New studies by pediatricians at UT Southwestern and Children’s Health show the effect of COVID-19 on children’s intellectual health. In addition, a study funded through a $2. 5 million grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) will investigate the ideal way to use oxygen in the resuscitation of premature babies.
A study led by Jacqueline Bolt, M. D. , UTSW Pediatric Emergency Medicine Fellow, tested how patterns and outcomes of pediatric intellectual and behavioral fitness (MBH) visits to the Emergency Department (ED) at Children’s Medical Center Dallas were replaced before and after the pandemic began. Dr. Bolt and his colleagues collected electronic medical record data from patients who visited the emergency branch from March to September between 2017 and 2019 to examine trends before the pandemic and then the same was between 2019 and 2020.
Researchers report in Pediatric Emergency Care that emergency room visits for pediatric MBH gradually increased in the years leading up to the pandemic, reflecting national trends. While general emergency branch visits for MBH decreased in 2020, the proportion of total visits increased by 42. 8%. The demographic teams with the highest accumulation of MBH visits included women, adolescents aged 15 to 17 years, and non-Hispanic patients. Pediatric patients who came to the emergency arm in 2020 for MBH treatment were particularly more likely to be admitted or transferred for inpatient psychiatric care than in previous years.
These findings highlight express spaces in pediatric HBM care that may benefit from targeted interventions. Future studies are needed to investigate longer-term trends as well as effective prevention and intervention strategies. “
Other researchers from UTSW and Children’s Health who contributed to the event include Faisalmohemed Patel, Laura Stone, Divya Pandian, Matthias Manuel and Nakia Gaines.
The NICHD grant will fund a multicenter randomized controlled trial in premature infants to be led by Vishal Kapadia, M. D. , Associate Professor of Pediatrics at UT Southwestern. It is based on a pilot study conducted at UTSW that tested optimal target oxygen saturation diversity that reduces oxygen toxicity. and allows the lungs of vulnerable premature babies to better adapt to the environment outside the womb.
Dr. Kapadia explained that supplemental oxygen is needed to maintain overall blood oxygen levels in very premature babies at birth because their lungs are not well developed. Overuse of oxygen at birth has been linked to oxygen toxicity, which can cause damage to immature organs. adding the lungs and brain. Too low oxygen use at birth can lead to respiratory failure and organ damage due to low blood oxygen levels.
To achieve this balance, the rules of the National Neonatal Resuscitation Program propose that resuscitation begin with low levels of a combination of air and oxygen and that the oxygen point be adjusted to reach target blood oxygen levels. These levels are based on expert opinion and information from healthy full-term infants who probably did not receive unintended cord clamping. Recent studies suggest that healthy full-term infants who enjoy unplanned cord clamping have higher blood oxygen levels at birth than previously reported.
Dr. Kapadia’s team conducted a pilot study to identify optimal blood oxygen levels at birth in premature babies, which will reduce oxygen toxicity and allow young children’s lungs to better adapt to environments outside the womb. The pilot study of 75 premature infants born at Parkland Memorial Hospital showed that when administered oxygen was adjusted to reach newly advised blood oxygen levels (as were healthy term infants consistent with delayed cord clamping), those newborns began breathing faster; achieved a center frequency greater than one hundred beats in line with the previous minute; had increased cerebral oxygenation; suffered less oxidative stress; and they were more likely to have no chronic lung disease compared to those whose blood oxygen levels are recently recommended.
The new one led by Dr. Kapadia aims to determine those findings in a much larger pattern of 800 premature babies born at medical centers across the country.
“This study has the prospect of monitoring preterm delivery rooms worldwide and offers an undeniable and affordable way to reduce mortality and lung disease in this population,” said Dr. Kapadia.
Southwest UT Medical Center
Bolt, J. , et al. (2022) Impact of COVID-19 on pediatric and behavioral fitness visits in the emergency department. Emergency care pédiatrique. doi. org/10. 1097/PEC. 0000000000002794.
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