Is it necessary to give calcium infusion during the exchange transfusion in newborns?

OBJECTIVES: We aimed to evaluate total serum calcium (TSC) and ionized serum calcium (ISC) levels and their effects on clinical outcomes in neonates underwent exchange transfusion (ET). METHOD: In this study, the data of newborn infants who underwent ET due to hyperbilirubinemia in a third level neonatal intensive care unit (NICU) were retrospectively analyzed. The patients were monitored by electrocardiogram during ET. Cardiac and respiratory rates, peripheral oxygen saturation, blood pressure values ​​and clinical findings as convulsion, tremor, hypertonia, laryngospasm, cyanosis and apnea were recorded in ET observation forms. The infants with no symptoms of hypocalcemia during the procedure were not routinely given IV calcium gluconate. TSC and ISC measured at the beginning, at the end and 24 h after the end of ET were evaluated retrospectively. RESULTS: Data of 36 newborn patients were evaluated. Median gestational age was 39 (35-40) weeks, mean birthweight was 2840 ± 841 (mean ± SD) grams. During the ET, desaturation was observed in five patients(13.9 %), sinus bradycardia in six(16.7 %), tachypnea in two(5.5 %), sinus tachycardia in one(2.8 %), and rare ventricular extrasystoles in one(2.8 %). Hypocalcaemia was not detected in any of the patients at the beginning of ET. Hypocalcemia was observed in two cases (5.5 %) at the end of ET. There was no statistically significant difference between the TSC and ISC levels at the beginning of ET, at the end and at the end of 24 h. CONCLUSION: As a result, routine intravenous (IV) calcium administration seems to be unnecessary provided that vital signs and neurological status are closely monitored during ET.

Comparison of the adherence of E.Coli and S. Aureus to ten different prosthetic mesh grafts: In vitro experimental study.

BACKGROUND: The prosthetic mesh grafts used to repair the abdominal wall may become infected, primarily by S. aureus and E. coli. This study sought to provide a rational basis for the choice of mesh used to repair a hernia when there is a likelihood of infection or contamination. METHODS: S. aureus and E. coli were incubated with ten types of prosthetic mesh graft (Table 1) in liquid growth medium. After sequential dilution of samples from the prosthetic mesh grafts, the colony forming units of adherent S. aureus and E. coli were counted. RESULTS: There was no significant difference in the numbers of E. coli and S. aureus adherent to simple polypropylene mesh grafts. Significantly more of both species were adherent to the polyester, expanded polytetrafluoroethylene (ePTFE), and composite prosthetic mesh grafts, except for E. coli on graft 5. Significantly fewer E. coli were adherent to composite mesh grafts 5, 8, and 10 than S. aureus. CONCLUSION: S. aureus and E. coli adhere to polypropylene similarly. In vitro, fewer S. aureus and E. coli adhere to simple polypropylene mesh grafts than to polyester, ePTFE, or composite prosthetic mesh grafts.