Aim: We aimed to determine the diagnostic role of systemic inflammatory (SI) incides in infants with moderate to severe HIE. We have also investigated the effect of hypothermia treatment (HT) over those indices. Method A retrospective cohort study of infants suffering from moderate-severe HIE was conducted in a tertiary level neonatal intensive care unit between September 2019 to March 2021. SI indices including systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were calculated for infants with HIE and controls at baseline, and after HT in those with HIE. Results A total of 103 infants (53 in the HIE group and 50 in the control group) were included in the study. Gestational ages, birth weights and the gender of the infants were similar between the groups. Infants in the HIE group had significantly higher NLR (p=0.001), SII (p=0.001), PIV (p=0.001), and SIRI (p=0.004) values when compared to control group. Those indices decreased significantly after HT in the HIE group. Areas under curve for NLR, PLR, MLR, SII, SIRI and PIV to predict HIE were found as 0.808, 0.597, 0.653, 0.763, 0.686 and 0.663 respectively. Cut off values having a good ability to predict HIE for SII and NLR were 410 and 1.12. Elevated NLR level above 1.12 was found to be an independent predictor for HIE as revealed by multivariate analyses. No associations were found between SI incides and aEEG patterns, presence of seizures and death. Conclusion SI indices may represent reliable and readily available predictors of HIE risk. NLR seems to be an independent factor in diagnosing moderate to severe HIE.

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Introduction: Early rescue surfactant is the most effective way of administering surfactant but many infants still receive surfactant later. Our aim was to explore the association between timing of surfactant administration and the development of patent ductus arteriosus and other neonatal morbidities. Materials and method: This retrospective study analyzed 819 preterm infants under 30 weeks of gestational age and under 1,500 g. Results: Five hundred and ninety three infants received surfactant during the study period, of these 365 received it within 2 h of life (early group) and 228 received it after two h (late group). Patent ductus arteriosus was detected in 175 (48%) of the early group and 168 (74%) of the late group, p = 0.001. Multinominal logistic regression analysis demonstrated that receiving surfactant after 2 h of life has a OR 3.5 (2.2-5.64 95 % CI) and a p-value of 0.001 for developing patent ductus arteriosus. Conclusion: In this study population we observed that late surfactant administration is associated with increased risk of patent ductus arteriosus.

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