Archives of disease in childhood. Fetal and neonatal edition
-
Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2010
Effect of the "InSurE" procedure on cerebral oxygenation and electrical brain activity of the preterm infant.
In preterm infants with respiratory distress syndrome (RDS) nasal continuous positive airway pressure (nCPAP) with the "InSurE" procedure (intubation, surfactant, extubation) is increasingly used. However, its effect on cerebral oxygenation and brain function is not known. ⋯ In the present study, the "InSurE" procedure did not induce perturbation of cerebral oxygen delivery and extraction, whereas electrical brain activity decreased for a prolonged period of time.
-
Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2010
Comparative StudyPredicting neonatal mortality among very preterm infants: a comparison of three versions of the CRIB score.
To validate Clinical Risk Index for Babies (CRIB) and CRIB II mortality prediction scores in a UK population of infants born at
-
Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2010
A simplified method for deriving shunt and reduced VA/Q in infants.
Right to left shunt and regional hypoventilation (reduced ventilation/perfusion ratio (V(A)/Q)) have different effects on the curve relating inspired oxygen (P(I)O(2)) to oxygen saturation measured by pulse oximetry (SpO(2)) and can be derived non-invasively from measurements of SpO(2) and inspired oxygen pressure (P(I)O(2)) using complex models of gas exchange. We developed a simpler computerised "slide-rule" method of making these derivations. ⋯ The slide-rule method was reliable for deriving shunt and right shift (reduced V(A)/Q) of the P(I)O(2) versus SpO(2) curve when compared with the more complex algorithm. The new method should enable wider clinical application of these measurements of oxygen exchange.
-
Arch. Dis. Child. Fetal Neonatal Ed. · Nov 2009
Multicenter StudyAnalgesics, sedatives and neuromuscular blockers as part of end-of-life decisions in Dutch NICUs.
Clinicians frequently administer analgesics and sedatives at the time of withholding or withdrawal of life-sustaining treatment in newborns. This practice might be regarded as intentionally hastening of death. ⋯ Analgesics and sedatives are generally increased after the end-of-life decision to treat pain and suffering and rarely to hasten death. Neuromuscular blockers were administered in 16% of deaths. Medical files provide insufficient documentation of considerations leading to the increase of medication, which hinders (external) review.