Journal of perinatology : official journal of the California Perinatal Association
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To examine influences on neonatologists' decision-making regarding resuscitation of extremely premature infants. ⋯ Neonatologists perceive a 'gray zone' of resuscitative practices and should understand that external influences may affect their delivery room resuscitation practices.
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A term infant requiring resuscitation was found to have a false-positive color change on a colorimetric carbon dioxide device as a result of administration of epinephrine via an endotracheal tube. Using models of direct application and vapor exposure with a test lung, we discovered that epinephrine, atropine, infasurf and naloxone may result in false-positive color change. This false-positive response may lead to delayed recognition of esophageal intubation.
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomized controlled trial of synchronized nasal intermittent positive pressure ventilation in RDS.
Comparison of outcomes of infants with respiratory distress syndrome (RDS), post-surfactant, extubated to synchronized nasal intermittent positive pressure ventilation (SNIPPV) or continued on conventional ventilation (CV). ⋯ Infants of BW 600 to 1250 g with RDS receiving surfactant with early extubation to SNIPPV had a significantly lower incidence of BPD/death. Primary mode SNIPPV is a feasible method of ventilation in small premature infants.
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Case Reports
Acute airway obstruction by a sheared endotracheal intubation stylet sheath in a premature infant.
Airway obstruction by foreign bodies is rarely encountered in the neonatal intensive care unit. The majority of those cases reported are iatrogenic. ⋯ The small airway of this premature infant posed a challenge to retrieve the foreign body and to ensure adequate gas exchange at the same time. The risks and benefits of available therapeutic options for this rare, but serious complication are reviewed.
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Comparative Study
Unintentional exposure of neonates to conventional radiography in the Neonatal Intensive Care Units.
To evaluate the extent of unintentional exposure to X-rays performed during routine diagnostic procedures in the Neonatal Intensive Care Units (NICUs). ⋯ In the NICUs participating in the study, neonates are currently being exposed to X-ray radiation in nonrelevant body regions. Higher awareness and training of the medical teams and radiographers are required to minimize unnecessary exposure of newborns to ionizing radiation.