Journal of perinatology : official journal of the California Perinatal Association
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Preterm infants typically experience heavy phlebotomy losses from frequent laboratory testing in the first few weeks of life. This results in anemia, requiring red blood cell (RBC) transfusions. We recently introduced a bedside point-of-care (POC) blood gas analyzer (iSTAT, Princeton, NJ) that requires a smaller volume of blood to replace conventional Radiometer blood gas and electrolyte analysis used by our neonatal intensive care unit (NICU). The smaller volume of blood required for sampling (100 vs 300-500 microl), provided an opportunity to assess if a decrease in phlebotomy loss occurred and, if so, to determine if this resulted in decreased transfusions administered to extremely low birth weight (ELBW) infants. ⋯ Use of a bedside blood gas analyzer is associated with clinically important reductions in RBC transfusions in the ELBW infant during the first two weeks of life.
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Optimising home oxygen delivery in infants has important logistical and safety implications. This can be aided by having a suitable reference range of normal values for arterial oxygen saturation using pulse oximetry (SpO(2)). ⋯ These data may be used to test the benefits in the home or hospital of having a reference range of normal values for cumulative SpO(2).
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To assess the agreement of transcutaneous carbon dioxide (TcPCO(2)) and end tidal carbon dioxide (PetCO(2)) with arterial carbon dioxide (PaCO(2)) values in infants < 28 weeks gestational age. ⋯ A moderate agreement with a wide variation in individual values was observed between noninvasive methods and PaCO(2) in preterm infants in the first 24 hours. Noninvasive monitoring methods cannot be substituted for PaCO(2) analyses in preterm infants during this critical period.
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Inhaled nitric oxide (iNO) reduces pulmonary vascular resistance by preferential vasodilation in ventilated lung units. In experimental animals, iNO also reduces airway resistance by smooth muscle relaxation. Hence, there may be a therapeutic role for iNO in evolving bronchopulmonary dysplasia (BPD). ⋯ Low-dose iNO had no acute effects on lung function, cardiac function and oxygenation in evolving BPD.
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Randomized Controlled Trial Clinical Trial
Effect of a single dose of sodium bicarbonate given during neonatal resuscitation at birth on the acid-base status on first day of life.
To study the effect of a single dose of sodium bicarbonate given during neonatal resuscitation at birth on the acid-base status on the first day of life. ⋯ Sodium bicarbonate given during neonatal resuscitation did not change the acid-base status in the first 24 hours of life.