Archives of disease in childhood. Fetal and neonatal edition
-
Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2018
Frequency, duration and cause of ventilator alarms on a neonatal intensive care unit.
To investigate the frequency and cause of neonatal ventilator alarms. Neonatal ventilators frequently alarm and also disturb babies, parents and nurses. If frequent they may cause alarm fatigue and be ignored. The number, frequency and details of neonatal ventilator alarms are unreported. ⋯ Frequent ventilator alarms are caused by physiological variability in the respiratory rate or minute volume, inappropriate alarm limits or too low maximum peak inflating pressure during volume-targeted ventilation. While most alarms were very short, sometimes alarms were ignored by neonatal intensive care unit staff for long periods.
-
Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2018
Randomized Controlled TrialNon-invasive high-frequency oscillatory ventilation in preterm infants: a randomised controlled cross-over trial.
Non-invasive high-frequency oscillatory ventilation (nHFOV) has recently been described as a novel mode of respiratory support for premature infants. This study was designed to determine whether nHFOV decreases CO2 partial pressure (pCO2) in premature infants more effectively than non-invasive continuous positive airway pressure (nCPAP). ⋯ We could not demonstrate an increased carbon dioxide clearance applying nHFOV compared with nCPAP in this cohort of preterm infants.
-
Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2018
Parental experience of interaction with healthcare professionals during their infant's stay in the neonatal intensive care unit.
To explore the experiences of parents of infants admitted to the neonatal intensive care unit towards interaction with healthcare professionals during their infants critical care. ⋯ Factors including the context of infant admission, interprofessional consistency, humane touches of staff and the transition into the culture of the neonatal unit are important issues for parents. These issues warrant further investigation to facilitate individualised family needs, attachment between parents and their baby and the professional team.
-
Arch. Dis. Child. Fetal Neonatal Ed. · May 2018
Observational Study3-lead electrocardiogram is more reliable than pulse oximetry to detect bradycardia during stabilisation at birth of very preterm infants.
Current neonatal resuscitation guidelines suggest the use of ECG in the delivery room (DR) to assess heart rate (HR). However, reliability of ECG compared with pulse oximetry (PO) in a situation of bradycardia has not been specifically investigated. The objective of the present study was to compare HR monitoring using ECG or PO in a situation of bradycardia (HR <100 beats per minute (bpm)) during preterm stabilisation in the DR. ⋯ PO detects the start and recovery of bradycardia events slower and less accurately than ECG during stabilisation at birth of very preterm infants. ECG use in this scenario may contribute to an earlier initiation of resuscitation manoeuvres and to avoid unnecessary prolongation of resuscitation efforts after recovery.
-
Arch. Dis. Child. Fetal Neonatal Ed. · May 2018
Randomized Controlled TrialInterobserver agreement and image quality of functional cardiac ultrasound measures used in a randomised trial of delayed cord clamping in preterm infants.
Functional cardiac ultrasound measures are used clinically and in trials for assessing the haemodynamic status of newborn infants. Superior vena cava (SVC) flow and right ventricular output (RVO) are established measures of systemic blood flow on the first postnatal day. The objective was to assess image quality and interobserver agreement of these measures in preterm infants enrolled in a randomised trial of immediate versus delayed cord clamping. ⋯ Interobserver variability for SVC flow is consistent with that previously reported, but higher for RVO. The findings should be incorporated into clinical practice, training, accreditation and trial design.