A continuously monitored HRC index provides an objective, noninvasive measure associated with abnormal brain imaging and adverse neurologic outcomes in ELBW infants.

Enteral EES did not decrease reflux events on 24-hour pH-MII at the dose studied. Therefore, it may be ineffective in the treatment of GERD in premature neonates.

Apnea of prematurity often occurs during and following caffeine therapy. We hypothesized that number of apnea events would be impacted by adjustments in caffeine therapy. An automated algorithm was used in all infants ≤32 weeks gestation admitted to a level IV Neonatal Intensive Care Unit from 2009 to 2014 to analyze chest impedance, electrocardiogram, and oxygen saturation data around the time of serum caffeine levels, caffeine boluses while on maintenance therapy, and caffeine discontinuation. Episodes of central apnea/bradycardia/desaturation (ABDs), and percent time with SpO <88% and <75% were measured. ABDs were analyzed in 302 preterm infants (mean gestational age 27.6 weeks) around the time of 485 serum caffeine levels, 90 caffeine boluses, and 273 episodes of caffeine discontinuation. Higher serum caffeine levels were not associated with fewer ABDs or higher heart rate. For caffeine boluses given due to clinically recognized spells, hypoxemia and algorithm-detected ABDs decreased day 1-2 after the bolus compared to the day before and day of the bolus (mean 4.4 events/day after vs. 6.6 before, = 0.004). After caffeine discontinuation, there was no change in hypoxemia and a small increase in ABDs (2 events/day 3-5 days after discontinuation vs. 1 event/day before and >5 days after, < 0.01). This increase in ABDs occurred irrespective of gestational age, respiratory support, or postmenstrual age at the time caffeine was stopped. In this retrospective analysis, caffeine boluses and caffeine discontinuation were associated with a small change in the number of ABD events in preterm infants.

Abstractsblood sample was obtained from each patient the first day of admission, and 48h and 72h hours after admission. S100B levels were measured using ECLIA method (Electro-Chemil-Luminiscence Immuno Assay-Elecsys 2010-Roche Diagnostic). Results The avarage serum S100B levels for the control group (N=48) was 0.12 microgL (-1) (cut-off point). Serum S100B levels were grossly elevated in both HT and NT groups of infants with asphyxia. The differences were statistically significant as follows: a) between the first (24h) and second (day 4) time interval significant at p<0.05; b) between the second (day 4) and third (day 7) time interval significant at p<0,005; c) between the first (24h) and third (day 7) time interval significant at p≤0,001. Serum S100B values were lower in HT (selective head cooling infants) compared to NT infants (p=0.049 at 48 hours). Conclusion Serum S100B levels were lower in the HT group after 72h, and strongly correlated with the neurodevelopment impairment. S100B levels are highly elevated following asphyxia. Serum S100B levels are lowering in the HT and strongly correlate with the early neurodevelopment outcome. CAN LOSS OF SLEEP-AWAKE CYCLICITY AT AEEG PREDICT Background and Aim Intraventricular hemorrhage (IVH) is the most common brain injury in preterm infants. Among infants with IVH 30% develops posthemorrhagic hydrocephalus (PPH).Actually there is no predicting factor for the developing of PPH. We observed if loss of sleep-awake cyclicity, at aEEG evaluation, is predictive for PPH. Methods 6 preterms of gestational age between 25 and 30 weeks were detected for IVH (II degree to IPH) at cerebral ultrasonography. Cerebral background activity was continuously performed by CFM (Brainz US).Results Sleep-awake ciclicity was observed in all 6 infants in the first 24 hours after the detection of IVH. But in 2 of these we noted the loss of cyclicity few days after the diagnosis of the bleeding. These 2 patients developed posthemorrhagic hydrocephalus whereas the other 4 infants didn′t develop PPH. Conclusions Loss of sleep-awake cyclicity, at aEEG, has a high positive predictive value for the developing of PPH in preterm infants with IVH; therefore study of cerebral background activity and in particular of sleep-awake cyclicity can be used as a early prognostic tools in patients at risk of PPH.