American journal of perinatology
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Randomized Controlled Trial
Efficacy and renal toxicity of one daily dose of amikacin versus conventional dosage regime.
This study assessed the efficacy and renal toxicity of one daily dose of amikacin versus several doses in infected full-term newborns. A clinical trial was conducted with 120 patients who were divided into two groups: group A (n = 60), infants who received amikacin 20 mg/kg/d in one dose; and group B (n = 60), infants who received amikacin 10 mg/kg/d every 12 hours. Both groups also received ampicillin 100 mg/kg/day. ⋯ No significant difference was found in efficacy or renal toxicity in either group. We recommend using amikacin in one daily dose. It could diminish the manipulation of intravenous access, reducing the risk of nosocomial infections.
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Randomized Controlled Trial Comparative Study
A comparison of a new, ultrathin-walled two-stage twin endotracheal tube and a conventional endotracheal tube in very premature infants with respiratory distress syndrome: a pilot study.
This was a pilot study to test the feasibility of use of the ultrathin-walled two-stage twin endotracheal tube (UTTS-T-ETT), with one half to one third the resistance to gas flow and one third to one seventh the dead space of a conventional tracheal tube, in very premature infants. Twenty-eight infants with gestational age 24 to 28 weeks and birthweight >/= 500 g with respiratory distress syndrome requiring intubation and mechanical ventilation were randomly assigned to be intubated with either the UTTS-T-ETT (13 infants) or with a conventional ETT (15 infants). The infants in the two groups were similar in GA, birthweight, age of entry in the study, and initial ventilator settings. ⋯ The use of the UTTS-T-ETT is feasible in preterm infants. There was no difference in adverse events associated with its use compared with a conventional ETT. Given the proven in vitro advantages and a favorable trend toward facilitation of extubation in this pilot study, a larger randomized trial to assess clinical benefit and confirm safety is indicated.
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The role of the neonatal nurse is vital for the successful implementation of developmental care and the provision of an optimal neonatal intensive care unit (NICU) environment. The goal was to identify nurses' perceived barriers to implementation or improving developmental care in their NICUs. Nursing perceptions related to barriers for implementing developmental care were assessed using a 12-point questionnaire during two New York City Neonatal Nursing regional conferences. ⋯ Use of simple light and sound measures may enhance perception of providing an optimal NICU environment. Neonatal nurses perceived barriers to care are often attributed to neonatal staff nursing and physician colleagues. This perception is decreased considerably in those NICUs in which multidisciplinary team meetings or champions are used to address the needs of caregivers by providing developmental care strategies.