Non-invasive ventilation has been used increasingly in recent years to reduce the duration of endotracheal ventilation and its complications, especially bronchopulmonary dysplasia. Nasal continuous positive airway pressure and nasal intermittent positive pressure ventilation are the most common non-invasive modalities, and nasal high-frequency oscillatory ventilation (n-HFOV) is relatively new but it seems effective and feasible. We present three premature cases who were ventilated with n-HFOV with Neotech RAM Cannula as interphase. In two cases, we used n-HFOV with good results to prevent extubation failure, and in one case, we used it to avoid intubation with success. n-HFOV may be useful both in early times of respiratory failure and also to facilitate extubation particularly in patients with prolonged intubation.

Aim Most of the preterm infants are transfused at least once during their stay in the neonatal intensive care unit (NICU). The aims of this study were to demonstrate if packed red blood cell (pRBC) transfusion modulates regional (cerebral, abdominal, renal) tissue oxygen saturation measured by near‐infrared spectroscopy (NIRS) and to demonstrate if we can use NIRS to guide transfusion decisions in neonates. Methods A multi‐probe NIRS device was applied to anaemic preterm infants of gestational age <33 weeks for 30–60 min before and 24 h after pRBC transfusion. We evaluated the results separately in the subgroup with a pre‐transfusion haemoglobin (Hb) < 8 g/dL. Cerebral, abdominal and renal tissue oxygen saturation (rSO2) and abdominal/cerebral, abdominal/renal and renal/cerebral rSO2 ratios before and 24 h after transfusion were compared. Results There was no significant difference in cerebral rSO2 and abdominal/renal rSO2 ratios before and 24 h after transfusion, but abdominal and renal rSO2 and abdominal/cerebral and renal/cerebral rSO2 ratios at the 24th h following transfusion increased significantly. This increase was observed in the subgroup with pre‐transfusion Hb < 8 g/dL. Although statistically significant, the increase in renal oxygenation was within the limits of variability. Conclusions The increase in tissue oxygenation in abdominal region after pRBC transfusion suggests decreased tissue oxygenation of intestines during severe anaemia despite cerebral oxygenation being maintained at that particular Hb level. The impact of the increase on renal oxygenation with pRBC transfusion is unclear and might need further investigation. Increase in abdominal rSO2 may cause reperfusion injury, oxidative damage and trigger necrotising enterocolitis.

Laryngotracheoesophageal clefts (LTECs) are rare congenital defects that are often accompanied by additional anomalies. The major issues in the treatment of these patients are intraoperative exposure insufficiency, technical difficulty of the operation, and anesthesia problems originating from the respiratory tract. Problems originating from mechanical ventilation and respiratory tract, eating disorders and relapse of fistula are among the problems encountered following surgery. Most of the time, concomitant additional anomalies also worsen the clinical picture. It was our aim with these case reports to report our experience in two cases with Type IV LTEC ranging from the inoperable type IV LTEC due to additional anomalies mounted up to severe respiratory distress to the carina that we operated on with a single stage anterior cervicothoracic approach on its fifth day on life.

<p><strong>Objective:</strong> Nitric oxide plays a preventive role in the development of necrotizing enterocolitis. Oral nitrite and nitrate intake has gained importance with the discovery of the conversion of nitrite to nitric oxide in acidic medium out of the synthesis of nitric oxide from L-arginine.</p><p><strong>Objective</strong> of this study was to examine the breast milk concentrations of nitric oxide and asymmetric dimethylarginine which is a competitive inhibitor of nitric oxide and to compare these concentrations in terms of gestational age and maturity of breast milk. </p><p><strong>Study Design:</strong> Forty-one women were included in the study. Milk samples were collected from 3 groups of mothers as term, late preterm and preterm on the postpartum days 3, 7 and 28. </p><p><strong>Results:</strong> When breast milk concentrations of nitric oxide were compared according to the postnatal day of the milk independently from gestational age; nitric oxide concentration was higher in the colostrum than in the transition milk and mature milk (p=0,035; p=0,001; respectively). For the comparison of asymmetric dimethylarginine concentrations among these groups and days; no statistically significant difference was observed in terms of gestational age and maturity of the milk (p=0.865, p=0.115; respectively). </p><p><strong>Conclusion:</strong> The highest nitric oxide concentration was found in the colostrum, suggesting that colostrum is a valuable food for newborns. Plasma concentrations of asymmetric dimethylarginine were negatively correlated with nitric oxide and did not show a correlation with breast milk, suggesting that asymmetric dimethylargininedoesn’t make nitric oxide inhibition in breast milk.</p>