Monitoring SpO: The Basics of Retinopathy of Prematurity (Back to Basics) and Targeting Oxygen Saturation.

Oxygen (O2) is a drug frequently used in newborn care. Adverse effects of hypoxia are well known but the damaging effects of excess oxygen administration and oxidative stress have only been studied in the last 2 decades. Many negative effects have been described, including retinopathy of prematurity .

End-of-life care in neonatal intensive care units in Iberoamerica: A look from the nursing perspective.

Introduction: End-of-life care (ELC) represents a quality milestone in neonatal intensive care units (NICU). The objective of this study was to explore how ELC are carried out in NICUs in Iberoamerica.

Methods: Cross-sectional study, through the administration of an anonymous survey sent to neonatal nursing professionals.

Capnography in newborns under mechanical ventilation and its relationship with the measurement of CO in blood samples.

Introduction: Monitoring the partial pressure of CO (PCO) in newborns who require ventilation would allow avoiding hypocapnia and hypercapnia. The measurement of end-tidal carbon dioxide (ETCO) is an alternative rarely implemented in this population.

Objective: To evaluate the relationship between ETCO and PCO in newborns.

Hypoxic Ischemic Encephalopathy in Units Reporting to the Ibero-American Society of Neonatology Network: Prevalence and Mortality.

Introduction: Hypoxic ischemic encephalopathy is a neurological condition occurring immediately after birth following a perinatal asphytic episode. Therapeutic hypothermia is a safe and effective intervention to reduce mortality and major disability in survivors. In Latin America, perinatal asphyxia is a major problem, but no data are available characterizing its current situation in the region or the impact of hypoxic ischemic encephalopathy on its management.

CCHD Screening Implementation Efforts in Latin American Countries by the Ibero American Society of Neonatology (SIBEN).

Congenital heart disease (CHD) is among the four most common causes of infant mortality in Latin America. Pulse oximetry screening (POS) is useful for early diagnosis and improved outcomes of critical CHD. Here, we describe POS implementation efforts in Latin American countries guided and/or coordinated by the Ibero American Society of Neonatology (SIBEN), as well as the unique challenges that are faced for universal implementation.

Abuse of Antibiotics in Perinatology: Negative Impact for Health and the Economy.

To use medications appropriately, patients need to be treated based on their clinical conditions, in doses that are based on their individual requirements, for an adequate amount of time, and at the lowest expense. The perinatal period is characterized by an excessive use of antibiotics. This antibiotic abuse can lead to antibiotic resistance, microbiome alterations, and dysbiosis, which have been associated with serious complications such as infections, abnormal brain development, allergies, autoimmune disorders, obesity, and an increase in mortality as well as an increase in health care expenditures.

Suspected Neonatal Sepsis: Tenth Clinical Consensus of the Ibero-American Society of Neonatology (SIBEN).

Suspected neonatal sepsis is one of the most common diagnoses made in newborns (NBs), but very few NBs actually have sepsis. There is no international consensus to clearly define suspected neonatal sepsis, but each time that this suspected diagnosis is assumed, blood samples are taken, venous accesses are used to administer antibiotics, and the mother-child pair is separated, with prolonged hospital stays. X-rays, urine samples, and a lumbar puncture are sometimes taken.

[Use (and abuse) of antibiotics in perinatal medicine].

Introduction: The rational use of antibiotics (ATB) implies that patients receive those adequate for their clinical needs, in correct doses according to their individual conditions, during an adequate period of time, and at the lowest cost for them and their community. The highest rate of ATB abuse occurs during the perinatal period, despite the fact that there is evidence of multiple short- and long-term negative effects. Furthermore, this abuse is associated with increased costs of medical care.

Early Detection with Pulse Oximetry of Hypoxemic Neonatal Conditions. Development of the IX Clinical Consensus Statement of the Ibero-American Society of Neonatology (SIBEN).

This article reviews the development of the Ninth Clinical Consensus Statement by SIBEN (the Ibero-American of Neonatology) on "Early Detection with Pulse Oximetry (SpO) of Hypoxemic Neonatal Conditions". It describes the process of the consensus, and the conclusions and recommendations for screening newborns with pulse oximetry.

Clinical hypoxic-ischemic encephalopathy score of the Iberoamerican Society of Neonatology (Siben): A new proposal for diagnosis and management.

Hypoxic ischemic encephalopathy is a major complication of perinatal asphyxia, with high morbidity, mortality and neurologic sequelae as cerebral palsy, mostly in poor or developing countries. The difficulty in the diagnosis and management of newborns in these countries is astonishing, thus resulting in unreliable data on this pathology and bad outcomes regarding mortality and incidence of neurologic sequelae. The objective of this article is to present a new clinical diagnostic score to be started in the delivery room and to guide the therapeutic approach, in order to improve these results.

[Family access to Neonatal Intensive Care Units in Latin America: A reality to improve].

Introduction: Family access to NICUs has benefits for the newborn (NB) and family, as the main way of humanised care.

Objective: To determine the current state of parents and families access to NICUs in Latin America.

Methods: A cross-sectional study was conducted in 15 countries using two questionnaires: 1) directed at head nurses with management and supervision activities, and 2) nurses with care tasks.

Using a novel laminar flow unit provided effective total body hypothermia for neonatal hypoxic encephalopathy.

Aim: This was a clinical observational trial on a laminar flow device that provides total body hypothermia for infants with hypoxic ischaemic encephalopathy (HIE).

Methods: We enrolled infants born at up to 35 weeks of gestation, who presented with HIE within six hours of birth. Total body cooling was achieved using the neonatal laminar flow unit for 72 hours, with continuous rectal temperature servo control, isolation and humidification.

[Consensus on the diagnostic and therapeutic approach to pain and stress in the newborn].

Pain and stress experienced by the newborn have not been addressed adequately. Infants in neonatal intensive care units often undergo painful and stressful invasive procedures, and inappropriate treatment increases morbidity and mortality. At the 5th Clinical Consensus of the Ibero-American Society of Neonatology, 32 neonatologists from the region were invited to establish recommendations for the diagnosis and treatment of neonatal pain and stress.

Safe oxygen saturation targeting and monitoring in preterm infants: can we avoid hypoxia and hyperoxia?

Unlabelled: Oxygen is a neonatal health hazard that should be avoided in clinical practice. In this review, an international team of neonatologists and nurses assessed oxygen saturation (SpO2 ) targeting in preterm infants and evaluated the potential weaknesses of randomised clinical trials.

Conclusion: SpO2 of 85-89% can increase mortality and 91-95% can cause hyperoxia and ill effects.

A randomised controlled trial of an automated oxygen delivery algorithm for preterm neonates receiving supplemental oxygen without mechanical ventilation.

Aim: Providing consistent levels of oxygen saturation (SpO2 ) for infants in neonatal intensive care units is not easy. This study explored how effectively the Auto-Mixer(®) algorithm automatically adjusted fraction of inspired oxygen (FiO2 ) levels to maintain SpO2 within an intended range in extremely low birth weight infants receiving supplemental oxygen without mechanical ventilation.

Methods: Twenty extremely low birth weight infants were randomly assigned to the Auto-Mixer(®) group or the manual intervention group and studied for 12 h.

Perfusion index in newborn infants: a noninvasive tool for neonatal monitoring.

Aim: To review the utility of perfusion index (PI) in the evaluation of neonatal clinical conditions. Twenty-five manuscripts were reviewed. PI provides information about haemodynamic stability, illness severity, early neonatal respiratory outcome, low superior vena cava flow and subclinical chorioamnionitis.

A laminar flow unit for the care of critically ill newborn infants.

Introduction: Medical and nursing care of newborns is predicated on the delicate control and balance of several vital parameters. Closed incubators and open radiant warmers are the most widely used devices for the care of neonates in intensive care; however, several well-known limitations of these devises have not been resolved. The use of laminar flow is widely used in many fields of medicine, and may have applications in neonatal care.

[Second Clinical Consensus of the Ibero-American Society of Neonatology: hemodynamic management of newborns].

This study reports on the process and results of the Second Clinical Consensus of the Ibero-American Society of Neonatology. Eighty neonatologists from 23 countries were invited to collaborate and participate in the event. Several questions of clinical-physiological importance in the hemodynamic management of newborns were addressed.