Neonatal Intensive Care Unit of Kyorin University Hospital (Part 2)

Abstract

Basic principal of our unit about nutritional and repiratory managements of extremely premature infant is discribed. Strict breast milk feeding is indicated during 3-4 weeks after birth and then premature formula is given alternating with breast milk. Sufficient calories for growth will be 120 Cal/kg/day, however total water intake is restricted to 150ml/kg/day until one's body weight becomes 1500 grams. Multivitamin syrup (Popon S) is administered from 2-3 weeks after birth, Iron syrup (Incremin) is given when one's body weight reaches 2000 grams. Intrvenous hyperalimentation will not be indicated actively at this point. Heart and repriratory rate monitoring is indicated for all the exstremely premature infant and infant of less than 34 weeks gestation in order to recognize apneic spells. Low dose oxygen and aminophylline are administered under transcutaneous oxygen monitoring. Continuouse positive airway pressure is indicated when PaCO_2 is more than 60 mmHg under 60% oxygen administration. Mechanical ventilation is indicated when PaCO2 is less than 50 mmHg and/or PaCO_2 is more than 60 mmHg under 100% oxygen therapy and apnea. Administrating oxygen must be fully moistured and warmed. During oxygen therapy. transcutaneous Po_2 and/or blood gases must be monitored.