Objectives: To determine if insensible water loss (IWL) differed between infants exposed or not exposed antenatally to corticosteroids and to explore possible mechanisms for the early postnatal diuresis associated wit...Objectives: To determine if insensible water loss (IWL) differed between infants exposed or not exposed antenatally to corticosteroids and to explore possible mechanisms for the early postnatal diuresis associated with antenatal steroid exposure. Design: Retrospective analysis of prospectively collected data. Setting: Level three neonatal intensive care unit. Patients: Ninety six infants,median gestational age 27.5 weeks (range 23- 33). Main outcome measures: Comparison of the IWL, urine output and osmolality, fluid input, electrolyte imbalance, respiratory illness severity (as assessed by surfactant requirement, maximum peak inspiratory pressure, and inspired oxygen concentration), and cardiovascular status (as assessed by inotrope requirement) between infants with antenatal corticosteroid exposure and gestational age matched controls. Results: The infants exposed to antenatal steroids differed significantly from the controls in having both a lower IWL (P= 0.0135) and a higher urine output (P=0.0036) on day 1, and fewer developed hyponatraemia (P=0.027) on day 2. Fewer of those exposed to antenatal steroids required inotropes (P=0.06), but their respiratory status was similar to that of the controls. Conclusions: Infants exposed to antenatal corticosteroids have a lower IWL. The results suggest that greater skin maturation, but also better perfusion rather than less severe respiratory status, explains the early diuresis in infants exposed to antenatal steroids.展开更多
患儿女,第5胎第1产,胎龄24＋2周,母亲因“宫颈癌全切术后,试管婴儿,胎膜早破”行剖宫产,Apgar评分1 min 2分,5 min 4分,10 min 5分,出生体重420 g。查体：极早产儿貌,皮肤菲薄透明,双眼未睁开,反应差,皮肤发绀,全身皮肤散在瘀斑及出血点...患儿女,第5胎第1产,胎龄24＋2周,母亲因“宫颈癌全切术后,试管婴儿,胎膜早破”行剖宫产,Apgar评分1 min 2分,5 min 4分,10 min 5分,出生体重420 g。查体：极早产儿貌,皮肤菲薄透明,双眼未睁开,反应差,皮肤发绀,全身皮肤散在瘀斑及出血点,三凹征阳性,抽泣样呼吸,两肺呼吸音低,心律齐,腹软,四肢肌张力低,原始反射未引出。诊断：新生儿窒息（重度）,呼吸衰竭,新生儿出血症,极早产儿。展开更多
文摘Objectives: To determine if insensible water loss (IWL) differed between infants exposed or not exposed antenatally to corticosteroids and to explore possible mechanisms for the early postnatal diuresis associated with antenatal steroid exposure. Design: Retrospective analysis of prospectively collected data. Setting: Level three neonatal intensive care unit. Patients: Ninety six infants,median gestational age 27.5 weeks (range 23- 33). Main outcome measures: Comparison of the IWL, urine output and osmolality, fluid input, electrolyte imbalance, respiratory illness severity (as assessed by surfactant requirement, maximum peak inspiratory pressure, and inspired oxygen concentration), and cardiovascular status (as assessed by inotrope requirement) between infants with antenatal corticosteroid exposure and gestational age matched controls. Results: The infants exposed to antenatal steroids differed significantly from the controls in having both a lower IWL (P= 0.0135) and a higher urine output (P=0.0036) on day 1, and fewer developed hyponatraemia (P=0.027) on day 2. Fewer of those exposed to antenatal steroids required inotropes (P=0.06), but their respiratory status was similar to that of the controls. Conclusions: Infants exposed to antenatal corticosteroids have a lower IWL. The results suggest that greater skin maturation, but also better perfusion rather than less severe respiratory status, explains the early diuresis in infants exposed to antenatal steroids.
文摘患儿女,第5胎第1产,胎龄24＋2周,母亲因“宫颈癌全切术后,试管婴儿,胎膜早破”行剖宫产,Apgar评分1 min 2分,5 min 4分,10 min 5分,出生体重420 g。查体：极早产儿貌,皮肤菲薄透明,双眼未睁开,反应差,皮肤发绀,全身皮肤散在瘀斑及出血点,三凹征阳性,抽泣样呼吸,两肺呼吸音低,心律齐,腹软,四肢肌张力低,原始反射未引出。诊断：新生儿窒息（重度）,呼吸衰竭,新生儿出血症,极早产儿。
