Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2012
Randomized Controlled Trial Comparative StudyEfficacy of tramadol versus fentanyl for postoperative analgesia in neonates.
To assess, in newborn infants submitted to surgical procedures, the efficacy of two opioids-fentanyl and tramadol-regarding time to extubate, time to achieve 100 ml/kg of enteral feeding and pain in the first 72 h after surgery. ⋯ Tramadol was as effective as fentanyl for postoperative pain relief in neonates but does not appear to offer advantages over fentanyl regarding the duration of mechanical ventilation and time to reach full enteral feeding. Trial registration NCT00713726.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jan 2012
Outcomes following the surgical ligation of the patent ductus arteriosus in premature infants in Scotland.
To determine morbidity, mortality and associated risk factors following patent ductus arteriosus (PDA) ligation in premature infants. ⋯ PDA ligation is well tolerated, with evidence of early benefit. The incidence of neurodisability or death from BPD at 1 year remains high. Increasing preoperative FiO(2) and lack of prior treatment with COIs are associated with increased mortality at 1 year.
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Arch. Dis. Child. Fetal Neonatal Ed. · Nov 2011
Effects of non-synchronised nasal intermittent positive pressure ventilation on spontaneous breathing in preterm infants.
Nasal intermittent positive pressure ventilation (NIPPV) may be beneficial but the mechanisms of action are undetermined. ⋯ NIPPV pressure peaks only resulted in a small increase in relative tidal volumes when delivered during spontaneous inspiration. During apnoea pressure peaks occasionally resulted in chest inflation, which ameliorated oxygen desaturations. Infants did not become entrained with the NIPPV pressure changes. Synchronising every rise in applied pressure with spontaneous inspiration may increase the effectiveness of NIPPV and warrants investigation.
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Arch. Dis. Child. Fetal Neonatal Ed. · Nov 2011
Comparative StudyReturn of spontaneous circulation with a compression:ventilation ratio of 15:2 versus 3:1 in newborn pigs with cardiac arrest due to asphyxia.
International guidelines recommend a compression to ventilation (C:V) ratio of 3:1 in neonates, and 15:2 for other paediatric age groups. The authors aimed to compare these two C:V ratios in a neonatal swine model of cardiac arrest following asphyxia. ⋯ In neonatal pigs with asphyxia-induced cardiac arrest, the response to a C:V ratio of 15:2 is not better than the response to a C:V ratio of 3:1 despite better generation of DBP during resuscitation.
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Arch. Dis. Child. Fetal Neonatal Ed. · Nov 2011
ReviewUnderstanding and managing breast milk jaundice.
The breastfed infant with prolonged unconjugated hyperbilirubinaemia can present a vexing clinical dilemma. Although it is a frequently observed and usually benign finding, prolonged jaundice in the breastfed newborn requires a thoughtful evaluation that excludes possible pathological aetiologies. While recommendations for the treatment of unconjugated hyperbilirubinaemia in the first 7 days of life are straightforward, the approach to the breastfeeding infant with jaundice that persists beyond the immediate neonatal period is less clearly delineated. A sound understanding of bilirubin physiology and familiarity with current literature must guide the management of the otherwise well breastfeeding infant with prolonged unconjugated hyperbilirubinaemia.