RULES OF EVIDENCE APPLIED TO TREATMENTS OF NEONATAL HYPOXEMIA AND ACIDOSIS

Abstract

BIOCHEMICAL MONITORING of the low birth weight infant during the first 24 hours of life frequently reveals abnormalities of acid-base balance and hypoxemia; these anomalies are very striking in infants with clinical signs of respiratory distress. The clinician is then faced with two problems: the first in diagnosis, the second in treatment. In the past few years certain regimes for respiratory distress have been recommended with varying degrees of fact and forcefulness. These include the careful maintenance of thermal balance to keep oxygen consumption at a minimum, correction of acidosis by NaHCO3 or THAM in rapid or slow infusion, adequate oxygenation sometimes requiring an inspired O2 concentration above 40%, assisted ventilation (either through a tracheal tube or by a negative pressure tank), and, finally, administration of agents acting on vasomotor tone.