Dr Davies and Mr Leivers comment that they have not found it necessary to make frequent adjustments to their parenteral nutrition regimens and that they therefore usually use one of three standard formulas. I have in the past worked in a major referral unit which used a similar system. I agree that apparently satisfactory parenteral nutrition is indeed possible with such a system when the infant is metabolically stable. There is an inevitable tendency, however, with such a system to either postpone the initiation of parenteral nutrition in the metabolically unstable infant or to tolerate minor electrolyte disturbances rather than alter a standard solution. In my experience allocating the problem to a senior staff member does not protect against mistakes. In the increasingly complex environment of a modern neonatal intensive care unit errors of all sorts are all too common. I believe that computers should be used whenever possible to help alleviate this problem. The clinical importance of minor electrolyte disturbances is certainly debatable. In the context of the availability of inexpensive microcomputers I do, however, submit that it is manifestly absurd that arithmetical complexity alone should act as a constraint on optimal clinical management.
[1]
Leonard B Strang.
Abstracts—are they really a dud currency?
,
1984,
Archives of Disease in Childhood.
[2]
N. Christy.
HPA failure and glucocorticoid therapy.
,
1984,
Hospital Practice.
[3]
D. Bell.
Two hundred glass injuries.
,
1984,
Archives of disease in childhood.
[4]
Stewart Rb,et al.
Cleft palate and gonadotrophin deficiency.
,
1984,
Archives of disease in childhood.
[5]
I. Hill,et al.
Treatment choice in acute rheumatic carditis.
,
1984,
Archives of disease in childhood.
[6]
Phil A. Silva,et al.
Childhood accidents — parents’ attitudes to prevention
,
1982,
Australian paediatric journal.
[7]
A. Beautrais,et al.
Childhood accidents in a New Zealand birth cohort
,
1982,
Australian paediatric journal.
[8]
C. Carter.
Mendelian Inheritance in Man
,
1967
.
[9]
R. Santen,et al.
Hypogonadotropic eunuchoidism. I. Clinical study of the mode of inheritance.
,
1973,
The Journal of clinical endocrinology and metabolism.
[10]
Fj Kallmann.
The genetic aspects of primary eunuchoidism
,
1944
.