Acta paediatrica
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'Permissive hypercapnia' is a familiar term in neonatal intensive care, given the widespread adoption of low-tidal-volume ventilation strategies applied with the goal of decreasing respiratory morbidity. Recent evidence suggesting that hypercapnic acidosis may itself have protective effects on the lung and other organs has led to the coining of a new phrase, 'therapeutic hypercapnia', which also encompasses the use of supplemental inspired CO(2). ⋯ Experimental evidence suggests that mild-moderate hypercapnia can improve tissue oxygenation and perfusion, which may ameliorate injury to the immature lung and brain. However, hypercapnia may also be associated with adverse outcomes, and the range of PaCO(2) levels that are both safe and effective for specific subsets of neonates has yet to be determined.
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To study if medication error rate decreased as a consequence of a simple observation process of registering its occurrence. ⋯ The presence of a person reviewing and registering the drug records apparently had by itself a substantial positive effect on the overall drug error rate. This phenomenon known as the Hawthorne effect should be taken in consideration when evaluating the efficacy of any preventive intervention aimed at improving patient safety.
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Comparative Study
Hand washing soap as a source of neonatal Serratia marcescens outbreak.
To describe an outbreak of Serratia marcescens infections in a neonatal intensive care unit (NICU) and to report investigations and interventions having led to the cessation of the outbreak. ⋯ It is the first time that S. marcescens is found in a NAS during a neonatal nosocomial outbreak. Molecular analysis is a method of choice to compare different strains. Identification and elimination of the nosocomial source and adherence to the infection control policies are essential to succeed in the containment of a nosocomial epidemic.
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The aim of the present study was to investigate the correlation between neonatal, paediatric and adult disease severity scores and reimbursement by health insurances. ⋯ We conclude that other scoring systems or measures of disease severity urgently need to be established to terminate the chronic underfunding of paediatric intensive care medicine in the developed countries.