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Objective:To report the prevalence of hypophosphatemia during the first week of life in preterm infants receiving aggressive parenteral nutrition and to analyze population variables associated with severe hypophosphatemia.Study design:A retrospective cohort of 61 neonates below 1250 g birth weight consecutively born at Hospital Italiano de Buenos Aires exposed to high caloric and protein intake from the first day of birth. Primary outcome was hypophosphatemia (phosphate <4 mg dl−1). A one-sample mean comparison test was used to compare our sample with a hypothesized population mean.Results:The prevalence of hypophosphatemia was 91% (95% confidence interval (CI) 82 to 97%). The mean phosphatemia value was 2.52 mg dl−1 (95% CI 2.18 to 2.86), significantly different from the hypothesized population mean (P<0.001). Patients with severe hypophosphatemia (<2 mg dl−1) were smaller. They presented with sepsis more frequently and received more vasoactive drugs and mechanical ventilation.Conclusion:The prevalence of hypophosphatemia in this group of preterm infants is high. The potential association with adverse clinical outcomes deserves further research. [ABSTRACT FROM AUTHOR]

Introduction: The WHO standards have been used as a gold standard for growth assessment in preterm infants since 1986. The introduction of the WHO standards in Argentina could improve detection of sub-optimal growth., Objective: To compare the proportion of growth retardation in terms of weight, body height and head circumference in preterm infants with a birth weight less than 1500 g (VLBW) assessed according to the WHO standards and the Sociedad Argentina de Pediatría (SAP) standards., Population and Methods: Cohort study in VLBW newborn infants. Measurements included were weight, height and head circumferences measured at 40, 53, 66, 79 and 92 postmenstrual weeks (±1 week). Sex was recorded as an independent outcome measure for both standards (WHO and SAP). Mean Z scores were analyzed for both standards using Student's test, and the difference of proportions was assessed using the c2 test (OR; 95% CI)., Results: Two hundred and four infants were included. No differences were observed in anthropometric outcome measures at birth by sex. A greater growth was seen in terms of weight and height as per the SAP standards compared to the WHO standards, which was more marked in male infants than female infants, and which diminished around their first year of life. Growth retardation in terms of height was observed in both males and females assessed with the WHO standards. No differences were observed in head circumference. A higher proportion of patients with a weight below 2 standard deviations at 3 months old was found as per the WHO (p < 0.01; OR: 0.36; 95% CI: 0.150.78), but that was not the case with height and head circumference., Conclusions: This study allows to suggest that changing the standards does not imply a significant modification in our follow-up practice over the first year of life of an infant.

Objective: The objective of this study was to assess the prevalence and characteristics of medication errors in pediatric and neonatal inpatients and to measure the impact of interventions to reduce medication errors., Methods: A preintervention and postintervention cross-sectional study was conducted of a sample of prescriptions that were ordered by physicians and medications that were administered by nurses to patients at the NICU, PICU, and general pediatric settings at the Hospital Italiano de Buenos Aires Department of Pediatrics in 2002 and 2004. Number and type of errors, time shift on which they occurred, and whether they had any kind of adverse event on the patient were recorded. Medication errors were stratified according to physicians' and nurses' status. Several interventions, including incorporating a positive safety culture without a punitive management of errors and specific prescribing and drug-administration recommendations were implemented between the 2 phases of the study., Results: A total of 590 prescriptions and 1174 drug administrations for 95 patients in the first phase of the study and 1144 prescriptions with 1588 drug administrations for 92 patients in the second phase were evaluated. The prevalence of medication error rate in the second phase was 7.3% (199 of 2732) and 11.4% (201 of 1764) in the first phase. The risk difference was -4.1%., Conclusions: The development of a program mainly centered on the promotion of a cultural change in the approach to medical errors can effectively diminish medication errors in neonates and children.