Journal of perinatology : official journal of the California Perinatal Association
-
Neuraxial anesthetic techniques are commonly used during the peripartum period to provide effective pain relief for labor and anesthesia during cesarean delivery. Major neurologic complications are rare after neuraxial anesthesia; however, spinal hematoma is associated with catastrophic neurologic outcomes (including lower-limb paralysis). ⋯ However, there is limited information about anesthetic implications of anticoagulation during the peripartum period. This article will review the risks of spinal hematoma after neuraxial anesthesia in pregnant patients; current guidelines for neuraxial anesthesia for anticoagulated patients; and relevant pharmacological data of specific anticoagulant and antithrombotic drugs in pregnancy.
-
Randomized Controlled Trial Comparative Study
Bubble and ventilator-derived nasal continuous positive airway pressure in premature infants: work of breathing and gas exchange.
During bubble nasal continuous positive airway pressure (B-NCPAP), gas flows through the expiratory limb of CPAP tubing submerged underwater to a depth in centimeters considered equal to the desired end expiratory pressure. Ventilator-derived NCPAP (V-NCPAP) controls the delivered pressure at the expiratory orifice. Limited data exist comparing the two forms of NCPAP on work of breathing (WOB) and other short-term respiratory outcomes. We compared WOB and gas exchange between B-NCPAP and V-NCPAP at equivalent delivered nasal prong pressures among a cohort of preterm infants on NCPAP. ⋯ WOB and ventilation with B-NCPAP and V-NCPAP are similar when equivalent delivered prong pressures are assured. Improved oxygenation with B-NCPAP is intriguing and requires further investigation.
-
Randomized Controlled Trial Comparative Study
Rocuronium for nonemergent intubation of term and preterm infants.
The aim of this study was to analyze clinical characteristics of rocuronium as premedication for nonemergent intubation in infants. ⋯ Rocuronium facilitated successful intubation and provided clinical paralysis quickly in most infants.
-
To identify maternal and neonatal factors that impact response to methadone therapy for neonatal abstinence syndrome. ⋯ Severity of neonatal abstinence syndrome may be mitigated by titrating methadone to the lowest effective dose during pregnancy and by encouraging breast milk feeds, which should be weaned gradually.
-
The aim of this study is to characterize baseline regional oxygen saturations (rSO(2)) in stable preterm infants during the first weeks of life. ⋯ Daily baseline rSO(2) in preterm infants changes over the first weeks of life, especially at the abdomen. Evolution in baseline rSO2 over time may indicate regional developmental maturation of physiological oxygen balance.