Pediatrics
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Randomized Controlled Trial Clinical Trial
Optimal thermal management for low birth weight infants nursed under high-powered radiant warmers.
Servocontrol of skin temperature for the critically ill premature neonate nursed on a radiant warmer bed has been assumed to be analogous to skin temperature control for infants nursed in convection-warmed incubators. There are significant differences between these two warming techniques, and no definitive data exist to aid the clinical specialist in governing radiant warmer control. Eighteen low birth weight premature infants less than 2 weeks of age were studied under powerful overhead radiant warmers to determine the optimal skin temperature for servocontrol of radiant heater output. ⋯ Oxygen consumption was significantly elevated at 35.5 degrees C (8.62 +/- 0.73 mL/kg/min, mean +/- SEM) compared with 36.5 degrees C (7.30 +/- 0.55 mL/kg/min). Changing servocontrol temperature to 37.5 degrees C produced no further significant decrease in oxygen consumption (7.41 +/- 0.70 mL/kg/min), and nine infants manifested supranormal deep rectal temperatures (greater than 37.5 degrees C). Optimal abdominal skin temperature control at 36.5 degrees C (slightly warmer than previously reported but less than 37.5 degrees C) is recommended for premature neonates nursed on radiant warmer beds.(ABSTRACT TRUNCATED AT 250 WORDS)
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Risk factors for acute upper respiratory tract disease in childhood were evaluated in a population-based sample of the Atlanta metropolitan area. Mothers from 449 households containing 575 children less than 5 years of age were selected by random-digit dialing and questioned about upper respiratory tract infection and ear infection occurring in their children during the preceding 2 weeks. Household demographic and socioeconomic characteristics, maternal smoking history and child day-care attendance and breast-feeding information were also obtained. ⋯ Maternal smoking was a second independent risk factor for a child's having upper respiratory tract infection (odds ratio = 1.7, P = .01). Thirty-one percent of all upper respiratory tract infection among day-care attendees and 66% of all ear infections among full-time day-care attendees were attributable to day-care attendance. Given the proportion of children in day care, 9% to 14% of the total burden of upper respiratory tract disease in this population was day care related.(ABSTRACT TRUNCATED AT 250 WORDS)