The Journal of pediatrics
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The Journal of pediatrics · Aug 2015
Sedatives and Analgesics Given to Infants in Neonatal Intensive Care Units at the End of Life.
To describe the administration of sedatives and analgesics at the end of life in a large cohort of infants in North American neonatal intensive care units. ⋯ Administration of sedatives and analgesics increased over time. Infants of older gestational age and those more critically ill were more likely to receive these drugs on the day of death. These findings suggest that drug administration may be driven by severity of illness.
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The Journal of pediatrics · Aug 2015
Observational StudyAre Infants with Bronchopulmonary Dysplasia Prone to Gastroesophageal Reflux? A Prospective Observational Study with Esophageal pH-Impedance Monitoring.
To perform an observational cohort study with esophageal pH-multichannel intraluminal impedance (pH-MII) monitoring in symptomatic preterm infants with and without bronchopulmonary dysplasia (BPD). ⋯ The increased number of (and sensitivity for) pH-only events among infants with BPD may be explained by several factors, including lower milk intake, impaired esophageal motility, and a peculiar autonomic nervous system response pattern.
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The Journal of pediatrics · Aug 2015
Randomized Controlled TrialSupreme Laryngeal Mask Airway versus Face Mask during Neonatal Resuscitation: A Randomized Controlled Trial.
To assess the effectiveness of supreme laryngeal mask airway (SLMA) over face mask ventilation for preventing need for endotracheal intubation at birth. ⋯ In newborns with gestational age ≥34 weeks and/or expected birth weight ≥1500 g needing PPV at birth, the SLMA is more effective than face mask to prevent endotracheal intubation. The SLMA is effective in clinical practice after a short-term educational intervention.
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The Journal of pediatrics · Aug 2015
Neonatal Pain and Infection Relate to Smaller Cerebellum in Very Preterm Children at School Age.
To examine whether specific neonatal factors differentially influence cerebellar subregional volumes and to investigate relationships between subregional volumes and outcomes in very preterm children at 7 years of age. ⋯ In very preterm children, exposure to painful procedures, as well as additional neonatal risk factors such as infection, were associated with reduced cerebellar volumes in specific subregions and poorer outcomes at school age.
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The Journal of pediatrics · Aug 2015
Extracorporeal Membrane Oxygenation in Pediatric Trisomy 21: 30 Years of Experience from the Extracorporeal Life Support Organization Registry.
To describe the use of extracorporeal membrane oxygenation (ECMO) in patients with trisomy 21 (T21), to identify risk factors for hospital mortality, and to compare outcomes with those of patients without T21. ⋯ The use of ECMO in patients with T21 has increased over time. Patients with a cardiac indication for ECMO have higher mortality compared with those supported for respiratory indications. Despite differences in indications for ECMO, patients with T21 have similar hospital survival as those without T21; thus, by itself, a diagnosis of T21 should not be considered a risk factor for in-hospital mortality when contemplating ECMO cannulation.