Elevated serum NGAL measured within 6 hours after birth reliably indicates acute kidney injury in asphyxiated neonates.

Objective. Evaluating the efficacy and safety of arginine and glutamine supplementation in decreasing the incidence of NEC among preterm neonates. Methods. Prospective case-control study done on 75 preterm neonates ≤34 weeks, divided equally into L-arginine group receiving enteral L-arginine, glutamine group receiving enteral glutamine, and control group. Serum L-arginine and glutamine levels were measured at time of enrollment (sample 1), after 14 days of enrollment (sample 2), and at time of diagnosis of NEC (sample 3). Results. The incidence of NEC was 9.3%. There was no difference in the frequency of NEC between L-arginine and control groups (P > 0.05). NEC was not detected in glutamine group; L-arginine concentrations were significantly lower in arginine group than control group in both samples while glutamine concentrations were comparable in glutamine and control groups in both samples. No significant difference was found between groups as regards number of septic episodes, duration to reach full oral intake, or duration of hospital stay. Conclusion. Enteral L-arginine supplementation did not seem to reduce the incidence of NEC. Enteral glutamine may have a preventive role against NEC if supplied early to preterm neonates. However, larger studies are needed to confirm these findings. This work is registered in ClinicalTrials.gov (ClinicalTrials.gov Identifier: NCT01263041).

Blood flow in SMA is significantly reduced after caffeine citrate infusion at a loading dose of 20 mg/kg. This effect continues for at least 2 h. Meanwhile, SMA BFV seems not affected by maintenance doses.

Because of the absence of any beneficial effect of meperidine on uterine dystocia, its use in labor should be limited to pain relief in the absence of epidural analgesia.

Serum endothelin 1 is significantly increased at day 3 of life in preterm neonates with respiratory distress syndrome who later develop bronchopulmonary dysplasia (BPD). It seems to be a promising predictive marker for BPD but further studies are needed to find the appropriate time for its measurement.

Background: Neonatal sepsis (NS) is a systemic uncontrolled inflammatory response to an infectious agent, resulting in oxidative stress. Melatonin antioxidant and free radical scavenger proved to be safe in neonates. We aimed to evaluate the efficacy and safety of melatonin as adjuvant therapy in NS. This was an interventional trial conducted on 40 preterm neonates with NS diagnosed on the basis of clinical and laboratory criteria. They were simply randomized to melatonin treated (MT) (n = 20) and conventionally treated (CT) (n = 20) groups. Melatonin was administered at a total dose of 20 mg enterally in two divided doses of 10 mg each, 1 h apart. Malondialdehyde (MDA) was assessed in patients at enrollment, 4 and 72 h later in MT, and 72hours later in CT. Fifteen healthy matched neonates were included as a control. Results: There were no significant differences between MT and CT groups regarding baseline sepsis workup. However, total leucocytic count, absolute neutrophil count, and C-reactive protein were significantly higher and platelets were significantly lower in CT compared to MT after 72 h. MDA was doubled in CT while reduced in MT 72 h after intervention (p = 0.000). Mortality was significantly lower in MT. No side effects following melatonin administration were reported. Conclusion:Melatonin is effective and safe adjuvant for treatment of NS that improves clinical and laboratory outcomes.

Background Timing is crucial when deciding if a patient can be successfully extubated. Both premature discontinuation and unnecessary delay of mechanical ventilation weaning have been associated with poor outcome. There are no enough guidelines for the assessment of readiness of newborns for extubation. The degree of lung aeration loss in different clinical conditions can be quantified via lung ultrasound (LUS). Objectives To evaluate the lung ultrasound score as a follow up tool in ventilated neonates and its validity as predictor of extubation. Subjects and Methods Prospective study done on 39 mechanically ventilated neonates 27-42 weeks’ gestation. Lung ultrasound was done daily for each patient till the day of weaning and lung ultrasound (LUS) score was calculated. Patients were divided into 2 groups according to trial of weaning; Success “S” group: in which weaning succeeded and Failure “F” group: in which weaning failed. Results The “F” group had significantly higher LUS score at time of intubation, pre- extubation and post-extubation compared with the “S” group (P- value= 0.002, 0.003 and 0.001 respectively). A cut off value of ≤ 10 for LUS score pre-extubation predict successful weaning with sensitivity 76% and specificity 64.3%. Conclusion LUS is an indicator for lung aeration and can be used as a tool to predict success of weaning of ventilated neonates.

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