The use of THAM in the treatment of neonatal acidaemia is surveyed over a 3-year period. Of 100 babies to whom the drug was given while they were breathing spontaneously, 17% had respiratory depression during, or within two minutes of injection. If only potentially viable babies are considered, the incidence of respiratory depression increases to 20% and the incidence in babies with respiratory distress is 17%. No single group of babies was particularly susceptible to this action of THAM, except those who had had a previous spontaneous apnoeic attack. No babies became apnoeic after the injection of sodium bicarbonate. It appears that in the 'good prognosis' group according to the hyperoxia test those babies who require correction of their pH have a higher death rate than those who do not. There was no statistically significant increase in the death rate of babies who deteriorated after THAM, but several of these babies only survived after treatment with artificial ventilation. There was an increased incidence of intraventricular haemorrhage in those babies who received 7% THAM rather than 3·60% THAM, but this may be due to other factors in their illness.
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