[SEN1500: design and implementation of a registry of infants weighing less than 1,500 g at birth in Spain]. / SEN1500: diseño y desarrollo del registro de niños de menos de 1.500 g al nacer en España.

OBJECTIVE: To design and implement a registry of infants weighing less than 1,500 g at birth in Spain. MATERIAL AND METHODS: Prospective, cohort, multicenter study. All live born infants weighing less than 1,500 g in several voluntarily participating neonatal units in public and private hospitals were included. RESULTS: In the first 4 years of the registry (2002 to 2005), 9,638 very-low-birth-weight infants were born in the 65 neonatal units that have so far joined the program. CONCLUSIONS: The goal of very-low-birth-weight infant databases is to try to improve the quality and safety of the medical care given to these newborns and their families. This type of program helps to coordinate and promote several areas, including those of health education, training of medical staff, research and development, surveillance and quality improvement.

[Nasal continuous positive airway pressure in preterm infants: comparison of two low-resistance models]. / Presión positiva continua en la vía aérea por vía nasal en el recién nacido prematuro: estudio comparativo de dos modelos de baja resistencia.

OBJECTIVE: To compare the safety and efficacy of two low expiratory resistance models of nasal continuous positive airway pressure (n-CPAP) in preterm infants. MATERIAL AND METHODS: A 1-year prospective trial was performed in the Neonatal Intensive Care Unit of La Fe Hospital to compare the Infant Flow (IF) and Medijet (MJ) devices. All preterm infants requiring n-CPAP for respiratory distress at birth (group I), infants weighting less than 1500 g requiring postextubation (group II) and those with apnea-bradycardia syndrome (ABS) (group III) were included. The patients were randomly assigned to IF or MJ. RESULTS: A total of 125 patients received 226 treatments (IF: n 5 126: MJ: n 5 110). The mean gestational age was 29.4 weeks and the mean birth weight was 1340 g.Efficacy. In group I (n 5 73) no difference were found between systems and 6 hours' after initiation of n-CPAP decreases in FiO2, CO2 and respiratory effort were similar. The need for intubation was also similar (IF: 34.6 %; MJ: 24.1 %). In group II (n 5 73) the need for reintubation at 48 hours was similar with both treatments (IF:19 %; MJ: 8 %). In group III (n 5 80) resolution of ABS was similar after 24 hours of n-CPAP (IF: 46 %; MJ: 58 %). The need for intubation was also similar (IF: 26 %; MJ: 10 %).Complications. Air leaks occurred in six preterm infants (IF: 4; MJ: 2). Severe abdominal distension occurred in 5 % with both systems. Five infants had significant nasal lesions (IF: 1; MJ: 4). CONCLUSIONS: The efficacy and safety of both systems was similar in the variables studied and no significant differences were found.

[Prevention of hemorrhagic disease in newborns in the Valencia community: current aspects and trends]. / Profilaxis de la enfermedad hemorrágica del recién nacido en la Comunidad Valenciana: aspectos actuales y tendencias.

OBJECTIVE: The aim of this study was to document the current patterns and trends in the prophylaxis of hemorrhagic disease of the newborn in the Community of Valencia. PATIENTS AND METHODS: We sent a questionnaire to all public maternity units asking about prophylaxis instructions, including dosage, via of administration and changes in these instructions during the last ten-year period. RESULTS: During the study period, a total of 397,104 infants were born. In 1985, all thirteen maternity units gave intramuscular prophylaxis. In 1990, fifteen of 16 maternity units gave parenteral prophylaxis, with the other giving oral vitamin K. Currently, of the eighteen public center 14 (77.8%) give intramuscular prophylaxis and the remaining 4 (22.2%) use an oral route. These 4 centers cover an area representing a population of 17.9% of the live births in 1994. CONCLUSIONS: In our community there is little evidence of change to oral route for the administration of vitamin K in the prophylaxis of hemorrhagic disease of the newborn. Because a doubt remains in the efficacy of oral vitamin K, a centralized system to control all cases of hemorrhagic disease of the newborn should be established in order to check the security of this route of administration.

[Pneumopericardium in the newborn (author's transl)]. / Neumopericardio en el período neonatal.

A case of pneumopericardium in a newborn affected of hyaline membrane disease, and undergoing assisted ventilación is presented. Literature is reviewed. Physiopatology, morbidity, mortality, and predispossing factors are described. Knowledge of the clinical simptomatology is essential in order to perform the prompt pericardiocentesis, should cardiac tamponade be present.