Efficiency of Oxygen Therapy by Simple Face Mask and Nasal Cannula for Acute Respiratory Failure in Infants and Young Children

Premises: Acute respiratory failure caused by respiratory diseases, which is a frequent pathology in infants and young children, requires oxygen therapy, which can be administered by different devices. Objectives: To evaluate the efficiency of two devices for oxygen administration by determining a clinical appraisal score for acute respiratory failure in infants and young children by oxygen therapy using simple face masks and nasal cannulas. Material and methods: 74 children, aged between one month and 3 years were included in our study. Oxygen therapy was administered by face mask to 38 patients, and by nasal cannula to 36 patients. A clinical appraisal score of respiratory failure was calculated both before and after oxygen therapy. Oxygen saturation was measured by pulse oximetry (SpO2) and arterial or capillary blood gas (SaO2) before, and 30 minutes and 60 minutes after the initiation of oxygen therapy. Results: We found an improvement in the clinical score regardless of the method of administration; this improvement was more obvious at 60 minutes than at the 30 min evaluation (p<0.001). The differences were statistically significant (p<0.0001) for all the measurements (baseline vs. 30 minutes, baseline vs. 60 minutes, 30 minutes vs. 60 minutes). An increase in both SaO2 and SpO2 values was found (p<0.001). Conclusions: The clinical score for acute respiratory failure and the SaO2 and SpO2 values significantly improved after oxygen therapy

EFICIENŢA OXIGENOTERAPIEI PRIN IZOLETA LA SUGARUL CU INSUFICIENŢĂ RESPIRATORIE ACUTĂ

Oxigenoterapia este principala metoda de tratament în insufi cienţa respiratorie acută la copil. Metoda administrării oxigenoterapiei cu izoleta la sugar reprezintă o metodă frecvent folosită în practica pediatrică. Obiective. Evaluarea efi cacităţii oxigenoterapiei administrate cu izoleta la sugarul cu insufi cienţă respiratorie acută de cauză pneumogenă prin compararea a două metode de măsurare a saturaţiei în oxigen a hemoglobinei: din sânge capilar arterializat şi prin pulsoximetrie. Material şi metodă. Au fost luaţi în studiu 30 de sugari, cu insufi cienţă respiratorie acută de cauză pneumogenă. S-a utilizat un scor clinic de apreciere a insufi cienţei respiratorii acute, care evaluează frecvenţa respiratorie, bătaia aripioarelor nazale, tiraj, cianoza, senzoriu, înainte şi după oxigenoterapie. Din sângele capilar arterializat s-a măsurat presiunea parţială a oxigenului şi saturaţia în oxigen a hemoglobinei şi s-a citit cu analizorul Automatic Blood Gas System. Concomitent s-a măsurat şi saturaţia în oxigen a hemoglobinei utilizând puls oximetrul. Măsurătorile au fost efectuate înaintea iniţierii terapiei cu oxigen şi după 30 de minute şi 60 de minute de la iniţierea oxigenoterapiei. Rezultate. Comparativ cu valorile bazale, înregistrate înaintea iniţierii oxigenoterapiei, s-a înregistrat ameliorarea semnifi cativă statistic a scorului clinic atât la 30 de minute cât şi la 60 de minute după instituirea terapiei cu oxigen (p < 0,001). Ameliorarea a fost mai amplă la 60 de minute. Presiunea parţială a oxigenului a avut un trend ascendent semnifi cativ sta tistic atât la determinarea la 30 de minute cât şi la 60 de minute (p < 0,001). Pentru ambele metode de măsurare ale SaO2 au fost înregistrate creşteri semnifi cative statistic (p < 0,001) ale acestei variabile după 30 respectiv 60 de minute. Concluzii. Oxigenoterapia administrată cu izoleta ameliorează insufi cienţa respiratorie acută evaluată prin scor clinic. Administrarea oxigenoterapiei cu izoleta la sugar creşte semnifi cativ valorile presiunii parţiale a oxigenului şi a saturaţiei în oxigen a hemoglobinei măsurată din sânge capilar, precum şi valorile saturaţiei în oxigen a he moglobinei determinate cu pulsoximetrul atât la 30 de minute, cât şi la 60 de minute. Creşterile celor trei parametri sunt mai ample la 60 de minute. Există o concordanţă semnifi cativă statistic între valorile saturaţiei în oxigen a hemoglobinei determinată din sânge capilar şi prin pulsoximetrie în toate determinările

Determinants of Early Initiation of Breastfeeding among Mothers of Children Aged Less Than 24 Months in Northwestern Romania

Early initiation of breastfeeding (EIBF), defined as putting newborns to the breast within 1 h of birth, may have important benefits for both infant and mother. The aim of this study was to assess EIBF practices and its determinants in northwestern Romania. This cross-sectional study was conducted from March to June 2019, based on a sample of 1399 mothers of children aged less than 24 months. The sample was recruited from the community, from 29 cities and 41 communes distributed across the six counties of the northwestern region of Romania. Mothers responded by face-to-face interviews to a structured questionnaire. Multivariate logistic regression was used to identify factors independently associated with EIBF. Only 24.3% of the mothers initiated breastfeeding within 1 h of birth. Delivering at a private hospital (adjusted odds ratio (AOR): 5.17, 95% confidence interval (CI) 3.87, 6.91), vaginal delivery (AOR: 4.39, 95% CI 3.29, 5.88), mother&ndash;newborn skin-to-skin contact for 1 h or more (AOR: 55.6, 95% CI 23.0, 134.2), and breastfeeding counseling during antenatal visits (AOR: 1.48, 95% CI 1.12, 1.97) were factors associated with increased likelihood of EIBF. Overall, the practice of EIBF was poor. Targeting modifiable factors associated with EIBF may be used to improve early initiation practice

Breastfeeding Practices and Determinant Factors of Exclusive Breastfeeding among Mothers of Children Aged 0–23 Months in Northwestern Romania

In terms of breastfeeding (BF) practices in Romania, there is a lack of up-to-date data. The aim of the present study was to assess current BF practices, and to investigate the factors associated with exclusive BF (EBF) under 6 months of age in northwestern Romania. A structured questionnaire was used to collect data among 1399 mothers of children aged 0–23 months, recruited between March and June 2019, from the community. BF practices were evaluated based on the World Health Organization indicators for assessing infant and young child feeding practices, whereas determinants of EBF were explored using logistic regression models. Almost all mothers (95.7%) breastfed their child at least once. The EBF rate was 46.7%, the continued BF rate at one year of age was 54.2%, and the continued BF rate at 2 years of age was 30.3%. The place of delivery and parental leave duration were strong determinants of EBF. The improving rates observed in this study for all the BF practices assessed suggest the continuation of efforts to develop effective national policies and programs for promoting, protecting, and supporting BF in Romania. Particular emphasis should be given to the creation in maternity hospitals of an environment that is supportive towards breastfeeding