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 Structured light plethysmography (SLP) is a novel and noncontact respiratory assessment technique. It provides tidal breathing measurement in patients difficult to cooperate. In this study, we aimed to determine data for tidal breathing parameters measured by SLP in newborns. Study Design Infants between 2 and 5 days of life without having any respiratory symptoms were eligible for this observational study. In total, 5 minutes of tidal breathing was recorded using SLP (Thora-3Di, PneumaCare Ltd, Cambridge, U.K.) in each infant. Various tidal breathing parameters including timing indices, flow-based parameters, and regional parameters were obtained from SLP data. Results A total of 57 infants underwent measurements in the study. Evaluable recordings from 42 term and 11 late preterm infants were analyzed. Median gestational age and birthweight of the infants were 38 (37–39) weeks and 3,195 (2,790–3,585) g, respectively. In terms of flow-based parameters, “tidal inspiratory flow at 50% of inspiratory volume divided by tidal expiratory flow at 50% of expiratory volume” was 1.29 (1.13–1.53). Relative contribution of the thorax to each breath in percentage was measured as 38.67 (28.21–43.60). Median values of left–right hemithoracic asynchrony and thoraco-abdominal asynchrony were 6.92 (5.35–9.04) and 17.96 (12.98–36.44) degrees in the study population, respectively. There were no differences in tidal breathing parameters except “hemithoracic asynchrony” between term and late preterm infants. Hemithoracic asynchrony was significantly lower in term neonates than late preterms. Conclusion SLP was found to be feasible to obtain measures of tidal breathing parameters in newborns and it could be performed successfully even in the first days of life.

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