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
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.
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The Journal of pediatrics · Aug 2015
Spontaneously Breathing Preterm Infants Change in Tidal Volume to Improve Lung Aeration Immediately after Birth.
To examine the temporal course of lung aeration at birth in preterm infants <33 weeks gestation. ⋯ Preterm infants begin taking deeper breaths approximately 30 breaths after initiating spontaneous breathing to inflate their lungs. Concurrent CO2 removal rises as alveoli are recruited. Lung aeration occurs in 2 phases: initially, large volume breaths with poor alveolar aeration followed by smaller breaths with elimination of CO2 as a consequence of adequate aeration.
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The Journal of pediatrics · Jul 2015
Randomized Controlled Trial Multicenter StudyMask versus Nasal Tube for Stabilization of Preterm Infants at Birth: Respiratory Function Measurements.
To compare the nasal tube with face mask as interfaces for stabilization of very preterm infants at birth by using physiological measurements of leak, obstruction, and expired tidal volumes during positive pressure ventilation (PPV). ⋯ The use of a nasal tube led to large leak, more obstruction, and inadequate tidal volumes compared with face mask.