Journal of perinatology : official journal of the California Perinatal Association
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Randomized Controlled Trial Comparative Study
Bubble and ventilator-derived nasal continuous positive airway pressure in premature infants: work of breathing and gas exchange.
During bubble nasal continuous positive airway pressure (B-NCPAP), gas flows through the expiratory limb of CPAP tubing submerged underwater to a depth in centimeters considered equal to the desired end expiratory pressure. Ventilator-derived NCPAP (V-NCPAP) controls the delivered pressure at the expiratory orifice. Limited data exist comparing the two forms of NCPAP on work of breathing (WOB) and other short-term respiratory outcomes. We compared WOB and gas exchange between B-NCPAP and V-NCPAP at equivalent delivered nasal prong pressures among a cohort of preterm infants on NCPAP. ⋯ WOB and ventilation with B-NCPAP and V-NCPAP are similar when equivalent delivered prong pressures are assured. Improved oxygenation with B-NCPAP is intriguing and requires further investigation.
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Randomized Controlled Trial
The effect of low-dose heparin on maintaining peripherally inserted percutaneous central venous catheters in neonates.
To evaluate the effect of low-dose heparin on duration of peripherally inserted percutaneous central venous catheter (PCVC) patency and catheter occlusion. ⋯ In neonates with PCVCs, low-dose continuous infusion of heparin (0.5 IU kg ⁻¹h⁻¹ within TPN fluids is an effective measure in terms of reducing catheter occlusion, allowing successful completion of the therapy, without increasing adverse effects. Furthermore, this effect of heparin may occur independently via occlusion-related factors that we evaluated in the study.
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Randomized Controlled Trial Comparative Study
High-flow nasal cannula and extubation success in the premature infant: a comparison of two modalities.
To compare the effectiveness of Fisher and Paykel (FP) and Vapotherm (VT) high-flow nasal cannula (HFNC) in preventing reintubation either within 72 h or <7 days after extubation of premature infants. The primary outcome was the rate of extubation failure defined as reintubation within 72 h. Secondary outcomes included reintubation after ≤7 days. ⋯ There was no difference between FP and VT in the extubation success of infants born between 26 and 29 weeks.
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Randomized Controlled Trial Comparative Study
Tele-education vs classroom training of neonatal resuscitation: a randomized trial.
To compare gain in knowledge and skills of neonatal resuscitation using tele-education instruction vs conventional classroom teaching. ⋯ Tele-education offers a feasible and effective alternative to conventional training in neonatal resuscitation among health-care providers.
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Randomized Controlled Trial
Effect of topical anesthesia and age on pain scores during retinopathy of prematurity screening.
The efficacy of topical anesthesia during retinopathy of prematurity (ROP) screening has been a controversial issue. To determine the efficacy of proparacaine eye drops (0.5%), we compared the Premature Infant Pain Profile (PIPP) scores in 40 preterm infants undergoing ROP screening. ⋯ Proparacaine eye drops offer significant relief of pain that is apparently short lived. Significantly lower PIPP scores at second ROP examinations suggested that infants of older GA may have a greater ability to tolerate ROP screening. We recommend the use of proparacaine eye drops for the short term, immediate relief of pain during ROP screening in preterm infants of lesser GA.