Acta paediatrica
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To assess efficacy of remifentanil in preterm newborns during mechanical ventilation. ⋯ Remifentanil is a manageable and effective opioid in the newborn undergoing mechanical ventilation, though randomized controlled trials and information about long-term outcomes are necessary.
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Atrial thrombosis is a relatively rare event in children. We report a case of a newborn with AFI who after restoration of sinus rhythm, developed atrial thrombus on a prominent Chiari network floating between the right and left atrium through the patent foramen ovale. The thrombus was resolved following treatment with heparin without events. ⋯ Atrial stunning was proposed as a key mechanistic phenomenon because the thrombus occurred after the cardioversion of AFI to sinus rhythm. Heparin may be effective in the resolution of atrial thrombus within a few days.
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Protective ventilation in neonates requires careful volume monitoring to prevent ventilator-induced lung injury caused by baro/volutrauma and hence chronic lung disease. This study investigated the effect of endotracheal tube (ET) leakage on the displayed tidal volume using an in vitro model. ⋯ Tidal volume underestimation arising from ET leakage depends on ventilator pressures, timing parameters and ventilator-specific algorithms for signal processing. Therefore, neonatologists should be aware of these issues to prevent lung over-inflation when adjusting target volume in the presence of ET leakage.