N. Y. Boo

Risk factors associated with umbilical vascular catheter-associated thrombosis in newborn infants

Objective: To determine the risk factors associated with umbilical vascular catheter‐associated thrombosis.

Randomized controlled trial of heparin for prevention of blockage of peripherally inserted central catheters in neonates

Aim: To determine whether the addition of heparin to total parenteral nutrition (TPN) fluid would prevent blockage of peripherally inserted central catheters (PICCs) in neonates. Methods: This was a randomized, double‐blind, controlled study of 66 eligible neonates with PICCs inserted for the administration of TPN. Infants were randomized to receive TPN containing either 1 IU ml‐1 of heparin (n= 35) or no heparin (n= 31). Results: There was no significant difference in the incidence of blocked catheters between the two groups of infants (heparin: 14.3%; no‐heparin: 22.6%, p= 0.4). Although a higher percentage (62.9%) of infants in the heparin group received a complete course of TPN successfully via PICC than those in the no‐heparin group (48.4%), the difference was not statistically significant (p= 0.3). There were no significant differences in the incidence of catheter‐related sepsis, hypertriglyceridaemia, hyperbilirubinaemia, coagulopathy or intraventricular haemorrhage between the two groups.

Six year trend of neonatal septicaemia in a large Malaysian maternity hospital

Abstract A study carried out in the Maternity Hospital, Kuala Lumpur over a 6 year period from 1986 to 1991, showed that the annual rates of septicaeia ranged from 5.2 to 10.2/100 admissions. Septicaemia accounted for between 11.0 to 30.4% of all neonatal deaths. The case fatality ratios ranged from 23.0 to 52.2%, being highest in 1989 when basic facilities were compromised. Low birthweight neonates accounted for 55.5% of those with septicaemia. The most common causative organisms were Staphylococcus epidermidis and Staphylococcus aureus in 1986 and 1987, but from 1988 Klebsiella species became the most common. More than 50% of neonatal septicaemia occurred after the age of 2 days. The results of the study demonstrated the dynamism of infection control: when control measures introduced earlier were not sustained, outbreaks of nosocomial infection recurred or worsened.

Predictors of neurodevelopmental outcome of Malaysian very low birthweight children at 4 years of age

Objective: To determine neonatal, early developmental and social risk factors that predict the neurocognitive and behavioural outcome of very low birthweight (VLBW) preschool children at four years of age.

Early cranial ultrasound changes as predictors of outcome during first year of life in term infants with perinatal asphyxia

Objectives: To identify the types of early cranial ultrasound changes that were significant predictors of adverse outcome during the first year of life in asphyxiated term infants.

Randomized controlled trial of oral versus intravenous fluid supplementation on serum bilirubin level during phototherapy of term infants with severe hyperbilirubinaemia.

Objective: To compare the rates of decrease in serum bilirubin levels in severely jaundiced healthy term infants given oral or intravenous fluid supplementation during phototherapy.

Randomized controlled study of the effects of different durations of light exposure on weight gain by preterm infants in a neonatal intensive care unit

A randomized controlled study was carried out on 96 preterm infants (>37 wk) with birthweight less than 2000 g admitted to a neonatal intensive care unit. The aim was to compare the weight gain between preterm infants exposed to 12 h cyclical lighting (intensity of light: 78.4 ± 24.7 lux, mean ± SD) and those exposed to a continuously dim environment (5.9 ± 1.9 lux). The exclusion criteria were infants with major congenital malformations or who needed continuous lighting for treatment procedure and care. From day 7 of life until discharge, 50 infants were randomized to receive 12 h cyclical lighting and 46 infants to a continuously dim environment. There was no significant difference in the mean birthweight (12 h lighting vs continuously dim: 1482 vs 1465 g, p= 0.8), mean gestational age (31.6 vs 31.4 wk, p= 0.6), median duration of hospital stay (28.5 vs 28.5 d, p= 0.8), mean age to regain birthweight (13.0 vs 12.9 d, p= 0.3), mean weight gained by day 14 (27.6 vs 36.2 g, p= 1.0), median weight gain per day (11.9 vs 12.2 g, p= 0.9) or median body weight on discharge (1800 vs 1800g, p= 0.4) between the two groups of infants.

Usefulness of stable microbubble test of tracheal aspirate for the diagnosis of neonatal respiratory distress syndrome

Objectives: To compare the overall accuracy of the stable microbubble test (SM test) with measurement of level of surfactant protein A (SP‐A) of tracheal aspirate for the diagnosis of respiratory distress syndrome (RDS).

Neonatal resuscitation training program in Malaysia: Results of the first 2 years

Objectives: To determine the number of providers and instructors trained by the initial 37 core instructors during the first 2 years following the launch of the Malaysian Neonatal Resuscitation Program (NRP). To identify remediable problems which interfered with the propagation of the NRP in Malaysia.

Successful clot lysis using low dose of streptokinase in 22 neonates with aortic thromboses

Objective: To determine whether intravenous infusion of low dose of streptokinase was effective in lysing umbilical arterial catheter (UAC)‐associated aortic thrombi.