Faculty Bibliography

This article explores the effect of a comprehensive developmental care training program on the medical outcome and cost of care for premature infants. Premature infants less than 34 weeks' gestation admitted to 2 regional neonatal intensive care units were prospective studies 6 months before and after implementation of the Wee Care program (Children's Medical Ventures, Norwell, MA). Environment, medical outcome, and hospital charges were recorded. The sample consisted of 242 infants (139 pre- and 103 postintervention). Although the medical outcomes of chronic lung disease, infection rate, mild retinopathy of prematurity, and intraventricular hemorrhage were significantly decreased, there was no change in incidence of severe retinopathy of prematurity. Hospital stay and hospital costs were significantly decreased. The authors conclude that a multidisciplinary, structured program in developmental care can lead to alterations in the neonatal intensive care unit environment associated with improved medical outcome, decreased length of hospitalization, and decreased cost of care.

Persistent interstitial pulmonary emphysema (PIPE) is an uncommon complication of premature infants suffering from hyaline membrane disease who have been treated with mechanical ventilation. The presumed mechanism for the development of the disease is via a break in the bronchioalveolar system that allows air to escape into the interstitium. We report a case of a 9-week-old child who developed the localized form of the disease and underwent a lobectomy. Immunohistochemical stains helped to demonstrate the communication between the airway system and interstitium. This report strengthens the theory that the disease develops from airway rupture at the alveolar level.