USING THE AUTOMATED FIO2- SPO2 CONTROL IN NEONATAL INTENSIVE CARE UNITS IN POLAND. A PRELIMINARY REPORT.

Aim: Analysis of the way in which a new method of implementing the automated control of oxygen therapy during respiratory support is applied in newborns with respiratory failure.

Material, Methods And Results: The AVEA-CLiO2 ventilator with automated FiO2- SpO2 control was used in our study of 121 newborns conducted between February 2014 and January 2015 in five neonatal intensive care units. A web-based database was used to gather information entered concurrently with using the FiO2- SpO2 control system.

THE CONSEQUENCES OF FAILING ELECTIVE NONINVASIVE RESPIRATORY SUPPORT AS COMPARED TO IMMEDIATE INTUBATION: A POPULATION STUDY OF VERY LOW BIRTH WEIGHT NEONATES.

Introduction: Elective noninvasive respiratory support has become common. However, many neonates fail this procedure and they may require intubation. The aim of this study was to determine the relative outcome of very low birth weight neonates who failed noninvasive respiratory support compared to those that were initially intubated and mechanically ventilated.

Quicker response results in better SpO2 control - a comparison of 3 FiO2-titration strategies in ventilated preterm infants.

Introduction: The impact of SpO2 target ranges (TR) has been carefully studied; however, reports suggest a wide variation among infants and centres in maintaining the intended range. Little is known about the effectiveness of different approaches to manual control. Auto-SpO2 controllers are now available which show promise.

Automated versus Manual Oxygen Control with Different Saturation Targets and Modes of Respiratory Support in Preterm Infants.

Objective: To determine the efficacy and safety of automated adjustment of the fraction of inspired oxygen (FiO2) in maintaining arterial oxygen saturation (SpO2) within a higher (91%-95%) and a lower (89%-93%) target range in preterm infants.

Study Design: Eighty preterm infants (gestational age [median]: 26 weeks, age [median] 18 days) on noninvasive (n = 50) and invasive (n = 30) respiratory support with supplemental oxygen, were first randomized to one of the SpO2 target ranges and then treated with automated FiO2 (A-FiO2) and manual FiO2 (M-FiO2) oxygen control for 24 hours each, in random sequence.

Results: The percent time within the target range was higher during A-FiO2 compared with M-FiO2 control.

Automated FiO2-SpO2 control system in neonates requiring respiratory support: a comparison of a standard to a narrow SpO2 control range.

Background: Managing the oxygen saturation of preterm infants to a target range has been the standard of care for a decade. Changes in target ranges have been shown to significantly impact mortality and morbidity. Selecting and implementing the optimal target range are complicated not only by issues of training, but also the realities of staffing levels and demands.

[Evaluation of sick neonates' medical interventions in maternity units before transport to reference centres].

Background: Interhospital transfer of the sick neonate should be an integral part of neonatal intensive care. However, it is essential that the referring hospital is able to provide the appropriate standard of care from birth up to the point of transfer.

Objective: To evaluate the quality of medical interventions before interhospital transport of sick neonates.

[Thermal comfort in preterm babies. Infra-red colour thermography findings. Preliminary report].

Objective: To assess the thermal comfort of clinically stable neonates with normal body temperature by using infra-red colour thermography (THY).

Material And Methods: 32 babies were enrolled in the study. The axillary temperature was maintained in the range 36.

A multicenter randomized controlled trial comparing effectiveness of two nasal continuous positive airway pressure devices in very-low-birth-weight infants.

Objective: Many studies suggest nasal continuous positive airway pressure is an effective and relatively complication-free means of respiratory support in premature infants. However, only limited data exist regarding the practical aspects of nasal continuous positive airway pressure delivery, including the best way to provide the positive airway pressure.

Design: Our aim was to compare the results of treatment using two different nasal continuous positive airway pressure devices: variable flow Infant Flow and constant flow nasal continuous positive airway pressure in two different groups of very-low-birth-weight infants in a multicenter randomized controlled trial.

Usefulness of the Apgar score: a national survey of Polish neonatal centers.

Introduction: The paper discusses the reliability of the Apgar score for evaluating newborns, particularly its usefulness in assessing the state of preterm or full term newborns born with hypoxia.

Aim: The paper provides a sum-up of the opinions on usefulness and reliability of the Apgar score given by doctors from 255 NICUs.

Material And Methods: Data for the analysis were gathered by means of a questionnaire opinion poll sent to 158 primary referral centers, 71 secondary referral centers and 26 tertiary referral centers.

Comparative study of clinical characteristics of amniotic rupture sequence with and without body wall defect: further evidence for separation.

Background: Amniotic rupture sequence (ARS) is a disruption sequence presenting with fibrous bands, possibly emerging as a result of amniotic tear in the first trimester of gestation. Our comparative study aims to assess whether there is a difference in the clinical pattern of congenital limb and internal organ anomalies between ARS with body wall defect (ARS-BWD) and ARS without BWD (ARS-L).

Methods: Among 1,706,639 births recorded between 1998 and 2006, 50 infants with a diagnosis of ARS were reported to the Polish Registry of Congenital Malformations.

Ophthalmological aspects of Pierson syndrome.

Purpose: To study the ocular phenotype of Pierson syndrome and to increase awareness among ophthalmologists of the diagnostic features of this condition.

Design: Retrospective, observational case series.

Methods: A multicenter study of 17 patients with molecularly confirmed Pierson syndrome.

[Physicians' attitudes toward pain in newborn infants. Preliminary results of a cross-sectional national survey].

Background: Since 1980s, the problem of pain experienced by newborns has met with increasing interest both in research work and in clinical practice. It is worth noting that significant progress in neurophysiologic basis of pain and in diagnostic and therapeutic methods have occurred during that time.

Aim: This study primarily aims at describing opinions of the doctors who work in the neonatal wards and neonatal intensive care units in Poland regarding the management of pain in newborns.

[Prevention of osteopenia in premature infants].

Proposition of recommendations for prevention of osteopenia in premature infants is presented in this article. In parenteral nutrition in premature infants calcium and phosphorus should be supplemented early in a dose of 80-100 mg/kg/24 h (2-2.5 mmol/kg/24 h) and 43-63 mg/kg/24 h (1.

[Parenteral nutrition in neonatal units: a survey of current practices in Poland].

Unlabelled: The aim of the study was to assess parenteral nutrition methods in neonatal units in Poland.

Material And Methods: Large scale questionnaire investigations concerning parenteral nutrition (PN) were carried out in neonatological centres in Poland. The questionnaires were distributed in the year 2007 to 463 wards.

[Diagnosis and treatment option strategy for invasive fungal infections in paediatric intensive care].

During the last 20 years rising prevalence of invasive fungal infections, mainly candidiasis or aspergillosis, are observed in paediatric intensive care units. Infections caused by Candida non-albicans species are a particular problem. Results of treatment depend on fast and correct diagnostics, avoidance of risk factors and selected pharmacotherapy.

[Endotracheal suctioning in neonates and children].

Endotracheal suction is essential to keep the respiratory capacity of the bronchial tree. The aim of this study was to establish the principles reducing potential side-effects, like hypoxia, bradycardia, hypotension, arrhythmia, nosocomial infections. Analysing the literature we have selected the following major beneficial factors: 1:2 to 2:3 cathether - tracheal tube diameter ratio, individual adjustment of the suctioning frequency, maximal duration of the procedure capped at 10-15 sec.

[Guidelines for the use of special purposes central vein catheters (Broviac, Hickman and Gronshong): proposals for recommendations].

On the basis of literature search and own experiences as well as the current opinions of the Polish National Survey in Paediatric and Neonatal Intensive Care for indications and use of tunnelized catheters with a cuff, the authors present the guidelines for special purpose central vein catheters in the newborn and infants.

[Weaning newborns from noninvasive ventilation].

The purpose of the study was to propose the recommendations for weaning infants from nasal continuous positive airway pressure (nCPAP) and nasal intermittent positive pressure ventilation (NIPPV). Despite the fact that both methods are commonly used for respiratory insufficiency in infants, detailed recommendations for weaning have not been described so far. The proposed recommendations are based on previously described data and a wide survey conducted among Polish neonatologists and intensive therapy paediatricians.

[Delivery room resuscitation with room air and oxygen in newborns. State of art, recommendations].

The authors present and discuss the current data, concerning delivery room resuscitation with oxygen and room air in neonates. On the ground of the results obtained from literature and the Polish National Survey on Paediatric and Neonatal Intensive Care, 2007/2008 issue, the authors give the following proposals regarding optimal oxygen treatment: 1. there is a need for optimizing tissue oxygenation in order to prevent injury caused by radical oxygen species; 2.

[Recommended treatment of apnea in premature infants. A review based on literature and own experience].

The authors reviewed the literature concerning different methods of treatment of apnea in premature infants. The authors consider that, apart from pharmacological treatment, noninvasive respiratory support methods play an important role in the prevention and treatment of newborns with apnea. The aim of the study is to present current recommendations concerning the principles of prevention and treatment of apnea in premature infants.

[Current neonatal resuscitation practices in Polish neonatal units - national survey].

Aim: We surveyed current neonatal resuscitation practices in Polish neonatal units to determine the factors, relevant to improving practices in this area.

Material And Methods: The study was performed within the framework of the National Standardization Programme on Neonatal Practices and Procedures in 2007. An 11 question survey included questions concerning the frequency of neonatal resuscitation, type of procedure performed during resuscitation ie.

[Analysis of infections in neonatal units in Poland].

Unlabelled: The aim of the study was to analyse the data concerning infections in neonatal units and to assess the facilities for bacteriological diagnosis.

Material: This national programme included 273 neonatal departments of which 175 were level I of referral, 72 departments were level II of referral, 26 units were level III of referral and 28 were paediatric intensive care departments.

Method: was by use of anonymous questionnaires sent to the 273 neonatal departments.

[Aims and methodology of the Polish National programme for Standardisation of Clinical Practices in Neonatology and Paediatric Intensive Care. Edition 2007/2008].

In this paper we outline the aims and methods of the Polish National Programme for Standardisation of Clinical Practice in Neonatology and Paediatric Intensive Care, with special reference to infants with low and extremely low birth weight. The aim of this Programme is to adjust the diagnostic and therapeutic procedures to the latest guide lines and recommendations. The first stage consisted of a national level survey in order to identify the diversity of procedures implemented in Medical University Clinical Departments, Neonatology Units and Paediatric Intensive Care Units.

[Local complications during nasal continuous positive airway pressure method therapy].

A review of the current knowledge about local complications during nasal continuous positive airway pressure method therapy in the neonate with respiratory failure is the subject of this article. In the authors' conviction, local damages make up one of the main causes of failure of therapy, or its interruption, especially in the newborn with extremely low birth weight. Apart from review of the literature, the authors describe the causes of the most frequent damages as well as methods of their prevention and treatment, developed during many years of using of this form of ventilation.