Acta paediatrica
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To review the outcome of preterm neonates treated with iNO. ⋯ There is an increasing trend in using iNO as a rescue treatment in preterm neonates. The outcomes were very poor in the preterm neonates <26(+0) weeks. A cautious approach is warranted in the absence of robust evidence to support the use of iNO, in preterm neonates <26(+0) weeks.
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Randomized Controlled Trial Comparative Study
High-flow nasal cannulae are associated with increased diaphragm activation compared with nasal continuous positive airway pressure in preterm infants.
High-flow nasal cannulae (HFNC) are increasingly used for respiratory management of preterm infants. However, their ability to provide support compared to nasal continuous positive airway pressure (CPAP) has been questioned. We compared the effect of HFNC versus nasal CPAP on diaphragm electrical activity (EAdi) in preterm infants. ⋯ In this cohort of preterm infants, the majority exhibited greater diaphragm activation, as assessed by neural breathing patterns, when supported with HFNC than IF-CPAP, suggesting that nasal CPAP may provide more effective respiratory support.
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Even short periods of hyperoxia may induce prolonged cerebral vasoconstriction in newborn infants, and this could theoretically lead to cerebral ischaemia even once normoxia is re-established. This study aimed to investigate the effect of brief hyperoxic exposures on regional cerebral tissue oxygen saturation (rStO2 ) and to evaluate whether any observed prolonged cerebral vasoconstriction was related to maturity. ⋯ We found no evidence to support the theory that transient hyperoxia induces prolonged cerebral vasoconstriction in infants with a postmenstrual age above 32 weeks.
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Femoral venous catheters (FVCs) provide multilumen access in critically ill infants with difficult venous access. This study reports our experiences of using a modified Seldinger technique to insert FVCs in our neonatal unit. ⋯ Femoral venous catheter insertion using a modified Seldinger technique appeared to provide alternate and immediate central venous access in critically ill infants.
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Patient monitoring generates a large number of alarms. The aim of this study was to evaluate the rate, type and management of alarms and to determine the risks of a distributed alarm system in a neonatal intensive care unit (NICU) with single family rooms. ⋯ Safe patient monitoring was challenging in a NICU with single family rooms, but possible by employing a distributed alarm system. The low number of repeat alarms indicated quick response times.