Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · Sep 2013
Randomized Controlled TrialCerebral desaturations in preterm infants: a crossover trial on influence of oxygen saturation target range.
To test the hypothesis that a higher pulsoximetric arterial oxygen saturation (SpO2) target range is associated with reduced cerebral tissue oxygen desaturations from baseline during events of hypoxaemia or bradycardia. ⋯ A lower SpO2 target range was associated with a greater cumulative cerebral StO2 desaturation score, caused by more frequent SpO2 desaturations. However, time at very low cerebral StO2 was not affected. Episodes of hyperoxaemia were not reduced.
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Arch. Dis. Child. Fetal Neonatal Ed. · Sep 2013
Randomized Controlled Trial Clinical TrialAnticonvulsant effect of xenon on neonatal asphyxial seizures.
Xenon, a monoatomic gas with very high tissue solubility, is a non-competitive inhibitor of N-methyl-D-aspartate (NMDA) glutamate receptor, has antiapoptotic effects and is neuroprotective following hypoxic ischaemic injury in animals. Xenon may be expected to have anticonvulsant effects through glutamate receptor blockade, but this has not previously been demonstrated clinically. We examined seizure activity on the real time and amplitude integrated EEG records of 14 full-term infants with perinatal asphyxial encephalopathy treated within 12 h of birth with 30% inhaled xenon for 24 h combined with 72 h of moderate systemic hypothermia. ⋯ Seizures stopped during xenon therapy but recurred within a few minutes of withdrawing xenon and stopped again after xenon was restarted. Our data show that subanaesthetic levels of xenon may have an anticonvulsant effect. Inhaled xenon may be a valuable new therapy in this hard-to-treat population.
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Arch. Dis. Child. Fetal Neonatal Ed. · Sep 2013
Randomized Controlled Trial Clinical TrialMask ventilation of preterm infants in the delivery room.
To measure tidal volumes (VT) and describe the interactions between spontaneous breaths and positive pressure ventilation (PPV) inflations during stabilisation of preterm infants in the delivery room (DR). We used a respiratory function monitor (RFM) to evaluate the first 5 min of mask respiratory support provided to preterm infants. ⋯ Facemask leak is large during resuscitation of preterm infants using round silicone masks. Tidal volumes delivered during PPV inflations are much higher than those generated during spontaneous breathing by an infant on CPAP.
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Arch. Dis. Child. Fetal Neonatal Ed. · Sep 2013
Randomized Controlled Trial Comparative StudyA randomised crossover study of low-flow air or oxygen via nasal cannulae to prevent desaturation in preterm infants.
To compare the efficacy of low-flow oxygen, low-flow air and sham treatment given via nasal cannulae in preventing desaturation (falls in oxygen saturation (SpO2)) in preterm infants. ⋯ At a flow rate of 0.1 l/min via nasal cannulae, air is no better than sham treatment in preventing desaturation in preterm infants, while 100% oxygen is superior to both.