Journal of perinatology : official journal of the California Perinatal Association
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized trial of normal saline versus 5% albumin for the treatment of neonatal hypotension.
This study was designed to assess the comparative efficacy of normal saline (NS) and 5% albumin (ALB) for treatment of hypotension in the acutely ill newborn. ⋯ NS was shown to be as effective as ALB for the correction of acute hypotension in the newborn infant. Given comparable efficacy of NS, along with its relatively low cost and availability, it should be considered the initial treatment of choice in this setting.
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Randomized Controlled Trial Clinical Trial
Usefulness of the minute ventilation test in predicting successful extubation in newborn infants: a randomized controlled trial.
We performed a prospective, randomized clinical trial to compare the usefulness of the minute ventilation test (MVT) with clinical judgement in predicting readiness for extubation in preterm newborns with respiratory distress syndrome requiring surfactant therapy and mechanical ventilation. ⋯ The MVT is an easily performed objective measure that can be used to predict readiness for extubation in preterm infants. In this study, it significantly shortened the time for extubation and was not associated with a higher rate of reintubation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Crossover trial comparing pressure support with synchronized intermittent mandatory ventilation.
To compare pressure support ventilation (PSV) with volume guarantee (VG) to synchronized intermittent mandatory ventilation (SIMV) in infants with respiratory distress syndrome (RDS). ⋯ Because of an increase in V(E) with PSV+VG, and no difference in the a/A ratio or sCdyn, we do not recommend the routine use of PSV+VG for this population.
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Randomized Controlled Trial Clinical Trial
Obtaining blood samples for anti-factor Xa quantification through umbilical artery catheters.
Neonates who are treated with low-molecular-weight heparin require repeated venipunctures to monitor anti-factor Xa (anti-FXa) levels. Generally, blood withdrawn from umbilical artery catheters (UACs) is not useful for such monitoring because heparin in the fluids running through the catheters contaminates the results. We tested methods for collecting blood for anti-FXa levels from UACs through which heparin-containing fluids were running, in an attempt to reduce the need for repeated venipunctures of anticoagulated neonates. ⋯ Blood samples for anti-FXa can be drawn from UACs through which heparin-containing solutions are infusing if a port is added through which no heparin-containing fluids are run, a line-clearing volume of at least 4.0 ml is drawn, and a contamination rate of 8% of samples is acceptable.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Early high-frequency oscillatory ventilation versus synchronized intermittent mandatory ventilation in very low birth weight infants: a pilot study of two ventilation protocols.
To evaluate the feasibility of conducting a prospective, randomized trial comparing early high-frequency oscillatory ventilation (HFOV) to synchronized intermittent mandatory ventilation (SIMV) in very low birth weight (VLBW) premature infants. This pilot study evaluated two ventilator management protocols to determine how well they could be implemented in a multicenter clinical trial. Although this pilot study was not powered to detect differences in outcome, we also collected outcome data. ⋯ The preliminary outcome data supports conducting the large randomized trial, which began in July of 1998. The protocols for the ventilator management of VLBW infants, both with HFOV and with SIMV were easily implemented and consistently followed, and are presented here.