Archives of disease in childhood. Fetal and neonatal edition
-
Arch. Dis. Child. Fetal Neonatal Ed. · May 2008
ReviewDifficult extubation in low birthweight infants.
Randomised trials have demonstrated that ventilation techniques which support every spontaneous breath are the most efficacious weaning modes. Nasal continuous positive airway pressure after extubation reduces the likelihood of incidents leading to the need for reintubation in very low birthweight infants; further work is needed to determine if there are advantages of particular delivery techniques. ⋯ Essential to the success of weaning and extubation are dedicated staff, whether this will be assisted by computerised decision-making tools requires testing. The above approaches are not mutually exclusive and those indicated by this review as appropriately evidence based should be considered by practitioners for current use to reduce difficult/unsuccessful extubation.
-
Arch. Dis. Child. Fetal Neonatal Ed. · May 2008
Comparative StudyImproved techniques reduce face mask leak during simulated neonatal resuscitation: study 2.
Techniques of positioning and holding neonatal face masks vary. Studies have shown that leak at the face mask is common and often substantial irrespective of operator experience. ⋯ Written instruction and demonstration of the identified optimal technique resulted in significantly reduced face mask leak.
-
Arch. Dis. Child. Fetal Neonatal Ed. · May 2008
Persistent lactic acidosis in neonatal hypoxic-ischaemic encephalopathy correlates with EEG grade and electrographic seizure burden.
Predicting at birth which infants with perinatal hypoxic-ischaemic injury will progress to significant encephalopathy remains a challenge. ⋯ Serum lactate levels in the first 30 minutes of life do not predict the severity of the ensuing encephalopathy. In contrast, sustained lactic acidosis is associated with severe encephalopathy on EEG and correlates with seizure burden.
-
Arch. Dis. Child. Fetal Neonatal Ed. · May 2008
Assessing the effectiveness of two round neonatal resuscitation masks: study 1.
Positive pressure ventilation (PPV) via a face mask is an important skill taught using manikins. There have been few attempts to assess the effectiveness of different face mask designs. ⋯ We compared a new neonatal face mask with an established design and found no difference in leak. On average the mask leak was >50% irrespective of operator experience or technique.
-
Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2008
Randomized Controlled TrialLingual sucrose reduces the pain response to nasogastric tube insertion: a randomised clinical trial.
To determine whether lingual sucrose modifies the pain response to nasogastric tube insertion in preterm infants. ⋯ Nasogastric tube insertion induces a pain response comparable with previously reported responses to heel lance in neonates. Single-dose lingual 24% sucrose is effective in reducing the behavioural and physiological pain response to nasogastric tube insertion in preterm infants and it appears to be safe.