Neonatal respiratory distress syndrome (NRDS) primarily occurs in premature infants and is one of the commonest causes of respiratory failure of the newborn 1. Epidemiology and risk factors The incidence and severity of NRDS is inversely related to gestational age and birth weight 2. Whilst 60-80% of neonates born earlier than 28 weeks of gestation and 15-30% born at 32-36 weeks of gestation develop NRDS, it is rare in those more than 36 weeks of gestational age 2. The incidence of NRDS is 80% for infants weighing <750g at birth and 55% for infants weighing 750-1000g 1. Other risk factors include maternal diabetes, caesarean delivery, asphyxia, multiple births, precipitous delivery, cold stress and a maternal history of previous affected infants 2. In contrast, incidence of NRDS decreases with prolonged rupture of membranes, chronic pregnancy associated hypertension and antenatal corticosteroid prophylaxis 2. Patho-physiology The primary cause of NRDS is impaired surfactant synthesis and secretion, which leads to atelectasis, ventilation-perfusion (V/Q) mismatch and hypoventilation resulting in hypoxaemia and hypercarbia 2. The relative deficiency of surfactant decreases lung compliance and functional residual capacity with an increase in the dead space 2. The combination of hypercapnia, hypoxia, and acidosis cause pulmonary arterial vasoconstriction, leading to shunting of blood from right to left 3. Progressive injury from atelectrauma, volutrauma, ischaemia and oxygen toxicity results in impaired endothelial and epithelial integrity with leakage of _________________________________________ 1

No abstract

Introduction: Critical congenital heart disease (CCHD) refers to any severe cardiac anomaly existing since birth and requiring surgical or catheter-based intervention during infancy Objective: To assess knowledge on pulse oximetry (POS) protocol and its interpretation among nursing officers attached to postnatal wards of Sri Jayewardenepura General Hospital. Method: A descriptive cross-sectional study was carried out to assess the nursing officers' knowledge on POS. Data were collected from the nursing officers in the postnatal wards who had working experience of one month or more by using an interviewer administered questionnaire. According to the responses, results were graded as unacceptable, acceptable and satisfactory. Results: Fifty three female nurses working in the postnatal wards participated in the study. The average working experience was 72 months. The average score obtained was 6.4 (SD 1.63) out of a total of 9. Ninety one percent scored above 5, 98% knew the correct sites of saturation measurements, 91% were aware about the purpose of neonatal POS and 66% knew the optimal time of performing the test. Seventy percent knew the test is positive if the SpO2 difference between limbs is more than 3, but only 43% knew the test is positive if SpO2 is <90% in any limb. Further, only 52% were aware of interpreting inconclusive test results (SpO2 90-94%). There was no significant difference (p<0.05) in the knowledge according to working experience.