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What is known and objective Newborns, particularly preterm babies, are prone to vascular vasospasm and thromboembolism. Differences in the haemostatic system, small vessel diameter and presence of any serious diseases are predisposing causes of thromboembolic disease in newborns. The lack of randomized controlled studies on the management of vasospasm and thromboembolism exacerbates the problem. We present a case series of the successful and safe use of PTX for the treatment of vasospasm and thrombosis in neonates. Methods The study was conducted in the Bezmialem Vakif University Hospital Neonatal Intensive Care Unit (NICU). A retrospective chart review was performed on consecutive patients treated for vascular spasm and thrombosis. Nine patients diagnosed with vasospasm or thrombosis were enrolled in the study. Results Five patients had arterial injuries. Six patients were premature, and five patients were diagnosed with thrombosis by using Doppler ultrasonography (US). The drug was diluted with 5% dextrose and administered intravenously at a dose of 5 mg/kg/h over six hours, ranging from 1 to 5 days. No drug‐related side effects were observed. All babies recovered, and no amputation was performed. What is new and conclusion PTX may be an alternative treatment for vascular vasospasm and thromboembolism with fewer side effects than anticoagulant and thrombolytic agents in neonates. Starting PTX in the early stages of vascular insult may prevent the development of vasospasm and thromboembolism and thus limb ischaemia.

Background: Procedural pain is one of the most significant problems in neonates, especially in premature babies. Harmless and effective pain relief modalities in newborns should thus be applied. Although sucrose is the most commonly used agent, the most effective dose and concentration of sucrose is not clear. In this study, we compared the efficacy of two different doses of sucrose during venepuncture in neonates. Methods: This was a prospective, randomized, double-blind study. The study was conducted during venous sampling. Oral 24% sucrose (Tool sweet TM Natus Medical, San Carlos, CA, USA) was given by sterile syringe onto the anterior part of the tongue. Group 1 (n = 65) received 0.2 mL/kg 24% sucrose and group 2 (n = 64) received 0.5 mL/kg 24% sucrose. The Bernese Pain Scale for Neonates (BPSN) was used to assess the pain scores before, during and after the procedure. Results: One hundred and twenty-nine premature infants were enrolled in the study, consisting of 67 girls (51.9%) and 62 boys (48.1%) aged 1-24 days (mean age, 8.34 AE 6.25 days). There was no significant difference in BPSN score between the groups (P > 0.05). There was also no statistically significant difference in BPSN subscale scores between the groups (P > 0.05). Conclusions: Twenty-four percent sucrose 0.2 mL/kg may be the minimum effective dose to relieve pain during venepuncture procedures in premature babies.

Objective: Neonatal sepsis is one of the most frequent and life threatening disorder in the first one month of life. The type of the causative organisms and their resistance may change by the time even in the same hospital. In this study, we aimed to evaluate characteristics of the culture-proven cases in our neonatal intensive care unit. Methods: Between January 2012-July 2015, 1735 neonates who were hospitalized at neonatal intensive care unit of Bezmialem Vakıf University Hospital. The 56 patients diagnosed as culture proven sepsis were involved in the study. Results: The mean gestational age of patients was 31.70±4.92 weeks, and the mean birth weight was 1654.07±906.6 grams. The patients were 76.8% premature and 23.2% term newborns. Early onset neonatal sepsis was diagnosed 14.3% of patients, late onset neonatal sepsis was diagnosed 85.7% of patients. KoNS was the most frequently isolated gram positive microorganism in whole cultures. Klebsiella pneumoniae was the most frequently isolated gram negative microorganisms. Vancomycin resistance was not determined in any of the gram positive microorganisms. Meropenem resistance was not determined and imipenem had a maximum value of 50% resistance in the evaluated gram negative microorganisms. Mortality rate was 12.5% in both early onset neonatal sepsis and in late onset neonatal sepsis. All of the babies who were died were premature in both sepsis groups. Conclusion: The type of sepsis and microorganisms and their antibiotic resistance changes amongst neonatal intensive care units and also in the same unit by the time. Active surveillance is recommended to update the treatment protocols.

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