Search

Objective: Optimal care in the delivery room is important to decrease neonatal morbidity and mortality. We aimed to evaluate neonatal resuscitation practices in Turkish centers. Materials and Methods: A cross-sectional survey consisted of a 91-item questionnaire focused on delivery room practices in neonatal resuscitation and was sent to 50 Turkish centers. Hospitals with

Limited data are available on pregnant women with COVID-19 and their neonates. We aimed to evaluate the epidemiological and clinical characteristics of newborns born to women infected with COVID-19. A multicenter cohort study was conducted among newborns born to mothers with COVID-19 in 34 neonatal intensive care units (NICUs) in Turkey. Pregnant women (n = 125) who had a positive RT-PCR test and their newborns were enrolled. Cesarean section, prematurity, and low-birthweight infant rates were 71.2%, 26.4%, and 12.8%, respectively. Eight of 125 mothers (6.4%) were admitted to an intensive care unit for mechanical ventilation, among whom six died (4.8%). Majority of the newborns (86.4%) were followed in isolation rooms in the NICU. Four of 120 newborns (3.3%) had a positive RT-PCR test result. Although samples taken on the first day were negative, one neonate became positive on the second day and the other two on the fifth day. Sample from deep tracheal aspirate was positive on the first day in an intubated case. Conclusion: COVID-19 in pregnant women has important impacts on perinatal and neonatal outcomes. Maternal mortality, higher rates of preterm birth and cesarean section, suspected risk of vertical transmission, and low rate of breastfeeding show that family support should be a part of the care in the NICU. Trial registration:identifier: NCT04401540 What is Known: center dot The common property of previous reports was the conclusions on maternal outcomes, rather than neonatal outcomes. center dot Published data showed similar outcomes between COVID-19 pregnant women and others. What is New: center dot Higher maternal mortality, higher rates of preterm birth and cesarean section, suspected risk of vertical transmission especially in a case with deep tracheal aspiration during the intubation, and the possible role of maternal disease severity on the outcomes are remarkable findings of this study. center dot In contrast to recommendation for breastfeeding, parents' preference to formula and expressed breast milk due to anxiety and lack of information shows that family support should be a part of the care in the NICU. Trial registration: ClinicalTrials.gov identifier: NCT04401540

Hipernatremik dehidratasyon yenidoğan döneminde yetersiz sıvı alımına bağlı sık görülebilen bir sorundur. Amplitude entegre elektroensefalografi ile sürekli EEG monitorizasyonu günümüzde yenidoğan ünitelerinde rutin nörolojik bakımın parçası haline gelmiştir, özellikle term hipoksik iskemik ensefalopatili bebeklerde ve şüpheli nöbetlerin ayrımında kullanılmaktadır.Çalışmamıza ocak 2010 ? mayıs 2011 tarihleri arasında Atatürk Üniversitesi Hastanesi Yenidoğan Yoğun Bakım Ünitesine hipernatremik dehidratasyon tanısıyla yatırılan term bebekler dahil edilmiştir. Yetersiz beslenme dışında bir nedenle açıklanamayan, 150 meq/lt'nin üzerinde serum sodyum konsantrasyonu saptanan term bebekler çalışmaya alınmıştır. Hastalara serum sodyum düzeyi 150 meq/lt'nin altına düşünceye kadar aEEG monitorizasyonu yapılmıştır. Hastaların hipernatremik dehidratasyonuyla aEEG paterni ve nörogelişimsel durumu arasında ilişki olup olmadığının araştırılması hedeflenmiştir. Uzun dönem değerlendirme Bayley III Gelişim Değerlendirme Testi ile yapılmıştır.Ocak 2010-mayıs 2011 tarihleri arasında 21 bebek hipernatremik dehidratasyon tanısıyla yenidoğan yoğun bakım ünitesine yatırılmıştır. Ortanca gestasyon yaşı, 39 hafta (37-42); hastaneye yatma yaşı 5 gün (3-10); doğum ağırlığı 3350 gr (2470-4400); ağırlık kaybı %17.3 (7-29)'dür. Başvuru nedenleri beslenme güçlüğü (%71), sarılık (%61), huzursuzluk (%57), ateş (%30), uyanmama (%28.5) ve konvülzyon (%9.5) olarak saptanmıştır.Yüksek serum sodyum düzeyi ile aEEG anormalliği arasında ilişki saptanmıştır. Uzun dönemde 17 hasta değerlendirilmiştir, çölyak hastası olan bir hastada ciddi nörolojik gerilik saptanmıştır. Bayley testinde bir hastada orta düzeyde gerilik bulunmuş, diğer hastaların değerleri ise normal sınırlarda bulunmuştur.Yenidoğan bebeklerin taburculuk sonrası erken dönemde takibi hipernatremik dehidratasyon riskini belirlemek için önemlidir. Bu bebeklerin uzun dönem takibi hakkında daha fazla bilgiye ihtiyaç duyulduğu görülmüştür. Amplitude entegre elektroensefalografi ile yapılan sürekli EEG monitorizasyonunun erken dönem prognoza ve mortaliteye dair bilgi edinmede yardımcı olabildiği belirlenmiştir. Hypernatremic dehydration due to inadequate fluid intake can be a significant problem during the neonatal period. The objective of the present study was to evaluate the term newborn infants admitted to Atatürk University Hospital neonatal intensive care unit for hypernatremic dehydration between January 2010 and may 2011. Continuous electroencephalography monitoring with amplitude-integrated electroencephalography has become a part of the routine neurological care in the neonatal unit, especially in full-term infants with hypoxia?ischemia and in infants suspected of seizures.Healthy term neonates who were admitted with serum sodium concentrations of >150 meq/lt and no explanation for hypernatremia other than inadequate milk intake. We performed amplitude-integrated electroencephalography until sodium level decrease < 150 meq/lt. We aimed to determine the relationship between hypernatremic dehydration in the term newborn and the background pattern of amplitude-integrated electroencephalography and neurodevelopmental outcome in those infants. Long-term follow-up evaluations were performed using Bayley Scales of Infant Development III test.Between January 2010 and may 2011, 21 newborns were admitted to neonatal intensive care unit with hypernatremic dehydration. Mean gestational age, 39 weeks (37 ? 42 weeks); hospitalization ages 5 days (3-10); birthweight, 3350 g (2470 ? 4400 g); weight loss, 17,3%(7? 29). The most common presenting complaints were feeding difficulties (%71), jaundice (%61), irritability (%57), fever (%30), letargy (%28.5) and convulsion (%9.5).We established relationship beetween aEEG and high serum sodium level. Long-term follow up was performed in 17 patients from the study group, and one patient with coeliac disease was found to be severely neurologiclly delayed. One patient was found to have moderate risk scores and other patients were found normal scores by bayley test.Early follow-up visits of newborns soon after discharge are important to determine risk for hypernatremic dehydration. Long-term follow up of this group of babies is also required to gather knowledge about. Continuous EEG monitoring with amplitude-integrated electroencephalography can help to determine about early prognosis outcome and mortality. 59

Pulmonary interstitial emphysema is defined as the accumulation of air in the perivascular adventitia as a result of rupture of small airways and over distendedalveoli. These is especially more frequent in premature infantswhom supported with mechanical ventilatory due to respiratory distress syndrome. Surgery can be applied to unstabile patients when conservative therapies are inconclusive. High-pressure ventilation should be avoided in these patients. Here in we want to report our experience on the use of nasal continuous positive air way pressure in a patient diagnosed with pulmonary interstitial emphysema which supported with invasive mechanical ventilation for 18 days., Pulmoner interstisyel amfizem alveoler ve küçük hava yollarının hasarlanması sonucu perivasküle radventisya içinde hava birikmesi olarak tanımlanır. Özellikle mekanik ventilatör desteği alan RDS tanılı prematüre bebeklerde daha sık görülmektedir. Tedavide konservatif yöntemlerin sonuçsuz kaldığı stabil olmayan hastalarda cerrahi uygulanabilmektedir. Bu hastaların ventilasyonunda yüksek basınç kullanımından kaçınılması gerekmektedir. Biz burada 18 gün konvansiyonel invaziv mekanik ventilasyon desteği alan pulmoner interstisyel amfizem tanılı bir hastanın takibinde nazal yolla sürekli pozitif hava yolu basıncı kullanımına dair deneyimimizi sunmak istedik.

Aim: Surgical ligation is treatment option in preterm infants with hemodynamically significant patent ductus arteriosus who are unresponsive to medical closure. We aimed to retrospectively evaluate preterms in whom surgical ligation was performed for hemodynamically significant patent ductus arteriosus between January 2007 and February 2012. Material and Methods: In our unit surgical ligation is beeing performed for hemodynamically significant patent ductus arteriosus in preterms who are unresponsive to medical closure or in whom it is contraindicated. The medical records of 34 preterm infants were retrospectively evaluated. Data related to demographic features, mode of respiratory support, need and duration of oxygen support, presence of intraventricular hemorrhage, bronkopulmonary displasia and acute renal failure, duration of hospital stay and mortality were recorded. Results: Median postnatal age at operation was 30 days 7-90 days . A total of 10 patients 29.4% died after operation. Twenty-four patients were discharged. Two deaths were related to surgical complications. Nine of twenty-four 37.5% discharged patients had need for oxygen support. All discharged patients escaped from oxygen support at median 18 postoperative 1-160 days days. When adjusted for gestational age and birth weight, operation day before 28th postnatal days and after 28th postnatal days did not affect the mortality and the need for oxygen support at discharge. Conclusion: It seems that surgical ligation is a good treatment option in preterm infants with hemodynamically significant patent ductus arteriosus who are unresponsive to medical closure. Our results indicate that the operation day 28th postnatal days does not affect the mortality and the need for oxygen support at discharge., Amaç: Hemodinamik olarak önemli patent duktus arteriozus tedavisinde medikal kapatma tedavisine cevap vermeyen hastalarda cerrahi ligasyon tedavi seçeneği olarak görünmektedir. Kliniğimizde Ocak 2007 Şubat 2012 tarihleri arasında duktus arteriozusu cerrahi olarak kapatılan hastaların sonuçlarının retrospektif olarak değerlendirilmesi amaçlanmıştır.Yöntemler: Yenidoğan Yoğun Bakım Kliniği’nde Hemodinamik olarak önemli patent duktus arteriozus tanısı alan bebeklerden medikal tedaviye yanıt alınamayan veya kontrendike olduğundan medikal tedavi verilemeyen bebeklere cerrahi ligasyon uygulandı. Toplam 34 preterm bebeğin kayıtları retrospektif olarak incelendi. Demografik özellikler, ameliyat öncesi ve sonrası solunum desteği, oksijen ihtiyacı ve süresi, intraventriküler kanama, bronkopulmoner displazi, akut böbrek yetmezliği, hastanede kalış süresi ve mortalite verileri kaydedildi.Bulgular: Ameliyat edilme yaşı postnatal ortanca 30 7-90 gün idi. Ameliyat sonrası toplam on hasta %29.4 kaybedilirken, 24 hasta taburcu edilebildi. Ölenlerden İkisi cerrahi komplikasyonlar nedeniyle kaybedildi. Yaşayan 24 hastadan 9’unun %37.5 taburculukta oksijen ihtiyacı vardı. Taburcu edilebilen tüm hastalar ameliyat sonrası ortanca 18 günde 1-160 oksijen desteğinden kurtuldu. Regresyon analizi, ameliyatın postnatal 28. günden önce veya sonra yapılmış olmasının taburculukta oksijen ihtiyacının olup olmamasını ve mortaliteyi etkilemediğini ortaya koydu.Somuç: Sonuç olarak medikal tedaviye cevap vermeyen Hemodinamik olarak önemli patent duktus arteriozuslu prematüre bebeklerde cerrahi tedavi uygulanabilir bir yöntem olarak görülmektedir. Çalışma sonuçlarımız cerrahi tedavinin 28 günden önce yapılmasının mortalite ve taburculukta oksijen desteği ihtiyacı üzerine etkisi olmadığına işaret etmektedir.

Beken, Serdar/0000-0002-8609-2684; BAS, AHMET YAGMUR/0000-0002-1329-2167; Bulbul, Ali/0000-0002-3510-3056; Karatekin, Guner/0000-0001-7112-0323, WOS: 000534242500056, PubMed: 31851725, Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey. Material and methods A prospective cohort study was performed between April 1, 2016 and April 30, 2017. the study included VLBW infants admitted to level III NICUs. Perinatal and neonatal data of all infants born with a birth weight of.1500 g were collected for infants who survived. Results Data from 69 NICUs were obtained. the mean birth weight and gestational age were 1137 +/- 245 g and 29 +/- 2.4 weeks, respectively. During the study period, 78% of VLBW infants survived to discharge and 48% of survived infants had no major neonatal morbidity. VLBW infants who survived were evaluated in terms of major morbidities: bronchopulmonary dysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers. Conclusion the present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs., Turkish Neonatal Society [2-2016]; Turkish Neonatal Society, This study was supported by the Turkish Neonatal Society, http://www.neonatology.org.tr, number 2-2016, received by AYB. Turkish Neonatal Society funded the study's online registry system. the funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Yüksek irtifada yaşayan insanlarda, deniz seviyesinde yaşayan insanlar ile karşılaştırıldığında fizyolojik normaller arasında farklılıklar olduğu gibi yüksek irtifada doğan bebeklerde de deniz seviyesinde doğanlar ile karşılaştırıldığında doğum haftaları, doğum ağrılıkları, doğum sonrası ölçülen oksijen saturasyonları gibi vital değerlerde farklılıklar olabilmektedir.Yapılan çalışmalar, duyarlılığın doğru tahminlerini sağlamak için yetersizdir. Biz çalışmamızda fonksiyonel oksijen satürasyonunu preduktal (sağ el) ve postduktal (her iki ayak) ölçen yeni jenerasyon oksimetre ile kritik konjenital kalp hastalıklarını taradık. Tarama testinde preduktal (sağ el) ve postduktal (her iki ayak) arasındaki saturasyon değerlerinin < % 95 veya > % 3 farkın optimal tarama değerleri olarak kabul ettik . Yüksek irtifada doğan bebeklerde ölçülen oksijen saturasyon değerleri ve perfüzyon indeksi değerleri ile kritik konjenital kalp hastalıkları arasındaki ilişkiyi incelemeyi amaçladık. It has been shown that the oxygen saturation of the babies born at high altitude after birth has a tendency to decrease as the altitude increases, and the birth weeks tend to decrease as the altitude increases. Although the altitude of the affected area affects the measured vital signs of the infants, it can also affect how long the parents have experienced at the place of delivery. It has been shown that if the parents of the infants lived in the region where the generation was long, the adaptability of the patients was improved and the oxygen saturation value was higher.Studies are insufficient to provide accurate estimates of sensitivity. We screened critical congenital heart diseases with a new-generation oximeter that measures functional oxygen saturation in the preductal (right-handed) and post-lux (both feet). In the screening test, we considered the optimal screening values of 3% of the saturation values between preduktal (right hand) and postductal (both feet). We aimed to investigate the relationship between oxygen saturation values and perfusion index values in infants born to high altitude and critical congenital heart diseases. 58