AimTo compare regional tissue oxygenation (rSO2) in the brain, intestine, and kidney between newborns with and without congenital heart defects (CHD).MethodsThis observational case-control study was conducted at the Neonatal Deparetment of Children's Hospital Ljubljana between December 2012 and April 2014. It included 35 newborns with CHD and 30 healthy age- and sex-matched controls. CHD were assessed echocardiographically and divided into acyanotic and cyanotic group. RSO2 in the brain, intestine, and kidney was measured using near-infrared spectroscopy (NIRS). Simultaneously, heart rate (HR), breathing frequency (BF), mean arterial blood pressure (MAP), and arterial oxygen saturation (Sao2) were recorded.ResultsNewborns with CHD had significantly lower rSO2 in the left brain hemisphere (67 ± 11% vs 76 ± 8%, P = 0.004), right brain hemisphere (68 ± 11% vs 77 ± 8%, P < 0.001), and the kidney (68 ± 13% vs 77 ± 10%, P = 0.015). RSO2 in the intestine did not significantly differ between the groups. HR, MAP, and Sao2 also did not differ between the groups, whereas BF was significantly higher in the CHD group (57 ± 12 vs 39 ± 10 breaths/min, P < 0.001). Between cyanotic and acyanotic group, we found no significant differences in rSO2 of any tissue.ConclusionsMonitoring tissue oxygenation by NIRS could enable a timely detection of hemodynamically important CHD.

The aim of this article is to present the problem of neonatal hypoglycaemia through clinical cases. Hypoglycaemia is the most common neonatal metabolic disturbance. It may be picked up incidentally in a neonate without clinical signs, or anticipated in a neonate at risk of hypoglycaemia. The lowest accepted blood glucose (BG) concentration is difficult to define, the one most often used in clinical practice it is a BG concentration of 2.2 mmol/L in the first 24 hours of life and of 2.6 mmol/L after the first day of life. After birth, transient mild decreases in BG levels are physiological. If hypoglycaemia persists, samples of blood and urine should be taken to diagnose the etiological factor causing it if the condition is not otherwise evident. Conclusion: Since persistent or recurrent hypoglycaemia may cause permanent long-term neurological impairment, it is important to diagnose and treat it appropriately and in good time in order to maintain normoglycaemia and assure normovolemia in a neonate. Moreover, the etiological factors causing hypoglycaemia should be sought so the therapy is also cause-targeted.