Resuscitation
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Randomized Controlled Trial Comparative Study Clinical Trial
Determination of heart rate in the baby at birth.
The International Liaison Committee on Resuscitation (ILCOR) publishes guidelines on neonatal resuscitation, which are evidence-based where possible. Initial assessment of heart rate, breathing and colour is an essential part of newborn resuscitation and the guidelines state that heart rate may be assessed using a stethoscope, or palpating the umbilical, brachial or femoral pulse. This study aimed to assess the most effective method(s) of heart rate assessment in the newborn baby. ⋯ Umbilical pulsations must not be relied upon if low or absent. In assessing heart rate in newborn resuscitation only the stethoscope is likely to be completely reliable. In the absence of a stethoscope only the umbilical pulse should be used with an awareness of its limitations.
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Randomized Controlled Trial Comparative Study Clinical Trial
Biphasic concentration change during continuous midazolam administration in brain-injured patients undergoing therapeutic moderate hypothermia.
To define the pharmacokinetics of midazolam, a probe for monitoring cytochrome (CYP) 3A 4 activity, during moderate hypothermic therapy. ⋯ This study has demonstrated for the first time that midazolum concentration changes biphasically even during continuous infusion in hypothermic therapy. The mechanisms for the change are unclear. Thus, further studies including confirmation of cytochrome 3A 4 activity are required, while monitoring for the development of undesirable effects from over-dosing is also needed.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized controlled trial of sodium bicarbonate in neonatal resuscitation-effect on immediate outcome.
Very little evidence is available that supports or disproves the use of medications in neonatal resuscitation. In this randomized controlled trial, we evaluated the effect of sodium bicarbonate given during neonatal resuscitation, on survival and neurological outcome at discharge. ⋯ Administration of sodium bicarbonate during neonatal resuscitation did not help to improve survival or immediate neurological outcome.