Journal of perinatology : official journal of the California Perinatal Association
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This series discusses errors in neonatology since the 1920s. Three historical periods are defined: the "Hands-Off" years, 1920 to 1950; the "Heroic" years, 1950 to 1970; and the "Experienced" years, 1970 to 2000. In this article, the "Hands-Off" years, we discuss lowered thermal environment, supplemental oxygen, initial thirsting and starving, synthetic vitamin K, SMA formula, and diaper markings.
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To assess the role of intrapartum fever in identifying asymptomatic term neonates with early-onset neonatal sepsis. ⋯ Over half of term neonates with sepsis were asymptomatic at delivery. Intrapartum fever was helpful in identifying over a quarter of asymptomatic term neonates with sepsis.
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Randomized Controlled Trial Clinical Trial
Obtaining blood samples for anti-factor Xa quantification through umbilical artery catheters.
Neonates who are treated with low-molecular-weight heparin require repeated venipunctures to monitor anti-factor Xa (anti-FXa) levels. Generally, blood withdrawn from umbilical artery catheters (UACs) is not useful for such monitoring because heparin in the fluids running through the catheters contaminates the results. We tested methods for collecting blood for anti-FXa levels from UACs through which heparin-containing fluids were running, in an attempt to reduce the need for repeated venipunctures of anticoagulated neonates. ⋯ Blood samples for anti-FXa can be drawn from UACs through which heparin-containing solutions are infusing if a port is added through which no heparin-containing fluids are run, a line-clearing volume of at least 4.0 ml is drawn, and a contamination rate of 8% of samples is acceptable.
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Randomized Controlled Trial Comparative Study Clinical Trial
Crossover trial comparing pressure support with synchronized intermittent mandatory ventilation.
To compare pressure support ventilation (PSV) with volume guarantee (VG) to synchronized intermittent mandatory ventilation (SIMV) in infants with respiratory distress syndrome (RDS). ⋯ Because of an increase in V(E) with PSV+VG, and no difference in the a/A ratio or sCdyn, we do not recommend the routine use of PSV+VG for this population.
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Comparative Study Clinical Trial Controlled Clinical Trial
Continuous blood gas monitoring using an in-dwelling optode method: comparison to intermittent arterial blood gas sampling in ECMO patients.
The ability to measure postmembrane arterial blood gases is essential in the management of critically ill neonates treated with extracorporeal membrane oxygenation (ECMO). A new technology using, the Paratrend 7 system (Diametrics Medical, High Wycombe,UK) allows for continuous measurement of pH, PCO(2) and PO(2), and calculates oxygen saturation, bicarbonate, and base excess. ⋯ The blood gases compared in the two methods had a strong correlation for pH, PCO(2) and PO(2). Results of this study indicate that this technology provides an accurate means of monitoring continuous blood gas parameters in neonatal ECMO patients. Use of the Paratrend 7 should allow reduced health-care provider exposure to blood and decreased patient iatrogenic blood loss.