Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle

Turkish Neonatal Society guideline for the follow-up of high-risk newborn infants

Developments in perinatal and neonatal care have increased the survival rate of high-risk newborns but led to a rise in chronic diseases seen in these infants. A significant number of them attend primary and secondary health care centers after discharge; however, there are very few standard protocols for the long-term follow-up of these babies. Therefore, we aimed to establish a follow-up guideline that emphasizes on universal screening schemes and takes into consideration national data. The guide presented here provides brief recommendations for physicians in light of evidence-based data for the follow-up of high-risk newborn infants. The steps taken to monitor and solve the problems of all high-risk infants may vary. We hope the use of such a standard approach in evaluating each infant in daily routine will improve the life quality of these high-risk infants.

Stress Oximetry: Description of a Test to Determine Readiness for Discontinuing Oxygen Therapy in Infants with Chronic Lung Disease

Background

In infants with CLD there are no objective tests to monitor an infant's progress towards weaning out of oxygen inhalation therapy (O₂IT). A test involving staged maneuvers of increasing respiratory stress while decreasing oxygen support, termed Stress Oximetry (StressOx), has been used at our center for weaning O₂IT.

Objective

To report the clinical utility of "StressOx" in evaluating readiness for discontinuing O₂IT in infants with CLD.

Methods

A retrospective review was done of StressOx tests administered at our center from 2002-2008. StressOx was performed based on a consistent clinical protocol in all eligible infants on O₂IT. O₂IT was generally discontinued after infant had passed two StressOx tests and subsequently infants were monitored for a minimum of 7 days to determine successful weaning.

Results

There were 279 infants with 899 tests that met inclusion criteria. An average of 3 tests per infant was done, one week apart. The test had a specificity of 97.4% and a positive predictive value of 99.6% in determining success of discontinuing O₂IT.

Conclusions

StressOx appears to be a clinically useful test that may help in determining an infant's ability to successfully wean out of O₂IT. Further validation of this test is warranted.