Gestational age is a critical factor in the management, decision-making, prognostication and follow-up of newborn infants. It is also essential for research and epidemiology. In the absence of an early assessment of fetal gestation by abdominal ultrasound, many neonatal units in developing countries determine gestational age by neonatal scores and last menstrual period-both of which are highly inaccurate. The aim of this pilot study was to determine whether postnatal foot length measurement could accurately determine gestational age in a specified South African hospitalized neonatal population. Foot length was measured with a plastic Verniere's caliper. Foot length was shown to correlate well with gestational age (r = 0.919,p < 0.001). Intra-observer and inter-observer variability of foot length measurements was low. Foot length can therefore be used with high accuracy to determine the gestational age in a population where there is poor access to or utilization of antenatal sonar.

Introduction The coronavirus disease‐2019 (COVID‐19) era is a challenging time for respiratory teams to protect their patients and staff. COVID‐19 is predominantly transmitted by respiratory droplets; in the clinical setting, aerosol generating procedures pose the greatest risk for COVID‐19 transmission. Bronchoscopy is associated with increased risk of patient‐to‐health care worker transmission, owing to aerosolized viral particles which may be inhaled and also result in environmental contamination of surfaces. Methods We describe our experience with the use of modified full‐face snorkeling masks for pediatric bronchoscopy procedures in four COVID‐19 infected children when filtering facepieces/respirators were in limited supply. Results Bronchoscopy was urgently required in four children, and could not be delayed until COVID‐19 test results were available. During the pandemic peak, when respirators were in short supply, modified full‐face snorkel masks (SEAC Libera, SEAC, Italy) were worn by the bronchoscopy team. Each mask was fitted with an O‐ring, adapter, and heat and moisture exchanger filter. To date, there have been no COVID‐19 infections among the bronchoscopy team staff, whereas the overall Hospital staff COVID‐19 prevalence rate has exceeded 13.5% (667/4949). Conclusion Emergency bronchoscopy procedures on COVID‐19 infected patients or patients with unknown infection status can be safely performed using modified full‐face snorkel masks.

Introduction: Bioreactance cardiac output (CO) monitors are able to non-invasively and continuously monitor CO. However, as a novel tool to measure CO, it must be proven to be accurate and precise. Objective: To determine the agreement between CO measured with a bioreactance monitor and transthoracic echocardiography-derived left ventricular output parameters in preterm infants. Methods: This is a prospective observational study in 63 preterm neonates with non-invasive respiratory support, not requiring inotrope support. The infants underwent continuous bioreactance monitoring of CO and stroke volume (SV) and simultaneous transthoracic echocardiography every 6 h until 72 h of life. Results: The agreement between bioreactance and transthoracic echocardiography, for both SV and CO, was poor. The percentage error was 67.5% for SV and 71.6% for CO. The mean error was 60.4% for SV and 69.8% for CO. Bias was affected by numerous variables. After correcting for time, CO and SV bias were significantly affected by the presence of an open patent ductus arteriosus and the level of CO. Conclusion: Bioreactance cannot be considered interchangeable with transthoracic echocardiography to measure CO in preterm infants during the transition phase. Agreement between bioreactance and other CO metrics should be assessed before concluding its accuracy or inaccuracy in neonates.

In resource-restricted regions, respiratory distress syndrome (RDS) data are often underreported, making the determination of effective interventions and their outcome difficult. The combination of oxygen, nasal continuous positive airway pressure (CPAP) and surfactant therapy has the potential to prevent 42% of RDS-related deaths in sub-Saharan Africa, despite the financial implications. This article provides a brief overview on the status of RDS management, mainly nasal CPAP and surfactant therapy in very-low-birth-weight infants, in resource-restricted regions of sub-Saharan Africa. Data from the public health sector, as compared to the private health sector, of the Western Cape province, South Africa, are used to illustrate what RDS management strategies are able to accomplish in a resource-restricted region. Upscaling of all components (antenatal care, antenatal corticosteroids, prevention of hypothermia and RDS management strategies) are required to decrease premature infant mortality rates in resource-restricted areas.