565 UNUSUAL SYNDROME IN PREMATURE INFANTS ASSOCIATED WITH INTRAVENOUS E-FEROL

Abstract

Three clusters of an unusual syndrome In premature infants in 3 intensive care nurseries were investigated. A case (C) was defined as an infant who developed ascites or at least 2 of the following in a 7-day period: serum direct bilirubin >2 mg/dl, blood urea nitrogen >40 mg/dl or serum creatinine >2 mg/dl, and platelet count <60,000/mm³. Of 68 babies weighing < 1250 gm at birth and surviving beyond 72h, 17 cases occurred with 13 deaths. All cases occurred after the introduction and use of intravenous E-Ferol (EF). 17 of 17 (100%) C but only 23 of 51 (41%) noncase (NC) babies had received EF (p<.001). C and NC infants were similar with respect to other complications, medications, and parenteral nutrition. Significant differences between C and NC babies who received EF (EF NC) are shown as mean ± SE:

EF therapy duration was similar among C and EF NC babies. A dose-response relationship was found with C occurring at EF doses exceeding 20 U/kg/day. Liver, kidney, and intestine routine histology from autopsied C had no uniformly specific abnormalities. No new C were reported after EF use was stopped in the nurseries.

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