新生児医療の進歩 : 後遺症なき生存をめざして

Neonatal medicine in Japan has made steady progress in recent decades and the survival rateof extremely premature babies is one of the best in the world. The following topics which contributedin the past and may contribute in the future to the sequela-free survival of small babies arediscussed. Artificial pulmonary surfactant has dramatically raised the survival rate of prematurenewborn with respiratory distress syndrome. High frequency oscillation and inhaled nitric oxideare successfully used to treat severe respiratory/circulatory disorders, such as persistent pulmonaryhypertension of the newborn and hypoplastic lung. So called“glucocorticoid-responsivehypotension”can be detected and treated before it presents any symptom by monitoring renalblood flow. Pathogenesis of periventricular leukomalacia, a major cause of cerebral palsy ofextremely low birth weight infants, needs to be elucidated for its treatment. Neonatal resuscitationprogram must be propagated to prevent sequelae in asphyxic babies. Artificial uterus is stilla science fiction, but basic research is currently underway.