Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2015
Randomized Controlled Trial Comparative Study Observational StudyBi-level CPAP does not improve gas exchange when compared with conventional CPAP for the treatment of neonates recovering from respiratory distress syndrome.
We hypothesised that short-term application of bi-level nasal continuous positive airway pressure CPAP (SiPAP) compared with conventional nasal CPAP (nCPAP) at the same mean airway pressure in infants with persistent oxygen need recovering from respiratory distress syndrome would improve CO2 removal with no change in oxygen requirement. ⋯ At similar mean airway pressures, SiPAP does not improve CO2 removal, oxygenation or other studied physiological parameters with the exception of mean blood pressure, which was not clinically significant.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2015
Randomized Controlled TrialCrossover study of proportional assist versus assist control ventilation.
To test the hypothesis that in very prematurely born infants remaining ventilated beyond the first week, proportional assist ventilation (PAV) compared with assist control ventilation (ACV) would be associated with reduced work of breathing, increased respiratory muscle strength and less ventilator-infant asynchrony which would be associated with improved oxygenation. ⋯ These results suggest that PAV compared with ACV may have physiological advantages for prematurely born infants who remain ventilated after the first week after birth.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2015
Randomized Controlled TrialIs synchronised NIPPV more effective than NIPPV and NCPAP in treating apnoea of prematurity (AOP)? A randomised cross-over trial.
Apnoea, desaturations and bradycardias are common problems in preterm infants which can be treated with nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV). It is unclear whether synchronised NIPPV (SNIPPV) would be even more effective. ⋯ Flow-SNIPPV seems more effective than NIPPV and NCPAP in reducing the incidence of desaturations, bradycardias and central apnoea episodes in preterm infants.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2015
Comparative StudyMonitoring tidal volumes in preterm infants at birth: mask versus endotracheal ventilation.
Upper airway distention during mask ventilation could reduce gas volumes entering the lung compared with ventilation via an endotracheal tube. Therefore, respiratory tract volumes were measured in lambs and tidal volumes were compared in preterm infants before and after intubation. ⋯ During neonatal mask ventilation, distention of the upper respiratory tract contributes to the tidal volumes measured and should be taken into account when targeting tidal volumes during mask ventilation.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2015
Intrapartum magnesium sulfate and need for intensive delivery room resuscitation.
To evaluate the association of intrapartum magnesium sulfate for fetal neuroprotection (MgSO4-FN) with the delivery room resuscitation and neonatal outcomes of preterm infants in an era of minimisation of invasive mechanical ventilation. ⋯ Intrapartum MgSO4 for fetal neuroprotection was not associated with an increased need for intensive delivery room resuscitation in this cohort of preterm infants.