RESUMO
Premature infants with hyaline membrane disease and related disorders are frequently hypovolemic. Furthermore, they frequently require repeated phlebotomies for laboratory evaluation of electrolytes, pH, oxygen tension, and other parameters. Adequate care of such infants is aided by small transfusions of heparinized blood. The walking donor program at the Sacramento Medical Center premature nursery furnishes these transfusions without exposing the infants to the hazards of receiving blood from many different donors. The program is described in detail, and the shortcomings of some of the alternative programs are pointed out.
Assuntos
Doadores de Sangue , Doenças do Prematuro/terapia , Choque/terapia , Transfusão de Sangue , Humanos , Recém-Nascido , Fatores de TempoRESUMO
Catheterization of the aorta via the umbilical artery provides a convenient route for monitoring arterial blood pressure, for obtaining blood specimens for measurement of blood gas tensions and chemistries, and for the infusion of fluids and pharmacologic preparations in sick newborn infants. Use of this technique may be accompanied by a number of complications of which thrombotic phenomena are the most common. Twenty-three of 98 (24%) newborn infants undergoing umbilical artery catheterization were found to have thrombotic complication determined by aortography. No correlation was present between the duration of time that the umbilical artery catheters were in place and the occurrence of thrombotic complications. From paired aortographic or aortographic and autopsy studies in 24 patients, it was concluded that if a thrombotic complication did not occur early, none was likely to occur subsequently. One patient was considered to have died as a direct result of a thrombotic complication. Aortography is a safe, simple, and reliable technique for the early detection of thrombotic complications of umbilical artery catheters. Umbilical artery catheterization is not without risk and careful selection of patients for this procedure is indicated.
Assuntos
Cateterismo/efeitos adversos , Trombose/etiologia , Artérias Umbilicais , Aortografia , Feminino , Humanos , Lactente , MasculinoRESUMO
Repeated transfusions of small increments of blood are frequently required for the sick newborn infant to correct endogenous hypovolemia and/or to replace blood obtained repeatedly for monitoring purposes. Current practices of blood banks are rarely geared to supply the small amounts of blood used for these individual transfusions. To provide a more efficient system, a walking donor program was established in which an appropriate hospital-based individual is cross matched as a donor for an infant for the duration of the infant's hospital stay. The program eliminates wastage of blood and donors and reduces the number of infectious agents to which the infant may be exposed.
Assuntos
Doadores de Sangue , Doenças do Recém-Nascido/terapia , Unidades de Terapia Intensiva , Berçários Hospitalares , Sistema ABO de Grupos Sanguíneos , Peso ao Nascer , Transfusão de Sangue , California , Teste de Coombs , Feminino , Cardiopatias Congênitas/terapia , Hematócrito , Hemoglobinas/análise , Antígenos da Hepatite B , Humanos , Doença da Membrana Hialina/terapia , Recém-Nascido , Cariotipagem , Linfócitos/citologia , Masculino , Métodos , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Sistema do Grupo Sanguíneo Rh-Hr , Sorodiagnóstico da SífilisRESUMO
A case of unilateral suprarenal abscess is reported. This is the third such reported case, and the first reported case successfully treated with preservation of the kidney. Diagnosis and treatment were aided significantly by a thorough preoperative radiological evaluation, including angiography.
