Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2010
Review Meta AnalysisOpioids for neonates receiving mechanical ventilation: a systematic review and meta-analysis.
To evaluate the effect of opioid analgesics, compared to placebo, no drug, or other non-opioid analgesics or sedatives, on pain, duration of mechanical ventilation, mortality, growth and neurodevelopmental outcomes in newborn infants on mechanical ventilation. ⋯ There is insufficient evidence to recommend routine use of opioids in mechanically ventilated newborns. Opioids should be used selectively, when indicated by clinical judgment and evaluation of pain indicators. If sedation is required, morphine is safer than midazolam.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2010
Multicenter StudyValidation of a neonatal pain scale adapted to the new practices in caring for preterm newborns.
BACKGROUND Neonatal pain assessment generally requires access to facial expression. Improved neonatology practices, such as greater protection against bright lights and non-invasive mask ventilation, have made facial observation more difficult. ⋯ FANS, which is reliable and valid, is the first scale to score pain in preterm newborns when facial expression is not accessible.
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2010
Comparative StudyAdditional value of two-channel amplitude integrated EEG recording in full-term infants with unilateral brain injury.
Amplitude integrated electroencephalography (aEEG) is a valuable tool for evaluating neonatal encephalopathy and identifying electrographic seizures. ⋯ Although there were no major differences found between seizure detection with one-channel or two-channel aEEG, in a subgroup of infants with a predominantly unilateral brain lesion, two-channel recording did provide additional information with identification of more seizure patterns on the affected side, sometimes also associated with a difference in BGP. To improve early diagnosis of unilateral lesions and improve seizure detection in these infants, routine use of two-channel recordings is recommended.
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2010
Accuracy of amplitude integrated EEG in a neonatal cohort.
To determine the sensitivity and specificity of amplitude integrated electroencephalogram (aEEG) compared to simultaneous standard electroencephalogram (sEEG) for seizure detection and background discontinuity. ⋯ Background abnormalities were detected with fair accuracy by aEEG but aEEG criteria alone would result in the overdiagnosis of neonatal seizures. Therefore seizures noted on aEEG require sEEG confirmation prior to implementing anticonvulsant therapy for neonatal seizures.