Neonatology—Science or Art?

PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 880-880
Keyword(s):  
Birth Weight ◽  
Child Health ◽  
Low Birth Weight ◽  
Human Development ◽  
Very Low Birth Weight ◽  
Research Network ◽  
Exact Science ◽  
Weight Outcomes

To the Editor.— The authors of the National Institute of Child Health and Human Development Neonatal Research network report1 of very low birth weight outcomes deserve a lot of praise for providing a survey of neonatal practices. But they are much too polite. In the discussion of "important intercenter variation as well as differences in the philosophy of care," the authors mildly note, "the practice of neonatal medicine remains in part an art rather than an exact science."

Very-low-birth-weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, May 1991 through December 1992

1995 ◽  
Vol 173 (5) ◽  
pp. 1423-1431 ◽  
Author(s):  
Avroy A. Fanaroff ◽  
Lindal L. Wright ◽  
David K. Stevenson ◽  
Seetha Shankaran ◽  
Edward P. Donovan ◽  
...  
Keyword(s):  
Birth Weight ◽  
Child Health ◽  
Low Birth Weight ◽  
Human Development ◽  
Very Low Birth Weight ◽  
Research Network ◽  
Weight Outcomes

Very Low Birth Weight Outcomes of the National Institute of Child Health and Human Development Neonatal Network

PEDIATRICS ◽  
1991 ◽  
Vol 87 (5) ◽  
pp. 587-597 ◽  
Author(s):  
Maureen Hack ◽  
Jeffrey D. Horbar ◽  
Michael H. Malloy ◽  
Linda Wright ◽  
Jon E. Tyson ◽  
...  
Keyword(s):  
Birth Weight ◽  
Child Health ◽  
Low Birth Weight ◽  
Human Development ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Weight Outcomes

This report describes the neonatal outcomes of 1765 very low birth weight (<1500 g) infants delivered from November 1987 through October 1988 at the seven participating centers of the National Institute of Child Health and Human Development Neonatal Intensive Care Network. Survival was 34% at <751 g birth weight (range between centers 20% to 55%), 66% at 751 through 1000 g (range 42% to 75%), 87% at 1001 through 1250 g (range 84% to 91%), and 93% at 1251 through 1500 g (range 89% to 98%). By obstetric measures of gestation, survival was 23% at 23 weeks (range 0% to 33%), 34% at 24 weeks (range 10% to 57%), and 54% at 25 weeks (range 30% to 72%). Neonatal morbidity included respiratory distress (67%), symptomatic patent ductus arteriosus (25%), necrotizing enterocolitis (6%), septicemia (17%), meningitis (2%), urinary tract infection (4%), and intraventricular hemorrhage (45%, 18% grade III and IV). Morbidity increased with decreasing birth weight. Oxygen was administered for ≥28 days to 79% of <751-g birth weight infants (range between centers 67% to 100%), 45% of 751-through 1000-g infants (range 20% to 68%), and 13% of 1001- through 1500-g infants (range 5% to 23%). Ventilator support for ≥28 days was given to 68% of infants at <751 g, 29% at 751 through 1000 g, and 4% at >1000 g. Hospital stay was 59 days for survivors vs 15 days for infants who died. Sixty-nine percent of survivors had subnormal (<10th percentile) weight at discharge. The data demonstrate important intercenter variation of current neonatal outcomes, as well as differences in philosophy of care and definition and prevalence of morbidity.

Very-low-birth-weight outcomes of the National Institute of Child Health and Human Development Neonatal Network, November 1989 to October 1990

1995 ◽  
Vol 172 (2) ◽  
pp. 457-464 ◽  
Author(s):  
Maureen Hack ◽  
Linda L. Wright ◽  
Seetha Shankaran ◽  
Jon E. Tyson ◽  
Jeffrey D. Horbar ◽  
...  
Keyword(s):  
Birth Weight ◽  
Child Health ◽  
Low Birth Weight ◽  
Human Development ◽  
Very Low Birth Weight ◽  
Weight Outcomes

Immunomodulation, Part I: Pentoxifylline

2005 ◽  
Vol 24 (4) ◽  
pp. 45-48 ◽  
Author(s):  
Susan Givens Bell
Keyword(s):  
Immune System ◽  
Birth Weight ◽  
Child Health ◽  
Low Birth Weight ◽  
Nosocomial Infection ◽  
Human Development ◽  
Very Low Birth Weight ◽  
Neonatal Morbidity ◽  
Research Network ◽  
Neonatal Immune System

SEPSIS CONTINUES TO BE A significant cause of neonatal morbidity and mortality. In a recent study by the National Institute of Child Health and Human Development Neonatal Research Network, 21 percent of very low birth weight neonates older than three days of age had one or more episodes of proven bloodstream sepsis (range for the 15 network centers: 11–32 percent). The study’s authors assert that strategies to decrease the incidence of nosocomial infection and the related social and economic impact are urgently needed.1 Researchers have been exploring various modalities, including immunomodulation, as adjuncts to antibiotics to enhance the neonatal immune system. Generally, immunomodulators act to stimulate or augment the immune system indirectly.

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