Pediatric research
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Comparative Study
Reference values of regional cerebral oxygen saturation during the first 3 days of life in preterm neonates.
Currently, reliable reference values of regional cerebral oxygen saturation (rScO2) for different gestational age (GA) groups are lacking, which hampers the implementation of near-infrared spectroscopy (NIRS) alongside monitoring arterial oxygen saturation (SaO2) and blood pressure in neonatal intensive care. The aim of this study was to provide reference values for rScO2 and cerebral fractional tissue oxygen extraction (cFTOE; (SaO2 - rScO2)/SaO2) for small adult and neonatal NIRS sensors. ⋯ rScO2 and cFTOE reference curves are provided for the first 72 h of life in preterm infants, which might support the broader implementation of NIRS in neonatal intensive care.
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Randomized Controlled Trial Comparative Study
Preventative effect of ondansetron on postanesthesia shivering in children undergoing caudal anesthesia: a randomized double-blinded clinical trial.
Ondansetron has been shown to decrease postanesthesia shivering in adults, but this effect has never been studied in children. This study aimed to determine whether ondansetron decreases postanesthesia shivering in children undergoing caudal anesthesia. ⋯ Ondansetron decreases postanesthesia shivering in children receiving caudal block after intravenous anesthesia.
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The regionalization of pediatric services has resulted in differential access to care, sometimes creating barriers to those living in underserved, rural communities. These disparities in access contribute to inferior healthcare outcomes among infants and children. We review the medical literature on telemedicine and its use to improve access and the quality of care provided to pediatric patients with otherwise limited access to pediatric subspecialty care. ⋯ By providing pediatric subspecialty care in more convenient settings such as local primary care offices and community hospitals, pediatric patients are more likely to receive care that adheres to evidence-based guidelines. In many cases, telemedicine can significantly improve provider, patient, and family satisfaction, increase measures of quality of care and patient safety, and reduce overall costs of care. Models of care that use telemedicine have the potential to address pediatric specialists' geographic misdistribution and address disparities in the quality of care delivered to children in underserved communities.