Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · Sep 2017
Observational StudyElectrical activity of the diaphragm during nCPAP and high flow nasal cannula.
To determine if the electrical activity of the diaphragm, as measure of neural respiratory drive and breathing effort, changes over time in preterm infants transitioned from nasal continuous positive airway pressure (nCPAP) to high flow nasal cannula (HFNC). ⋯ Neural respiratory drive and breathing effort assessed by electrical activity of the diaphragm is similar in the first 3 hours after transitioning stable preterm infants from nCPAP to HFNC with a 1:1 pressure-to-flow ratio.
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Arch. Dis. Child. Fetal Neonatal Ed. · Sep 2017
Letter Randomized Controlled Trial Clinical TrialRandomised crossover study comparing speed of heart rate display in newborns using ECG plus pulse oximeter versus pulse oximeter alone.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2017
Can Ambu self-inflating bag and Neopuff infant resuscitator provide adequate and safe manual inflations for infants up to 10 kg weight?
Manual resuscitation devices for infants and newborns must be able to provide adequate ventilation in a safe and consistent manner across a wide range of patient sizes (0.5-10 kg) and differing clinical states. There are little comparative data assessing biomechanical performance of common infant manual resuscitation devices across the manufacturers' recommended operating weight ranges. We aimed to compare performance of the Ambu self-inflating bag (SIB) with the Neopuff T-piece resuscitator in three resuscitation models. ⋯ The Ambu SIB was able to accurately deliver targeted pressures across all three models from preterm to infant. The Neopuff infant resuscitator was unable to deliver the targeted pressures in the infant model developing clinically significant levels of inadvertent PEEP which may pose risk during infant resuscitation.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2017
Randomized Controlled TrialHigh flow nasal cannula versus NCPAP, duration to full oral feeds in preterm infants: a randomised controlled trial.
To compare the time taken by preterm infants with evolving chronic lung disease to achieve full oral feeding when supported with humidified high flow nasal cannula (HFNC) or nasal continuous positive airway pressure (NCPAP). ⋯ Preterm infants treated with HFNC did not achieve full oral feeding more quickly than infants treated with NCPAP.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2017
Research ethics committee decision-making in relation to an efficient neonatal trial.
Randomised controlled trials, a gold-standard approach to reduce uncertainties in clinical practice, are growing in cost and are often slow to recruit. We determined whether methodological approaches to facilitate large, efficient clinical trials were acceptable to UK research ethics committees (RECs). ⋯ A majority of RECs in this study consider the use of electronic patient record data, short information sheets, opt-out consent and mention of possible inclusion benefit to be acceptable in neonatal comparative-effectiveness research. We identified a need for guidance for RECs in relation to opt-out consent processes. These methods provide opportunity to facilitate large randomised controlled trials.