***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
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    Input: AIMS To evaluate a  parental question naire as a means of providing outcome measures for a multicentre r and omised controlled trial of treatment for post-haemorrhagic ventricular dilatation . METHODS The parents of 88 survivors were sent a question naire  before a paediatric assessment at the age of 30 months . The parents ’ responses to individual questions taken mainly from the Griffiths ’ mental development scales and their perception of the child ’s ability to see and hear were compared with the paediatric findings . A model , based on the parents ’ responses to particular questions , allowed the categorisation of the children as normal , impaired , moderately or severely disabled ; this was compared with similar categorisation based on the full paediatric assessment . RESULTS Agreement on items concerning gross motor function ranged between 81 and 99 % , concerning dressing between 77 and 80 % , concerning feeding between 91 and 99 % , and concerning language between 85 and 93 % . Similar proportions of children were identified as disabled by the parents ( 60 % ) and by the paediatrician ( 66 % ) . Of 29 children who had developmental quotients  less than 70 , parents identified 28 as disabled , 18 of them as severely disabled . They were not so good at identifying children with impairments without functional loss . CONCLUSIONS Further work is required but there is sufficient encouragement from the results to pursue this methodology further for use in comparing groups in r and omised trials Seventy three preterm infants weighing less than 1500 g or less than 32 weeks ' gestation , or both , were allocated r and omly to treatment ( fresh frozen plasma 10 ml/kg on admission and at 24 hours of age ) or control groups . Fifteen ( 41 % ) out of 37 control patients  sustained intraventricular haemorrhage compared with five ( 14 % ) of 36 patients receiving treatment ( X2 = 5.24 , P = 0.022 ) . No difference was found in coagulation factors measured at birth or at 48 hours of age in both groups . Fresh frozen plasma appears to have a beneficial effect in the prevention of intraventricular haemorrhage Colloid infusions are often given to treat hypotension in preterm infants . The aim of this work was to assess whether it was the amount of protein or the volume of the colloid infused which accounted for the observed increase in blood pressure .  Sixty preterm infants were r and omised ( 20 in each group ) to receive 5 ml/kg 20 % albumin , 15 ml/kg fresh frozen plasma , or 15 ml/kg 4.5 % albumin . All infusions were given at a rate of 5 ml/kg/hour in addition to maintenance fluids . The infants were r and omised when hypotensive ( systolic blood pressure less than 40 mm Hg for two hours ) . There was no significant difference in the blood pressure of the three groups before or one hour after beginning the infusion . The mean increase in blood pressure one hour after completing the infusion , however , was significantly lower in infants receiving 20 % albumin : 9 % compared with 17 % in the group receiving 4.5 % albumin , and 19 % in the group receiving fresh frozen plasma . It is concluded that the volume infused rather than albumin load is important in producing a sustained increase in blood pressure The effects of concurrent administration of albumin with total parenteral nutrition were studied in 12 premature newborns ( birth weight 1.26 + /- 0.1 kg [ mean + /- SEM ] and gestational age 30 + /- 0.8 weeks [ mean + /- SEM ] ) compared with a control group of 12 premature newborns ( birth weight 1.17 + /- 0.2 kg and gestational age 29 + /- 0.1 weeks ) who received total parenteral nutrition . All newborns had a plasma albumin level below 3 g/dL and were in cardiorespiratory distress requiring assisted ventilation .  Albumin supplementation of total parenteral nutrition result ed in a sustained increase in serum albumin concentration as well as increased mean arterial blood pressures in the study group . Slow albumin infusion had no observed effect on the severity of respiratory distress . Study group infants regained birth weight earlier than control group infants . These data suggest that the concurrent administration of albumin may be clinical ly beneficial in critically ill newborn infants To test the hypothesis that restriction of sodium intake during the first 3 to 5 days of life will prevent the occurrence of hypernatremia and the need for administration of large fluid volumes , we prospect ively and r and omly assigned 17 babies ( mean + /- SD : 850 + /- 120 gm ; 27 + /- 1 weeks of gestation ) to receive in blind fashion either daily maintenance sodium or salt restriction with physician-prescribed parenteral fluid intake . Maintenance-group infants received 3 to 4 mEq of sodium per kilogram per day ; restricted infants received no sodium supplement other than with such treatments as transfusion . Sodium balance studies conducted for 5 days demonstrated that maintenance salt intake result ed in a daily sodium balance near zero , whereas sodium-restricted infants continued to excrete urinary sodium at a high rate , which promoted a more negative balance ( average daily sodium balance -0.30 + /- 1.78 SD in maintenance group vs -3.71 + /- 1.47 mEq/kg per day in restriction group ; p less than 0.001 ) . Care givers tended to prescribe daily increases in parenteral fluids for the salt-supplemented infants , perhaps because serum sodium concentrations were elevated in these infants after the first day of the study ( p less than 0.001 ) . Hypernatremia developed in two sodium-supplemented infants ( greater than 150 mEq/L ) , and hyponatremia developed in two sodium-restricted infants ( less than 130 mEq/L ) ; however , the restricted infants were more likely to have normal serum osmolality ( p less than 0.05 ) . Both groups of infants produced urine that was neither concentrated nor dilute , with a high fractional excretion of sodium ; renal failure was not observed . The mortality rate was not affected , but the incidence of bronchopulmonary dysplasia was significantly less in the sodium-restricted babies ( p less than 0.02 ) . We conclude that in tiny premature infants , a fluid regimen that restricts sodium may simplify parenteral fluid therapy targeted to prevent hypernatremia and excessive administration of parenteral fluids AIM To examine the effect of intravascular volume expansion for the treatment of hypovolaemia in sick preterm neonates . METHODS An intravenous infusion of 20 ml per kg of 4.5 % albumin was given to 14 preterm neonates . The effects on systolic blood pressure , central peripheral temperature difference ( c-pT ) , and plasma arginine vasopressin concentration ( pAVP ) were measured . RESULTS Thirteen babies showed a rise in systolic blood pressure . The six babies with the highest initial values of pAVP and c-pT showed a fall in both of these after infusion . The babies with lower initial pAVP ( below 4 pmol/l ) showed either a rise ( two ) or no change ( six ) after albumin infusion . There was a significant correlation between c-pT and log pAVP before ( r2=0.61 ; p<0.05 ) and after infusion ( r2=0.45 ; p<0.05 ) . CONCLUSIONS Plasma AVP concentration is related to c-pT in unwell preterm newborns . This study suggests that clinical assessment of hypovolaemia in preterm newborns is poor and could be improved by using OBJECTIVE Our purpose was to determine if dobutamine or dopamine results in greater improvements in systemic blood flow in very preterm infants with low flow during the first 24 hours of life . STUDY DESIGN A 2-center , r and omized , double-blind study . Infants ( n = 42 ) with low superior vena cava ( SVC ) flow ( < 41 mL/kg/min ) in the first 12 hours were r and omly assigned to receive 10 mL/kg normal saline solution , followed by 10 microg/kg/minute of dobutamine or dopamine . If low flow persisted or recurred , the inotrope was increased to 20 microg/kg/minute , with crossover to the other inotrope if treatment failed to maintain flow . RESULTS Volume produced a more significant increase in SVC flow than dopamine ( + 43 % ) . At the highest dose , dobutamine result ed in a significantly greater increase in SVC flow than dopamine ( mean , + 9.9 vs -3.2 mL/kg/min , P = .02 ) . Dopamine result ed in a significantly greater increase in blood pressure . Infants receiving dobutamine only at 24 hours had a greater right ventricular output than infants receiving dopamine ( mean , 295 vs 167 mL/kg/min , P < .001 ) . Forty percent failed to increase or maintain SVC flow in response to either inotrope . No significant differences in mortality or morbidity were found . CONCLUSIONS Dobutamine produced a greater increase in blood flow than dopamine In a r and omized blinded study we compared two colloid solutions in 30 neonates undergoing major surgery . Fifteen neonates received 4.5 % Human albumin solution ( HAS ) ( mean volume 25.6 ml.kg-1 , SD 9.5 ) and the others received Haemaccel ( Hoechst ) ( 24.9 ml.kg-1 , SD 10 ) . Pre and postoperative plasma albumin and haemoglobin concentrations and plasma colloid osmotic pressure ( COP ) were compared . In the group given Haemaccel there was an appreciable and statistically significant decrease in the mean plasma albumin concentration from 34.27 to 28.27 g.1(-1 ) ( mean difference 6 , CI 3.38 to 8.62 ) and the mean COP decreased significantly from 22.2 to 19.9 mmHg ( mean difference 2.3 , CI 0.3 to 4.5 ) . In the HAS group there was no significant change in either the plasma albumin concentration or COP . There was a small but significant decrease in the mean haemoglobin concentration from 15.92 to 14.35 g.dl-1 ( mean difference 1.56 , CI 0.57 to 2.55 ) after HAS . We conclude that HAS is the superior colloid for volume replacement in neonates undergoing surgery Exchange transfusion , as a form of therapy , was contrasted with the use of fresh frozen plasma or conventional supportive care alone in the management of 19 infants with birth weights of less than 1,000 gm , without severe respiratory distress , and in the management of 82 infants , birth weights less than 2,000 gm , with severe respiratory distress whose disease manifested itself within the first 24 hours of life .  Survival for more than five days was similar , regardless of therapy , in infants weighing less than 1,000 gm without severe RDS . In contrast , the use of exchange transfusion significantly decreased the case fatality rate of infants with severe RDS . In the groups receiving exchange transfusion , the mortality rate was 41 % , whereas the groups receiving either plasma or supportive care alone the mortality was 80 % . Study of coagulation factors and red cell concentrations of fetal hemoglobin and of 2,3-DPG failed to demonstrate any relationship between either improvement in coagulation or oxygen unloading and the improved survival of infants receiving exchange transfusion . Following exchange transfusion there was a significant decrease in the ratio of FIO2 to PaO2 , suggesting that pulmonary perfusion and /or ventilation was improved by the procedure Objective To study the renal effects ( measured by creatininemia ) of plasma volume expansion with a medium molecular weight hydroxyethyl starch in the newborn . Design A prospect i ve , r and omized , double-blinded , pilot study . Patients The study included 26 neonates weighing 690–4030 g ( gestational age , 26–40 wks ) , without cardiac or renal failure or major hemostasis abnormalities and requiring a peripherally inserted central catheter for parenteral nutrition . Setting Pediatric and neonatal intensive care unit of a university-affiliated hospital . Interventions Plasma volume expansion was performed to facilitate insertion of the central catheter . After parental consent , neonates were r and omly allocated to receive intravenous infusions at 10 mL·kg−1 of 5 % albumin or 6 % hydroxyethyl starch 200/0.5 . Sample size was calculated to detect an increase in mean creatininemia of > 20 & mgr;mol·L−1 ( with & agr ; = 0.05 , & bgr ; = 0.80 ) . Measurements and Main Results No clinical ly or statistically significant differences were found between the two groups 6 hrs , 24 hrs , 48 hrs , and 7 days after plasma volume expansion . The study could detect an increase in creatininemia ≥20 & mgr;mol·L−1 with a power of 80 % . Conclusions In 13 healthy neonates , plasma volume expansion with 10 mL·kg−1 of 6 % hydroxyethyl starch 200/0.5 does not increase creatininemia BACKGROUND Fluid restriction has been reported to improve survival of infants without chronic lung disease ( CLD )  , but it remains unknown whether it reduces CLD in a population at high risk of CLD routinely exposed to antenatal steroids and postnatal surfactant without increasing other adverse outcomes . AIM 
    Output:
    
REVIEW ER 'S CONCLUSIONS There is no evidence from r and omised trials to support the routine use of early volume expansion in very preterm infants without cardiovascular compromise .
There is insufficient evidence to determine whether infants with cardiovascular compromise would benefit from volume expansion .
There is insufficient evidence to determine what type of volume expansion should be used in preterm infants ( if at all ) or for the use of early red cell transfusions .