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Many studies have been conducted to determine the most reliable technique for evaluating the position of the endotracheal tube in patients receiving mechanical ventilation support. In this study, we aimed to determine the endotracheal tube position by ultrasonography in intubated patients with a diagnosis of critical CHD followed in the neonatal ICU. Methods: In this prospective observational clinical study, we performed point-of-care ultrasound for endotracheal tube localisation in 65 intubated newborns with critical CHD. After routine radiography, each patient underwent point-of-care ultrasound examination with a portable ultrasonography device for endotracheal tube end-carina measurement. Endotracheal tube end-carina measurements on chest radiographs were compared with ultrasound images. Results: The mean gestational age and birth weight were 37.8 ± 2.19 weeks and 2888 ± 595 g, respectively. Ultrasound images were obtained after an average of 2.08 ± 1.6 hours from the radiographs. The average ultrasound time allocated to each patient was 5 minutes. The mean endotracheal tube tip-to-carina distance on chest X-ray and ultrasound were optimally 1.33 ± 0.64 cm and 1.43 ± 0.67 cm, respectively. There was no significant difference between chest X-ray and ultrasound measurements in endotracheal tube end-carina distance values evaluated by the Bland–Altman method (mean difference 0.10 cm, p = 0.068). There was a linear correlation between the endotracheal tube tip-carina distance in ultrasound and radiography evaluation (r2 = 0.60, p < 0.001). Conclusion: It has been concluded that critical CHDs are frequently accompanied by vascular anomalies, and the endotracheal tube tip-carina distance measurement can be used by determining the carina section as a guide point in the ultrasonographic evaluation of the endotracheal tube location in this patient population.

Kesintili aortik ark (KAA) neonatal dönemde bulgu veren oldukça karmaşık ve yönetimi zor bir konjenital kalp hastalığıdır (KKH). Bu vakalarda, çıkan ve inen aorta arasında anatomik ve luminal kesinti vardır. KAA, geçmişte mortalitesi yüksek olan ancak günümüzde yaşam beklentisi giderek artan bir kardiyak anomalidir. KAA’nın tedavisi cerrahi olarak arkus tamiri yapılmasıdır. Sol ventrikül çıkım yolu (LVOT) darlığının eşlik etmesi daha komplike cerrahi teknikleri uygulanmasını gerektirir. Bu yazıda tip B KAA ve LVOT darlığı nedeniyle Yasui prosedürü uygulanan ve postoperatif 12. günden sonra yenidoğan yoğun bakım ünitesinde izlenen bir bebeğin yoğun bakım sürecinden yola çıkarak kardiyak hasta izlem ilkeleri tartışılmaktadır. Açık kalp cerrahisi yapılan bebek hastaların yönetimi konusundaki deneyimlerin kardiyak bakım ile ilgilenen yenidoğan hemşire ve doktor ekipleri için yararlı olması amaçlanmıştır.

Objective:Congenital heart diseases (CHD) are the most common causes of birth defects that have increased the risk of infections. Neonatal sepsis is a life-threatening condition and early diagnosis can be life-saving. We aimed to evaluate the potential role of the systemic immune-inflammatory index in the early diagnosis of neonatal sepsis.Methods:A retrospective cohort study was conducted on 166 newborns with a diagnosis of neonatal sepsis who were admitted to our hospital with CHD between January 2017 and June 2021. Haematological indices including neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune-inflammatory index were calculated for all patients at the time of diagnosis of neonatal sepsis (sepsis). The sepsis values of these indices were compared with the admission values (pre-sepsis) of the patients.Results:The mean gestational age and birth weight of the patients were 38.36 ± 1.42 weeks and 3057.75 ± 484.68 g. It was found that absolute neutrophil count, systemic immune-inflammatory index, neutrophil/lymphocyte ratio, but not platelet/lymphocyte ratio were significantly increased at the time of sepsis. The receiver operating characteristic curve showed that systemic immune-inflammatory index, neutrophil/lymphocyte ratio, and absolute neutrophil count have predictive ability to define neonatal sepsis among newborns with CHD. The systemic immune-inflammatory index produced an area under the curve receiver operating characteristic curve of 0.76 (70% sensitivity, 70.5% specificity). To discriminate neonatal sepsis, the cut-off values of systemic immune-inflammatory index, neutrophil/lymphocyte ratio, and absolute neutrophil count were 517.19, 2.62, and 9210/mm3, respectively.Conclusion:As an easily accessible and reliable indicator, systemic immune-inflammatory index may be used in combination with the other parameters in the early diagnosis of neonatal sepsis.

Objective: Supraventricular tachycardia, one of the most common conditions requiring emergency cardiac intervention in newborns, is also the most common symptomatic tachyarrhythmia in newborns. Therefore, early diagnosis and treatment approach is important. Method: Demographic findings, clinical findings, and treatment approaches of newborns hospitalized with the diagnosis of supraventricular tachycardia between January 2011 and November 2020 in the Neonatal Intensive Care Unit of our hospital were evaluated retrospectively. Results: Thirty-eight patients without congenital heart disease (except secundum-type atrial septal defect) and diagnosed with supraventricular tachycardia were evaluated retrospectively. The mean week of gestation was 38.2 ± 1.8, the mean age at diagnosis was 10.7 ± 10.1 days, the number of patients with heart failure was 8 (21%), the number of patients with Wolff-Parkinson White syndrome was 8 (21%), the number of patients with fetal arrhythmia was 6 (15.7%) and the mean number of hospitalization days was 15.7±13.5. The patients were given adenosine in the first stage and propranolol, amiodarone, propafenone and flecainide in the second stage as medical treatment. Cardioversion was performed in 5 (13%) patients due to resistant supraventricular tachycardia. Conclusion: Early diagnosis and treatment of supraventricular tachycardia are very important in terms of reducing morbidity and mortality. Therefore, we think that increasing awareness of supraventricular tachycardia among clinicians following newborn babies will enable newborns with supraventricular tachycardia to receive early diagnosis and treatment., Objective: Supraventricular tachycardia, one of the most common conditions requiring emergency cardiac intervention in newborns, is also the most common symptomatic tachyarrhythmia in newborns. Therefore, early diagnosis and treatment approach is important.Method: Demographic findings, clinical findings, and treatment approaches of newborns hospitalized with the diagnosis of supraventricular tachycardia between January 2011 and November 2020 in the Neonatal Intensive Care Unit of our hospital were evaluated retrospectively.Results: Thirty-eight patients without congenital heart disease (except secundum-type atrial septal defect) and diagnosed with supraventricular tachycardia were evaluated retrospectively. The mean week of gestation was 38.2 ± 1.8, the mean age at diagnosis was 10.7 ± 10.1 days, the number of patients with heart failure was 8 (21%), the number of patients with Wolff-Parkinson White syndrome was 8 (21%), the number of patients with fetal arrhythmia was 6 (15.7%) and the mean number of hospitalization days was 15.7±13.5. The patients were given adenosine in the first stage and propranolol, amiodarone, propafenone and flecainide in the second stage as medical treatment. Cardioversion was performed in 5 (13%) patients due to resistant supraventricular tachycardia.Conclusion: Early diagnosis and treatment of supraventricular tachycardia are very important in terms of reducing morbidity and mortality. Therefore, we think that increasing awareness of supraventricular tachycardia among clinicians following newborn babies will enable newborns with supraventricular tachycardia to receive early diagnosis and treatment.

Amac: Respiratuar sinsityal virus enfeksiyonu (RSV) nedeniyle yenidogan yogun bakim unitesine (YYBU) yatan bebeklerin ortalama trombosit hacmi (MPV) duzeylerinde meydana gelen degisiklikleri belirlemek. Ayrica bu degisikliklerin hastaligin siddeti, hastanede kalis suresi ve Silverman Anderson solunum siddeti skoru (SAS) ile iliskili olup olmadiginin degerlendirilmesi amaclandi. Materyal ve metodlar: Bu retrospektif calismada, hasta grubu YYBU'de RSV enfeksiyonu tanisi almis ≥34 gebelik haftasinda dogan yenidogan bebeklerden, kontrol grubu ise RSV enfeksiyonu olmayan saglikli yenidoganlardan olusuyordu. Olgularin MPV degerleri RSV olan ve olmayan gruplar arasinda karsilastirildi. Bulgular: RSV olan gruptaki MPV duzeyi kontrol grubundan anlamli olarak dusuktu (p 0.05). Calisma hastalarinda SAS’lari ile MPV duzeyleri arasinda istatistiksel olarak anlamli bir iliski bulunmadi (p

Objective This study aimed to ascertain the effects of astaxanthin (ASX) in an experimental necrotizing enterocolitis (NEC) model using rat pups. Study Design Forty-two pups born from five Wistar albino rats were randomly divided into three groups as the control group, NEC + placebo (saline), and NEC + ASX. Pups in the NEC + ASX group were given 100 mg/kg/day oral ASX from day 1 to day 4 of the study. Saline of 2 mL/kg was given to the NEC + placebo group. Histopathological, immunohistochemical (caspase-3), and biochemical evaluations including the total antioxidant status (TAS), total oxidant status (TOS), superoxide dismutase (SOD), glutathione (GSH), lipid hydroperoxide (LPO), 8-hydroxydeoxyguanosine (8-OHdG), advanced oxidation protein products (AOPP), myeloperoxidase (MPO), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and nuclear factor erythroid 2–related factor 2 (Nfr-2) activities were all performed. Results A better survival rate and weight gain were demonstrated in the NEC + ASX group (p Conclusion ASX treatment has been shown to effectively reduce the severity of intestinal damage in NEC due to its antioxidant, anti-inflammatory, and antiapoptotic properties. Key Points

Hydrogen peroxide (H(2)O(2)) is an oxidizing agent. High concentrations of H(2)O(2) are used in the chemical industry, and 3% concentrations are used in household disinfectants. Severe H(2)O(2) toxicity occurs with a 35% concentration. After poisoning with H(2)O(2), corrosive damage occurs. We describe a 3-day-old male who ingested H(2)O(2) accidentally and was treated with supportive care. Hydrogen peroxide intoxication usually occurs in adults accidentally. This is the first report of a newborn case of H(2)O(2) ingestion.

Objective The aim of the study is to investigate the therapeutic effects of astaxanthin (AST) and resveratrol (RVT) on multiorgan damage in an animal model of the supraceliac aortic ischemia-reperfusion (I/R). Methods In this study, 28 rats (n = 7/group), 200 to 250 g in weight, were randomized to four groups (1: Sham, 2: Control + I/R, 3: AST + I/R, and 4: RVT + I/R). Following the abdominal incision, aortic dissection was performed in the sham group without injury. Other groups underwent I/R injury via supraceliac aortic clamping (20 minutes) and reperfusion. The rats were administered olive oil (3 mL/kg) orally for 2 weeks before and 1 week after the laparotomy. Additionally, oral AST (10 mg/kg) or RVT (50 mg/kg) was given to the study groups. All rats were sacrificed on the 3rd week of the experiment after blood samples were taken for analysis. Multiple rat tissues were removed. Results We found that RVT increased total antioxidant status (TAS) and superoxide dismutase (SOD) levels, and decreased total oxidant status (TOS), oxidative stress index (OSI), myeloperoxidase (MPO), and malondialdehyde (MDA) levels, while AST increased the levels of TAS, decreased TNF-α, MDA, TOS, and OSI (p Conclusion Our study suggests that AST and RVT might show therapeutic effects against oxidative tissue damage and apoptosis in an animal model of aortic I/R. Further studies are required. Key Points

Usually, swallowing of maternal blood is the cause of bloody vomiting in healthy term newborns. Other reported causes include gastritis, esophagitis, gastric ulcer, and duodenal ulcer. We report a newborn girl born by cesarean at 37(2/7 ) weeks who had hematemesis on postnatal day 1 and hematochezia on day 2. An erythrocyte transfusion was given on day 3. Gastroscopy performed on day 4 showed multiple gastric ulcers. Antacid treatment was given. On day 12, the newborn had a good general condition and stable vital signs and was discharged. Gastric ulcer needs to be considered as the etiology of hematemesis in healthy term newborns.

The effect of hypothermia treatment on white blood cell (WBC), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) values as an indicator of inflammation was evaluated in newborns with hypoxic ischemic encephalopathy (HIE). The study was performed that the before-therapeutic hypothermia (TH) and after-TH WBC, lymphocytes, neutrophils, monocytes and NLR, LMR and PLR values of the complete blood cell count were retrospectively evaluated. The results of the patient group were compared with the results of healthy newborns. A total of 78 patients who underwent TH were evaluated in our study. Mean values before and after TH were NLR3.8/2.7, LMR 5.6/8.6, and PLR 60.3/67.1 respectively. A statistical significance was present for NLR values before and after TH in those with seizure in our study (4.15±2.95/3.01±2.54) but no statistical significance was found for LMR or PLR. In neonates with HIE, effect of TH on complete blood cell count and inflammatory mechanisms (mediated neutrophil and lymphocyte) may be minimal.

The aim of this experiment was to investigate the role of melatonin and spirulina on multiorgan damage induced by ischemia/reperfusion injury (IR) in a rat model. A total of 32 male rats weighing 200-220 g were allocated into 4 groups (n = 8/group) (Sham, Control-IR [CIR], Melatonin-IR [MIR], and Spirulina-IR [SIR]). Sham group underwent midline laparotomy and dissection of the aorta without injury. In other groups, an IR model was established by clamping (ischemia) and releasing (reperfusion) the abdominal aorta at the supraceliac level for 20 min. All rats were given 3 ml/kg of distilled water by gavage for 14 days before and 7 days after the experiment. The treatment groups received either melatonin (50 mg/kg) or spirulina (50 mg/kg) by the same route. On the 21st day of the experiment, the rats were sacrificed. We found that melatonin and spirulina ameliorated the effects of IR at different levels of significance (ranging from p = .01 to p < .001), increasing total antioxidant capacity (TAC) and superoxide dismutase levels, and decreasing total oxidant status, oxidative stress index (OSI), myeloperoxidase, tumor necrosis factor-alfa and malondialdehyde levels. When compared MIR and SIR groups, only TAC and OSI levels did differ in favor of melatonin between the groups (p < .05). Histopathological and immunohistochemical examinations showed that melatonin and spirulina similarly reduced IR-related tissue damage and apoptosis. We concluded that melatonin and spirulina may have a protective role against oxidative tissue damage and apoptosis in the abdominal aortic IR animal model. PRACTICAL APPLICATIONS: Coarctation of aorta (CoA) and interrupted aortic arch (IAA) are serious cardiac defects with high morbidity and mortality if not diagnosed and treated early in life. Restoration of blood flow in CoA or IAA through prostaglandin E1 infusion, angioplasty or surgery can cause ischemia/reperfusion (IR) injury. This reperfusion period may be complicated IR injury at remote organs. It may be beneficial to increase antioxidant capacity in preventing stress-induced tissue damage. Melatonin and spirulina are agents with strong antioxidant properties. In this animal research, protective role of these products on multiorgan damage induced by IR was investigated for the first time. We found that both melatonin and spirulina ameliorate the effects of IR to varying degrees. This study provides evidence that melatonin and spirulina may have preventive effects on oxidative tissue damage and apoptosis in the abdominal aortic IR animal model.

We aimed to evaluate maternal serum thiol/disulphide homeostasis in pregnancies complicated by fetal distress (FD). A total of 100 patients beyond the 34th week of pregnancy were included in this study, and they were divided into two groups. The study group included 50 patients who had been diagnosed with FD; the control group was composed of 50 patients who had shown no signs of FD and who had undergone an elective (previous) caesarean section (CS). The native thiol, total thiol and native thiol/total thiol (%) concentrations were lower in Group 1 patients than Group 2 patients (

Objective Vasoactive-inotropic Score (VIS) was developed to quantify the amount of inotropic support provided in the postoperative period. We investigated the predictive value of (VIS) for mortality in neonates with congenital heart disease (CHD). Study design Prospective cohort. Patients 119 newborns who underwent cardiac surgery. Setting Tertiary NICU-CHD center of Ankara from November 2016 to January 2019. Intervention/Measurement VIS values were calculated by a standard formula for the first 72 postoperative hours, and the maximum score was recorded. Primary outcomes Duration of mechanical ventilation, NICU length of stay, and mortality. Results At surgery, the median (IQR) age was 15 d (9-31). The patients were divided into two groups according to mortality; Group 1 (Non-survivors) (n=36) and Group 2 (Survivors) (n=83). Higher VIS score was correlated to longer duration of mechanical ventilation (P=0.009, r=0.33), and was higher among patients who died (P=0.003). Area under the curve (AUC) was 0,83 (P15.5) was independently associated with increased odds for mortality (OR: 8.1, 95% CI: 1.8-35.7, P=0.005). Conclusions In newborns with CHD, a higher VIS within 72 hours after cardiac surgery is associated with increased duration of mechanical ventilation, and mortality. VIS may be useful for prediction of mortality at early postoperative period.

The thiol-disulfide homeostasis is essential for the body to maintain effective antioxidant defense mechanisms. We aimed to show the relationship between sepsis and thiol-disulfide homeostasis in newborns.In this prospective study, 66 newborns with sepsis (group 1) and 51 healthy controls (group 2) were included. In group 1, 53 newborns were diagnosed as clinical sepsis (group 1a) and 13 as definite sepsis (group 1b). The study has two time points; the day of diagnosis (step 1) and three days after the treatment (step 2). At step 1, group 1 and group 2 were compared for thiol-disulfide homeostasis as well as inflammatory markers. At step 2, the same laboratory tests were repeated only in group 1.At step 1, the levels of C-reactive protein (CRP) and interleukin-6 (IL-6) were higher, while native thiol and total thiol levels were lower in group 1 compared to controls. Serum disulfide/total thiol ratio was also significantly higher in group 1. When analyzed for subgroups of group 1, demonstration of microorganism did not affect the serum thiol levels. Within group 1, at step 2, although CRP and IL-6 levels were significantly lowered compared to step 1, we did not observe significant changes in thiol-disulfide parameters.The thiol-disulfide homeostasis may have a role in the pathogenesis of sepsis in newborns. The related parameters might be new markers for the diagnosis of sepsis in newborn patients. Further studies are needed to define the role of thiol-disulfide homeostasis in the course of neonatal sepsis.

Lung damage due to hyperoxia and inflammation are important causes of bronchopulmonary dysplasia (BPD). We aimed to investigate the beneficial effects of Apocynin (Apo) on rat pups exposed to hyperoxia and inflammation. Forty-eight rat pups were randomly divided into 3 groups as hyperoxia (95% O2) + lipopolysaccharide (LPS), hyperoxia + LPS + Apo treated and control (21% O2). Rat pups in the Apo group received Apo at a daily dose of 40 mg/kg. Histopathological (Hematoxylin-Eosin, Masson trichrome), immunochemical (surfactant B and C protein staining) evaluations and biochemical studies incluiding, total antioxidant status (TAS), total oxidant status (TOS), OSI (oxidant stress index), AOPP (advanced protein degradation product), Lipid hydroperoxide (LPO), 8-OHdG, NADPH oxidase activity (NOX), superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), myeloperoxidase (MPO), tumor necrosis factor-alpha (TNF- α), interleukin-1 beta (IL-1β), IL-18, IL-6, caspase-1 and 3, nuclear factor erythroid 2-related factor 2 (NFR2), Nod-like receptor pyrin domain-containing 3 (NLRP3) activities were studied. After Apo treatment, AOPP, LPO, 8-OHdG, NOX, TOS, OSI levels decreased; SOD, CAT, GSH and TAS levels increased (P < 0.05). Apo reduced inflammatory cell infiltration and proinflammatory cytokines with reduction in NLRP3 inflammasome in addition to increased Nrf2 levels. Moreover, caspase-1 and 3 levels decreased with Apo (P < 0.05). Apo was found to provide preventive and therapeutic effects by reducing oxidant stress, blocking inflammation and increasing antioxidant status. Beyond anti-oxidative effects, Apo also have anti-inflammatory effects by suppressing NLRP3 inflammasome activation and inducing Nrf2 as well. Therefore, Apo might be a potential option in the treatment of BPD.

Congenital glucose-galactose malabsorption (CGGM) is an autosomal recessive disorder originating from an abnormal transporter mechanism in the intestines. It was sourced from a mutation in the SLC5A1 gene, which encodes a sodium-dependent glucose transporter. Here we report a 2-day-old girl with CGGM who presented with severe hypernatremic dehydration due to diarrhea beginning in the first hours of life. Mutation analysis revealed a novel homozygous mutation NM_000343.3 c.127G > A (p.Gly43Arg) in the SLC5A1 gene. Since CGGM can cause fatal diarrhea in the early neonatal period, timely diagnosis of the disease seems to be essential.

Background/aim: We aimed to ascertain the effects of astaxanthin on the lungs of rat pups with bronchopulmonary dysplasia (BPD) induced by hyperoxia and lipopolysaccharide (LPS). Materials and methods: Forty-two newborn Wistar rats born to spontaneous pregnant rats were divided into three groups: Hyperoxia (95% O2) + lipopolysaccharide (LPS) group, hyperoxia + LPS + astaxhantin group and control: no treatment group (21% O2). Pups in the hyperoxia + LPS + astaxanthin group were given 100 mg/kg/day oral astaxanthin from the first day to the fifth day. Histopathologic and biochemical evaluations including glutathione (GSH), total antioxidant status (TAS), total oxidant status (TOS), lipid hydroperoxide (LPO), 8-hydroxydeoxyguanosine (8-OHdG), advanced oxidation protein products (AOPP), myeloperoxidase (MPO), total thiol, tumor necrosis factor-alpha (TNF-α), interleukin 1 beta (IL1β) and caspase-3 activities were performed. Results: A better survival rates and weight gain were demonstrated in the hyperoxia + LPS + astaxanthin group (p Conclusion: Astaxanthin was shown to reduce lung damage caused by inflammation and hyperoxia with its antiinflammatory, anti-oxidant, anti-apoptotic properties and to protect the lung from severe destruction.

Background/aim: Most inborn metabolic diseases are diagnosed during the neonatal period. The accumulation of toxic metabolites may cause acute metabolic crisis with long-term neurological dysfunction and death. Renal replacement therapy (RRT) modalities allow the efficient removal of toxic metabolites. In this study, we reviewed our experience with continuous venovenous hemodiafiltration (CVVHDF) as RRT for newborns with an inborn metabolic disease. Materials and methods: Patients diagnosed with an inborn metabolic disease who received CVVHDF treatment at our neonatal intensive care unit between January 2014 and December 2017 were included in this study. Their demographic and clinical data were collected, and the efficacy and safety of CVVHDF was evaluated. Results: Nine continuous RRT (CRRT) sessions as CVVHDF were performed in eight newborns with a diagnosis of urea cycle defect (n= 5), maple syrup urine disease (n= 2), or methylmalonic acidemia (n= 1). The mean age at admission was 10 ± 8.6 days (range: 3–28 days). The mean plasma levels of ammonium were 1120 ± 512.6 mg/dL and 227.5 ± 141.6 mg/dL before and at the end of treatment, respectively. Plasma levels of leucine were 2053.5 ± 1282 µmol/L and 473.5 ± 7.8 µmol/L before and at the end of treatment, respectively. The CVVHDF duration was 32.3 ± 11.1 h (median: 37 h; range: 16–44 h), and the mean length of hospitalization was 14.6 ± 12.9 days. The mean duration of CVVHDF was 32.3 ± 11.1 h (range: 16–44 h). Circuit clotting was the most common observed complication (37.5%) and the survival rate was 50%. Among surviving patients, two developed severe and two developed mild mental and motor retardation. Conclusion: CVVHDF is a CRRT modality that can be used to treat newborns with an inborn metabolic disease. Early diagnosis, and commencement of specific medical therapy, diet, and extracorporeal support, if needed, are likely to result in improved short- and long-term outcomes. Key words: Inborn metabolic diseases, renal replacement therapy, continuous venovenous hemodiafiltration, newborn, survival

Necrotizing enterocolitis (NEC) is one of the most important life- threatening diseases in neonates. Recurrent episodes of supraventricular tachycardia (SVT) can lead to gut ischemia, with subsequent reperfusion injury resulting in NEC. Mesenchymal stem cells (MSCs) are multi-potential cells which can differentiate into multiple cell types.

Lung ultrasonography (LUS) is a noninvasive bed-side test and increasingly used by clinicians in the management and follow-up of respiratory distress syndrome (RDS) in premature infants.To compare the results of three natural surfactants according to LUS scores in premature infants with RDS.This was a prospective study on 62 preterm infants (25-34 weeks) with RDS and receiving surfactant according to 2016 European guidelines. All patients underwent a clinical evaluation and chest X-ray at three study points; at the first hours of life (presurfactant), and at 6-12th hour (early postsurfactant) and 24th hour (late postsurfactant) of surfactant. Simultaneously fractional inspired oxygen (FiOGestational age (In newborns with RDS, poractant alpha and beractant have similarly reduced oxygen need in accordance to the LUS findings. However, they seem to be superior compared to calfactant.

Background/aim: Extracorporeal membrane oxygenation (ECMO) is a form of life support for patients with respiratory failure, cardiac failure, or both. The aim of this study was to evaluate neonates supported with ECMO and report our experience as a Turkish neonatal intensive care unit. Materials and methods: We retrospectively reviewed 11 newborn infants treated with ECMO at Ankara University for respiratory and cardiac failure. We reported the demographic, diagnostic, laboratory, and clinical data of the patients. Results: Eleven patients (9 male, 2 female) received ECMO support with a mean gestational age of 39.1 ± 1.6 weeks and mean birth weight of 3513 ± 506 g. Six patients received venoarterial (VA) ECMO and five patients received venovenous (VV) ECMO. Mean age at initiation and duration of ECMO was 7.2 ± 7.4 days (2–24 days) and 10.4 ± 4.9 days (5–21 days), respectively. Mean oxygenation index (OI) before ECMO was 48.5 ± 5.7. ECMO was withdrawn from one patient due to severe brain injury. The survival rate for ECMO was 73% and the survival rate to discharge was 64%, whereas the survival rate in congenital diaphragmatic hernia (CDH) cases was 40%. Conclusion: Our early results from ECMO for neonates are encouraging. Identification of patients for ECMO support and timely referral will offer a survival opportunity to complex neonatal cases.

Maghsoudi, Behzad/0000-0002-1279-8799; Kritsotakis, Evangelos/0000-0002-9526-3852; Yalcin, Ata Nevzat/0000-0002-7243-7354; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; ALDEMIR KOCABAS, Bilge/0000-0002-6396-5243; Masjedi, Mohammad Reza/0000-0002-6871-382X; Masjedi, Mansoor/0000-0001-6175-9289; Gan, Chin Seng/0000-0002-6758-4798; Oncul, Oral/0000-0002-1681-1866; Sabetian, Golnar/0000-0001-8764-2150; YAMAN, Ayhan/0000-0002-5651-1286; Ozdemir, Halil/0000-0002-7318-1688; Leon, Hector Armando Rincon/0000-0003-0715-200X; Delia, Muntean/0000-0001-9100-4530; Atasay, Fatma Begum/0000-0002-9114-5293; Zand, Farid/0000-0003-3489-3372; Kuchenbecker, Ricardo/0000-0002-4707-3683; Medeiros, Eduardo A/0000-0002-6205-259X; ROMERO LOPEZ-ALBERCA, CRISTINA/0000-0001-5856-8668; Salomao, Reinaldo/0000-0003-1149-4598; ozdemir, sonay incesoy/0000-0003-2863-901X; Meco, Basak Ceyda/0000-0003-2951-9634; Horoz, Ozden Ozgur/0000-0001-7590-650X; Horhat, Florin George/0000-0001-6133-0204; Kazi, Mohammad Mukhit/0000-0003-3824-5540; Ciftci, Ergin/0000-0002-4955-160X; Abouqal, Redouane/0000-0002-6117-4341; Leblebicioglu, Hakan/0000-0002-6033-8543; Garcell, Humberto Guanche/0000-0001-7279-0062; Kendirli, Tanil/0000-0001-9458-2803; de Souza, Maria Cecilia B V/0000-0003-0318-3087; Sanaei Dashti, Anahita/0000-0002-2827-3575; UNAL, SERHAT/0000-0003-1184-4711; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Barahona G., Nayide/0000-0003-3559-6900; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517; ERDEVE, OMER/0000-0002-3193-0812; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Gikas, Achilleas/0000-0002-8455-9631; Baylan, Orhan/0000-0002-6529-7824; Mitrev, Zan/0000-0001-7859-8821; yildizdas, dincer/0000-0003-0739-5108; Ngo, Quy Chau/0000-0002-6787-2757; Duszynska, Wieslawa/0000-0002-5880-4904; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; Gupta, Umesh/0000-0001-7717-1404; Navarro Fuentes, Karla Reyna/0000-0002-6894-8872; zali, Mohammadreza/0000-0002-9027-4560; Morocho Tutillo, Diego Rolando/0000-0002-4974-7856; El Kholy, Amani/0000-0002-0645-7664; Kanj, Souha/0000-0001-6413-3396; Assiri, Abdullah/0000-0002-5605-2876; Unal, Necmettin/0000-0002-9440-7893; Jayatilleke, Kushlani/0000-0002-3931-6630; KARABAY, OGUZ/0000-0003-1514-1685 WOS: 000341307100001 PubMed: 25179325 We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U. S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN. Copyright (C) 2014 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Background Transitional delay in postnatal respiratory adaptation including transient tachypnea of the neonate (TTN) as a result of failure to clear fetal lung fluid is not uncommon and can be problematic in some infants delivered by elective ceserean delivery. (ECD) Objective We hypothesise that application of CPAP at birth via T-piece based neopuff to infants delivered at 34–39th gestational week by ECD delivery may enhance airway liquid clearance and decrease the rate of failure in respiratory adaptation and related NICU hospitalisation. Methods Spontenously breathing infants who were delivered by ECS were randomised either to receieve CPAP, 5 cmH20 administered via face mask for 20 min with 25–30% O2(intervention group) or to be managed with standard care in DR. Respiratory outcomes were assessed and modified Silvermann score, respiratory rate, heart rate, oxygen saturations were serially recorded for the first six hours. Results 16 (% 5.8)infants out of 273 infants, 137 intervention and 136 control were hospitalised in the NICU because of respiratory distress. 7 of 16 patients were TTN where as the others transitional delay. Respiratory hospitalisation rate was significantly lower for the intervention group (4/137%8.8 vs12/136 2.2 p = 0.035). The preventive effect of CPAP on TTN could not reach to statistical significance (% 4.4 vs 0.72 p = 0.06). No adverse complication including pneumothorax was noted. Conclusions Delivery room early CPAP intervention decreased the rate of failure in respiratory adaptation without causing pneumothorax in infants delivered by ECD.