Acta paediatrica
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Multicenter Study
Response to resuscitation of the newborn: early prognostic variables.
To characterize the development of clinically relevant variables the first minutes after birth and identify early prognostic markers in newborn infants requiring resuscitation. ⋯ Apgar scores, heart rate, SaO(2), and time to first breath in newly born infants in need of resuscitation may be used for early identification of infants with a poor prognosis. These data may be helpful in describing the severity of depression in single infants and to select infants in need of interventional therapy.
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Comparative Study
Fast bedside measurement of blood count and C-reactive protein in neonates with suspected late-onset sepsis.
Conventional and fast complete blood count (CBC) and C-reactive protein (CRP) measurements were compared in 56 neonates with suspected sepsis. Mean differences between pairs (conventional minus fast) of the corresponding CBC and CRP values were significant for the six CBC parameters tested (p<0.02), but not for CRP (p=0.18). ⋯ In neonatal sepsis, conventional and fast methods are comparable only for CRP but not for CBC variables.
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Pulmonary thromboembolism is rarely recognized in young children, even in hospital settings. All current management decisions for children with deep vein thrombosis (DVT) are directly extrapolated from treatment recommendations for adults with no further validation. We report the case of a 6-y-old child presenting with deep vein thrombosis of the leg veins and fatal pulmonary embolism. The fatal outcome in our case highlights the need for more epidemiological studies in children, not only to predict the recurrence of pulmonary emboli but also to prepare standard treatment guidelines for the management of DVT and pulmonary emboli in children. We speculate that there may be a role for temporary inferior vena cava filters in young children with extensive DVT of the legs. ⋯ This case highlights the need for more epidemiological studies to predict the recurrence of pulmonary emboli and effective guidelines for the management of paediatric DVT and pulmonary emboli in children.
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We present three cases of neonatal cardiac tamponade due to umbilical venous catheterization, a rare, but potentially fatal complication. ⋯ Pericardial effusion and cardiac tamponade should be considered in any infant with a central venous line who develops a rapid, unexplained clinical deterioration. Timely diagnosis and drainage has been proven to be life-saving.
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Randomized Controlled Trial Clinical Trial
Sustained pressure-controlled inflation or intermittent mandatory ventilation in preterm infants in the delivery room? A randomized, controlled trial on initial respiratory support via nasopharyngeal tube.
To prove the hypothesis that sustained pressure-controlled inflation compared to intermittent mandatory ventilation for lung recruitment via nasopharyngeal tube after delivery is more effective in reducing the rate of endotracheal intubation and mechanical ventilation in very preterm infants. ⋯ Sufficient spontaneous breathing within the first 48 h of life without endotracheal intubation and mechanical ventilation was achieved in about 30% with both methods of initial respiratory support.