Search

Background: Despite their widespread use, umbilical venous catheters (UVCs) are associated with various complications. Methods: This single-center retrospective cohort study examined UVC-related complications in preterm neonates within a tertiary Neonatal Intensive Care Unit (NICU) from January 2020 to December 2022. The study aimed to analyze these complications in relation to UVC positioning. Results: Over the course of three years, 146 preterm neonates underwent UVC insertion. The cohort's mean gestational age was 29.2 ± 3 weeks, with a median birth weight of 1110 g (817-1482 g). The median UVC placement duration was 8 days (6-10), totalling 1220 catheter days. Overall, 37% of the UVC placements were categorized as optimal, 35.6% as low-lying, 20.5% as high-lying, and 6.8% were categorized as malpositioned. The UVC-related complications occurred in 62 neonates (42.5%), with central line-associated bloodstream infection (CLABSI) in 8.2%, portal vein thrombosis (PVT) in 2.7%, pericardial effusion in 0.7%, and necrotizing enterocolitis (NEC) in 2.7% of neonates. The incidence of UVC-related complications was lowest with high-lying positions (23.3%), followed by optimal positioning (31.5%), low-lying (63.5%), and the highest in malpositioned UVCs (70%). UVC placement exceeding 8 days were significantly associated with increased complications. Conclusion: The study highlights an elevated rate of complications associated with umbilical vein catheterization emphasizing the need for judicious use, especially in preterm neonates. [ABSTRACT FROM AUTHOR]

Objective: Recent advances in neonatal medicine have led to the improvements in diagnosis, prevention and management of fetal hydrops (HF). Although incidence of immune HF has significantly decreased, the incidence of non-immune HF has remained largely unchanged and mortality rate continues to be high, with rates up to 75.5%. Methods: A retrospective chart review of newborns who were admitted due to HF to the Institute of Child and Youth Healthcare of Vojvodina, Novi Sad, Serbia, from January 1st, 2001 to January 1st, 2018. It involved the analysis of demographic, antenatal, and postnatal parameters as well as examination of etiology and outcome. Results: There were 18 cases of HF, comprising 12/18 (66.66%) males, 6/18 (33.34%) females. Mean gestational age was 34.96±3.15gw (min-max 29.43-41.00); mean birth weight 2564.44±652.45g (min-max 1510.00-3650.00), Etiology of fetal hydrops was determined in 14/18 (77.78%), newborns; in 6/18 (33.33%) newborns was of immune, and in 8/18 (44.45%) of non-immune origin. Death occurred in 10/18 (55.56%) newborns. Patients who did not survive were more frequently born from multiple pregnancies (p=0.03), had lower values of Apgar score 1st and 5th minutes (p=0.011; p=0.001, respectively), more frequently presented with pericardial effusions (p=0.002) and multiple sites of effusions (p=0.02), cardiac insufficiency (p=0.019), acute kidney injury (p=0.004) and lower values of pH (p=0.035). High-frequency oscillatory ventilation was more frequently used in this group (p=0.018). Conclusion: Mortality among newborn with HF remains high. Poor prognosis is associated with multiple pregnancies, lower Apgar scores, severe acidosis, as well as the presence of pericardial effusion, multiple sites of effusions, cardiac insufficiency and acute kidney injury, and use of high-frequency oscillatory ventilation as a life-saving mode of ventilation. [ABSTRACT FROM AUTHOR]

Hemorrhagic fever with renal syndrome (HFRS) is an acute infective multisystemic disease that commonly presents with fever, hemorrhage and acute renal failure. A 17-year-old boy presented with thrombocytopenia, profuse subconjunctival hemorrhage and anuric renal failure with fluid overload. The patient required continuous ambulatory peritoneal dialysis. He developed diuresis but did not recover renal function during reconvalescent period. Hantaan, Puumala, Seoul, Belgrade virus infection with haemorrhagic fever with renal syndrome was confirmed by serologic test. [ABSTRACT FROM AUTHOR]