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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]

Introduction Acute kidney injury (AKI) is a common clinical condition with serious consequences that is increasing in incidence. It may be result from inadequate renal perfusion due to circulatory collapse [...], The aim of this study was to determine the effects of erythropoietin (EPO), moderate hypothermia, and a combination thereof on the kidneys of newborn rats damaged during perinatal asphyxia. An animal model of perinatal asphyxia (Wistar rats) was used in which after birth, newborn rats were divided into four groups of 15 animals each: G1, rats exposed only to asphyxia; G2, rats exposed to asphyxia and hypothermia (rectal temperature 32°C) and which received EPO (darbepoetin alpha) intraperitoneally; G3, rats exposed to asphyxia and hypothermia; G4, rats exposed to asphyxia and which received EPO. The rats were sacrificed on the 7th day of life and histopathological evaluation of kidneys was performed. Damage to the proximal tubules was significantly higher in group G1 rats than in groups G2, G3, and G4 rats (p < 0.01). Damage to the distal tubules was found only in group G1 rats. Histological changes in the proximal tubules were more prominent than in the distal tubules (p Keywords Perinatal asphyxia * Hypothermia * Erythropoietin * Kidney * Rats

Aim: To identify risk factors associated with the failure of extubation of mechanically ventilated very-low-birth-weight newborns.Study Design: Prospective observational study. Assessment of the occurrence of extubation failure in relation to demographic and ventilation parameters, the SpO2/FiO2 ratio, the spontaneous breathing test (SBT) and values of the Silverman-Andersen score (SAS). Extubation failure was defined as the need for reintubation for any reason within 72 h after extubation.Results: Extubation failed in 14/50 (28%) patients. Tidal volume applied at the moment of extubation (p = 0.030), the values of the SpO2/FiO2 ratio (p = 0.006), SBT (p = 0.034) and SAS measured for 60 min after extubation and later (p = 0.010, p = 0.000001, p∼0.000, respectively) showed a significant association with reintubation.Conclusions: Measured TV, SpO2/FiO2 ratio, SBT at the moment of extubation and values of SAS starting 1 h after extubation might be valuable parameters in identifying those VLBW newborns in the risk to fail extubation. [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]

Objective. To evaluate the usefulness of four neonatal pain scales (DAN, NIPS, PIPP, and NPAS) in describing newborn's response to a painful event in clinical settings. Methods. Prospective observational study at university-affiliated neonatal unit. Three hundred-sixty newborns were observed during venepuncture and heel lancing as a part of routine blood workout. Values of pain scales were determined in three time frames (start of procedure -- T0, maximal response -- T1, end of procedure -- T2). Results. In T0 versus T1 time frame, a sharp increase of percentage was observed in all pain scales independently of procedure with high statistical significance ( P ∼∼ 0.00). NIPS showed the highest (venepuncture 742%%; heel lancing 1472%%) and PIPP the lowest increase (venepuncture 303%%; heel lancing 510%%). In T1 versus T2 time frame, for venepuncture NIPS showed the highest (49%%) and PIPP the lowest (38%%) percentage of decrease, whereas for heel lancing PIPP had the highest (28%%) and NIPS the lowest (20%%) one. All pain scales showed significant individual and overall variability (CV > 30%%). PIPP had the lowest (42.7 ++ 14.3) and NIPS the highest (103.8 ++ 91.3) overall coefficient of variation. DAN's confidence parameters were the most uniform ones (se 1.0, sp 0.93, ppv 0.93, npv 1.0), whereas PIPP's confidence parameters were the highest while measuring high intensity pain (se 0.94, sp 1.0, ppv 1.0, npv 0.94). Conclusion. DAN is a pain scale convenient for the use in clinical settings, especially if a fine distinction of magnitude of the present pain is not needed, whereas PIPP can be used if adequate equipment is available. [ABSTRACT FROM AUTHOR]

Infertility, defined as 'unsuccessful conception after 1 year of unprotected intercourse' is an increasing problem in many countries. Demographic data in Serbia continue to show negative trend of depopulation. One-third of married couples in Serbia are childless and half of them cannot have offspring due to health problems. Analysis of morbidity and mortality of premature newborns IVT ( in vitro fertilization) conceived and treated in two Department of Intensive Care, in Novi Sad and Belgrade, Serbia during 2 years. Significant number of IVF conceived newborns are treated at NICUs. Prematurity, low birth weight, perinatal asphyxia, systemic infection, as well as proper initial stabilization, especially prevention and early treatment of systemic hypotension are important factors contributing to morbidity of these patients. [ABSTRACT FROM AUTHOR]

Objectives: To determine the effect of feeding with donor breast milk in comparison to formula on growth and development in low-birth-weight (LBW) newborns. Methods: Retrospective study of medical records of 92 LBW newborns treated in Intensive Care Unit and fed with donor breast milk, Institute of Child and Youth Healthcare of Vojvodina, Novi Sad from January 1st 2016 till December 31st 2016. Data were compared with historical group of 78 LBW newborns treated in the same facility and fed with formula from January 1st 2010 till December 31st 2010. Results: Enteral feeding was introduced highly significantly sooner and weight-gaining of donor breast milk-fed newborns was highly significantly faster compared to formula-fed newborns (p<0.001). Incidence of necrotizing enterocolitis was 57.62% lower in donor breast milk-fed group. Number of days spent on mechanical ventilation decreased while number of days spent on noninvasive ventilation increased in the donor milk-fed group (p<0.001). Conclusions: Feeding low birth weight infants with donor breast milk resulted in better rate of early neonatal growth, lower incidence of necrotizing enterocolitis and less invasive respiratory support modalities compared to those ones predominately fed with formula. Therefore promoting of breastfeeding, as well as advocating for donor breast milk banking as the better choice in the absence of mother's own milk. More in-depth research is needed to identify the long-term neurodevelopmental outcomes of donor breast milk-fed newborns. [ABSTRACT FROM AUTHOR]