Iatrogenic hazards of neonatal intensive care in extremely low birthweight infants.

Abstract

Yu, V. Y. H., Hewson, P. H. and Hollingsworth, E. (1979). Aust. Paediatr. J., 15, 233–237. Iatrogenic hazards of neonatal intensive care in extremely low birthweight infants. The history of neonatal paediatrics has evidenced over‐enthusiasm in the introduction of innovations in management which are almost always accompanied by unforseen hazards. We have scrutinised present practices in the intensive care of 55 infants weighing < 1000 g at birth, which might be responsible for the current trends in iatrogenic disease patterns. Umbilical arterial catheterization was associated with a 29% complication rate. Hyperoxia was documented in 81% of infants during oxygen therapy. Retrolental fibroplasia was present in 1 survivor. Blood sampling for microbiochemical and haematological monitoring increased the need for replacement blood transfusions. Postnatally acquired cytomegalovirus infection occurred in 4 infants, 3 of whom were probably infected from transfused blood. Complications associated with current nutritional management included hyperglycaemia, hypocalcaemia and hyponatraemia. Iatrogenic factors might have contributed to the occurrence of necrotizing enterocolitis, patent ductus arteriosus and cholestatic jaundice. We conclude that current neonatal intensive care practices need ongoing scrutiny and great caution should be taken in introducing new advances.