Neonatology
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Acute episodes of hypoxemia in ventilated preterm infants are triggered by changes in ventilation, lung volume (LV) and respiratory system compliance (C(RS)) that are not prevented by conventional synchronized intermittent mandatory ventilation (SIMV). ⋯ In this animal model, targeted V'(E) was effective in reducing hypoxemia caused by apnea. When apnea was accompanied by a reduction in LV and C(RS), the combined adjustment of PIP and ventilator rate was more effective than each individually. This combined strategy may be effective in ameliorating acute episodes of hypoxemia in preterm infants but this remains to be proven.
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Premature infants with lung injury often experience intermittent episodes of hypoxemia. ⋯ Thus, intermittent hypoxic stress during hyperoxic induction of BPD in mice potentiates oxidative stress in lung tissue and exacerbates alveolar developmental arrest.
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Review Meta Analysis Comparative Study
Resuscitation of newborn infants with 21% or 100% oxygen: an updated systematic review and meta-analysis.
The issue of whether 21% O(2) is more effective than 100% O(2) for resuscitation of newborn infants remains controversial. ⋯ There is a significant reduction in the risk of neonatal mortality and a trend towards a reduction in the risk of severe hypoxic ischemic encephalopathy in newborns resuscitated with 21% O(2).
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Historical Article
History of neonatal resuscitation. Part 1: Artificial ventilation.
The construction of manual ventilators by Hunter, Chaussier, and Gorcy seemed to set the stage for artificial ventilation of the neonate at the end of the 18th century. When Leroy d'Etiolles recognized pneumothorax as a complication of ventilation in 1828, the Paris Academy of Science advised against positive pressure ventilation. Indirect techniques like that of Silvester or the Schultze swingings gained widespread acceptance and prevailed until the First World War. Modern ventilators were developed following the poliomyelitis epidemics in the 20th century.
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Review Meta Analysis
A systematic review and meta-analysis of a brief delay in clamping the umbilical cord of preterm infants.
The optimal timing of clamping the umbilical cord in preterm infants at birth is the subject of continuing debate. ⋯ The procedure of a delayed cord clamping time of at least 30 s is safe to use and does not compromise the preterm infant in the initial post-partum adaptation phase.