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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Objective To compare the lung ultrasonography (LUS) scores after two different natural surfactant administration as a parameter reflecting lung inflation. Study Design Preterm infants of 32 gestational weeks and below who were diagnosed with respiratory distress syndrome (RDS) were randomly assigned to be administered either poractant alfa or beractant, prospectively. Serial LUS scans were obtained by an experienced neonatologist in a standardized manner before and after (2 and 6 hours) surfactant administration. The LUS scans were evaluated by protocols based on scores and lung profiles. Results Thirty-seven infants received poractant alfa and 36 received beractant. The baseline characteristics and presurfactant LUS scores were similar in groups. The scores were significantly decreased after surfactant administration in both groups (2 hours, p = < 0.001; 6 hours, p = < 0.001). LUS scores in poractant group were significantly lower than beractant group when compared at each time point. At the end of 6 hours, the number of infants with the normal profile was significantly higher in the poractant group (∼65%) than the beractant group (22%). Conclusion LUS is beneficial for evaluating lung aeration after surfactant treatment in preterm infants with RDS. A better lung aeration can be achieved in the early period with the use of poractant alfa.