Relationship Between Oxygen Saturation and Umbilical Cord pH Immediately After Birth

The aim of this study is to determine the relationship between oxygen saturation (SpO2) by pulse oximetry levels and umbilical cord arterial pH values in healthy newborns during the first 15 minutes of life. Methods: The study was performed with healthy term, appropriate-for-gestational-age newborn infants. The infants were divided in two groups: umbilical cord arterial blood pH value ≤7.19 (group 1) and >7.19 (group 2); SpO2 levels during the first 15 minutes of life were compared between groups. Results: The study was completed with 129 infants (33 in group 1 and 96 in group 2). A significant correlation was found between first-measured preductal and postductal SpO2 levels by pulse oximetry and umbilical cord arterial pH values ([r2:0.72(0.62 -0.79); p < 0.001] and [r2:0.32(0.25 – 0.54); p < 0.001], respectively). In group 1, infants had lower SpO2 levels at both preductal and postductal measurements during the first 11 minutes of life and time to reach ≥90% SpO2 level was longer compared with infants in group 2. Conclusion: Determination of umbilical arterial blood pH values, in addition to clinical findings and oxygen saturation measurements, might be helpful in deciding the concentration of oxygen and whether or not to continue oxygen supplementation in the delivery room

How should we give vitamin D supplementation? evaluation of the pediatricians’ knowledge in Turkey

Abstract Background We aimed to determine the knowledge and attitudes of Turkish pediatricians concerning vitamin D supplement. Methods The study was planned cross-sectional to be carried out between April–May 2015 in Turkey. A questionnaire form that determined the participants’ opinions and practices concerning vitamin D supplement was completed via face-to-face interview. Results A total of 107 pediatricians (49.3%) and 110 pediatric residents (50.7%) participated in the study. Of the physicians, 85.2% recommended vitamin D supplement for all infants and children regardless of diet, 13.4% recommended for the infants which are solely breastfed. Vitamin D supplement is recommended at a dose of 400 IU/day by 88.8% of pediatricians and by 90% of pediatric residents. Of the pediatricians and pediatric residents, 72% and 68.2%, respectively commence vitamin D supplement when the newborn is 15 days old. The rates of recommending vitamin D supplement until the age of one and two years were higher among pediatricians (48.6% and 41.1%, respectively) than pediatric residents (40.9% and 32.7%, respectively). The rate of starting vitamin D supplement for fontanelle closure was significantly higher among pediatric residents (15.5%) than pediatricians (3.7%) (p = 0.002). It was determined that the rate of prescribing vitamin D supplement until fontanelle closure was higher among pediatric residents (18.2%) than pediatricians (0.9%). Conclusions The present study suggest that the knowledge of pediatricians about recommendation of vitamin D needs to be enhanced by education programs in addition to free vitamin D supplement provided by the Ministry of Health

An observational, prospective, multicenter study on rescue high-frequency oscillatory ventilation in neonates failing with conventional ventilation.

BackgroundTo achieve gas exchange goals and mitigate lung injury, infants who fail with conventional ventilation (CV) are generally switched to high-frequency oscillatory ventilation (HFOV). Although preferred in many neonatal intensive care units (NICUs), research on this type of rescue HFOV has not been reported recently.MethodsAn online registry database for a multicenter, prospective study was set to evaluate factors affecting the response of newborn infants to rescue HFOV treatment. The study population consisted of 372 infants with CV failure after at least 4 hours of treatment in 23 participating NICUs. Patients were grouped according to their final outcome as survived (Group S) or as died or received extracorporeal membrane oxygenation (ECMO) (Group D/E). Patients' demographic characteristics and underlying diseases in addition to their ventilator settings, arterial blood gas (ABG) analysis results at 0, 1, 4, and 24 hours, type of device, ventilation duration, and complications were compared between groups.ResultsHFOV as rescue treatment was successful in 58.1% of patients. Demographic and treatment parameters were not different between groups, except that infants in Group D/E had lower birthweight (BW) (1655 ± 1091 vs. 1858 ± 1027 g, p = 0.006), a higher initial FiO2 setting (83% vs. 72%, p 7.065 (OR: 19.74, 95% CI 4.83-80.6, p 16.35 mmol/L (OR: 1.06, 95% CI 1.01-1.1, p = 0.006), and lactate level 0.05).ConclusionRescue HFOV as defined for this population was successful in more than half of the patients with CV failure. Although the response was not associated with gestational age, underlying disease, device used, or initial MV settings, it seemed to be more effective in patients with higher BW and those not requiring nitric oxide. Initial pH, HCO3, and lactate levels on ABG may be used as predictors of a response to rescue HFOV