most common cutaneous anomaly detected during neonatal spinal examination. Congenital dermal sinus tract, a rare type of spinal dysraphism, occurs along the midline neuraxis from occiput down to the sacral region. It is often diagnosed in the presence of a sacral dimple together with skin signs, local infection, meningitis, abscess, or abnormal neurological examination. We report a case of acute flaccid paralysis with sensory level in a 4 mo old female infant with sacral dimple, diagnosed by magnetic resonance imaging to be a paraspinal subdural abscess. Surgical exploration revealed a congenital dermal sinus tract extending from the subdural abscess down to the sacral dimple and open to the exterior with a minute opening.展开更多
Background:Nasal continuous positive airway pressure(NCPAP)is frequently used in preterm infants.However,there is no consensus on when and how to wean them from NCPAP.Data sources:Based on recent publications,we have ...Background:Nasal continuous positive airway pressure(NCPAP)is frequently used in preterm infants.However,there is no consensus on when and how to wean them from NCPAP.Data sources:Based on recent publications,we have reviewed the criteria of readiness-to-wean and factors affecting weaning success.A special focus is placed on the methods of weaning from NCPAP in preterm infants.Results:Practical points of when and how to wean from NCPAP in preterm infants are explained.Preterm infants are ready to be weaned from NCPAP when they are stable on a low NCPAP pressure with no(or minimal)oxygen requirement.Methods used to wean from NCPAP include:sudden weaning of NCPAP,gradual decrease of NCPAP pressure,graded-time-off NCPAP(cycling),weaning to high or low flow nasal cannula,and a combination of these methods.The best strategy for weaning is yet to be determined.Cycling-off NCPAP increases the duration of NCPAP and length of hospital stay without beneficial effect on success of weaning.Gradual decrease of NCPAP pressure is more physiological and better tolerated than cycling-off NCPAP.Conclusion:Further studies are needed to reach a consensus regarding the optimal timing and the best method for weaning from NCPAP in preterm infants.展开更多
文摘Caffeine is the most commonly used medication for treatment of apnea of prematurity. Its effect has been well established in reducing the frequency of apnea, intermittent hypoxemia, and extubation failure in mechanically ventilated preterm infants. Evidence for additional short-term benefits on reducing the incidence of bronchopulmonary dysplasia and patent ductus arteriosus has also been suggested. Controversies existamong various neonatal intensive care units in terms of drug efficacy compared to other methylxanthines, dosage regimen, time of initiation, duration of therapy, drug safety and value of therapeutic drug monitoring. In the current review, we will summarize the available evidence for the best practice in using caffeine therapy in preterm infants.
文摘Sacral dimples are the most common cutaneous anomaly detected during neonatal spinal examination. Congenital dermal sinus tract, a rare type of spinal dysraphism, occurs along the midline neuraxis from occiput down to the sacral region. It is often diagnosed in the presence of a sacral dimple together with skin signs, local infection, meningitis, abscess, or abnormal neurological examination. We report a case of acute flaccid paralysis with sensory level in a 4 mo old female infant with sacral dimple, diagnosed by magnetic resonance imaging to be a paraspinal subdural abscess. Surgical exploration revealed a congenital dermal sinus tract extending from the subdural abscess down to the sacral dimple and open to the exterior with a minute opening.
文摘Background:Nasal continuous positive airway pressure(NCPAP)is frequently used in preterm infants.However,there is no consensus on when and how to wean them from NCPAP.Data sources:Based on recent publications,we have reviewed the criteria of readiness-to-wean and factors affecting weaning success.A special focus is placed on the methods of weaning from NCPAP in preterm infants.Results:Practical points of when and how to wean from NCPAP in preterm infants are explained.Preterm infants are ready to be weaned from NCPAP when they are stable on a low NCPAP pressure with no(or minimal)oxygen requirement.Methods used to wean from NCPAP include:sudden weaning of NCPAP,gradual decrease of NCPAP pressure,graded-time-off NCPAP(cycling),weaning to high or low flow nasal cannula,and a combination of these methods.The best strategy for weaning is yet to be determined.Cycling-off NCPAP increases the duration of NCPAP and length of hospital stay without beneficial effect on success of weaning.Gradual decrease of NCPAP pressure is more physiological and better tolerated than cycling-off NCPAP.Conclusion:Further studies are needed to reach a consensus regarding the optimal timing and the best method for weaning from NCPAP in preterm infants.
