• Title/Summary/Keyword: Exchange Transfusion

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Risk factors and clinical characteristics of necrotizing enterocolitis in full-term newborns (만삭아에서의 괴사성 장염의 위험인자와 임상증상)

  • Jeoung, Young Mi;Je, Hyun Gon;Son, Sang Hee
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.489-493
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    • 2006
  • Purpose : The purpose of this study was to determine those factors which could contribute to the development of necrotizing enterocolitis(NEC) in fullterm. Methods : We retrospectively reviewed the medical record of 20 full-terms with NEC(${\geq}$modified Bell's staging criteria IIa) who were admitted to the Neonatal Intensive Care Unit of Il Sin Christian hospital from January 1998 through July 2005, and for each case, the next 2 healthy newborns were matched as controls. Results : Mean gestational age and birth weight in the fullterm with NEC group was 38.42 weeks and 2,915 g; in the healthy fullterm without NEC group, it was 38.61 weeks and 3,148 g. When compared with the control group, NEC infants had a significantly higher frequency of chorioamnionitis, protracted diarrhea. As for Apgar score at 1 min <7, respiratory problem, congenital heart disease. there were no differences in frequency of preeclampsia, maternal diabetes, maternal drug abuse, meconium-stained amniotic fluid, polycythemia or exchange transfusion. Conclusion : Most of these full term infants have a predisposing factor before developing NEC. Our study suggested that NEC in fullterm infants was significantly associated with protracted diarrhea, and congenital heart disease.

Auditory brainstem response (ABR) results in NICU graduates (신생아 집중치료실 퇴원아의 청성뇌간반응(ABR) 결과에 미치는 위험인자 및 경과)

  • Choi, Hee-Joung;Lee, Tae-ho;Oh, Ki-Won;Kim, Heng-Mi
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1301-1307
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    • 2006
  • Purpose : Hearing loss is one of the most common birth defects, and early detection and intervention positively impact language/speech and cognitive development. It has been reported that NICU graduates have a high incidence of hearing loss. So we investigated the incidence, risk factors and clinical outcome of hearing loss in NICU graduates. Methods : This study involved neonatal auditory brainstem response (ABR) testing of newborn infants who graduated from the NICU of Kyungpook National University Hospital during a 3-year period (between July 2002 and June 2005) and subsequent follow-up of these infants. Results : ABR evaluations were performed on 474 infants. Of these infants, 64 showed abnormal ABR (13.5 percent). Of 128 ears from these 64 infants, two ears (1.6 percent) and 10 ears (7.8 percent) were classified as severe and profound hearing loss, respectively. The infants with abnormal ABR had higher incidence of prematurity, low birth weight, very low birth weight, neonatal asphyxia, cranio-facial malformation and amikacin treatment over 15 days (P<0.05). In infants with hyperbilirubinemia, the peak level of serum bilirubin, duration of phototherapy and exchange transfusion were not associated with the higher incidence of hearing loss. Follow-up ABR evaluation was performed on 15 infants with abnormal ABR at $8.8{\pm}4.4months$. In follow-up ABR, 80.0% showed improvement or normalization of threshold sensitivity. Conclusion : NICU graduates exhibit high risk for hearing loss. Systemic and effective hearing assessment program is needed for these high risk infants.

Etiology, Management, and Prognosis of Severe Hyperbilirubinemia (Serum Bilirubin Level=25 mg/dL) in Newborn (중증 고빌리루빈혈증(혈청 빌리루빈 >25 mg/dL)의 발병 원인과 치료 및 예후)

  • Hwang, Jong Hee;Lee, Ji Hyun;Kim, Yu Jin;Koo, Su Hyun;Lee, Jang Hun;Choi, Chang Won;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1102-1106
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    • 2005
  • Purpose : The present study examined the etiology, management, and the difference of prognosis according to methodology of treatment in severe hyperbilirubinemia with total serum bilirubin levels of more than 25 mg/dL. Methods : Medical records of severe hyperbilirubiemia in newborns(serum level=25 mg/dL) admitted to the NICU of Samsung Medical Center between October 1994 and June 2004 were reviewed retrospectively. Infants were grouped according to methodology of treatment : Group I(phototherapy only, n=42), Group II(exchange transfusion, n=6). And In addition, we evaluated the etiology and the difference of prognosis. Results : A total of 48 documented cases of severe hyperbilirubinemia were identified. Birth weight was significantly lower in Group 2($2,852{\pm}1,085g$) compared to Group 1($3,137{\pm}437g$)(P<0.05). There were no significant differences in gestational age, sex, mode of delivery, inborn, age at presentation, and age at first examination and admission between the two study groups. Maximal bilirubin level was significantly higher in Group 2($45{\pm}16mg/dL$) compared to Group 1($29{\pm}6mg/dL$) (P<0.05). But there were no significant differences in neurologic outcome. Conclusion : Our study suggests that the present guidelines for managing hyperbilirubinemia in newborns should be effective but follow-up with the first postnatal week would be necessary for each detection and treatment in the newborn infants with high risk of severe hyperbilirubinemia.