Journal of perinatology : official journal of the California Perinatal Association
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Clinical Trial Observational Study
The concordance of ultrasound technique versus X-ray to confirm endotracheal tube position in neonates.
Given the distressingly high incidence of ETT malposition in the neonatal population, patients are exposed to ionizing radiation to confirm endotracheal tube (ETT) position. Our objective is to determine if ultrasound technique is concordant with X-ray in determining whether an ETT is deeply positioned or not. ⋯ As the largest clinical trial of its kind to date, with the greatest number of ultrasound operators, we have further established US as a feasible imaging modality to determine whether an ETT is deeply positioned or not.
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During therapeutic whole body cooling (WBC), the core temperature is usually monitored with an esophageal probe. Most infants receive mechanical ventilation while being cooled. As the temperature in the esophagus responds rapidly to changes in the ambient temperature, inhalation of warmed gas from ventilator may lead to overestimation of ventilated patients' actual temperature, causing automated cooling devices to overcool patients well below the desired set temperature targets. To determine if the esophageal temperature recordings during therapeutic WBC differ between ventilated and non-ventilated infants. ⋯ Warmed inhaled gas does not interfere with the esophageal temperature during WBC.
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To evaluate the cardiovascular response to short-term prone positioning in neonates. ⋯ Short-term prone positioning is associated with decreased SV, CO and SBF and increased calculated SVR index.
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Multicenter Study
Outcomes of extremely preterm infants after delivery room cardiopulmonary resuscitation in a population-based cohort.
To describe the relationship of delivery room cardiopulmonary resuscitation (DR-CPR) to short-term outcomes of extremely preterm infants. ⋯ Premature infants receiving DR-CPR had worse outcomes. Mortality and morbidity varied by GA.
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To compare the management options, risks and thematic content that obstetricians and neonatologists discuss in periviable counseling. ⋯ Obstetricians and neonatologists provided complementary counseling content to patients, yet neither specialty took ownership of steroid discussions. Joint counseling and/or family meetings may minimize observed redundancy and inconsistencies in counseling.