Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2009
Evaluation of portal venous gas detected by ultrasound examination for diagnosis of necrotising enterocolitis.
Early diagnosis of necrotising enterocolitis (NEC) is difficult but essential for timely therapy. The diagnostic hallmarks and specific radiological signs for NEC are pneumatosis intestinalis (PI) and portal venous gas (PVG), but PVG in abdominal ultrasound (PVG-US) has been proposed as an effective tool in the diagnosis of NEC as well. ⋯ Screening for PVG-US is a useful, easy and quick bedside test with a high specificity for NEC. Moreover, these results question the value of the Walsh criteria in the diagnosis of NEC.
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Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2009
Randomized Controlled TrialThe effect of two levels of pressure support ventilation on tidal volume delivery and minute ventilation in preterm infants.
To study the effect of different levels of pressure support ventilation (PSV) on respiratory parameters in preterm infants during the weaning phase of mechanical ventilation. ⋯ Pressure support ventilation increases total minute ventilation and stabilises breathing in proportion to the level of pressure support used. This may be advantageous and provide a useful ventilation strategy for use during weaning stages of mechanical ventilation in preterm infants.
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Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2009
Sleeping position, oxygenation and lung function in prematurely born infants studied post term.
To determine the effect of sleeping position on the lung function of prematurely born infants when post term, whether any effect was similar to that before discharge from the neonatal unit, and if it differed according to bronchopulmonary (BPD) status. ⋯ These results suggest that lung function impairment does not explain why prematurely born infants are at increased risk of sudden infant death syndrome in the prone compared with the supine position.
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Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2009
Oxygen saturation and heart rate during delivery room resuscitation of infants <30 weeks' gestation with air or 100% oxygen.
Because of concerns about harmful effects of 100% oxygen on newborn infants, air has started to be used for resuscitation in the delivery room. ⋯ Most very preterm infants received supplemental oxygen if air was used for the initial resuscitation. In these infants, the use of backup 100% oxygen and titration against Spo(2) resulted in a similar course to "normal" term and preterm infants. Of the infants resuscitated with 100% oxygen, 80% had Spo(2) > or =95% during the first 10 min. The HR changes in the two groups were very similar.
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Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2009
Volume-guarantee ventilation: pressure may decrease during obstructed flow.
Two unexpected observations were made during ventilation with the Dräger Babylog 8000+ in volume-guarantee mode: (a) during complete obstruction to gas flow down the endotracheal tube (ETT), positive inspiratory pressure (PIP) was reduced to half way between the maximum inflating pressure and the positive end expiratory pressure (PEEP) even though the set expired tidal volume had not been achieved; (b) an external Dräger waveform monitor may stop displaying real-time waveforms when a tube-obstructed alarm is activated. ⋯ During complete ETT obstruction, the PIP is set to a pressure midway between maximum PIP and PEEP even if this is less than the PIP used before the obstruction. Further research is needed to evaluate whether this reduction in PIP is associated with prolongation of precipitating events.