Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · Nov 2006
Sustainable use of continuous positive airway pressure in extremely preterm infants during the first week after delivery.
Early use of nasal continuous positive airway pressure (nCPAP) may reduce lung damage, but it is not clear how many extremely preterm infants can be cared for without mechanical ventilation on the first days after delivery. ⋯ Extremely preterm infants can be extubated to nCPAP soon after delivery, with a reasonable probability of not requiring immediate reintubation.
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Arch. Dis. Child. Fetal Neonatal Ed. · Nov 2006
Non-invasive measurement of reduced ventilation:perfusion ratio and shunt in infants with bronchopulmonary dysplasia: a physiological definition of the disease.
An objective definition of bronchopulmonary dysplasia (BPD) is required to interpret trial outcomes and provide a baseline for prognostic studies. Current definitions do not quantify disease severity. The cardinal measures of impaired gas exchange are a reduced ventilation:perfusion ratio (V(A):Q) and increased right to left shunt. These can be determined non-invasively by plotting arterial oxygen saturation (Spo(2)) against inspired oxygen pressure (PIo(2)). ⋯ The predominant gas exchange impairment in BPD is a reduced V(A):Q, described by the right shift of the Spo(2) versus PIo(2) relationship. This provides a simpler method for defining BPD, which can grade disease severity.
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Arch. Dis. Child. Fetal Neonatal Ed. · Sep 2006
Review Historical ArticlePinching, electrocution, ravens' beaks, and positive pressure ventilation: a brief history of neonatal resuscitation.
Since ancient times many different methods have been used to revive newborns. Although subject to the vagaries of fashion for 2000 years, artificial respiration has been accepted as the mainstay of neonatal resuscitation for about the last 40. ⋯ There is, however, little evidence to support current recommendations, which are largely based on expert opinion. The challenge for neonatologists today is to gather robust evidence to support or refute these recommendations, thereby refining this common and important intervention.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2006
ReviewAre carbon dioxide detectors useful in neonates?
Maintenance of neonatal normocarbia may prevent chronic lung disease and periventricular leucomalacia, but this requires frequent arterial sampling, which has risks. Alternative methods for measuring CO2 are therefore desirable. ⋯ However, this method relies on the presence of exhaled CO2, which may be reduced in certain situations, such as cardiopulmonary arrest. Colorimetric CO2 detectors are therefore valuable adjuncts for airway management, especially during resuscitation, but Pa(CO2) is still the best measure of CO2 in neonatal practice.