Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2000
ReviewNebulized racemic epinephrine for extubation of newborn infants.
Following a period of mechanical ventilation, post-extubation upper airway obstruction can occur in newborn infants, especially after prolonged, traumatic or multiple intubations. The subsequent increase in upper airway resistance may lead to respiratory insufficiency and failure of extubation. The vasoconstrictive properties of epinephrine, and its proven efficacy in the treatment of croup in infants, has led to the routine use of inhaled nebulised epinephrine immediately post-extubation in some neonatal units. It is also recommended for neonates with post-extubation tracheal obstruction and stridor in neonatal and respiratory textbooks and reviews. ⋯ randomised controlled trials are needed comparing inhaled nebulised racemic epinephrine with placebo in neonates post-extubation. This should be looked at both as a routine treatment post-extubation and as specific treatment for post-extubation upper airway obstruction. Study populations should include the group of infants at highest risk for upper airway obstruction from mucosal swelling because of their small glottic and sub-glottic diameters (ie those infants with birthweights less than 1000 grams).
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Cochrane Db Syst Rev · Jan 2000
ReviewEmollient ointment for preventing infection in preterm infants.
This section is under preparation and will be included in the next issue. ⋯ In two small studies, prophylactic application of emollient ointment decreased transepidermal water loss, decreased the severity of dermatitis, and decreased the risk of suspect sepsis and proven sepsis. Further clinical studies are warranted to validate these results.
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The single most important risk factor for postpartum maternal infection is Cesarean delivery. ⋯ The reduction of endometritis by two thirds to three quarters justifies a policy of administering prophylactic antibiotics to women undergoing elective or non-elective Cesarean section.
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The cause of Guillain-Barré syndrome (GBS) is inflammation of the peripheral nerves which corticosteroids would be expected to benefit. ⋯ Corticosteroids should not be used in the treatment of Guillain-Barré syndrome. If a patient with Guillain-Barré syndrome needs corticosteroid treatment for some other reason its use will probably not do harm. The effect of intravenous methylprednisolone combined with intravenous immunoglobulin in Guillain-Barré syndrome is being tested with a randomised trial.
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Cochrane Db Syst Rev · Jan 2000
ReviewAntioxidant vitamin and mineral supplements for age-related macular degeneration.
It has been proposed that antioxidants may prevent cellular damage in the retina by reacting with free radicals produced in the process of light absorption. ⋯ The question as to whether people with age-related macular degeneration should take antioxidant vitamin or mineral supplements to prevent progression of the disease has not been answered by research to date. The results of ongoing trials are awaited.