Acta paediatrica
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Randomized Controlled Trial Clinical Trial
Randomized controlled trial of heparin for prevention of blockage of peripherally inserted central catheters in neonates.
To determine whether the addition of heparin to total parenteral nutrition (TPN) fluid would prevent blockage of peripherally inserted central catheters (PICCs) in neonates. ⋯ Addition of heparin to TPN fluid was not associated with a significant reduction in the incidence of blocked PICCs. However, the sample size of this study was too small to exclude even rather marked differences between the groups.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparing suprapubic urine aspiration under real-time ultrasound guidance with conventional blind aspiration.
To determine the optimal method of suprapubic aspiration (SPA), the success rates of real-time ultrasound-guided SPA were compared with those of conventional SPA, and factors associated with success were studied. Thirty infants were randomly allocated to group A (for real-time ultrasound-guided SPA) and 30 infants to group B (for blind SPA with a prehydration protocol). The results showed that the overall success rates for all attempts were similar (26/30 or 87% in group A vs 24/30 or 80% in group B, p > 0.05). The first attempts in both groups were equally successful (both 18/30 or 60%). In comparison with failed attempts, successful ultrasound SPA attempts were associated with a greater bladder depth (mean +/- SD: 28 +/- 11 vs 21 +/- 5 mm, p < 0.01), length (32 +/- 12 vs 23 +/- 9 mm, p < 0.05) and volume (17 +/- 13 vs 8 +/- 6 ml, p < 0.01), but similar width (33 +/- 9 vs 29 +/- 5 mm, p > 0.05). In blind SPA, successful attempts were associated with the presence of bladder dullness on percussion (odds ratio 29). ⋯ This study confirms that ultrasound-guided SPA has a high success rate. Blind SPA could also be equally successful with appropriate preparation. Ultrasound-guided SPA is recommended when the bladder depth exceeds 3 cm, or the bladder length exceeds 3.7 cm. If an ultrasound machine is not available, blind SPA may be an alternative, with attention being paid to prehydration and the demonstration of bladder dullness by percussion.
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Randomized Controlled Trial Clinical Trial
Food intake and oral sucrose in preterms prior to heel prick.
To investigate the soothing effect of feeding on infants in distress, the effects of 2 mL 15% and 1 mL 25% sucrose given orally 2 min before heel prick in fasting preterms to reduce the pain response were assessed. The effects of milk intake by nasogastric tube were also assessed once during the last hour before heel prick, and the effects of milk intake by nasogastric tube once during the last hour before heel prick together with 1 mL 25% sucrose given orally 2 min before heel prick. The pain response was measured as changes in crying time, behavioural state, skin conductance and heart rate. ⋯ Differences in the measured variables before and during heel prick showed that only the crying time was reduced when the infants received milk or 25% sucrose prior to heel prick (p < 0.05). If the infants received milk and 25% sucrose before heel prick, the crying time and the level of behavioural state were reduced (p < 0.05). The increase from before to during heel prick in skin conductance (number and amplitude of the waves) and heart rate correlated with the crying time (p < 0.01).
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Randomized Controlled Trial Comparative Study Clinical Trial
Oral versus rectal midazolam as a pre-anaesthetic sedative in children receiving dental treatment under general anaesthesia.
Dental treatment in children who are too young or too apprehensive to cooperate is often performed under sedation. In Sweden, the tradition has been to administer sedatives rectally in small children, but oral liquid sedation is now increasingly used. ⋯ Both the oral and the rectal routes can in most cases be appropriate. However, the better sedative effect of rectal administration of midazolam makes it a more favourable route in pre-cooperative and non-compliant children.