Journal of perinatology : official journal of the California Perinatal Association
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To document low sound levels, the range and pattern of levels, and the relative effects of operational (staff and equipment generated) and facility (building generated) noise on the acoustic environment of a level III nursery. ⋯ Staff behavior as well as the acoustical characteristics of the facility determine the levels of noise and quiet in an intensive care nursery.
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Periodic breathing (PB) is a common respiratory pattern in preterm infants. Our aim was to determine the influence of PB on the pattern of oxygenation in preterm infants with significant PB at discharge from hospital. ⋯ We conclude that PB is a common cause of prolonged desaturation in preterm infants at discharge.
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Case Reports
Subcutaneous emphysema and pneumomediastinum as presenting manifestations of neonatal tracheal injury.
Neonatal tracheal injury/perforation is an uncommon complication of traumatic deliveries or endotracheal intubation. We present a case of neonatal tracheal injury following delivery at term that presented with subcutaneous emphysema and pneumomediastinum before any attempt at intubation. The clinical course, treatment, and outcome are described.
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Catheterization of the aorta through the umbilical artery and/or of peripheral arteries in neonates may be accompanied by a number of complications, of which thrombotic phenomena and peripheral vasospasm are the most common. Two neonates with peripheral ischemia caused by vasospasm from indwelling umbilical artery catheterization and one infant with left hand ischemia due to a left radial artery line were successfully treated with 2% nitroglycerin ointment. No adverse effects were noted.
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Pulse oximetry is widely used in the NICU, but clinicians often distrust the displayed values during patient motion, i.e., questionable oxygen saturation (SpO(2)) and pulse rate (PR) values. Masimo Corporation (Irvine, CA) has developed pulse oximetry with claims of resistance to sources of interference. To test this premise, we compared the performance of the Masimo SET pulse oximeter to a conventional device, Nellcor N-200, and then with three other new-generation pulse oximeters, Nellcor N-395, Novametrix MARS, and Philips Viridia 24C. ⋯ Routine use of Masimo SET pulse oximetry in the NICU could improve clinician confidence in the parameter leading to more judicious titration of oxygen with possible reductions in hypoxic (e.g., pulmonary hypertension) and hyperoxic (e.g., retinopathy of prematurity) pathology. Additionally, a more trustworthy technology should equate with fewer confirmatory arterial blood gas analyses (less blood loss), and faster weaning from the mechanical ventilation (less chronic lung disease).