DALLAS – Oct. 19, 2022 – New research from pediatricians at UT Southwestern and Children’s Health reveals the impact of COVID-19 on children’s mental health. Separately, a study funded by 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 during the resuscitation of premature babies.
Dr Jacqueline Bolt
COVID-19 and mental health
A study led by Dr Jacqueline Bolt, a UTSW pediatric emergency medicine fellow, examined how patterns and outcomes of pediatric mental and behavioral health (MBH) visits to the Emergency Department (ED) at Children’s Medical Center Dallas changed before the pandemic and after. that started. Dr. Bolt and her colleagues collected electronic medical record information from patients who visited the ED from March to September between 2017 and 2019 to study trends before the pandemic, and then compared the same time between 2019 and 2020.
The researchers report in pediatric emergency care that ER visits for pediatric MBH increased gradually in the years before the pandemic, mirroring national trends. Although overall MBH emergency department visits decreased in 2020, the proportion of total visits increased by 42.8%. Demographic groups with the highest increase in MBH visits included females, adolescents 15 to 17 years old, and non-Hispanic patients. Pediatric patients presenting to the emergency department in 2020 for MBH treatment were significantly more likely to be admitted or transferred for inpatient psychiatric care than in previous years.
“These findings highlight specific areas in pediatric MBH care that may benefit from targeted interventions,” said Dr. Bolt. “Future research is needed to investigate longer-term trends as well as effective prevention and intervention strategies.”
Other UTSW and Children’s Health researchers who contributed to the study include Faisalmohemed Patel, Laura Stone, Divya Pandian, Matthias Manuel and Nakia Gaines.
Oxygen and premature babies
Dr Vishal Kapadia
The NICHD grant will fund a multicenter randomized controlled trial in premature infants that will be led by Dr Vishal Kapadia, Associate Professor of Pediatrics at UT Southwestern. It is based on a pilot study conducted at UTSW that tested the optimal target oxygen saturation range that decreases oxygen toxicity and allows the lungs of vulnerable premature infants to better adapt to the environment outside the womb.
Dr. Kapadia explained that extra oxygen is often needed to maintain normal blood oxygen levels in extremely premature babies at birth because their lungs are not well developed. Excessive oxygen use at birth has been linked to oxygen toxicity, which can lead to injury to immature organs, including the lungs and brain. Using too little oxygen at birth can lead to respiratory failure and organ damage due to low oxygen levels in the blood.
To achieve this balance, the National Neonatal Resuscitation Program guidelines recommend that resuscitation begin with low levels of an air-oxygen mixture and that the oxygen level be adjusted to achieve target blood oxygen levels. These levels are based on expert opinion and data from healthy full-term infants who likely did not receive delayed cord clamping. Recent research suggests that healthy full-term babies who undergo delayed 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 for premature infants, which will reduce oxygen toxicity and allow infants’ lungs to better adapt to environments outside the home. uterus. The pilot study in 75 premature infants born at Parkland Memorial Hospital showed that when administered oxygen was adjusted to achieve higher than currently recommended blood oxygen levels (similar to healthy full-term infants undergoing delayed clamping of the cord), these newborns began to breathe more rapidly; reached a heart rate greater than 100 beats per minute earlier; had better cerebral oxygenation; suffered less oxidative stress; and were more likely to survive without chronic lung disease compared to those with currently recommended blood oxygen levels.
The new study led by Dr. Kapadia aims to verify these findings in a much larger sample of 800 premature babies delivered at medical centers across the country.
“This research has the potential to transform delivery room management of preterm infants worldwide and provide a simple and inexpensive way to reduce death and lung disease in this population,” said Dr. Kapadia.
About UT Southwestern Medical Center
UT Southwestern, one of the nation’s leading academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes and includes 24 members of the National Academy of Sciences, 18 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute investigators. The full-time faculty of more than 2,900 is responsible for groundbreaking medical advances and is committed to rapidly translating science-driven research into new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 100,000 hospital patients, more than 360,000 emergency room cases, and oversee nearly 4 million outpatient visits annually.
