Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)
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Central venous catheter (CVC) insertion in neonates and small infants is a challenging and high risk procedure. Ultrasound (US) guided cannulation increases the success rate and reduces procedural-related complications. The internal jugular vein is the most frequent site for US-guided CVC insertion. However this approach is technically demanding in neonates and small infants. US-guided supraclavicular cannulation of the brachiocephalic vein (BCV) is a new approach that may be advantageous in case of difficult central venous catheterization. We present our preliminary experience with this technique in a case series of neonates and small infants. ⋯ The US-guided supraclavicular approach to the BCV is a feasible and safe alternative in neonates and very small infants. More studies are needed to define the role of this new venous access before its routine application in daily practice.
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It is well known that some symptoms in children with ventriculoperitoneal shunt are associated with a higher risk of developing shunt malfunction. However none of those symptoms are sensitive or enough specific enough to diagnose the shunt malfunction. ⋯ A diagnostic scale is designed for assessing the risk of shunt malfunction, selecting those patients with a higher risk. The use of this scale could help the management of these patients, reducing complementary tests, as well the usual radiation suffered by these children.
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An analysis is presented of delivery room (DR) neonatal resuscitation practices in Spanish hospitals. ⋯ There is an improvement in some practices of neonatal resuscitation. Significant differences have been found as regards the equipment or practices in the DR, when comparing hospitals of different levels of care.
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Comparative Study
[Pulse oximetry versus electrocardiogram for heart rate assessment during resuscitation of the preterm infant].
Heart rate (HR) assessment is essential during neonatal resuscitation, and it is usually done by auscultation or pulse oximetry (PO). The aim of the present study was to determine whether HR assessment with ECG is as fast and reliable as PO during preterm resuscitation. ⋯ Reliable HR is obtained later with the PO than with the ECG during preterm resuscitation. PO underestimates HR in the first minutes of resuscitation.