Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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In our neonatal intensive care unit, the incidence density of infections related to central catheters, assessed retrospectively over 2 years, exceeded that described in the literature. To reduce this incidence density, clinical practice guidelines were implemented for the insertion and maintenance of central lines. The purpose of this study was to evaluate the impact of the protocol on the incidence density and the incidence rate of nosocomial bloodborne infections. ⋯ Gestational age and birth weight were significantly lower in period 2 (29.6±2.3 GW vs 27.3±1.9, P=0.001; 1239±379g vs 915±175g, P<0.001) and the catheterization duration differed between the 2 periods (20±11 days vs 13±6 days, P<0.0001). A trend for a lower incidence density of infection was observed in the second period (16 per 1000 catheter days vs 10 per 1000 catheter days, P=0.06). Although the 2 groups' baseline characteristics were different, this study suggests a positive impact of clinical practice guidelines for the insertion and maintenance of central venous catheters on the incidence of nosocomial infections related to central catheters.
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Various analgesics and sedatives are currently available for critically ill newborns requiring tracheal intubation in the delivery room. Even if pain management has improved over the past few years, there are few recent data on the French clinical practices in the delivery room. ⋯ The use of sedation-analgesia is still insufficient in French maternity units. Tracheal intubation without the use of analgesia and sedation should be performed only for life-threatening situations in the delivery room.