Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2012
Multicenter StudyCooling and seizure burden in term neonates: an observational study.
To investigate any possible effect of cooling on seizure burden, the authors quantified the recorded electrographic seizure burden based on multichannel video-EEG recordings in term neonates with hypoxic-ischaemic encephalopathy (HIE) who received cooling and in those who did not. ⋯ A decreased seizure burden was seen in neonates with moderate HIE who received cooling. This finding may explain some of the therapeutic benefits of cooling seen in term neonates with moderate HIE.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2012
Neonatal resuscitation: are your trainees performing as you think they are? A retrospective review of a structured resuscitation assessment for neonatal medical trainees over an 8-year period.
To ascertain whether Newborn Life Support Course (NLS) accredited trainees could demonstrate resuscitation skills appropriate to their level of training by providing standardised assessments of both junior and senior paediatric trainees during their induction period. ⋯ Significant numbers of trainees who have been formally trained in neonatal resuscitation skills previously do not pass the standardised resuscitation assessment, thus require an additional input to maintain their competence in neonatal resuscitation.
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2012
ReviewThe management of neonatal pulmonary hypertension.
Most neonates with clinically significant pulmonary hypertension (PH) will have either persistent PH of the newborn (PPHN) or bronchopulmonary dysplasia. Cyanotic congenital heart disease must be actively ruled out as part of the differential diagnosis of PPHN. ⋯ Specific tools in the treatment of PPHN include modern ventilatory strategies, inhaled nitric oxide, sildenafil, prostacyclin and extracorporeal membrane oxygenation. Rarely will a cardiac lesion be primarily responsible for neonatal PH although pulmonary vein stenosis and the persistence of an arterial duct must be considered, particularly in the older preterm baby with bronchopulmonary dysplasia.
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Arch. Dis. Child. Fetal Neonatal Ed. · May 2012
Effective ventilation at conventional rates with tidal volume below instrumental dead space: a bench study.
The authors previously showed that 48% of infants <800 g were ventilated with tidal volume (VT) < dead space (DS) using volume guarantee (VG) ventilation. Here, The authors sought to confirm those findings under the rigorous conditions of a bench study. ⋯ Contrary to conventional physiology, effective CO(2) elimination appears to be possible with VT
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Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2012
Multicenter StudyNeonatal intensive care unit safety culture varies widely.
Variation in healthcare delivery and outcomes in neonatal intensive care units (NICUs) may be partly explained by differences in safety culture. ⋯ There is significant variation and scope for improvement in safety culture among these NICUs. The NICU variation was similar to variation in adult ICUs, but NICU scores were generally higher. Future studies should validate whether safety culture measured with the SAQ correlates with clinical and operational outcomes in NICUs.