Role of blood lactic acid in assessing the need for erythrocyte transfusion in healthy preterm infants with anemia of prematurity

The study included 60 healthy preterm infants [26 males and 34 females] with anemia of prematurity during the second week of life. Their gestational age ranged from 28 to 33 weeks. They were selected from the neonatology unit of A1-Hussein University Hospital during the period front June, 1994 to March, 1995. The aim of this work is to evaluate blood lactic acid as an indicator of early tissue hypoxia in identifying the need of blood transfusion to anemic otherwise healthy preterm infants and consequently save unnecessary blood transfusion. The results showed that the infant's body weight at transfusion and the estimated hemoglobin and hematocrit values were significantly increased after blood transfusion. There was a significant decrease in high blood lactate levels after blood transfusion while there was not such a decrease in normal lactate group following red cell transfusion. Moreover, there was a very high significant correlation between high blood lactate group and hematocrit values before and after blood transfusion, while such correlation was not found in nomal lactate group. We can conclude that elevated blood lactate levels is a good indicator to identify the need of anemic otherwise healthy preterm infants to save unnecessary blood transfusion

Evaluation of urinary leukocyte esterase and nitrite tests for diagnosis of bacterial urinary tract infections in the pediatric intensive care unit

This study included 100 infants and children with some urinary tract symptoms who were selected from the pediatric intensive care unit of Al-Hussein University Hospital. The aim of this work is to evaluate the diagnostic performance of the urinary leukocyte esterase and nitrite tests on random urine samples. Also, microscopic urinalysis and urine culture were done to patients with some urinary troubles in the pediatric ICU to provide guidelines for its use. The results showed that the urinary leukocyte esterase test had a sensitivity of 80.36% in detecting leukocyturia [> 10 leukocytes/mm3].The urinary nitrite test had a specifity of 98.01% in detecting bacteriuria. The combination of the urinary leukocyte esterase, nitrite tests and microscopic urinalysis for bacteriuria had a sensitivity of 100%, a specifity of 99.23% and a negative predictive value of 100%. We conclude that, the urinary leukocyte esterase and nitrite tests are rapid screening tests for diagnosis of bacterial urinary tract infections in the pediatric intensive care unit