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  • 1
    Electronic Resource
    Electronic Resource
    Neurodevelopmental outcome after prenatal exposure to opiates (1998)
    Springer
    European journal of pediatrics 157 (1998), S. 724-730 
    Details
    ISSN: 1432-1076
    Keywords: Key words Opiate-exposed infants ; Drug withdrawal ; Clinical and neurodevelopmental outcome ; Griffiths Developmental Scale ; Prevention
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To study the developmental effects of prenatal exposure to opiates, a prospective follow up study of 34 drug-exposed (opiates and nicotine) and 42 reference infants (nicotine exposure only) was conducted from January 1992 to September 1995. At the time of delivery, 12 of 34 mothers used opiates without medical control. Twenty-two mothers participated in a methadone maintenance programme. At 1 year, the average Griffiths Developmental Quotient (DQ) was lower in the drug-exposed group (mean: 100.5 vs. references 107.9; P 〈 0.001). This difference was mainly due to lower subscales “locomotor” (mean 100.8 vs. 111.4; P 〈 0.05) and “intellectual performance” (mean 100.8 vs. 108.5; P 〈 0.05) in the drug-exposed group. Severe developmental retardation mean DQ (−2 SD) was diagnosed in 2 drug-exposed infants. Mild developmental retardation (mean DQ: 1 SD– 〉 2 SD) was found in 7 drug-exposed and in 3 reference infants (P 〈 0.05). Neurological abnormalities were found more frequently in the drug-exposed group (11 vs. 3 infants; P 〈 0.01). Among the opiate-exposed infants, the subscales “hearing and speech” and “intellectual performance” were lower in the uncontrolled drug-using than in the methadone group. The 17 fostered infants showed no difference in developmental outcome compared with the 10 infants living with their biological parents (mean DQ: 100.0 versus 101.3). Conclusions At 1 year infants prenatally exposed to opiates are at risk for mild psychomotor developmental impairment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050923
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  • 2
    Electronic Resource
    Electronic Resource
    Decreased incidence of extra-alveolar air leakage or death prior to air leakage in high versus low rate positive pressure ventilation: Results of a randomised seven-centre trial in preterm infants (1992)
    Springer
    European journal of pediatrics 151 (1992), S. 904-909 
    Details
    ISSN: 1432-1076
    Keywords: Mechanical ventilation ; Preterm infant ; Extra-alveolar air leakage ; Randomised trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two different ventilation techniques were compared in a seven-centre, randomised trial with 181 preterm infants up to and including 32 completed weeks gestational age, who needed mechanical ventilation because of lung disease of any type. Technique A used a constant rate (60 cycles/min), inspiratory time (IT) (0.33s) and inspiratory: expiratory ratio (I∶E) (1∶2). The tidal and minute volume was only changed by varying peak inspiratory pressure until weaning via continuous positive airway pressure. Technique B used a lower rate (30 cycles/min) with longer IT (1.0s). The I∶E ratio could be changed from 1∶1 to 2∶1 in case of hypoxaemia. Chest X-rays taken at fixed intervals were evaluated by a paediatric radiologist and a neonatologist unaware of the type of ventilation used in the patients. A reduction of at least 20% in extra-alveolar air leakage (EAL) or death prior to EAl was supposed in infants ventilated by method A. A sequential design was used to test this hypothesis. The null hypothesis was rejected (P=0.05) when the 22nd untied pair was completed. The largest reduction in EAL (−55%) was observed in the subgroup 31–32 weeks of gestation and none in the most immature group (〈28 weeks). We conclude that in preterm infants requiring mechanical ventilation for any reason of lung insufficiency, ventilation at 60 cycles/min and short IT (0.33s) significantly reduces EAL or prior death compared with 30 cycles/min and a longer IT of 1s. We speculate that a further increase in rate and reduction of IT would also lower the risk of barotrauma in the most immature and susceptible infants.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01954127
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    Paper (German National Licenses)
    Fulltext
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