Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Dec 2003
How to score arousals in preterm infants? Can we use recommendations of the Pediatric Wake-up Club?
Infants' arousals from sleep reflect the activation of various brain stem and cortical structures and their characteristics change with age. Arousal scoring based on the Pediatric Wake-up Club definition of arousal in infants was evaluated to determine whether arousals could be reliably identified and assessed in preterm infants also. Polygraphic recordings were made in seven stable preterm infants with a mean postconceptional age of 34.4 +/- 1.2 weeks. ⋯ Respiratory rate was higher (35 +/- 15 bpm) during the arousal than in the periods preceding (29 +/- 14 bpm; p < 0.01) and following (29 +/- 11 bpm; p < 0.001) it. Heart rate decreased during the arousal (131 +/- 30 bpm) when compared with the preceding 10-second period (140 +/- 14 bpm; p < 0.05). We found that arousals in preterm infants can be reliably identified and assessed using the Pediatric Wake-up Club's arousal definition for term infants.
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Wien. Klin. Wochenschr. · Dec 2003
[Nocturnal noninvasive ventilation of children and adolescents with neuromuscular diseases: effect on sleep and symptoms].
Sleep disordered breathing (SDB) is an inevitable complication of progressive neuromuscular disorders (NMD). Aim of the study was to prospectively investigate the impact of three months of non-invasive ventilation (NIV) on sleep and SDB-associated symptoms in children and adolescents with advanced NMD. ⋯ In children with NMD intermittent nocturnal NIV results in objective and subjective improvements of sleep quality and symptoms associated with SDB.
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Wien. Klin. Wochenschr. · Dec 2003
Classification of sudden infant death (SID) cases in a multidisciplinary setting. Ten years experience in Styria (Austria).
Sudden infant death syndrome (SIDS) remains a challenge for health professionals despite decreasing rates in recent years. The figures for different areas and time periods are hardly comparable, because of differences in postmortem investigations and classification criteria. In 1992, the European Society for the Study and Prevention of Infant Deaths (ESPID) proposed a classification for any sudden and unexpected death in infancy. This proposal has been used in our study since 1993 to better classify sudden infant death (SID) cases. ⋯ An extensive analysis of SID events is a prerequisite for reliable and comparable SIDS statistics. Our data show that in several SID cases careful post-mortem examinations led to an explanation of death. In other cases, minor alterations may have contributed to the lethal event. These findings should therefore be considered in the classification of SIDs. The ESPID classification of 1992 appears to be very useful for this purpose and its use may therefore be recommended.
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Wien. Klin. Wochenschr. · Dec 2003
Case Reports[The Tübingen palatal plate--an innovative therapeutic concept in Pierre-Robin sequence].
Infants with Pierre-Robin sequence (PRS) may suffer severe upper airway obstruction resulting in hypoxemia that is difficult to treat. We are currently evaluating a new therapeutic approach involving an oral appliance that widens the pharynx by pulling the base of the tongue forward using a preepiglottic baton. Here we present a patient treated with this device who showed a decrease in his desaturation index from 50 to < 1.