ao-11. ambroxol for antepartum stimulation of neonatal lung maturity

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Results 142 (64.5%) returned the survey. 25% of respondents were uncomfortable or very uncomfortable deciding when to end resuscitation. About 20% of respondents reported low levels of comfort in performing the other domains. For each of the domains physicians had the highest level of comfort, closely followed by RTs on night shift. After controlling for other variables in the model, 6 years or more experience in the NICU was positively associated with comfort in performing and also ending the resuscitation. All staff indicated a need for training and practicing teamwork and also infrequently used procedures and devices. Conclusions Additional training in team work and infrequently used proce- dures may be helpful to improve comfort levels in as many as 20% of professionals in the NICU. doi:10.1016/j.earlhumdev.2010.09.018 AO-11. Ambroxol for antepartum stimulation of neonatal lung maturity Boris Marinov, Nelly Jekova, Andriana Andreeva, Kalina Milanova Department of Perinatology at The University Maternity Hospital Maichin Dom, Sofia, Bulgaria Aim In the last few decades efforts have been made to enhance the fetal lung maturity by means of drugs administered to the mother. The multiple side effects of glucocorticoids have raised the need to look for other ways for prevention of the neonatal respiratory distress syndrome (NRDS) in the preterm infant. Recent investigations consider Ambroxol to be capable of accelerating the fetal lung maturation as it was shown to stimulate the synthesis and the release of pulmonary surfactant by type II pneumocytes. The aim of our prospective study was to assess the effect of Ambroxol, given prenatally, on the rate and severity of the NRDS in the preterm infants. Materials and methods Twenty-seven pregnant women between 27 and 32 weeks with preterm labor and their 27 prematurely born infants were entered in the study. Fifteen of the women were randomised to receive Ambroxol prenatally (study group) and 12 women did not receive any medication for acceleration of fetal lung maturity (control group). Ambroxol was given orally in a daily dose of 60 mg (30 ml) every 12 h for seven to ten days depending on the gestational age. The newborn infants were clinically and radiologically assessed for development and severity of NRDS and were treated according to the European Consensus guidelines on management of NRDS2007 Update. Results Severe NRDS occurred in 2 infants (14%) from the study group compared to 5 (41%) in the control group. All of them had multiple surfactant doses and were ventilated for more than 72 h. The remaining 7 infants (59%) from the control group needed at least one dose of surfactant and artificial ventilation in the following three days. Nine (60%) of the infants in the study group had mild NRDS treated by nasal CPAP and 4 (26%) had no signs of respiratory distress syndrome. Conclusions These results suggest that Ambroxol can reduce the incidence and severity of NRDS in the premature infants. doi:10.1016/j.earlhumdev.2010.09.019 AO-12. Our first experiences using Retcam Shuttle in ophthalmological examinations Vadnay Akos DEOEC Debrecen University of Medicine and Health Care Sciences, Hungary Aim We are using a Retcam Shuttle type video recording equipment from October of 2009 in NICU of DEOEC. Our aim is to report this instrument. Materials and methods We use the Retcam's mobility in two NICUs of DEOEC and in the Department of Ophthalmology for screening retinopathy of prema- turity and other diseases. We are going to show its usability in this presentation and our first experiences illustrated with pictures. Results We examined 322 patients with this instrument, and we treated 31 of them with laser photocoagulation from 2009 October to 2010 July. Over 200 students have learnt ophthalmology in this period partially from its pictures. Conclusions We can declare that the instrument is easy to use making wide field, high density pictures of the fundus of the eye, which is very useful in following and judging the therapy of borderline cases of retinopathy of prematurity, it is definitive in teaching, fulfills the professional standards, helps a lot in informing the patient's relatives, and gives an ability to archive. doi:10.1016/j.earlhumdev.2010.09.020 AO-13. Recombinant erythropoietin for neuro-protection in small preterm infants: Our experience Aspazija Sofijanova, Aleksandar Sajkovski, Liljana Kojich, Silvana Naunova-Timovska, Radica Muratovska-Delimitova Department of Neonatal Intensive Care Unit, University Children Hospital, Skopje, Republic of Macedonia Aim During the past decade, recombinant human Epo (rhEpo) has been widely used in preterm infants to prevent/treat anemia of prematurity. EPO was considered not capable of passing through blood-brain-barrier at low dose. Evidence from animal experiments reveals that rhEpo must be given in high doses at the beginning or within a short (up to 6 h) critical time period after the onset of brain injury to achieve a significant neuro-protective effect. Abstracts S5

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Results

142 (64.5%) returned the survey. 25% of respondents wereuncomfortable or very uncomfortable deciding when to endresuscitation. About 20% of respondents reported low levels ofcomfort in performing the other domains. For each of the domainsphysicians had the highest level of comfort, closely followed by RTson night shift. After controlling for other variables in the model,6 years or more experience in the NICU was positively associatedwith comfort in performing and also ending the resuscitation. All staffindicated a need for training and practicing teamwork and alsoinfrequently used procedures and devices.

Conclusions

Additional training in team work and infrequently used proce-dures may be helpful to improve comfort levels in as many as 20% ofprofessionals in the NICU.

doi:10.1016/j.earlhumdev.2010.09.018

AO-11. Ambroxol for antepartum stimulation of neonatallung maturity

Boris Marinov, Nelly Jekova, Andriana Andreeva, Kalina MilanovaDepartment of Perinatology at The University Maternity Hospital“Maichin Dom”, Sofia, Bulgaria

Aim

In the last few decades efforts have beenmade to enhance the fetallung maturity by means of drugs administered to the mother. Themultiple side effects of glucocorticoids have raised the need to look forother ways for prevention of the neonatal respiratory distresssyndrome (NRDS) in the preterm infant. Recent investigationsconsider Ambroxol to be capable of accelerating the fetal lungmaturation as it was shown to stimulate the synthesis and the releaseof pulmonary surfactant by type II pneumocytes. The aim of ourprospective study was to assess the effect of Ambroxol, givenprenatally, on the rate and severity of the NRDS in the preterm infants.

Materials and methods

Twenty-seven pregnant women between 27 and 32 weeks withpreterm labor and their 27 prematurely born infants were entered inthe study. Fifteen of the women were randomised to receiveAmbroxol prenatally (study group) and 12 women did not receiveany medication for acceleration of fetal lung maturity (controlgroup). Ambroxol was given orally in a daily dose of 60 mg (30 ml)every 12 h for seven to ten days depending on the gestational age.The newborn infants were clinically and radiologically assessed fordevelopment and severity of NRDS and were treated according to theEuropean Consensus guidelines on management of NRDS—2007Update.

Results

Severe NRDS occurred in 2 infants (14%) from the study groupcompared to 5 (41%) in the control group. All of them had multiplesurfactant doses andwere ventilated formore than 72 h. The remaining7 infants (59%) from the control group needed at least one dose ofsurfactant and artificial ventilation in the following three days. Nine(60%) of the infants in the study group had mild NRDS treated by nasalCPAP and 4 (26%) had no signs of respiratory distress syndrome.

Conclusions

These results suggest that Ambroxol can reduce the incidence andseverity of NRDS in the premature infants.

doi:10.1016/j.earlhumdev.2010.09.019

AO-12. Our first experiences using Retcam Shuttle inophthalmological examinations

Vadnay AkosDEOECDebrecen University of Medicine and Health Care Sciences, Hungary

Aim

We are using a Retcam Shuttle type video recording equipmentfrom October of 2009 in NICU of DEOEC. Our aim is to report thisinstrument.

Materials and methods

We use the Retcam's mobility in two NICUs of DEOEC and in theDepartment of Ophthalmology for screening retinopathy of prema-turity and other diseases. We are going to show its usability in thispresentation and our first experiences illustrated with pictures.

Results

We examined 322 patients with this instrument, and we treated31 of them with laser photocoagulation from 2009 October to 2010July. Over 200 students have learnt ophthalmology in this periodpartially from its pictures.

Conclusions

We can declare that the instrument is easy to use making widefield, high density pictures of the fundus of the eye, which is veryuseful in following and judging the therapy of borderline cases ofretinopathy of prematurity, it is definitive in teaching, fulfills theprofessional standards, helps a lot in informing the patient's relatives,and gives an ability to archive.

doi:10.1016/j.earlhumdev.2010.09.020

AO-13. Recombinant erythropoietin for neuro-protection in smallpreterm infants: Our experience

Aspazija Sofijanova, Aleksandar Sajkovski, Liljana Kojich,Silvana Naunova-Timovska, Radica Muratovska-DelimitovaDepartment of Neonatal Intensive Care Unit, University Children Hospital,Skopje, Republic of Macedonia

Aim

During the past decade, recombinant human Epo (rhEpo) hasbeen widely used in preterm infants to prevent/treat anemia ofprematurity. EPO was considered not capable of passing throughblood-brain-barrier at low dose. Evidence from animal experimentsreveals that rhEpo must be given in high doses at the beginning orwithin a short (up to 6 h) critical time period after the onset of braininjury to achieve a significant neuro-protective effect.

Abstracts S5