Journal of perinatology : official journal of the California Perinatal Association
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Randomized Controlled Trial Clinical Trial
Obtaining blood samples for anti-factor Xa quantification through umbilical artery catheters.
Neonates who are treated with low-molecular-weight heparin require repeated venipunctures to monitor anti-factor Xa (anti-FXa) levels. Generally, blood withdrawn from umbilical artery catheters (UACs) is not useful for such monitoring because heparin in the fluids running through the catheters contaminates the results. We tested methods for collecting blood for anti-FXa levels from UACs through which heparin-containing fluids were running, in an attempt to reduce the need for repeated venipunctures of anticoagulated neonates. ⋯ Blood samples for anti-FXa can be drawn from UACs through which heparin-containing solutions are infusing if a port is added through which no heparin-containing fluids are run, a line-clearing volume of at least 4.0 ml is drawn, and a contamination rate of 8% of samples is acceptable.
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Randomized Controlled Trial Comparative Study Clinical Trial
Crossover trial comparing pressure support with synchronized intermittent mandatory ventilation.
To compare pressure support ventilation (PSV) with volume guarantee (VG) to synchronized intermittent mandatory ventilation (SIMV) in infants with respiratory distress syndrome (RDS). ⋯ Because of an increase in V(E) with PSV+VG, and no difference in the a/A ratio or sCdyn, we do not recommend the routine use of PSV+VG for this population.
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Comparative Study Clinical Trial Controlled Clinical Trial
Continuous blood gas monitoring using an in-dwelling optode method: comparison to intermittent arterial blood gas sampling in ECMO patients.
The ability to measure postmembrane arterial blood gases is essential in the management of critically ill neonates treated with extracorporeal membrane oxygenation (ECMO). A new technology using, the Paratrend 7 system (Diametrics Medical, High Wycombe,UK) allows for continuous measurement of pH, PCO(2) and PO(2), and calculates oxygen saturation, bicarbonate, and base excess. ⋯ The blood gases compared in the two methods had a strong correlation for pH, PCO(2) and PO(2). Results of this study indicate that this technology provides an accurate means of monitoring continuous blood gas parameters in neonatal ECMO patients. Use of the Paratrend 7 should allow reduced health-care provider exposure to blood and decreased patient iatrogenic blood loss.
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To document low sound levels, the range and pattern of levels, and the relative effects of operational (staff and equipment generated) and facility (building generated) noise on the acoustic environment of a level III nursery. ⋯ Staff behavior as well as the acoustical characteristics of the facility determine the levels of noise and quiet in an intensive care nursery.
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Periodic breathing (PB) is a common respiratory pattern in preterm infants. Our aim was to determine the influence of PB on the pattern of oxygenation in preterm infants with significant PB at discharge from hospital. ⋯ We conclude that PB is a common cause of prolonged desaturation in preterm infants at discharge.