Seminars in perinatology
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Seminars in perinatology · Dec 2002
Randomized Controlled Trial Clinical TrialHyperoxemia caused by resuscitation with pure oxygen may alter intracellular redox status by increasing oxidized glutathione in asphyxiated newly born infants.
In a prospective, randomized, blinded trial we have studied the effects of resuscitation upon oxygenation in a group of asphyxiated newly born infants receiving room air or 100% oxygen as the gas source. During the acute phase of asphyxia and until the resuscitation procedure concluded, we determined serial blood gases as well as reduced and oxidized glutathione, enzymes involved in the glutathione redox cycle, and antioxidant enzyme activities. ⋯ We hypothesize that hyperoxemia may be 1 of the triggering factors responsible for an increased oxidation of GSH (reduced glutathione). Moreover, an increased antioxidant enzyme activity, which reflects an oxidative stress, indicates that the antioxidant capacity of the newly born infant may have been surpassed.
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Seminars in perinatology · Dec 2002
Comparative StudyThe flow-pressure plot: a new look on the patient-ventilator interaction in neonatal care.
Most modern neonatal ventilators have now a built-in flow sensor and, as a spin-off of their mechanical action, provide some information about lung function characteristics as compliance and resistance after computation of the flow and pressure signals. Additionally, respiratory graphics as volume-pressure and flow-volume plots can be displayed. In clinical practice, however, they are rarely used to refine the ventilator setting. ⋯ This flow-pressure diagram appears to be useful in the real-time computation of respiratory mechanics based on the Rahn's law of respiratory motion. Its major advantage, however, is the easy pattern recognition of subtle changes in infant-ventilator interaction, ie, excessive triggering, fighting against the ventilator, augmented breath, tube subobstruction. It may be useful to add the flow-pressure plot to the classical respiratory graphics allowing to monitor mechanical ventilation more accurately and to fine tune the ventilator setting accordingly.