Journal of perinatology : official journal of the California Perinatal Association
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Comparative Study
Heated humidified high-flow nasal cannula: use and a neonatal early extubation protocol.
Respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) are frequent complications of prematurity. To decrease ventilator-induced lung injury, we evaluated the safety, efficacy and neonatal outcomes of a heated humidified high-flow nasal cannula (HFNC) system and an early extubation protocol (EEP) designed for preterm infants 25 to 29 weeks' gestational age (GA). ⋯ High-flow nasal cannula use appears safe and well-tolerated. Infants extubated to HFNC spent fewer days on the ventilator. Additional benefits may include a decreased rate of ventilator associated with pneumonia and improved growth.
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To examine influences on neonatologists' decision-making regarding resuscitation of extremely premature infants. ⋯ Neonatologists perceive a 'gray zone' of resuscitative practices and should understand that external influences may affect their delivery room resuscitation practices.
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Comparative Study
High-flow nasal cannula as a device to provide continuous positive airway pressure in infants.
To measure the intrapharyngeal pressure (IPP) generated by high-flow nasal cannula (HFNC) at varying flow rates up to 5 l min(-1). ⋯ HFNC delivers significant IPP and is potentially a well-tolerated and viable option to provide CPAP at flows of > or = 3 min(-1) in infants with respiratory distress.
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A term infant requiring resuscitation was found to have a false-positive color change on a colorimetric carbon dioxide device as a result of administration of epinephrine via an endotracheal tube. Using models of direct application and vapor exposure with a test lung, we discovered that epinephrine, atropine, infasurf and naloxone may result in false-positive color change. This false-positive response may lead to delayed recognition of esophageal intubation.