Die Peritonealdialyse zur Behandlung reifer und unreifer Neugeborener mit Atemnosyndrom

✍ Scribed by Rolf Kellner; Hans-Ullrich Gülzow; Willi Heine; Margit Hille; Lothar Pelz; Christian Plath; Roswitha Siemer; Hans-Joachim Stolpe

• Publisher: Springer
• Year: 1974
• Tongue: English
• Weight: 993 KB
• Volume: 118
• Category: Article
• ISSN: 0340-6997
• DOI: 10.1007/bf00440028

✦ Synopsis

Some authors have recommended peritoneal dialysis to improve the therapy of the respiratory distress syndrome (RDS) of newborns. In 1968 we published a report estimated on a newborn suffering from I~DS. As a pH of 6.73, was 2 hrs after birth, we administered standard therapy and peritoneal dialysis. The baby has survived and his development has been uneventful.

This case and the results obtained by other authors in the treatment of RDS with peritoneal dialysis have led us to treat prematures and newborns suffering from severe I~DS with peritoneal dialysis in addition to standard therapy (infusions of TttAM, glucose, electrolytes, amino acids, administration of antibiotics and oxygen, and, when indicated, intermittent positive-pressure respiration). Peritoneal dialysis was carried out with bland hypertonie solution in continuous flow technics.

We have treated 13 prematures and 1 newborn suffering from RDS and a premature suffering from erythroblastosis with hydrops and t~DS. Except for the mature newborn, the gestational age was 25 to 33 weeks. Four prematures had birth weights below 1250 g. The Apgar score of 10 newborns was 3 or less 1 rain after birth. Thirteen newborn needed resuscitation in the delivery room. Eight newborns were treated with respiration during the first few hours after birth and 4 other prematures at a later stage. Clinical and laboratory data after birth, on admission to the pediatric hospital and during the course of the disease are shown in tables and figures. The indications for the peritoneal dialysis are described in tables. In 2 patients we saw no positive effect, and we saw only a slight effect in 4 patients. Four prematures survived. The physical and psychological development was normal in 3 infants. One premature with a birth weight of 1200 g had recovered before she died of Candida sepsis at the age of 26 days.

Results of the treatment and the efficacy and technical problems of peritoneal dialysis in RDS of newborns are discussed. Our opinion is that the peritoneal * Untersuchungen im Rahmen des medizinisehen Forschungsprojektes ,,Perinatologie" des Ministeriums ffir Gesundheitswesen der DDR.

1~. Kellner et al.

dialysis is a good additional aid in the treatment of RDS of prematures and newborns.