Acta paediatrica
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Guidelines recommend neonatal resuscitation without controlling tidal volume or positive end-expiratory pressure (PEEP). However, these may improve gas exchange, lung volume and outcome. ⋯ Very premature lambs can be resuscitated effectively using volume-guarantee ventilation and PEEP. Tidal volumes affected PaCO(2) within minutes but had little effect on oxygenation. PEEP halved the oxygen requirement compared with no PEEP. Resuscitating premature babies with controlled tidal volumes and PEEP might improve their outcome.
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To evaluate the feasibility of detecting duct-dependent congenital heart disease before hospital discharge by using pulse oximetry. ⋯ Systematic screening for CCHD with high accuracy requires a new-generation oximeter, and comparison of saturation values from the right hand and one foot substantially improves the detection of CCHD.
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Comparative Study
End-of-life decisions in delivery room and neonatal intensive care unit.
The increase in neonatal survival in recent decades has been followed by an increase in later disabilities. This has given rise to many new ethical issues. In different countries, efforts are being made to define ethical guidelines regarding withholding or withdrawing intensive care and end-of-life decisions in critically ill newborn infants. These guidelines have to be differentiated from ethical decision-making models which structure the process of decision making for an individual child. Such a framework has been in existence in our clinic for 10 years. ⋯ In contrast to earlier years, in-hospital death in our clinic is nowadays usually preceded by structured and documented medical end-of-life decisions.
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Randomized Controlled Trial Comparative Study
The impact of newborn bathing on the prevalence of neonatal hypothermia in Uganda: a randomized, controlled trial.
To elucidate the impact of bathing on the prevalence of hypothermia among newborn babies exposed to the skin-to-skin (STS) care technique before and after bathing. ⋯ Bathing newborn babies shortly after birth increased the risk of hypothermia despite the use of warm water and STS care for thermal protection of the newborn.
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We developed and validated a pain scale (ABC scale) for term babies based on acoustic features of crying. ⋯ The ABC scale proved to be simple and reliable for assessing pain in healthy, non-intubated term newborns.