Indian journal of pediatrics
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Randomized Controlled Trial
Bubble vs conventional continuous positive airway pressure for prevention of extubation failure in preterm very low birth weight infants: a pilot study.
To compare the efficacy of bubble and conventional nasal continuous positive airway pressure (CPAP) in preventing extubation failure (EF) in preterm infants. ⋯ The possibility that bubble CPAP may be associated with reduced EF as suggested in this pilot study requires further investigation in an adequately powered multicentric study.
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To analyze the outcome of inborn preterm neonates with respiratory-distress-syndrome (RDS), using the approach of administering nasal-continuous-positive-airway-pressure (CPAP) alone and administering surfactant only if they require mechanical ventilation (MV). ⋯ Institution of CPAP alone in all spontaneously breathing preterm babies with RDS and administration of surfactant to only those needing MV reduces the need for intubations and surfactant administration without affecting the outcome adversely. Extreme preterms with RDS, however, may be given surfactant if they happen to be intubated for resuscitation at birth.
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Acute kidney injury is common in hospitalized children and is associated with siginficant morbidity and mortality especially in critically ill children. A complete evaluation is necessary for all children with AKI as early recognition and treatment is paramount. Apart from clinical evaluation, urinalysis, biochemical investigations and imaging studies helps in the diagnosis of the specific cause of AKI and assessing its severity. ⋯ Immediate initiation of renal replacement therapy (RRT) is indicated in the presence of life threatening changes in fluid, electrolyte and acid-base balance. Other measures like treating the underlying cause of AKI, adapting dosage of drugs to renal function, treatment of infections and providing adequate nutrition is important. Children with AKI should be followed up as they are at risk for development of chronic kidney disease.