Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2002
ReviewUpdate on modalities of mechanical ventilators.
Recent advances in ventilator technology have often not been confirmed by randomised trials and instead serious shortcomings have been highlighted. Ventilation modes should only be introduced into routine clinical practice when proved efficacious in appropriately designed studies and no adverse outcomes identified by long term follow up.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2002
ReviewOxygen therapy for infants with chronic lung disease.
Supplemental oxygen is a safe and effective treatment for infants with established chronic lung disease who are not at risk of further progression of retinopathy of prematurity (ROP). Oxygen saturations of < 92% should be avoided and a target range of at least 94-96% aimed for. The saturation target range for very preterm infants at risk of developing ROP is more controversial, but the therapeutic index is probably considerably narrower.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2002
ReviewRole of lung function testing in the management of mechanically ventilated infants.
The mechanical characteristics of the ventilated lung can only be interpreted when the volume of the lung, the elastic properties, and the degree of airway obstruction have been accurately quantified by pulmonary function testing. More gentle ventilation strategies (permissive hypercapnia) are used, and the efficacy of mechanical ventilation can be verified in the intensive care unit. Pulmonary function testing brings new insights, awareness, and applications, but its limitations need to be taken into account when interpreting the acquired data.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2002
ReviewMonitoring cardiovascular function in infants with chronic lung disease of prematurity.
In addition to persistent airways disease, survivors of premature birth with chronic lung disease are at risk of cardiovascular sequelae, including pulmonary hypertension, systemic hypertension, left ventricular hypertrophy, and exercise intolerance. The major treatment of pulmonary hypertension is supplemental oxygen, but drugs such as calcium channel blockers may also be required. The use of inhaled nitric oxide for its long term management is being investigated
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2002
Comparative StudyIn vitro comparison of nasal continuous positive airway pressure devices for neonates.
To compare the resistance in vitro of different devices used for the delivery of nasal continuous positive airway pressure (NCPAP) in neonates. ⋯ A large variation in the potential fall in pressure may occur in the clinical setting. Devices with short double prongs had the lowest resistance to flow. These results have implications in the selection of the optimal device/s for clinical application and for future comparisons in randomised trials of NCPAP in neonates.