The Journal of pediatrics
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The Journal of pediatrics · May 2013
Randomized Controlled Trial Comparative StudyA randomized controlled trial to compare heated humidified high-flow nasal cannulae with nasal continuous positive airway pressure postextubation in premature infants.
To determine whether postextubation respiratory support via heated, humidified, high-flow nasal cannulae (HHHFNC) results in a greater proportion of infants younger than 32 weeks' gestation being successfully extubated after a period of endotracheal positive pressure ventilation compared with conventional nasal continuous positive airway pressure (NCPAP). ⋯ HHHFNC and NCPAP produced similar rates of extubation failure.
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The Journal of pediatrics · May 2013
Randomized Controlled TrialA randomized clinical trial evaluating nasal continuous positive airway pressure for acute respiratory distress in a developing country.
Invasive mechanical ventilation is often not an option for children with acute respiratory infections in developing countries. An alternative is continuous positive airway pressure (CPAP). The authors evaluated the effectiveness of CPAP in children presenting with acute respiratory distress in a developing country. ⋯ CPAP decreases respiratory rate in children with respiratory distress compared with children not receiving CPAP. The technology was successfully used by local nurses. No complications were associated with its use. CPAP is a relatively low-cost, low-technology that is a safe method to decrease respiratory rate in children with nonspecific respiratory distress.
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The Journal of pediatrics · May 2013
Early sepsis does not increase the risk of late sepsis in very low birth weight neonates.
To examine whether preterm very low birth weight (VLBW) infants have an increased risk of late-onset sepsis (LOS) following early-onset sepsis (EOS). ⋯ Risk of LOS after EOS was not increased in VLBW infants. Surprisingly, risk of LOS following EOS appeared to be reduced in the smallest, most premature infants, underscoring the need for age-specific analyses of immune function.
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The Journal of pediatrics · Apr 2013
Randomized Controlled TrialVitamin D status in neonates undergoing cardiac operations: relationship to cardiopulmonary bypass and association with outcomes.
To determine the incidence of vitamin D deficiency in neonates with congenital heart disease and whether differences exist by race. In addition, we determined the effect of cardiopulmonary bypass on vitamin D levels and explored associations between 25-hydroxyvitamin D [25(OH)D] levels and postoperative outcomes. ⋯ Vitamin D deficiency is prevalent in neonates with congenital cardiac defects, and lower postoperative 25(OH)D levels are associated with the need for increased inotropic support in neonates undergoing cardiac operations. These findings support that vitamin D deficiency may play a role in myocardial injury and postoperative recovery and warrants further investigation.