Journal of perinatology : official journal of the California Perinatal Association
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Although interest in nasal continuous positive airway pressure (nCPAP) to avoid intubation is increasing, there is limited data regarding patient selection and outcome. We sought to determine the baseline parameters associated with failure. ⋯ We hope these findings will help those using elective nCPAP to refine their practice and those considering its use in establishing reasonable guidelines, as well as be useful for designing clinical research.
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A full-term infant developed respiratory distress immediately after birth, requiring a prolonged course of extra-corporeal membrane oxygenation, followed by high-frequency ventilation. She was unable to wean off mechanical ventilation, required tracheostomy, and ultimately lung transplantation. A novel mutation in the surfactant C protein gene was identified as the cause of her lung disease.
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Case Reports
Case of chest-wall rigidity in a preterm infant caused by prenatal fentanyl administration.
The inability to appropriately ventilate neonates shortly after their birth could be related in rare cases to chest-wall rigidity caused by the placental transfer of fentanyl. Although this adverse effect is recognized when fentanyl is administered to neonates after their birth, the prenatal phenomenon is less known. Treatment with either naloxone or muscle relaxants reverses the fentanyl effect and may prevent unnecessary excessive ventilatory settings.