Acta paediatrica
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Multicenter Study
Use of supplementary equipment for resuscitation of newborn infants at tertiary perinatal centres in Australia and New Zealand.
Neonatal resuscitation is a common and important intervention. International consensus statements advise how newborns should be resuscitated and suggest equipment to be used. Use of equipment not specifically recommended in these guidelines has been advocated. We wished to determine how widely this supplementary equipment is used in a geographically defined region. ⋯ There is considerable variation in the equipment and techniques used to resuscitate newly born infants. Use of equipment not specifically recommended in international consensus statements is widespread. These are potentially effective tools to improve resuscitation. The evidence supporting their use is, however, limited. Urgent evaluation of their efficacy and safety is required before even more widespread use occurs.
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Multicenter Study
Response to resuscitation of the newborn: early prognostic variables.
To characterize the development of clinically relevant variables the first minutes after birth and identify early prognostic markers in newborn infants requiring resuscitation. ⋯ Apgar scores, heart rate, SaO(2), and time to first breath in newly born infants in need of resuscitation may be used for early identification of infants with a poor prognosis. These data may be helpful in describing the severity of depression in single infants and to select infants in need of interventional therapy.
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Multicenter Study
Is procalcitonin useful in early diagnosis of serious bacterial infections in children?
To compare diagnostic accuracy of procalcitonin for early diagnosis of serious bacterial infection (SBI) in children presenting with fever and no focus of infection. ⋯ For early diagnosis of SBI in children presenting with fever and no focus of infection, the diagnostic utility of procalcitonin is similar to the traditional markers infection and clinical scoring. While a low procalcitonin level cannot be used to exclude SBI in this population, a combination of PCT, CRP and WBC may be more useful in predicting SBI.
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To provide descriptive data on women who delivered at 23-25 wk of gestation, and to relate foetal and neonatal outcomes to maternal factors, obstetric management and the principal reasons for preterm birth. ⋯ Women who deliver at 23-25 wk comprise a risk group characterized by a high risk of reproductive failure and pregnancy complications. Survival rates were similar regardless of the reason for preterm birth. Policies of active perinatal management virtually eliminated intrapartum stillbirths.
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Multicenter Study
Positive pressure ventilation at neonatal resuscitation: review of equipment and international survey of practice.
The equipment used to provide positive pressure ventilation to newborns needing resuscitation at delivery varies between institutions. Devices were reviewed and their use surveyed in a sample of neonatal centres worldwide. ⋯ This survey shows considerable variation in practice, reflecting this lack of evidence and consequent uncertainty among clinicians. Comparison of the two most popular manual ventilation devices, the Laerdal Infant Resuscitator and the Neopuff Infant Resuscitator, is urgently required.