Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2013
Multicenter Study Controlled Clinical TrialMinimally-invasive surfactant therapy in preterm infants on continuous positive airway pressure.
To evaluate the applicability and potential effectiveness of a technique of minimally-invasive surfactant therapy (MIST) in preterm infants on continuous positive airway pressure (CPAP). ⋯ Surfactant delivery via a narrow-bore tracheal catheter is feasible and potentially effective, and deserves further investigation in clinical trials.
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Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2013
Comparative StudyEnd tidal carbon dioxide is as reliable as transcutaneous monitoring in ventilated postsurgical neonates.
To compare the agreement, precision and repeatability of end tidal carbon dioxide (EtCO2 ) and transcutaneous carbon dioxide (TcCO2 ) with partial pressure of arterial CO(2) ( PaCO2) in postoperative neonates. ⋯ In postoperative neonates, EtCO2 and TcCO2 demonstrated a clinically acceptable agreement with PaCO2.
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Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2013
Clinical TrialTreatment of presumed hypotension in very low birthweight neonates: effects on regional cerebral oxygenation.
Previous studies have correlated poor neurological outcomes with hypotension. Treatment of hypotension in very low birthweight (VLBW) infants is common, and most often is based solely on the blood pressure measurement. Whether treatment improves cerebral oxygenation is unclear. ⋯ These results suggest that treating hypotension in VLBW neonates based solely on a blood pressure measurement of less than 30 mm Hg, while increasing blood pressure, may not increase cerebral oxygenation, possibly because many of these patients are in the autoregulatory zone for cerebral blood flow.
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Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2013
Positioning of infants in the neonatal intensive care unit for lumbar puncture as determined by bedside ultrasonography.
Realising the paucity of data in the standardisation of the optimal position for lumbar puncture (LP) in hospitalised neonates, we have designed an observational study to measure the interspinous distance in infants in a university hospital setting. The infants were placed in two lateral recumbent and two upright positions (lateral recumbent without flexing the hips, lateral recumbent with maximal hip flexion, sitting without flexing the hips and sitting with maximal hip flexion) with concomitant heart rate (HR), transcutaneous oxygen saturation (OS) and interspinous distance (with ultrasonography) measurements. ⋯ Although statistically significant drops in OSs have been observed between lateral recumbent and sittting with flexion, lateral recumbent with flexion and sitting without flexion, and lateral recumbent with flexion and sitting with flexion positions; no adverse hypoxic events occurred during positioning. Sitting flexed position, which seems to be sufficiently safe and serve to enhance the success rate of a LP, should be favoured for sick neonates whenever the infant's condition permit a spinal tap.
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Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2013
National neonatal data to support specialist care and improve infant outcomes.
'Liberating the NHS' and the new Outcomes Framework make information central to the management of the UK National Health Service (NHS). The principles of patient choice and government policy on the transparency of outcomes for public services are key drivers for improving the performance. ⋯ Other key characteristics have been an integrated approach to ensure that data are captured once and serve multiple needs, collaboration between professional organisations, parents, academic institutions, the commercial sector and NHS managers, and responsiveness to changing requirements. The authors discuss these aspects of national neonatal specialist data and point to future developments.