Assessing hypoxic respiratory failure in mechanically ventilated neonates: A comparative study of oxygen saturation index and oxygenation index.

OBJECTIVE: To investigate the correlation between oxygen saturation index (OSI) and oxygenation index (OI) for evaluating the blood oxygenation status in neonates with respiratory failure requiring mechanical ventilation support and to assess the predictive capability of OSI in determining clinically relevant OI cutoffs. METHODS: A prospective study was conducted on neonates who received invasive mechanical ventilation at the neonatal intensive care unit of tertiary hospital in Vietnam. Bland-Altman analysis was utilized to evaluate the agreement between OSI and OI. RESULTS: A total of 123 neonates, including both term and preterm infants, were included in the study. A high agreement rate of 94.3% within the 95% limits of agreement (between OI and OSI), with a narrow similarity value of 3.3 (95% CI: -5.1 to 11.8) and high correlation coefficient (r = 0.791, p<0.001) was observed. The OSI cut-off value for predicting an OI of >15 was determined to be 7.45, with a sensitivity of 100% and a specificity of 87.4% (AUC 0.955; 95% CI: 0.922-0.989, p < 0.05). Similarly, an OSI cutoff value of 9.9 corresponded to an OI of 25, displaying a sensitivity of 100% and specificity of 87.4% (AUC 0.92). The receiver operating characteristic (ROC) curves for OSI exhibited statistically significant results (p < 0.05). CONCLUSION: The findings demonstrate a strong correlation between OSI and OI in neonates with respiratory failure. Furthermore, OSI, as a non-invasive method, can serve as a substitute for OI to evaluate the severity of hypoxic respiratory failure and lung injury in neonates.

Main Clinical and Laboratory Features of Children with Bacterial Meningitis: Experience from a Tertiary Paediatric Centre in Central Vietnam.

Objective: Our study aimed to summarize symptoms and laboratory findings of bacterial meningitis at a Vietnam tertiary care hospital. Methods: We performed a retrospective study and enrolled 33 children diagnosed with bacterial meningitis admitted at the Pediatric Center, Hue Central Hospital, between January 2019 and July 2021. Results: Only 24.2% (8 out of 33) cases can determine etiology of bacterial meningitis. Streptococcus pneumonia was the most common pathogen. The mortality in this study was 12.1%. The most commn symptoms were fever (93.9%) and vomiting (60.6%). Loss of consciousness and poor appetite were predominant among patients who died (75%); seizures and local paralysis accounted for a half. For cerebrospinal fluid (CSF), the cloudy or turbid color was the most common in bacterial meningitis (54.5%), CSF leucocytes in a half of patients were greater than 500 cells/mm3 (48.5%). CSF white blood cells count was higher among children who died. Conclusion: Streptococcus pneumonia was the most common pathogen. Fever, vomiting, loss of consciousness, local paralysis, and increased leucocytes, neutrophils of CSF were more common in severe cases.

Is Serum Lactate a Good Predictor of Mortality in Children Aged 2 Months to 5 Years With Pneumonia in Central Vietnam.

Pneumonia is a major cause of morbidity and mortality in children globally. Lactate, a product of anaerobic cellular metabolism, has been used as an indicator of poor tissue oxygenation and cellular hypoxia. Our objective was to determine whether serum lactate concentration at hospital admission predicted mortality in children aged 2 months to 5 years with pneumonia. Two hundred and eighty-one pediatric patients admitted to the Department of Pediatrics of a provincial hospital with WHO-defined pneumonia and severe pneumonia were included; of whom, 8 died during hospital stay. The median serum lactate concentration was 4.8 mmol/l (IQR 2.6-6.9) among children who died and 3.6 mmol/l (IQR 2.8-4.3) among children who survived (P > .05); 4.1 mmol/l (IQR 2.7-4.7) among children with severe pneumonia and 3.5 mmol/l (IQR 2.8-4.3) among children with pneumonia (P > .05). Serum lactate concentration had a low value in predicting pneumonia-related mortality (AUC 0.68, 95% CI 0.62-0.73); and the concentration cut-off of >4.06 mmol/l had the best sensitivity and specificity (75% and 68.9%, respectively) with a 2.4-fold risk of death (LR+ 2.4; 95% CI 1.6-3.7). Although hyperlactatemia was associated with severity and mortality in children 2 months to 5 years of age with pneumonia, its benefit was unclear.