The Journal of pediatrics
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The Journal of pediatrics · Oct 2014
Multicenter Study Observational StudyTidal volumes in spontaneously breathing preterm infants supported with continuous positive airway pressure.
To describe changes in tidal volume (VT) and their correlation to changes in oxygen saturation and heart rate in spontaneously breathing preterm infants immediately after birth. ⋯ The 50th percentile for spontaneous VT in preterm infants during mask CPAP ranged from 4.2 to 5.8 mL/kg, with wide individual variation observed in the first minutes after birth. Preterm infants requiring CPAP after birth may take longer to achieve so-called "normal" saturation targets.
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The Journal of pediatrics · Oct 2014
Multicenter StudyVariation in the management of infants hospitalized for bronchiolitis persists after the 2006 American Academy of Pediatrics bronchiolitis guidelines.
To describe variation across US pediatric hospitals in the utilization of resources not recommended for routine use by the American Academy of Pediatrics guideline for infants hospitalized with bronchiolitis and to examine the association between resource utilization and disposition outcomes. ⋯ Substantial use and variation in 5 resources not recommended for routine use by the American Academy of Pediatrics bronchiolitis guideline persists with increased utilization associated with increased LOS without the benefit of decreased readmission. Future work should focus on developing processes that can be widely disseminated and easily implemented to minimize unwarranted practice variation when evidence and guidelines exist.
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The Journal of pediatrics · Oct 2014
Multicenter StudyResource utilization and outcomes of infective endocarditis in children.
To evaluate resource use and outcomes of infective endocarditis in children with and without preexisting heart disease via a national cohort. ⋯ Infective endocarditis remains a significant cause of morbidity, mortality, and resource use particularly in children with heart disease.
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The Journal of pediatrics · Sep 2014
Multicenter StudyImpact of inpatient bronchiolitis clinical practice guideline implementation on testing and treatment.
To determine the association between institutional inpatient clinical practice guidelines (CPGs) for bronchiolitis and the use of diagnostic tests and treatments. ⋯ Most children's hospitals have an institutional bronchiolitis CPG in place. The content of these CPGs is largely uniform in practice recommendations against tests and treatments. The presence of institutional CPGs did not significantly reduce the ordering of tests and treatments. Online accessibility of a written CPG and prolonged duration of implementation reduce tests and treatments.
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The Journal of pediatrics · Aug 2014
Randomized Controlled Trial Multicenter Study Comparative StudyComparison of devices for newborn ventilation in the delivery room.
To evaluate the effectiveness and safety of a T-piece resuscitator compared with a self-inflating bag for providing mask ventilation to newborns at birth. ⋯ There was no difference between the T-piece resuscitator and a self-inflating bag in achieving an HR of ≥100 bpm at 2 minutes in newborns≥26 weeks gestational age resuscitated at birth. However, use of the T-piece decreased the intubation rate and the maximum pressures applied.