Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2014
Randomized Controlled Trial Comparative StudyRespiratory mechanics during NCPAP and HHHFNC at equal distending pressures.
To compare the effect of heated, humidified, high-flow nasal cannula (HHHFNC) and nasal continuous positive airways pressure (NCPAP) on lung function and mechanics in preterm infants with respiratory distress syndrome (RDS) at the same level of retropharyngeal pressure (Prp). ⋯ Despite differing mechanisms for generating positive airway pressure, when compared at the same Prp, NCPAP and HHHFNC provide similar effects on all the outcomes explored.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2014
Comparative Study Observational StudyThe precision and accuracy of Nellcor and Masimo oximeters at low oxygen saturations (70%) in newborn lambs.
Administration of oxygen in the delivery room is informed by oxygen saturation (SpO₂). An oxygen saturation range of 60%-70% is the threshold for administering oxygen in the first minutes after birth. The accuracy of newer generation oximeters to measure SpO₂ has not been compared against the 'gold standard', direct arterial blood oxygen saturation (SaO₂) when SaO₂ is low. The aim of this study was to determine the accuracy and precision of Nellcor and Masimo oximeters to measure SpO₂ when SaO₂ <70%. ⋯ At SaO₂<70%, both monitors overestimated oxygen saturation (SpO₂) compared with the gold standard. Both oximeters were equally inaccurate when SaO₂ was low.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2014
Comparative Study Observational StudyAre high flow nasal cannulae noisier than bubble CPAP for preterm infants?
Noise exposure in the neonatal intensive care unit is believed to be a risk factor for hearing loss in preterm neonates. Continuous positive airway pressure (CPAP) devices exceed recommended noise levels. High flow nasal cannulae (HFNC) are an increasingly popular alternative to CPAP for treating preterm infants, but there are no in vivo studies assessing noise production by HFNC. ⋯ At the gas flows studied, HFNC are not noisier than BCPAP for preterm infants.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2014
Multicenter Study Observational StudyFresh frozen plasma use in the NICU: a prospective, observational, multicentred study.
To examine the use of fresh frozen plasma (FFP) in Italian neonatal intensive care units (NICUs); specifically to quantify compliance with guideline recommendations and to evaluate the relationship between coagulation tests and subsequent bleeding episodes. ⋯ FFP transfusion is a relatively frequent intervention in the NICU. In the present analysis, we found a remarkably high proportion of FFP transfusions given to non-bleeding neonates for indications not compliant with guideline recommendations. Platelet counts and coagulation studies were poor predictors of clinical bleeding.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2014
ReviewPrenatal diagnosis of chromosomal imbalances.
Prenatal array comparative genome hybridisation (aCGH) testing has by and large replaced routine karyotyping in many healthcare settings. While this will lead to more diagnoses, uncertain, unexpected or unhelpful findings are also likely to increase. This is the case for aCGH in any setting, but we discuss the particular challenges the prenatal setting generates and suggest areas that need further debate and discussion as well as some pragmatic ways forward.