Biology of the neonate
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Biology of the neonate · Jan 2003
ReviewResuscitation of premature infants: what are we doing wrong and can we do better?
Neonatal resuscitation is based on experience with little evidence to support the methods advocated. Current guidelines make no distinction between the techniques for term and very premature infants. The guidelines support the use of 100%, cold, dry oxygen delivered with devices that provide variable peak inspiratory pressures and tidal volumes with no positive end-expiratory pressure (PEEP). ⋯ It is surprising they are not routinely recommended for resuscitation when establishing the lung volume is paramount. Volutrauma is a potential problem in neonatal resuscitation and yet none of the devices give any indication of the tidal volume delivered. There is considerable potential for improvement in techniques of neonatal resuscitation through the application of evidence already available and much scope for further research in this field.
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Biology of the neonate · Jan 2003
Use of sound-absorbing panel to reduce noisy incubator reverberating effects.
To assess the amplification and distortion of noise in incubators by measuring noise levels from various sources under various conditions. ⋯ Incubators are reverberating environments, which amplify the baby's cry and other noises produced inside the hood. The frequency components of noises are altered by the hood. The sound absorbing panel reduced this phenomenon.
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Biology of the neonate · Jan 2003
Reproducibility of cerebral near infrared spectroscopy in neonates.
Near infrared spectroscopy (NIRS) allows to study cerebral hemodynamics and oxygenation in neonates, which may be useful for early detection of cerebral hypoxemia. So far this method is not reliable enough to be used clinically. Reproducibility is one of the prerequisites for reliable quantitative monitoring. ⋯ The cerebral oxygen saturation parameter rSO(2) showed a good reproducibility, with an inter-measurement variance slightly but not significantly higher than the physiological baseline variation. The NIRS concentration parameters HbO(2), HbD, and HbT were less reproducible, with significant variation due to repeated sensor replacement. However, for cerebral oximetry rSO(2) is likely to be more important than the other NIRS parameters, so that NIRS has the potential to become a quantitative cerebral monitoring method.
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Biology of the neonate · Jan 2003
Early arterial lactate and prediction of outcome in preterm neonates admitted to a neonatal intensive care unit.
In the present study early arterial lactate samples were examined to predict adverse outcome in preterm neonates. ⋯ Arterial lactate levels within 3 h of life can be used to select preterm neonates who are at risk of an adverse outcome.
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Biology of the neonate · Jan 2003
Application of the open-lung concept during positive-pressure ventilation reduces pulmonary inflammation in newborn piglets.
It has been shown that application of the open-lung concept (OLC) during high-frequency oscillatory ventilation (HFOV) attenuates pulmonary inflammation. We hypothesized that this attenuation could also be achieved by applying the OLC during positive-pressure ventilation (PPV). ⋯ There were no differences in tumor necrosis factor alpha levels. We conclude that application of the OLC during PPV reduces pulmonary inflammation as compared with conventional PPV and that the magnitude of this reduction is comparable to that of HFOV.