Archives of disease in childhood. Fetal and neonatal edition
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The physiological anaemia experienced by preterm babies is exacerbated by common care practices such as early clamping of the umbilical cord at birth and gradual exsanguination by phlebotomy for laboratory monitoring. The need for subsequent transfusion with red blood cells can be reduced by delaying cord clamping for 30-60 s in infants who do not require immediate resuscitation. The need for transfusions can be further reduced by limiting phlebotomy losses, providing good nutrition, and using standard guidelines for transfusion based on haemoglobin or haematocrit. ⋯ Restrictive transfusion guidelines may reduce the number of transfusions given, but there is no reduction in donor exposures if a single-donor transfusion programme is used. There is some evidence that more liberal transfusion guidelines may help to prevent brain injury, but information on the impact of transfusion practice on long-term outcome is lacking. Until further guidance emerges, transfusion thresholds lower than those used in the two trials should not be used, as there is no evidence that lower thresholds are safe.
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Arch. Dis. Child. Fetal Neonatal Ed. · Nov 2008
Ultrasonographic determination of neonatal spinal canal depth.
To determine by ultrasound (US) the spinal canal depth (SCD) in neonates and subsequently establish a nomogram and simple formula for calculating this distance. ⋯ SCD measurements are easily determined by US in neonates, with good correlation between weight and MSCD.
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Arch. Dis. Child. Fetal Neonatal Ed. · Sep 2008
Randomized Controlled Trial Multicenter StudyMorphine analgesia and gastrointestinal morbidity in preterm infants: secondary results from the NEOPAIN trial.
To investigate the influence of morphine therapy and other factors on the attainment of full enteral feeds and on acquired gastrointestinal pathology in preterm infants. ⋯ Morphine delays the attainment of full enteral feeds, partly by delaying the start of feeding, but does not discernibly increase gastrointestinal complications. The attainment of full feeds is influenced by morphine dose, but other factors seem to be important, including birth weight and neonatal morbidity.
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Arch. Dis. Child. Fetal Neonatal Ed. · Sep 2008
Randomized Controlled Trial Comparative StudyDoes the monitoring method influence stability of oxygenation in preterm infants? A randomised crossover study of saturation versus transcutaneous monitoring.
Hyperoxia and variable oxygenation are associated with morbidity in preterm infants. The optimal range of oxygen tensions is not known. This study aimed to determine whether care based on transcutaneous oxygen tension (TcPO2) or saturation (SpO2) monitoring is associated with less time spent with high oxygen tension and less variability of oxygenation. ⋯ Within the target ranges studied SpO2 monitoring was associated with significantly more variable oxygenation than TcPO2 monitoring.
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Arch. Dis. Child. Fetal Neonatal Ed. · Sep 2008
A respiratory function monitor improves mask ventilation.
This study investigated whether the use of a respiratory monitor during simulated neonatal resuscitation reduced leak at the face mask. It showed the leak was more than halved, being reduced from 27% to 11% when 25 participants used the monitor to identify and correct the mask leak.