[Persistent pulmonary hypertension of the newborn following ingestion of nonsteroidal anti-inflammatory drugs during pregnancy]. / Hipertensión pulmonar neonatal grave tras ingestión de antiinflamatorios no esteroideos durante el embarazo.

Nonsteroidal anti-inflammatory drugs induce the inhibition of prostaglandin synthesis, which can cause constriction of the fetal ductus arteriosus in the pregnancy. We report two cases of antenatal closure of ductus arteriosus with severe pulmonary hypertension following maternal ingestion of nonsteroidal anti-inflammatory drugs (niflumic acid and acetylsalicylic acid) in the last days before delivery. To our knowledge, this is only the second case in literature describing antenatal closure of ductus arteriosus after the administration of niflúmic acid. Prescription of nonsteroidal anti-inflammatory drugs must be avoided during pregnancy. Fetal echocardiography must be monitored in those women treated with nonsteroidal anti-inflammatory drugs.

[Erythropoietin treatment in critically ill children]. / Tratamiento con eritropoyetina en niños críticamente enfermos.

OBJECTIVE: To analyze whether erythropoietin treatment increases hemoglobin and decreases transfusion requirements in critically ill children. PATIENTS AND METHODS: We performed an observational, prospective study of 23 critically ill children aged between 1 month and 6 years. Recombinant human eritropoietin (rHuEPO) was administered at a dosage of 150-750 U/kg/week over 3 days. Hemogram, reticulocyte, iron metabolism, serum ferritin and transferrin were measured before treatment started and weekly thereafter. RESULTS: After erythropoietin treatment, hematocrit, hemoglobin and red blood cells progressively increased, with a maximal response in the sixth week. At the end of treatment, hemoglobin increased 1.68 g/dl, hematocrit by 5 % and erythrocytes 600,000/ml/mm3. Transfusion requirements decreased from 59 transfusions at baseline to 12 in the first week of treatment and none from the sixth week. No treatment-related adverse effects were observed. CONCLUSION: Erythropoietin can be an effective treatment for anemia in some critically ill children, decreasing the number of transfusions and increasing hemoglobin.