Journal of perinatology : official journal of the California Perinatal Association
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Comparative Study Controlled Clinical Trial
Prospective crossover comparison between NAVA and pressure control ventilation in premature neonates less than 1500 grams.
Neurally adjusted ventilatory assist (NAVA) synchronizes spontaneous respiratory effort with mechanical ventilation. Electrodes detect the electrical activity of the diaphragm (Edi) and transmit this information to the ventilator, allowing the patient to determine their own respiratory rate (RR), peak pressures, and inspiratory and expiratory times in synchrony with the ventilator. The objective of this study was to evaluate if premature neonates ventilate as effectively on NAVA as compared to pressure control ventilation (PCV). ⋯ Premature neonates ventilated with NAVA required less PIP, FiO2 and RR to achieve lower PCO2 and better compliance compared with PCV.
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Neonatal intensive care unit (NICU) discharge readiness is defined as the masterful attainment of technical skills and knowledge, emotional comfort, and confidence with infant care by the primary caregivers at the time of discharge. NICU discharge preparation is the process of facilitating comfort and confidence as well as the acquisition of knowledge and skills to successfully make the transition from the NICU to home. In this paper, we first review the literature about discharge readiness as it relates to the NICU population. Understanding that discharge readiness is achieved, in part, through successful discharge preparation, we then outline an approach to NICU discharge preparation.
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Evaluate physiological and behavioral pain responses of premature infants following instillation of mydriatic eyedrops for retinopathy of prematurity (ROP) examinations. While burning and stinging occurs in older patients, the infant pain response is not well characterized. ⋯ Mydriatic drops cause a clinically significant pain response in one-third of infants. Non-pharmacological supportive measures are recommended for all infants until predictive factors are defined.
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To evaluate the efficacy and safety of passive cooling during transport of asphyxiated newborns. ⋯ Exclusive passive cooling achieves significantly earlier initiation of effective hypothermia for asphyxiated newborns but should not delay transport for active cooling.
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SFTPC (surfactant protein C) mutations resulting in SP-C deficiency causing ongoing respiratory failure in the neonatal period represent a rare entity. We report a full-term female infant who developed respiratory distress and respiratory failure shortly after birth. From the first day of life the infant was mechanically ventilated. ⋯ Mechanical ventilation was no longer needed, and the patient was discharged without additional oxygen demand. The patient remained well under therapy till the age of 6 months. After that time, the therapy was successfully discontinued.