Back from Helsinki. The meeting was excellent, with a very high quality faculty, even though I diluted that down a little. I have put my presentation on this website, under ‘presentations from our group’ (link here). I presented on my current favourite topic, how to, and whether, we should treat hypotension in the very immature infant. Feel free to download and use however you feel. I was asked last year for the EAPS meeting in Istanbul to present a review about how to assess perfusion in the newborn. This is the question I am most often (appropriately) asked when I present the opinion that we should be treating poor perfusion, rather than low blood pressure. So that presentation is also available if you are interested.
One of the good thing about the Annual Surfactant Meeting meeting is that they get the invited presenters to write a review article which also gets published. They are handed out as part of the package to guests and then printed in ‘Neonatology’. I decided to write a review article which covered several topics in neonatal hemodynamic management, rather than just hypotension in the preterm, and it is now available. ‘Barrington KJ: Common Hemodynamic Problems in the Neonate. Neonatology 2013;103:335-340.
There are several other excellent reviews. One of which is the review by Ben Stenson of the recent situation with the oxygen saturation targets trials and the current implications of them. Not all of the details of the recent trials are in his paper, as these review articles were submitted before the end of 2012, so they are already a little out of date, with BOOST and COT having now been published. He explained very clearly in his talk the implications of the change in oxygen saturation calibration algorithms during the saturation targeting trials. I understand it all much better now, and it is even more clear than before that we should really be avoiding 85% to 89%.
What was also striking is the new recommendations from a multinational European group were also presented and are printed in ‘Neonatology’. David Sweet, who presented them noted that the previous saturation target recommendations (just 3 years ago) were 85 to 93%! I think this is good ammunition to fight back against the idiots at ‘Public Citizen’ who are recurrently claiming that the study was unethical because the 91% to 95% target range was the ‘more conventional range’. Clearly it wasn’t everywhere.
The new recommendations are to keep saturations between 90% to 95%, the extra 1% at the bottom just to make it more practicable for the nursing staff in routine daily use. Like the rest of these recommendations, this is the best evidence based guideline we can currently make.