Normoblastemia multinuclear en un recién nacido secundaria a hipoxia / Multinucleated normoblastemia in a newborn secondary to hypoxia

Es posible detectar normoblastos en los frotis de sangre periférica de los recién nacidos. En general, la cantidad de normoblastos por cada 100 leucocitos está en el intervalo de 0 a 10. Se observan con más frecuencia de lo usual ante una situación de hipoxia porque la hipoxia intrauterina aumenta la producción de eritrocitos. Sin embargo, no se había informado antes un caso de normoblastos multinucleados en un recién nacido a causa de la hipoxia. Presentamos el caso de un recién nacido con normoblastos multinucleados secundarios a hipoxia intrauterina. Este caso es importante porque es la primera vez que se han detectado normoblastos multinucleados en el frotis de sangre periférica de un recién nacido hipóxico.

Normoblasts may be seen in peripheral blood smear of newborns. The number of normoblasts per 100 white blood cells is generally in the range of 0-10.They can be seen more common than usual in hypoxic condition, because intrauterine hypoxia increases the production of red blood cells. However, multinucleated normoblasts in a newborn caused by hypoxia haven't been reported before. We present a newborn with multinucleated normoblasts secondary to intrauterine hypoxia. This case is important; because it is the first time multinucleated normoblasts in peripheral blood smear of a hypoxic newborn has been detected.

Normoblastemia multinuclear en un recién nacido secundaria a hipoxia. / Multinucleated normoblastemia in a newborn secondary to hipoxia.

Normoblasts may be seen in peripheral blood smear of newborns. The number of normoblasts per 100 white blood cells is generally in the range of 0-10.They can be seen more common than usual in hypoxic condition, because intrauterine hypoxia increases the production of red blood cells. However, multinucleated normoblasts in a newborn caused by hypoxia haven't been reported before. We present a newborn with multinucleated normoblasts secondary to intrauterine hypoxia. This case is important; because it is the first time multinucleated normoblasts in peripheral blood smear of a hypoxic newborn has been detected.

Es posible detectar normoblastos en los frotis de sangre periférica de los recién nacidos. En general, la cantidad de normoblastos por cada 100 leucocitos está en el intervalo de 0 a 10. Se observan con más frecuencia de lo usual ante una situación de hipoxia porque la hipoxia intrauterina aumenta la producción de eritrocitos. Sin embargo, no se había informado antes un caso de normoblastos multinucleados en un recién nacido a causa de la hipoxia. Presentamos el caso de un recién nacido con normoblastos multinucleados secundarios a hipoxia intrauterina. Este caso es importante porque es la primera vez que se han detectado normoblastos multinucleados en el frotis de sangre periférica de un recién nacido hipóxico.

Inhaled beta-2 agonist salbutamol for the treatment of transient tachypnea of the newborn.

OBJECTIVE: To evaluate the efficacy of inhaled salbutamol, a beta-2 adrenergic agonist, for the treatment of transient tachypnea of the newborn (TTN) and to determine whether inhaled salbutamol is safe in newborn infants. STUDY DESIGN: Inhaled salbutamol or normal saline solution was administered to 54 infants with gestational ages ranging from 34 to 39 weeks and TTN. The response to salbutamol therapy was evaluated by determining respiratory rate, clinical score of TTN, level of respiratory support, and fraction of inspired oxygen before and at 30 minutes and 1 and 4 hours after salbutamol nebulization. RESULTS: Among the 54 infants with TTN, 32 received salbutamol and 22 received normal saline solution. After one dose, the salbutamol group showed significant improvements in respiratory rate, clinical score of TTN, fraction of inspired oxygen, and level of respiratory support (P < .05). After treatment, the mean pH, partial pressure of arterial oxygen, and partial pressure of arterial carbon dioxide values were better in the salbutamol group when compared with the placebo group (P < .05). Duration of hospitalization in the neonatal intensive care unit was also shorter for the salbutamol group (P < .05). CONCLUSION: Inhaled salbutamol treatment was effective with respect to both clinical and laboratory findings of TTN and without adverse events.

Abnormal circadian blood pressure regulation in children born preterm.

OBJECTIVE: To assess a possible relationship between prematurity and casual blood pressure (BP) by means of 24-hour ambulatory BP monitoring (ABPM). STUDY DESIGN: ABPM was performed in 41 children aged 5 to 17 years who were born prematurely with (n = 11) or without intrauterine growth restriction, and in 27 matched children who were born at term with a birth weight appropriate for gestational age. RESULTS: Although BP did not differ between the preterm group and control subjects during the daytime, nocturnal standardized systolic BP was elevated (P < .05) and a lack of nocturnal decrease was more prevalent in the preterm children compared with the control subjects (73% versus 41%, P = .01). The difference was caused by a marked increase of nighttime systolic BP in the light-for-date children (1.17 +/- 0.61 standard deviation scores; P < .01), although preterm children with appropriate weight (0.33 +/- 1.00) were not different from control subjects (0.09 +/- 0.73). Nighttime BP standard deviation scores were closely correlated with standardized heart rate, compatible with a role of sympathetic hyperactivation. CONCLUSION: Subtle abnormalities of BP regulation, indicated by a selective increase of nocturnal systolic BP, are present during childhood in subjects born prematurely, and are prominent in those with intrauterine growth restriction.