Neonatology
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Evaluation of the agreement between axillary temperature measurements and rectal temperature measurements in neonates. ⋯ The mean difference between axillary and rectal temperature shows a wide variation. Axillary temperature measurements cannot be used interchangeably with rectal measurements in neonates.
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Pediatric units, especially neonatal units, are highly vulnerable to error generally and to medication error in particular. Potential failures are distributed across the entire medication process, occurring mostly at the time of medication prescription and during preparation for drug administration. ⋯ Violations of good prescribing practice are common in neonatal units. A simple intervention should improve the quality of handwritten medical prescriptions for newborns admitted to intensive care settings.
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Many clinicians intubate newborns using a stylet, but how many always check if the device is intact after use? We describe a case of endobronchial obstruction by a plastic sheath coating the metal stylet, and suggest ways to reduce the incidence of this serious iatrogenic complication.
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Therapeutic lung lavage is an emerging treatment for meconium aspiration syndrome (MAS), but the ideal fluid volume and lavage technique remain unclear. ⋯ Open suction, vibratory chest squeezing and an aliquot volume of 15 ml/kg each improve the efficacy of lung lavage in MAS, and merit inclusion in the lavage technique in clinical trials of this therapy.
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Several studies have demonstrated the efficiency and safety of mild hypothermia (33 degrees C) used for treating moderate encephalopathy. In animal models, deep hypothermia proved to be neuroprotective. ⋯ The results support the safety of deep hypothermia. Further studies are needed to confirm these results and the neuroprotective effect of this approach.