Abstracts

bmjpo: first published as 10.1136/bmjpo-2021-RCPCH.59 on 18 April 2021. Downloaded from http://bmjpaedsopen.bmj.com/ on January 28, 2023 by guest. Protected by copyright.
100 COMPARISION OF EFFECT OF DRY CORD CARE VERSUS Abstract 100 Table 2 Comparision of cord separation time and
CHLORHEXIDINE CORD CARE ON CORD SEPARATION umbilical sepsis
TIME IN HEALTHY NEWBORNS
Dry cord care Chlorhexidine P value
Rydam Basnet, Sunil Raja Manandhar, Anwesh Bhatta, Rakesh Kumar Shah, Ritika Basnet.
Nepal Number 256 258
Cord separation in days 7.70±1.2 (range 3–15) 7.77±1.4(range 4–18) 0.759
10.1136/bmjpo-2021-RCPCH.58 Omphalitis 0 0

Background Umbilical cord infection (omphalitis) is a major

cause of neonatal mortality and morbidity in developing coun-
try like Nepal. Detached umbilical stump is an important colo- The key clinical and epidemiologic features of the two
nizing site for different types of bacteria and it also provides study groups are shown in table 1.
direct access to blood stream. Inadequate cord care may lead Both groups were comparable. mean cord separation time
to omphalitis as well as neonatal sepsis. This study compares in dry cord care group was 7.70±1.2 days, and in chlorhexi-
2 cord care regimens. dine group it was 7.77±1.4 days. There was no significant
Objectives General: To compare two different cord care regi- difference between these two regimens. None of the newborns
mens (dry cord care vs chlorhexidine) developed umbilical sepsis.
Specific: Conclusions There was no significant difference between the
• To evaluate the cord separation time in both regimens. cord separation times in both cord care regimens. Both dry
• To find out the incidence of omphalitis cord care and chlorhexidine cord care regimens were found
Methods Comparative observational study carried out in over to be safe and effective.
a three month period of August 2019 to October 2019 in a
tertiary hospital after receiving ethical clearance.
Study population consisted of healthy neonates born 103 COMPARATIVE ANALYSIS OF VITAL CAPACITIES OF
between 37 -42 weeks. Consent was taken from parents. ATHLETES, SINGERS AND OTHER STUDENTS OF AGE
Babies admitted to NICU, with any umbilical disorders or 13–14 YEARS- A CROSS-SECTIONAL, OBSERVATIONAL
requiring umbilical catheterization were excluded. STUDY
Babies were randomized in two groups dry cord care
Seher Taneja, Jyoti Bose. India
(group I) and chlorhexidine care (group II) via computer gen-
erated numbers. In group I after delivery, umbilical cord was 10.1136/bmjpo-2021-RCPCH.59
kept dry and nothing was applied. In group II 4% chlorhexi-
dine gluconate gel was applied once on the umbilical cord Background Oxygen is vital for all bodily functions. Larger
immediately after cutting. the vital capacity, more efficiently the body can distribute oxy-
In both the groups parents were counseled to avoid unhy- gen. A survey observed that more than a third of school chil-
gienic cord care practices. dren in four big cities of India suffer from reduced lung
Sample size : 280 capacity, with Delhi showing the worst results. Poor air quality
Personal data of the mother and the newborn’s were has been implicated for it.
recorded. A questionnaire was administered on regular neona- Objectives With the hypothesis that playing sports and devel-
tal follow up at well baby clinic or by phone on 15 days of oping hobbies like singing could improve vital capacity and
life. ability to tolerate air pollution, we compared the vital capaci-
256 babies enrolled in group I as 24 babies did not follow ties of athletes, singers, and other students of 13–14 years
up and 258 babies were enrolled in group II as 22 babies with the objective of correlating the effect of exercise and
were lost to follow up. singing on the pulmonary functions.
Results 730 babies were delivered over three months period Methods The study was conducted over a period of 3 months
and 514 babies were enrolled. Among them 313 (60%) males. in Springdales school on a sample size of 60 students divided
Mean birth weight - 3057±443 grams, mean gestational in 3 groups of 20. Equal numbers of boys and girls of same
age - 38.63±1.0 weeks, Mean maternal age - 27.2 years. age group were taken. Vital capacity of following groups was
measured by Student’s spirometer
Group A: athletes who have been actively participating in
Abstract 100 Table 1 Showing basic demographics sports over the last one year,
Dry cord care Chlorhexidine P value Group S : singers who have been a part of the school
group group choir over the last one year,
Group Non AS non-athletes, non singers.
Number of participants 256 258 After taking Informed consent and brief history, weight,
Birth Weight in gram(mean ±SD) 3048.75±453 3066.78±434 0.795 height and vital capacity were measured. Quantitative variables
Gestational age at birth weeks 38.67±1.0 38.59±1.0 0.312 were compared using unpaired t-test/Mann-Whitney Test and
Male 148(57.8%) 165(64%) 0.175 qualitative variables using Chi-Square test/Fisher’s exact test.
Female 108(42.2%) 93(36%) Univariate linear regression was used to identify significant
Vaginal delivery 101 (39.5%) 116 (45%) 0.212 factors affecting lung capacity. A p-value of less than 0.05 was
Caesarean section 155 (60.5%) 142 (55%) considered statistically significant.
Maternal age (years ) 27.04±3.2 27.44±3 0.103 Results Anthropometric data was matched with spirometric
Primiparous 139 (54.3%) 132(51.2%) 0.481 parameter. Athletes (3452.5±696.7 cm3) and singers (3015
Multiparous 117(45.7%) 126(48.8%) ±346.83 cm3) had significantly higher vital capacity than the
control group (2625±543.74 cm3). The vital capacities of

A30 BMJ Paediatrics Open 2021;5(Suppl 1):A1–A132

 Abstracts

bmjpo: first published as 10.1136/bmjpo-2021-RCPCH.59 on 18 April 2021. Downloaded from http://bmjpaedsopen.bmj.com/ on January 28, 2023 by guest. Protected by copyright.
Abstract 103 Table 1 Vital capacity of athletes, singers and non athlete non singers
Group A Group p value Group S Group Non AS p value
Non AS

Mean ±SD Mean ±SD Mean ±SD Mean ±SD

Vital Capacity(ml) 3452.5 696.7 2625 543.74 0.0002* 3015 346.83 2625 543.74 0.01*

pressuring the manometer would result in accurate cuff pres-

Abstract 103 Table 2 Univariate linear regression for factors sure readings enabling detection of dangerously high pressures.
affecting vital capacity Methods An airway model was intubated with Halyard size
Unstandardized Coefficients P value 95% Confidence interval for B 3.0 micro-cuff ETT. Using a commercially available manome-
ter, a three way tap and syringe the cuff was inflated to a set
B Std. Error Lower Bound Upper Bound
pressure in increments of 1 cm H2O between 0 and 40 cm
Age (yrs) 205.000 174.025 .244 143.349 553.349 H2O. The manometer was then connected to the pilot bal-
Height 36.450 16.800 .034 2.821 70.079 loon to check the pressure using 3 methods:
Weight 16.297 13.464 .231 43.248 10.654 Control 1) Manometer connected directly to the pilot bal-
Overweight 245.833 166.344 .145 578.807 87.140 loon (no tubing used therefore pressure in the system = 0 cm
Group H2O)
Non AS Control 2) Manometer connected to the pilot balloon via
Athletes 827.500 197.617 .0002 427.446 1227.554 extension tubing with 3 way tap and syringe in circuit (pres-
Singers 195.000 72.106 .010 49.028 340.972 sure in tubing and manometer system = 0 cm H2O)
Sex Test 3) Manometer connected to the pilot balloon via
Female extension cable with 3 way tap and syringe in circuit with the
Male 331.667 160.210 .043 10.972 652.361 entire circuit pre-pressurised to 20 cmH2O before connecting
Set-up 2) was used as a control to show how the tubing
and 3 way tap affected the readings. For each method three
measurements were performed at every 1 cm H2O increment
athletes and singers were also significantly different. Non-ath- and the average reading was taken.
letes non-singers had a significantly higher body mass index Results Using method 1 the average manometer reading was sig-
(23.87±2.35 kg/m2) as compared to athletes (20.66±1.52 kg/ nificantly lower than the pre-set cuff pressure for example pre-
m2) and singers (22.6±1.84 kg/m2). Univariate linear regres- set pressures of 20 & 40 cm H2O read only 5.3 and 8 cm
sion demonstrated that male gender and height significantly H2O respectively. Using method 2 the average readings dropped
affected lung capacity. even further from the pre-set pressure. Using method 3 with the
Conclusions In conclusion, encouraging regular exercise and manometer pre-pressurised to 20 cm H2O the reading dropped
singing in children improve vital capacity. Children are most if the cuff pressure was £19 cm H2O and increased if the cuff
susceptible to the harmful effects of air pollution. Opting for pressure was 21 cm H2O. A pre-set pressure of 0 gave a read-
a healthy lifestyle may be an effective strategy to deal with ing of 11 cm H2O, 10 read as 17.7 cm H2O, 30 read as 20
the menace of air pollution. cm H2O and 40 read as 21.3 cm H2O.
Conclusions The results indicate that the intervention of con-
necting a manometer renders the reading inaccurate. This dis-
parity is due to the dead space in the manometer and also
104 MONITORING ENDOTRACHEAL TUBE CUFF PRESSURES
the tubing as shown by the lower readings from method 2.
IN PAEDIATRIC CRITICAL CARE – ARE DANGEROUSLY
The hypothesis of filling the dead space by pre-pressurising
HIGH PRESSURES GOING UNDETECTED?
the manometer system did not result in more accurate read-
Rory Sweeney, Brendan Kelly, Christopher Flannigan. UK ings as the pressure merely equalised across the system. There-
fore the only way to ensure cuff pressures are not
10.1136/bmjpo-2021-RCPCH.60 dangerously high is to deflate the cuff and use the 3-way tap
system or cuff inflator to inflate to a safe pressure.
Background The use of cuffed endotracheal tubes (ETTs) in
paediatric critical care has become widespread with the devel-
opment of high volume – low pressure cuffs which require
significantly lower sealing pressure than traditional ETTS. 108 ACTIONABLE PHARMACOGENETIC VARIANTS IN HONG
There remains a risk of over inflation which can impair tra- KONG CHINESE EXOME DATA AND PROJECTED
cheal capillary perfusion causing pressure necrosis of the sur- PRESCRIPTION IMPACT IN THE HONG KONG
rounding fragile epithelium potentially resulting in permanent POPULATION LEADING TO PRECISION MEDICINE
upper airway damage such as sub-glottic stenosis. Cuff pres-
Mullin Yu, Brian Chung, Marcus Chan, Kit San Yeung, Clara Tang, Claudia Chung. Hong
sure can vary over time therefore careful monitoring is vital
Kong
to ensure the pressure remains within a safe range.
Objectives Connecting a manometer to the pilot balloon is 10.1136/bmjpo-2021-RCPCH.61
one method to monitor cuff pressure. A prior study demon-
strated that connecting a manometer caused a drop in pres- Background Pharmacogenetics is the study of variability in
sure giving a falsely low readings. We hypothesised that pre- drug response caused by genetic variations. It is estimated that

BMJ Paediatrics Open 2021;5(Suppl 1):A1–A132 A31