Journal of perinatology : official journal of the California Perinatal Association
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Before the use of extracorporeal membrane oxygenation (ECMO), infants with a severe form of congenital diaphragmatic hernia (CDH) had a high mortality and morbidity. Recent studies have shown an improvement in the survival of these infants after ECMO treatment; however, the existing data do not provide sufficient informations regarding the quality of survival and developmental outcome of these infants. The objective of this study was to evaluate survival, intracranial lesions, and the neurodevelopmental outcome of infants with CDH treated with ECMO. ⋯ Our preliminary findings indicate that 35% of infants with severe CDH requiring ECMO had central nervous system abnormalities (intracranial lesions, including ventricular dilatation). The survival rate in our study population is consistent with recent reports. As a group, infants with severe CDH display mild neuromotor and cognitive delay in development at 24 months of age.
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Sound reduction strategies in the neonatal intensive care unit (NICU) must focus on the sources of excessive sound. We studied the relative contribution of personnel conversation and heating, ventilation, and air conditioning (HVAC) airflow by measuring several parameters of sound during four environmental conditions: unaltered ambient sound, HVAC airflow off, HVAC airflow and conversation off, and conversation off. All measurements were decreased by interrupting HVAC airflow and conversation. ⋯ The method of sound reduction did not change the frequency distribution of sound. Attention to personnel conversation may be effective in lowering sound exposure in the NICU. The contribution of HVAC airflow should be measured in new constructions and renovations.
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Biography Historical Article
Ignác Semmelweis and the etiology of fetal and neonatal sepsis.
It is well-known that Ignác Semmelweis discovered the etiology and prophylaxis of puerperal sepsis. However, few historians have focused on his understanding of the pathophysiology of fetal and neonatal sepsis. ⋯ This insight was particularly valuable in that it helped him decipher the mystery of puerperal sepsis. This paper presents some of these concepts and supporting evidence.
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We performed this study to determine if percutaneous central lines (PCLs) were associated with infection more often than peripherally placed intravenous catheters (PIVs). ⋯ PCLs do not become infected more often than PIVs.