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Objectives: In anticipation of increasing rates of bronchiolitis post-easing of Covid restrictions, the UK began "respiratory surge planning". We compared bronchiolitis admissions prior-to (pre-31 March 2020) and peri-pandemic (post 1 April 2020), with the hypothesis of increased severity and volume. Method(s): Retrospective cohort study of infants aged 0-6 months admitted to a UK DGH from 1 April 2016 to 31 January 2022 comparing winter and summer periods. 535 infants met inclusion criteria (mean age 83.5 +/- 31 days). Primary outcome measures: length of stay (LOS), heated-humidified high-flow nasal cannulae oxygen (HHHFNC) use and PICU retrieval. RSV and Covid status were recorded. Parametric data was analysed with Student's t-test. Non-parametric data was evaluated with Chi-square test. pvalues <0.05 were deemed statistically significant (CI 95%). Result(s): Pre-pandemic 92% (408/442) of cases occurred in the winter compared to 61% (57/93) peri-pandemic. Winter mean LOS pre- and peri-pandemic were 2.47+/- 2.2 and 1.89 +/- 2.0 days respectively (p=0.047). Summer mean LOS for pre- and peri-pandemic were 2.62 +/-2.0 and 2.28 +/- 1.8 days respectively (p=0.47). The annual mean LOS pre- and peri-pandemic were 2.48 +/- 2.15 and 2.04 +/- 1.9 days respectively (p=0.05). There was no significant difference in HHHFNC use, with 21% and 22% pre- and peri-pandemic respectively (p=0.84). PICU retrievals were zero to five per 6-months, with no distinct trends. Conclusion(s): We found dramatic decreases in bronchiolitis admissions from April 2020 with a summer spike in 2021;but no overall difference in severity. LOS was shorter peri-pandemic. This may help future service planning.
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Objective: Pneumonia is an important disease that causes sepsis in newborns and constitutes the majority of deaths due to infections, especially in developing countries. Pulse oximeters that are widely used in clinics, can determine heart rate, arterial oxygen saturation, additionally perfusion index (PI). In this study, the role of PI in determining the severity and prognosis of the disease in newborns with late-onset pneumonia (LOP);the relationship between PI and respiratory support need and Silverman Anderson Retraction Score (SAS) were aimed to determine. Material(s) and Method(s): In this prospective study, 30 term newborns diagnosed with late-onset pneumonia (LOP) were at the time of hospitalization,at the 24th hours of their treatment, and discharge;in the control group, PI measurements were made from the right upper extremity every 10 seconds for 3 minutes at the discharge of 30 term healthy newborns between December 2017 and June 2018. By comparing the data, it was aimed to determine the relationship of PI with the severity of the disease, prognosis, need for respiratory support and Silverman Anderson Retraction Score (SAS). Result(s): Their mean birth weights was 2000 - 4600 g the mean was 3570 g in the study, 2800 - 4100 g the mean was 3610 g in the control group and there was no significant difference (p>0.05);Gestational ages were 365/7 - 413/7, mean 392/7 in the study group, 373/7 - 405/7 in the control group, mean 396/7 weeks, and the statistical difference between the groups was not significant (p>0.05). The ratio of female/male was similar in the groups. Their median age was 9.5 days (3-27) in the control, 21 days (5-28) in the study group, and higher in the study group (p<0.05). The median capillary refill time was 1.7 seconds in the control, 1.6 seconds in the study group, and similar between the groups. The mean PI was 2.3+/-0.9 in the control group. In the study group, it was 3.6+/-1.2 on hospitalization, 3.2+/-1.2 on the first day, 3.4+/-0.7 at discharge. In the study group, PI values on hospitalization and first day were higher (p<0.05). There were reticular infiltration 50% bilateral, 30% right paracardiac, 10% left paracardiac, 3.3% right lower lobe. Alpha hemolytic streptococci in 1 (3.3%), Acinetobacter iwoffii in 1 (3.3%), Respiratory syncytial virus 6 (20%), Coronavirus 4 (13.3%), Rhinovirus 2 (6.7%) and Influenza A 1 (3.3%) patient were determined. We applied free flow oxygen 17 (56.7%), oxygen by hood 5 (16.7%), heated humidified high-flow nasal cannula 1 (3.3%), nasal continuous airway pressure 4 (13.3%), nasal intermittent positive pressure ventilation 4 (13.3%) cases. PI was higher in the patients needing positive pressure on admission (p<0.05). A positive correlation was found between SAS and PI on admission in the study group (p=0.008). The number of patients whose PI decreased during hospitalization increased over time. Conclusion(s): In the neonates with LOP, the severity of the disease, the need for respiratory support and prognosis cannot be predicted by PI. There was no relation between SAS and PI. It was concluded that more accurate results can be achieved by measuring PI using more patients, more sensitive probes and technically more advanced monitors. New studies should be conducted to determine the role of PI in demonstrating well-being and early detection of life-threatening conditions in the healthy newborns. Copyright © 2022 Ankara Pediatric Hematology Oncology Training and Research Hospital. All rights reserved.
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SESSION TITLE: COVID-19 Case Report Posters 2 SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: The SARS-CoV-2 pandemic spawned the use and study of novel therapeutics, re-purposed drugs, and interventions– all with limited success. Seraph® 100 Microbind Affinity Blood Filter® [Seraph®] is an investigational device that was given Emergency Use Authorization (EUA) by the Food and Drug Administration in 2019 to treat severe coronavirus disease. Higher viremia is correlated with higher mortality. Seraph® uses extracorporeal filtration to aid the innate immune system by reducing viral load and mitigating downstream effects of inflammation. CASE PRESENTATION: A forty-eight year old gentleman presented to the emergency room with coughs and fever of 101° F. He tested positive via polymerase chain reaction [PCR] testing for SARS-CoV-19 pneumonia. A computed-tomography angiogram [CTA] of the chest was negative for pulmonary embolism, but demonstrated significant bilateral ground-glass opacities consistent with viral pneumonia. Vitals were notable for an oxygen saturation of 69% on room air that improved to 96% on 6 liters/minute [L/min] of supplemental oxygen via nasal cannula. He was initiated on both dexamethasone and remdesivir. Within hours, the patient's oxygen requirements escalated to 15 L/min via non-rebreather to high flow humidified nasal cannula with a flow rate of 40 L/min and 60% FiO2. On day three, he was transferred to the ICU for treatment with Seraph®. After one treatment, the patient was weaned from high flow humidified nasal cannula to room air. On day five, after a second treatment, he transferred to the floor. He was discharged on day six, on room air, having completed his course of remdesivir, with an additional 5 days of oral steroids. DISCUSSION: Preliminary data regarding Seraph® remain limited with only select eligible patients undergoing therapy. Cases like our patient demonstrate dramatic improvements with even one or two treatments which correlate well with data that show up to 99% reduction in the bloodstream of targeted pathogens per pass. While database collection data have revealed trends towards improved outcomes, further investigation into populations most likely to benefit from treatment is needed. Timing, immunocompromised status and other comorbidities that raise or lower the chances of successful hemofiltration need to be considered. CONCLUSIONS: Studies in the SARS-CoV-2 pandemic augment ongoing research as filtration devices are used to target bacterial infections, cytokines and inflammatory markers. Since the invention of antibiotics, multi-drug resistant organisms have increased in prevalence. Novel interventions such as Seraph® warrant investigation to prevent infectious diseases from becoming unmanageable threats. Reference #1: Kielstein JT, Borchina DN, Fühner T, Hwang S, Mattoon D, Ball AJ. Hemofiltration with the Seraph® 100 Microbind® Affinity filter decreases SARS-CoV-2 nucleocapsid protein in critically ill COVID-19 patients. Crit Care. 2021;25(1):190. Published 2021 Jun 1. doi:10.1186/s13054-021-03597-3 Reference #2: Pape A, Kielstein JT, Krüger T, Fühner T, Brunkhorst R. Treatment of a Critically Ill COVID-19 Patient with the Seraph 100 Microbind Affinity Filter. TH Open. 2021;5(2):e134-e138. Published 2021 Apr 14. doi:10.1055/s-0041-1727121 Reference #3: Schmidt JJ, Borchina DN, van T Klooster M, et al. Interim-analysis of the COSA (COVID-19 patients treated with the Seraph® 100 Microbind® Affinity filter) registry [published online ahead of print, 2021 Dec 7]. Nephrol Dial Transplant. 2021;gfab347. doi:10.1093/ndt/gfab347 DISCLOSURES: No relevant relationships by Aneesa Afroze No relevant relationships by Lydia Meece No relevant relationships by Angela Park