Archives of disease in childhood. Fetal and neonatal edition
-
Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2009
Randomized Controlled TrialRandomised crossover trial of four nasal respiratory support systems for apnoea of prematurity in very low birthweight infants.
Apnoea of prematurity (AOP) is a common problem in preterm infants which can be treated with various modes of nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive pressure ventilation (NIPPV). It is not known which mode of NCPAP or NIPPV is most effective for AOP. ⋯ A variable flow NCPAP device may be more effective in treating AOP in preterm infants than a conventional ventilator in NIPPV mode. It remains unclear whether synchronised NIPPV would be even more effective.
-
Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2009
Multicenter StudyTreatment of asphyxiated newborns with moderate hypothermia in routine clinical practice: how cooling is managed in the UK outside a clinical trial.
This is a phase 4 study of infants registered with the UK TOBY Cooling Register from December 2006 to February 2008. The registry was established on completion of enrolLment to the TOBY randomised trial of treatment with whole body hypothermia following perinatal asphyxia at the end of November 2006. ⋯ In the UK, therapeutic hypothermia following perinatal asphyxia is increasingly being provided. The target body temperature is successfully achieved and the clinical complications observed were not attributed to hypothermia. Treatment with hypothermia may have prevented the worsening of the encephalopathy that is commonly observed following asphyxia.
-
Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2009
Extracting respiratory data from pulse oximeter plethysmogram traces in newborn infants.
To investigate whether valid respiratory data can be extracted from the pulse oximeter plethysmographic (pleth) trace in healthy newborn infants, pleth data were collected from the foot, and respiratory airflow was simultaneously measured using a facemask. The pleth waveform was analysed using fast Fourier transform (FFT), low-pass filtering (LPF), and by plotting the peak-to-peak amplitude variation (PtP). ⋯ Respiratory information, including respiratory rate and a respiratory-like waveform, can reliably be extracted from the pleth trace of a standard pulse oximeter in newborn infants. Such analysis may be clinically useful for non-invasive assessment of respiratory problems in infants and young children.
-
Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2009
Evolution of tidal volume requirement during the first 3 weeks of life in infants <800 g ventilated with Volume Guarantee.
Volume-targeted ventilation is used in neonates to reduce volutrauma and inadvertent hyperventilation. Little is known about appropriate tidal volume (V(T)) settings in extremely low birthweight (ELBW) infants who remain intubated for extended periods. ⋯ Despite permissive hypercapnia, V(T) requirement rises with advancing postnatal age in ELBW infants. The increase is greatest during the third week of life, which is probably due to distension of the upper airways (acquired tracheomegaly) and increasing heterogeneity of lung inflation (increased alveolar dead space).