Early human development
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Early human development · May 2012
Gentle ventilation: the new evidence from the SUPPORT, COIN, VON, CURPAP, Colombian Network, and Neocosur Network trials.
Many neonates have respiratory disorders requiring oxygen supplementation and respiratory support. Even though advances in respiratory care such as surfactant and new ventilatory techniques have improved outcomes, mortality from respiratory failure and morbidities such as bronchopulmonary dysplasia are still common. ⋯ It is possible that the control infants had lung injury secondary to mechanical ventilation. This review will address the recent trials of early continuous positive airway pressure (CPAP) as an alternative to the common practice of surfactant and mechanical ventilation.
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Early human development · May 2012
Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units.
Very-low-birth-weight (VLBW, <1500 g birth weight) infants are at high risk for both early- and late-onset sepsis. Prior studies have observed a predominance of Gram-negative organisms as a cause of early-onset sepsis and Gram-positive organisms as a cause of late-onset sepsis. These reports are limited to large, academic neonatal intensive care units (NICUs) and may not reflect findings in other units. The purpose of this study was to determine the risk factors for sepsis, the causative organisms, and mortality following infection in a large and diverse sample of NICUs. ⋯ This is the largest report of sepsis in VLBW infants to date. Incidence for early-onset sepsis and late-onset sepsis has changed little over this 14-year period, and overall mortality in VLBW infants with early- and late-onset sepsis is higher than in infants with negative cultures.
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We sought to determine the risk factors, incidence, and mortality of very late onset bacterial infection (blood, urine, or cerebrospinal fluid culture positive occurring after day of life 120) in preterm infants. ⋯ Important predictive risk factors for early and late onset sepsis (birth weight and gestational age) did not contribute to risk of developing very late onset infection. Evaluation for infection (whether positive or negative) was a significant risk factor for death. GPC and fungal infections were associated with high mortality.
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Early human development · Apr 2012
Comparative StudySpecific change in spectral power of fetal heart rate variability related to fetal acidemia during labor: comparison between preterm and term fetuses.
Spectral analysis of fetal heart rate (FHR) variability is a useful method to assess fetal condition. There have been several studies involving the change in spectral power related to fetal acidemia, but the results have been inconsistent. ⋯ The changes in spectral power responding to a low pH are different between term and preterm fetuses. Spectral analysis of FHR variability may be useful fetal monitoring for early detection of fetal acidemia.