Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2007
Impact of service changes on neonatal transfer patterns over 10 years.
Many changes have been made to the staffing and organisation of neonatal care in the UK in the past 10 years. This study assessed the extent to which these changes had affected the transfer of babies between different parts of the service. ⋯ Organisational changes in neonatal care during the 10-year period have been insufficient to deal with the rising demand, as reflected by the persistently high rate of inappropriate transfers.
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Oxygen is the most commonly used therapy in neonatal nurseries as an integral part of respiratory support. The goal of oxygen therapy is to achieve adequate delivery of oxygen to the tissue without creating oxygen toxicity. ⋯ Despite this, we still know very little about how much oxygen these babies actually need, or how much oxygen is safe to give, especially in the first few weeks of life. Recent observational studies have raised concerns that giving oxygen to target the saturation at "physiological" levels in newborn preterm babies may do more harm than good, but to date, clinicians have not been able to resolve the uncertainties surrounding optimum oxygen therapy.
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Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2007
Multicenter StudyRelationship of neonatologists' end-of-life decisions to their personal fear of death.
To study the relationship of Australian and New Zealand (ANZ) neonatologists' personal fear of death to their forgoing life-sustaining treatment and hastening death in newborns destined for severe disability and newborns for whom further treatment is considered non-beneficial or overly burdensome. ⋯ ANZ neonatologists' personal fear of death and their attitude to hastening death when further treatment is considered futile are significantly related. Neonatologists' fear of death may influence their end-of-life decisions.
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Resuscitation guidelines recommend administration of free-flow oxygen to newly born infants who breathe but remain cyanosed. Self-inflating resuscitation bags are described as unreliable for this purpose. We measured oxygen concentrations >or=80% delivered through a 240 mL Laerdal self-inflating resuscitation bag and from 5 mm tubing inside a cupped hand.