Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)
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Since previous publication in 2005, the most significant changes that have been addressed in the 2010 International Liaison Committee on Resuscitation (ILCOR) recommendations are as follows: (i) use of 2 vital characteristics (heart rate and breathing) to initially evaluate progression to the following step in resuscitation; (ii) oximetry monitoring for the evaluation of oxygenation (assessment of color is unreliable); (iii) for babies born at term it is better to start resuscitation with air rather than 100% oxygen; (iv) administration of supplementary oxygen should be regulated by blending oxygen and air; (v) controversy about endotraqueal suctioning of depressed infants born through meconium-stained amniotic fluid; (vi) chest compression-ventilation ratio should remain at 3/1 for neonates unless the arrest is known to be of cardiac etiology, in which case a higher ratio should be considered; (vii) use of therapeutic hypothermia for infants born at term or near term evolving to moderate or severe hypoxic-ischemic encephalopathy, with protocol and follow-up coordinated through a regional perinatal system (post-resuscitation management); (viii) cord clamping delay for at least 1 minute in babies who do not require resuscitation (there is insufficient evidence to recommend a time for clamping in those who require resuscitation) and, (ix) it is appropriate to consider discontinuing resuscitation if there has been no detectable heart rate for 10 minutes, although many factors contribute to the decision to continue beyond 10 minutes. Under certain circumstances, non-initiation of resuscitation could be proposed taking into consideration general recommendations, own results and parents' opinion.
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To analyse the efficacy and tolerance of non-invasive mechanical ventilation (NIMV) via high-flow oxygen therapy nasal cannulae in children after withdrawal of mechanical ventilation and/or with moderate respiratory insufficiency. ⋯ Non-invasive mechanical ventilation via high-flow oxygen therapy nasal cannulae is effective and well tolerated in a high percentage of children after withdrawal of mechanical ventilation or with moderate respiratory insufficiency.
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Multicenter Study Clinical Trial
[Safety and effectiveness of nitrous oxide for sedation-analgesia in emergency departments].
⋯ Administration of nitrous oxide achieves proper sedation and analgesia during painful procedures, especially in children older than 5 years. Adverse events reported were few, mild and expected. Most parents would accept its use again in a similar situation.
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Clinical Trial
[Safety and efficacy of continuous infusion propofol for diagnostic upper gastrointestinal endscopy in spontaneous breathing].
Invasive procedures (IP) are an important reason for admision to PICU. Paediatric patients need a special anaesthetic approach and deep sedation is frequently required. The objective was to evaluate the safety and efficacy of continuous infusion propofol to achieve sedation for diagnostic upper gastrointestinal endoscopy (UGE) in spontaneous breathing. ⋯ Continuous propofol infusion seems to be both effective and safe to achieve sedation for diagnostic upper gastrointestinal endoscopy in spontaneously breathing.