Pediatric research
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Randomized Controlled Trial Clinical Trial
Sucrose reduces pain reaction to heel lancing in preterm infants: a placebo-controlled, randomized and masked study.
In term infants sucrose given by mouth has been reported to reduce duration of crying after a heel prick. This study was designed primarily to investigate the effect of sucrose administered orally immediately before heel lancing on the nociceptive reaction in preterm infants as assessed by change in heart rate and duration of crying. A secondary objective was to document changes in cerebral blood volume during acute pain. ⋯ We found the heart increased by a mean of 35 beats/min (bpm) after sucrose and 51 bpm after placebo (median difference 16 bpm, interquartile range 1-30 bpm, p = 0.005). Infants cried 67% of time after sucrose and 88% after placebo (median difference 10%, interquartile range 3-33%, p = 0.002). Cerebral blood volume decreased in 5 of 14 infants after sucrose and in 6 of 14 infants after placebo (difference not significant).
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Comparative Study
Measurement of cerebral venous oxyhemoglobin saturation in children by near-infrared spectroscopy and partial jugular venous occlusion.
Changes in cerebral venous oxyhemoglobin saturation reflect changes in the balance between cerebral oxygen delivery and cerebral oxygen consumption. Invasive monitoring of cerebral venous saturation (CSVO2) has provided useful information in the management of critically ill adults at risk of cerebral hypoxia. This study describes the development and validation of a non-invasive method of measuring CSVO2 suitable for use in sick neonates using near-infrared spectroscopy (NIRS) and partial jugular venous occlusion. ⋯ Three different methods of analyzing the NIRS signal were compared. The best agreement was obtained when the changes occurring during the first 5 s of partial jugular venous occlusion were studied. Greatest accuracy was seen in those subjects with least movement artifact, and we believe this technique will be reliable in sick neonates.