AndrewR. Wilkinson

Prenatal deficiency of phosphate, phosphate supplementation, and rickets in very-low-birthweight infants

A preliminary study showed that placental histology was abnormal for babies who subsequently had rickets. The findings--low plasma phosphate concentration; maximum percentage tubular reabsorption of phosphate; and high urinary calcium loss--are those of renal conservation of phosphate in the presence of phosphate deficiency. In a controlled trial no baby receiving phosphate supplements (50 mg per day) had radiological evidence of rickets whereas bone changes were apparent in 42% of the control group. Prenatal deficiency of phosphate, due to placental insufficiency, can be corrected by phosphate supplementation thereby preventing rickets of prematurity.

EVIDENCE OF INADEQUATE HUMIDIFICATION OF INSPIRED GAS DURING ARTIFICIAL VENTILATION OF NEWBORN BABIES IN THE BRITISH ISLES

Data on routine humidifier settings used in respiratory support for newborn babies were obtained from 242 neonatal units in the British Isles. For each of the most commonly used humidifiers inspired gas humidity was measured under routine clinical conditions with an electronic hygrometer. Most endotracheally intubated babies breathe inspired gas of well below physiological humidity (44 mg H2O/l) and many below the minimum recommended for adults by the British Standards Institution (33 mg H2O/l). Inadequate humidification could contribute to several complications of artificial ventilation in newborn babies by inhibiting mucociliary clearance.