Impact of the Coronavirus Pandemic on High-Risk Infant Follow-Up (HRIF) Programs: A Survey of Academic Programs.

OBJECTIVE: The impact of the COVID-19 pandemic on the functioning and services of academic high-risk infant follow-up (HRIF) clinics throughout North America. STUDY DESIGN: Prospective 25-question questionnaire survey through REDCAP links that was sent over 10 weeks, to 105 US and 10 Canadian programs. Finally, 59 of 105 US programs and 5 of 10 Canadian responses were analyzed using SAS version 9.4. RESULTS: In the US, 67% of programs reported closures between 1-5 months, whereas in Canada 80% of programs closed for 1-3 months. In the US 86% of programs provided telemedicine visits and only 42.5% provided multidisciplinary HRIF telemedicine visits. We enumerated innovative approaches specifically for the conduct of Telemedicine visits, the need for the standardization of various tests and services in a telemedicine setting, and to emphasize the urgent need for more government funding to improve follow-up and developmental services to this fragile group of newborns.

Discharging Preterm Infants Home on Caffeine, a Single Center Experience.

Background: Apnea of prematurity (AOP) affects preterm neonates. AOP, combined with intermittent hypoxemic (IH) events frequently prolongs the length of stay. Caffeine is the preferred medication to treat AOP and may help improve IH events. There is lack of information on the safety of discharging preterm neonates home on caffeine for AOP in the literature. Our objective was to assess safety and benefits, if any, of discharging preterm infants home on caffeine. Methods: After IRB approval, preterm infants discharged home from the neonatal intensive care unit (NICU) on caffeine were compared with those without a discharge prescription for the period of January 2013 to December 2017. Results: A total of 297 infants were started on caffeine, and of those, 87 infants were discharged home on caffeine. There was no difference in length of stay between two groups. Duration of caffeine at home was 31 (28-42) days. The average cost of apnea monitor and caffeine at home per 30 days was USD 1326 and USD 50. There was no difference in number or reasons for emergency department (ED) visits or hospitalizations between two groups. Conclusion: AOP affects almost all preterm infants and along with intermittent hypoxemic events, and is one of the most common reasons for prolonged hospital stay. Discharging stable preterm infants home on caffeine may be safe, especially in those who are otherwise ready to be discharged and are only awaiting complete resolution of AOP/IH events.

Lactate as a diagnostic test for septic peritoneal effusions in dogs and cats.

Lactate concentration in peritoneal fluid was evaluated and compared to blood lactate concentration in dogs and cats with septic and nonseptic abdominal effusions. All dogs with septic effusions had a peritoneal fluid lactate concentration >2.5 mmol/L and a peritoneal fluid lactate concentration higher than blood lactate, resulting in a negative blood to fluid lactate difference. In dogs, the diagnostic accuracy of the peritoneal fluid lactate concentration and the blood to fluid lactate difference in differentiating septic peritoneal effusion was 95% and 90%, respectively. Peritoneal fluid lactate concentration and blood to fluid lactate difference were not accurate tests for detecting septic peritoneal effusions in cats.