Archives of disease in childhood. Fetal and neonatal edition
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Arch. Dis. Child. Fetal Neonatal Ed. · Nov 2010
Randomized Controlled TrialSweeten, soother and swaddle for retinopathy of prematurity screening: a randomised placebo controlled trial.
To assess the efficacy of oral sucrose combined with swaddling and non-nutritive suck (NNS) as a method for reducing pain associated with retinopathy of prematurity (ROP) screening. ⋯ ROP screening is a necessary but recognised painful procedure. Sucrose combined with NNS and swaddling reduced the behavioural and physiological pain responses. However, pain scores remained consistently high and appropriate pain relief for ROP screening remains a challenge.
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Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2010
Randomized Controlled TrialRemifentanil for endotracheal intubation in neonates: a randomised controlled trial.
To evaluate the efficacy and safety of remifentanil as a premedication in neonates undergoing elective endotracheal intubation. ⋯ Although remifentanil is comparable to fentanyl and succinylcholine in attenuating adverse physiologic responses during neonatal intubation, muscle rigidity is a concern at doses of 3 microg/kg. Further trials are required to evaluate ideal dosing regimens and combinations of agents for use with remifentanil in neonates.
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Arch. Dis. Child. Fetal Neonatal Ed. · Mar 2010
Randomized Controlled TrialNasal continuous positive airway pressure (CPAP) versus bi-level nasal CPAP in preterm babies with respiratory distress syndrome: a randomised control trial.
To evaluate the clinical course, respiratory outcomes and markers of inflammation in preterm infants with moderate respiratory distress syndrome (RDS) assigned from birth to nasal continuous positive airway pressure (NCPAP) or bi-level NCPAP. ⋯ Bi-level NCPAP was associated with better respiratory outcomes versus NCPAP, and allowed earlier discharge, inducing the same changes in the cytokine levels. It was found to be well tolerated and safe in the study population.
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Arch. Dis. Child. Fetal Neonatal Ed. · Nov 2009
Randomized Controlled Trial Comparative StudyFlow-cycled versus time-cycled sIPPV in preterm babies with RDS: a breath-to-breath randomised cross-over trial.
Few data exist about patient-triggered ventilation techniques in neonatal critical care. Our aim was to compare pressure-limited synchronised intermittent positive pressure (or assist/control) ventilation (sIPPV) in the classical time-cycled (TC-sIPPV) mode against flow-cycled (FC-sIPPV) modality. In this latter, typical sIPPV full respiratory support is provided but both the initiation and the end of inflation are determined by the infant's spontaneous respiratory efforts by using airway flow changes. ⋯ FC-sIPPV may safely result in a better patient ventilator synchrony. Inspiratory time usually set in neonatal critical care is higher than that decided by the baby during spontaneous effort. This should be considered when establishing time-cycled ventilation.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2009
Randomized Controlled TrialRandomised crossover trial of four nasal respiratory support systems for apnoea of prematurity in very low birthweight infants.
Apnoea of prematurity (AOP) is a common problem in preterm infants which can be treated with various modes of nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive pressure ventilation (NIPPV). It is not known which mode of NCPAP or NIPPV is most effective for AOP. ⋯ A variable flow NCPAP device may be more effective in treating AOP in preterm infants than a conventional ventilator in NIPPV mode. It remains unclear whether synchronised NIPPV would be even more effective.