Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2013
Randomized Controlled TrialAxillary temperature measurement during hypothermia treatment for neonatal hypoxic-ischaemic encephalopathy.
To determine the accuracy of axillary temperature relative to core rectal temperature during whole-body therapeutic hypothermia for moderate-to-severe hypoxic-ischaemic encephalopathy. ⋯ As there is wide variability in the difference between axillary and rectal temperatures at all stages of whole-body cooling, our data do not support the use of axillary temperature as a surrogate for core rectal temperature during therapeutic hypothermia.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2013
The 3:1 is superior to a 15:2 ratio in a newborn manikin model in terms of quality of chest compressions and number of ventilations.
Most cases of delivery room cardiopulmonary arrest result from an asphyxial process. Experimental evidence supports an important role for ventilation during asphyxial arrest. The optimal compression: ventilation (CV) ratio remains unclear and recommendations for newborns have varied from 3:1, 5:1 and 15:2. ⋯ Providers using a 3:1 versus 15:2 achieve a greater depth of compressions over 2 min with a greater difference noted in women. More consistent compression depth over time was achieved with 3:1 as opposed to the other ratios. Thus, the 3:1 ratio is appropriate for newly born infants requiring resuscitation.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2013
Variability of respiratory parameters and extubation readiness in ventilated neonates.
A spontaneous breathing trial (SBT) has been used to guide suitability of extubation in VLBW infants. Respiratory variability (RV) has been used to assess extubation readiness in adults but was never investigated in preterms. The combination of a SBT and RV may further improve prediction of successful extubation. ⋯ A significant decrease in V(T)/T(I)variability occurred in infants requiring re-intubation. The combination of a SBT failure and decreased variability in T(I)or V(T)was highly predictive of failure. This combination is promising but requires prospective evaluation in a larger population.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2013
Perceived role in end-of-life decision making in the NICU affects long-term parental grief response.
Shared decision making (DM) is increasingly advocated as the most appropriate model to support parents confronted with end-of-life (EoL) decisions for a child in the neonatal intensive care unit (NICU). However, few studies have explored its impact on their long-term grief. ⋯ In decisions to forego life-sustaining treatment in the NICU, the perception of a shared decision is associated in the long term with lower grief scores than perceptions of the other types of DM.