Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2008
Multicenter Study Comparative StudyDoctors' and nurses' attitudes towards neonatal ethical decision making in Ireland.
To explore the clinical staff attitudes towards ethical decision making in neonatal intensive care units (NICUs) in Ireland, to establish differences between doctors and nurses and to compare attitudes in Ireland with those in Europe. ⋯ In Ireland, NICU doctors and nurses hold similar attitudes towards ethical decision making. Personal and professional factors have a statistically significant impact on attitude score. Compared with the rest of Europe, attitudes in Ireland appear more similar to those of southern rather than northern European countries.
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2008
Multicenter StudyDefining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures.
Neonatal seizures are often subclinical, making accurate diagnosis difficult. ⋯ Only one-third of neonatal EEG seizures displays clinical signs on simultaneous video recordings. Moreover, two-thirds of these clinical manifestations are unrecognised, or misinterpreted by experienced neonatal staff. In the recognition and management of neonatal seizures clinical diagnosis alone is not enough.
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2008
ReviewDifficult extubation in low birthweight infants.
Randomised trials have demonstrated that ventilation techniques which support every spontaneous breath are the most efficacious weaning modes. Nasal continuous positive airway pressure after extubation reduces the likelihood of incidents leading to the need for reintubation in very low birthweight infants; further work is needed to determine if there are advantages of particular delivery techniques. ⋯ Essential to the success of weaning and extubation are dedicated staff, whether this will be assisted by computerised decision-making tools requires testing. The above approaches are not mutually exclusive and those indicated by this review as appropriately evidence based should be considered by practitioners for current use to reduce difficult/unsuccessful extubation.
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2008
Comparative StudyImproved techniques reduce face mask leak during simulated neonatal resuscitation: study 2.
Techniques of positioning and holding neonatal face masks vary. Studies have shown that leak at the face mask is common and often substantial irrespective of operator experience. ⋯ Written instruction and demonstration of the identified optimal technique resulted in significantly reduced face mask leak.
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2008
Persistent lactic acidosis in neonatal hypoxic-ischaemic encephalopathy correlates with EEG grade and electrographic seizure burden.
Predicting at birth which infants with perinatal hypoxic-ischaemic injury will progress to significant encephalopathy remains a challenge. ⋯ Serum lactate levels in the first 30 minutes of life do not predict the severity of the ensuing encephalopathy. In contrast, sustained lactic acidosis is associated with severe encephalopathy on EEG and correlates with seizure burden.