Care of the Seriously Ill Neonate With Hyaline Membrane Disease and With Sepsis (Sclerema Neonatorum)

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Abstract
1. Intensive treatment of 595 infants with hyaline membrane disease has increased the survival rate from 46% in the years 1966 to 1968 to 68% in the years 1971 to 1972. This improvement is seen in infants with a gestational age of 28 weeks and more in both sexes, not only in the milder form of the disease, but also in the more severely affected infants, whether in the asphyxiated or in the nonasphyxiated group. Mechanical ventilation seems to be a valuable therapeutic tool, particularly in the most severely affected infants. 2. Postmortem examinations have shown the prevalence of three major disturbances other than those of respiration: ventricular and subarachnoidal hemorrhage, infections, and iatrogenic lesions. 3. Among the 355 survivors, the overall frequency of late somatic and neurological sequellae has been found to be 6.5%. 4. It seems justified to stop all reanimation practices in the presence of a ventricular hemorrhage, since this neonatal complication has led always to severe brain damage in the survivors. 5. Exchange transfusion can be effective in the clinical management of septicemia associated with sclerema neonatorum, when given repeatedly.

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