The New England journal of medicine
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Randomized Controlled Trial Multicenter Study Comparative Study
Laparotomy versus peritoneal drainage for necrotizing enterocolitis and perforation.
Perforated necrotizing enterocolitis is a major cause of morbidity and mortality in premature infants, and the optimal treatment is uncertain. We designed this multicenter randomized trial to compare outcomes of primary peritoneal drainage with laparotomy and bowel resection in preterm infants with perforated necrotizing enterocolitis. ⋯ The type of operation performed for perforated necrotizing enterocolitis does not influence survival or other clinically important early outcomes in preterm infants. (ClinicalTrials.gov number, NCT00252681.).
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Randomized Controlled Trial Multicenter Study Comparative Study
Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury.
The balance between the benefits and the risks of pulmonary-artery catheters (PACs) has not been established. ⋯ PAC-guided therapy did not improve survival or organ function but was associated with more complications than CVC-guided therapy. These results, when considered with those of previous studies, suggest that the PAC should not be routinely used for the management of acute lung injury. (ClinicalTrials.gov number, NCT00281268.).
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Randomized Controlled Trial Multicenter Study
Caffeine therapy for apnea of prematurity.
Methylxanthines reduce the frequency of apnea of prematurity and the need for mechanical ventilation during the first seven days of therapy. It is uncertain whether methylxanthines have other short- and long-term benefits or risks in infants with very low birth weight. ⋯ Caffeine therapy for apnea of prematurity reduces the rate of bronchopulmonary dysplasia in infants with very low birth weight. (ClinicalTrials.gov number, NCT00182312.).