Neonatology
-
Randomized Controlled Trial Comparative Study
Estimating the endotracheal tube insertion depth in newborns using weight or gestation: a randomised trial.
When intubating newborns, clinicians aim to place the tip of the endotracheal tube (ETT) in the mid-trachea. Clinicians usually estimate the ETT insertion depth based on weight. ETT tips are often incorrectly positioned in newborns. Estimating the insertion depth based on gestation may be more accurate. ⋯ Estimating the ETT insertion depth in newborns using gestation compared to weight did not result in more correctly placed ETTs.
-
Observational Study
Factors Associated with Adverse Events during Tracheal Intubation in the NICU.
The incidence of adverse tracheal intubation-associated events (TIAEs) and associated patient, practice, and intubator characteristics in the neonatal intensive care unit (NICU) setting are unknown. ⋯ Adverse TIAEs and severe oxygen desaturation events are common in the NICU setting. Modifiable risk factors associated with TIAEs identified include intubator training level and use of paralytic medications.
-
Comparative Study
Neurally adjusted ventilatory assist in preterm neonates with acute respiratory failure.
Neurally adjusted ventilatory assist (NAVA) is a novel mode of ventilation that has been demonstrated to improve infant-ventilator interaction, compared to the conventional modes in retrospective and short-term studies. ⋯ In acutely ill preterm neonates, NAVA can be safely and efficiently applied for 12 consecutive hours. Compared to PRVC, NAVA is well tolerated with fewer sedatives.
-
Therapeutic hypothermia for hypoxic ischaemic encephalopathy (HIE) has been proved effective. Standard equipment is expensive, while ice packs used in low resource settings are labour intensive and associated with wider temperature fluctuations. ⋯ PCM provides a low cost and effective method to maintain therapeutic hypothermia. However, careful monitoring is required during induction and the rewarming phase to avoid hypothermia outside the therapeutic range.
-
Observational Study
Plasma Proendothelin-1 as an Early Marker of Bronchopulmonary Dysplasia.
Bronchopulmonary dysplasia (BPD) is a common complication in preterm infants. Clinical prediction of BPD at an early stage in life is difficult. Plasma proendothelin-1 (CT-proET-1) is a lung injury biomarker in pulmonary hypertension and respiratory distress. ⋯ CT-proET-1 is a novel promising biomarker for predicting the development of BPD in preterm infants when measured at the end of the first week of life.