Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2009
Multicenter StudyTreatment of asphyxiated newborns with moderate hypothermia in routine clinical practice: how cooling is managed in the UK outside a clinical trial.
This is a phase 4 study of infants registered with the UK TOBY Cooling Register from December 2006 to February 2008. The registry was established on completion of enrolLment to the TOBY randomised trial of treatment with whole body hypothermia following perinatal asphyxia at the end of November 2006. ⋯ In the UK, therapeutic hypothermia following perinatal asphyxia is increasingly being provided. The target body temperature is successfully achieved and the clinical complications observed were not attributed to hypothermia. Treatment with hypothermia may have prevented the worsening of the encephalopathy that is commonly observed following asphyxia.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2009
Extracting respiratory data from pulse oximeter plethysmogram traces in newborn infants.
To investigate whether valid respiratory data can be extracted from the pulse oximeter plethysmographic (pleth) trace in healthy newborn infants, pleth data were collected from the foot, and respiratory airflow was simultaneously measured using a facemask. The pleth waveform was analysed using fast Fourier transform (FFT), low-pass filtering (LPF), and by plotting the peak-to-peak amplitude variation (PtP). ⋯ Respiratory information, including respiratory rate and a respiratory-like waveform, can reliably be extracted from the pleth trace of a standard pulse oximeter in newborn infants. Such analysis may be clinically useful for non-invasive assessment of respiratory problems in infants and young children.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2009
Evolution of tidal volume requirement during the first 3 weeks of life in infants <800 g ventilated with Volume Guarantee.
Volume-targeted ventilation is used in neonates to reduce volutrauma and inadvertent hyperventilation. Little is known about appropriate tidal volume (V(T)) settings in extremely low birthweight (ELBW) infants who remain intubated for extended periods. ⋯ Despite permissive hypercapnia, V(T) requirement rises with advancing postnatal age in ELBW infants. The increase is greatest during the third week of life, which is probably due to distension of the upper airways (acquired tracheomegaly) and increasing heterogeneity of lung inflation (increased alveolar dead space).
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2009
Multicenter StudySpecialty-based, voluntary incident reporting in neonatal intensive care: description of 4846 incident reports.
To examine the characteristics of incidents reported after introduction of a voluntary, non-punitive incident reporting system for neonatal intensive care units (NICUs) in the Netherlands; and to investigate which types of reported incident pose the highest risk to patients in the NICU. ⋯ Incidents occur much more frequently in Dutch NICUs than has been previously observed, and their impact on patient morbidity is considerable. Reported incidents concerning mechanical ventilation, blood products, intravascular lines, parenteral nutrition and medication dosing errors pose the highest risk to patients in the NICU.
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2009
Investigating the variations in survival rates for very preterm infants in 10 European regions: the MOSAIC birth cohort.
To investigate the variation in the survival rate and the mortality rates for very preterm infants across Europe. ⋯ There are wide variations in the survival rates to discharge from neonatal intensive care for very preterm deliveries and in the timing of death across the MOSAIC regions. In order to directly compare international statistics for mortality in very preterm infants, data collection needs to be standardised. We believe that the standard point of comparison should be using all those infants alive at the onset of labour as the denominator for comparisons of mortality rates for very preterm infants analysing the cohort by gestational age band.