Assessment of sickness severity of illness in neonates: review of various neonatal illness scoring systems

Sickness severity scores are widely used for neonates admitted to neonatal intensive care units to predict severity of illness and risk of mortality and long-term outcome. These scores are also used frequently for quality assessment among various neonatal intensive care unit and hospital. Accurate and reliable measures of severity of illness are required for unbiased and reliable comparisons especially for benchmarking or comparative quality improvement care studies. These scores also serve to control for population differences when performing studies such as clinical trials, outcome evaluations, and evaluation of resource utilisation. Although presently there are multiple scores designed for neonates’ sickness assessment but none of the score is ideal. Each score has its own advantages and disadvantages. We did literature search for identifying all neonatal sickness severity score and in this review article, we discuss these scores along with their merits and demerits.     

新生儿高胆红素血症对机体的损伤

新生儿高胆红素血症是新生儿住院的主要原因之一,是常见于新生儿早期的以皮肤巩膜黄染为主要表现的病症.患儿血清总胆红素及未结合胆红素水平大幅度升高,如不及时干预可能对新生儿脑功能、肾功能、听力及心功能产生损伤,严重者可致死亡.研究证实,高胆红素血症对新生儿的脑神经、听力、肾脏及心脏均可造成损伤,且靶器官的受损程度与血中胆红素水平呈正相关.该文就高胆红素血症对新生儿的不良影响作一综述.     

不同剂量丙种球蛋白治疗ABO溶血病疗效比较

目的比较不同剂量静脉注射用丙种球蛋白(IVIG)治疗新生儿ABO血型不合溶血病的疗效。方法将出生后2 d内确诊的新生儿ABO血型不合溶血病患儿随机分为单剂组(70例)和多剂组(66例),单剂组静脉滴注IVIG 1 g/(kg.d),1 d;多剂组剂量500 mg/(kg.d),共3 d。生后第42天随访血红蛋白及生长发育等情况。结果单剂组需要双面光疗时间较多剂组短(P<0.01),两组患儿第42天血红蛋白水平、贫血发生率差异无显著性,两组患儿均不需换血治疗,均未发生胆红素脑病。结论单次大剂量IVIG(1 g/kg)治疗新生儿ABO血型不合溶血病是一种高效、经济、安全的治疗方法。     

Spread and Fate of Amniotic Fluid Cellular Content in the Middle Ear

In this study, 24 temporal bones with an age range from neonates to 23-month-old infants were serially sectioned and studied for the spread and fate of amniotic fluid cellular content (AFCC) in the middle ear and mastoid. Most children had had either a moderate or massive contamination. AFCC clusters were found to spread to all compartments, with the sites of predilection being the stapes region, the lower lateral attic and the tympanic isthmus. AFCC created an intensive foreign body giant cell reaction and the foreign material practically dissolved in 5 months as a result of the organization process. Tiny remnants of AFCC appeared as late as 15 months after birth. It seems likely that AFCC contamination predisposes the ears to recurring otitis media. The sequalae of the massive granulation tissue development involves obliteration of Prussak's space and its aeration routes, as well as blockage of the tympanic isthmus, leading to extensive disease in the major attic compartments.