Indian journal of pediatrics
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A brief overview of extracorporeal membrane oxygenation and its use in infants and children is presented. The history, selection, operative procedure, daily management and complications are discussed. The international results are shown.
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For many years pediatric procedural and postoperative pain has been undertreated or not treated. In some areas this practice still exists and is a likely reflection of persistence of myths related to the infant's ability to perceive pain. Such myths include the lack of ability to perceive pain or remember painful experiences. ⋯ Additionally, the use of epidural opioids is extremely useful in patients following major abdominal, thoracic, and orthopedic surgery. Traditional medications such as oral and parenteral narcotics, non-steroidal anti-inflammatory drugs, and acetaminophen (paracetamol), are much more commonly used to treat postoperative pain. Regardless of the analgesic regimen chosen, we must assure our pediatric patients the least painful perioperative experience possible.
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Comparative Study Clinical Trial
End tidal carbon dioxide monitoring--its reliability in neonates.
End tidal Carbon dioxide monitoring was undertaken prospectively in all Ventilated neonates in our NICU admitted from March 1995 to August 1995 irrespective of the birth weight, gestational age and indication of ventilation. The aim was to determine the correlation between ETCO2 and PaCO2 in various clinical situations. The arterial blood gases were obtained in all ventilated babies with simultaneous and continuous ETCO2 monitoring and were analysed by AVL 995 Hb blood gas analyser. ⋯ Results of the correlation analysis revealed that the correlation coefficient in the study group ranged from 0.55 to 0.96 and was statistically significant in babies > 2.5 kg and 1.5-2.5 kg, in term and preterms 32-36 wks, and in babies with MAS, SBA and Recurrent Apnoea. The correlation coefficient was lowest in babies with HMD, being 0.55. The study showed that ETCO2 correlates closely with PaCO2 in most clinical situations in neonates and we recommend its use in all level III NICUs in ventilated babies.