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19 papers 25 to 100 followers
Julien I E Hoffman
No abstract text is available yet for this article.
2016: Neonatology
Yacov Rabi, Nalini Singhal, Alberto Nettel-Aguirre
OBJECTIVE: We conducted a blinded, prospective, randomized control trial to determine which oxygen-titration strategy was most effective at achieving and maintaining oxygen saturations of 85% to 92% during delivery-room resuscitation. METHODS: Infants born at 32 weeks' gestation or less were resuscitated either with a static concentration of 100% oxygen (high-oxygen group) or using an oxygen-titration strategy starting from a concentration of 100% (moderate-oxygen group), or 21% oxygen (low-oxygen group)...
August 2011: Pediatrics
Ilona C Narayen, Nico A Blom, Andrew K Ewer, Maximo Vento, Paolo Manzoni, Arjan B te Pas
Pulse oximetry (PO) screening for critical congenital heart defects (CCHD) has been studied extensively and is being increasingly implemented worldwide. This review provides an overview of all aspects of PO screening that need to be considered when introducing this methodology. PO screening for CCHD is effective, simple, quick, reliable, cost-effective and does not lead to extra burden for parents and caregivers. Test accuracy can be influenced by targets definition, gestational age, timing of screening and antenatal detection of CCHD...
March 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Yacov Rabi, Abhay Lodha, Amuchou Soraisham, Nalini Singhal, Keith Barrington, Prakesh S Shah
BACKGROUND: After 2006 most neonatal intensive care units (NICUs) in Canada stopped initiating newborn resuscitation with 100% oxygen. METHODS: In this retrospective cohort study, we compared neonatal outcomes in infants born at ≤ 27 weeks gestation that received <100% oxygen (OXtitrate group, typically 21-40% oxygen) during delivery room resuscitation to infants that received 100% oxygen (OX100 group). RESULTS: Data from 17 NICUs included 2326 infants, 1244 in the OXtitrate group and 1082 in the OX100 group...
November 2015: Resuscitation
Christian F Poets, Robin S Roberts, Barbara Schmidt, Robin K Whyte, Elizabeth V Asztalos, David Bader, Aida Bairam, Diane Moddemann, Abraham Peliowski, Yacov Rabi, Alfonso Solimano, Harvey Nelson
IMPORTANCE: Extremely preterm infants may experience intermittent hypoxemia or bradycardia for many weeks after birth. The prognosis of these events is uncertain. OBJECTIVE: To determine the association between intermittent hypoxemia or bradycardia and late death or disability. DESIGN, SETTING, AND PARTICIPANTS: Post hoc analysis of data from the inception cohort assembled for the Canadian Oxygen Trial in 25 hospitals in Canada, the United States, Argentina, Finland, Germany, and Israel, including 1019 infants with gestational ages of 23 weeks 0 days through 27 weeks 6 days who were born between December 2006 and August 2010 and survived to a postmenstrual age of 36 weeks...
August 11, 2015: JAMA: the Journal of the American Medical Association
Mithilesh Lal, Win Tin, Sunil Sinha
AIM: To evaluate the efficacy of automated control of the fraction of inspired oxygen (FiO2 ) in comparison with manual FiO2 control in maintaining target pulse oxygen saturation (SpO2 ) range. METHODS: Crossover physiological study involving preterm infants requiring mechanical ventilation and supplemental oxygen. Each infant was studied for two consecutive 12 hours in a random sequence. Outcome measures included the proportion of time with SpO2 within and outside the target range of 90-95%, extreme hypoxaemia (< 80%) and hyperoxaemia (≥ 98%)...
November 2015: Acta Paediatrica
Win Tin, Mithilesh Lal
Pulse oximetry is one of the most commonly used monitoring devices in clinical medicine. It was first introduced to neonatal medicine in the mid-1980s to monitor oxygenation and guide therapy, and it is now used widely in the delivery room during resuscitation. More recently, it is utilized to screen for congenital heart disease. Pulse oximetry is based on the variation in the ratio of the light absorbances of tissues during systole and diastole. It has become the mainstay of non-invasive continuous oxygen monitoring but with a wide variation in clinical practices and without good research evidence...
June 2015: Seminars in Fetal & Neonatal Medicine
Manuel B Schmid, Reinhard J Hopfner, Susanne Lenhof, Helmut D Hummler, Hans Fuchs
BACKGROUND: Episodes of hypoxemia and bradycardia frequently occur with apnea of prematurity in preterm infants. Little is known about the impact of different event types on the brain. OBJECTIVES: To describe the influence of hypoxemia and bradycardia, either isolated or in combination, on cerebral oxygenation. METHODS: In 16 preterm infants with intermittent hypoxemia and/or bradycardia, cerebral tissue oxygen saturation (StO2, as measured by near-infrared spectroscopy), heart rate and pulse oximetric saturation (SpO2) were recorded simultaneously for 16 h...
2015: Neonatology
Alexandra Clarke, Emma Yeomans, Kristy Elsayed, Alison Medhurst, Philip Berger, Elizabeth Skuza, Kenneth Tan
OBJECTIVES: Strategies for oxygen therapy for preterm infants, such as the Vermont-Oxford's 'Breathsavers' guidelines, seek to strike a balance between the potential risks of the extremes of hyperoxia and hypoxia in preterm infants. Using an algorithm based on those guidelines, we aimed to compare the proportion of time spent within the SpO2 target range during algorithm-based management of oxygen delivery compared with routine nursing care. STUDY DESIGN: In a randomised crossover trial, maintenance of SpO2 over a 4-hour period during routine care was compared with algorithm-based control (administered by a dedicated research nurse)...
2015: Neonatology
Veena Manja, Satyan Lakshminrusimha, Deborah J Cook
IMPORTANCE: The optimal oxygen saturation (SpO2) target for extremely preterm infants is unknown. OBJECTIVE: To systematically review evidence evaluating the effect of restricted vs liberal oxygen exposure on morbidity and mortality in extremely preterm infants. DATA SOURCES: MEDLINE, PubMed, CENTRAL, and CINAHL databases from their inception to March 31, 2014, and abstracts submitted to Pediatric Academic Societies from 2000 to 2014. STUDY SELECTION: All published randomized trials evaluating the effect of restricted (SpO2, 85%-89%) vs liberal (SpO2, 91%-95%) oxygen exposure in preterm infants (<28 weeks' gestation at birth)...
April 2015: JAMA Pediatrics
Anne Synnes, Steven P Miller
No abstract text is available yet for this article.
April 2015: JAMA Pediatrics
James Zapata, John Jairo Gómez, Robinson Araque Campo, Alejandro Matiz Rubio, Augusto Sola
AIM: Providing consistent levels of oxygen saturation (SpO2 ) for infants in neonatal intensive care units is not easy. This study explored how effectively the Auto-Mixer(®) algorithm automatically adjusted fraction of inspired oxygen (FiO2 ) levels to maintain SpO2 within an intended range in extremely low birth weight infants receiving supplemental oxygen without mechanical ventilation. METHODS: Twenty extremely low birth weight infants were randomly assigned to the Auto-Mixer(®) group or the manual intervention group and studied for 12 h...
September 2014: Acta Paediatrica
Ola Didrik Saugstad, Dagfinn Aune
BACKGROUND: The optimal oxygen saturation for extremely low birth weight infants in the postnatal period beyond the delivery room is not known. OBJECTIVES: To summarize and discuss the results of the randomized trials, constituting the NEOPROM (Neonatal Oxygenation Prospective Meta-analysis) collaborative study, examining the effect of low versus high functional oxygen saturation targets in the postnatal period in premature infants with gestational age <28 weeks...
2014: Neonatology
Buranee Swatesutipan, Pracha Nuntnarumit
BACKGROUND: The recent newborn resuscitation guidelines have recommended that a pulse oximeter and oxygen blender be used to keep oxygen saturation (SpO2) within the target range. However, an oxygen blender and compressed air are not generally available in delivery rooms. OBJECTIVES: To determine whether using low-flow oxygen at 0.5-1 liters/min for positive pressure ventilation (PPV) via a self-inflating bag (SIB) without a reservoir is effective and able to maintain SpO2 within the target range...
2014: Neonatology
Ben J Stenson, William O Tarnow-Mordi, Brian A Darlow, John Simes, Edmund Juszczak, Lisa Askie, Malcolm Battin, Ursula Bowler, Roland Broadbent, Pamela Cairns, Peter Graham Davis, Sanjeev Deshpande, Mark Donoghoe, Lex Doyle, Brian W Fleck, Alpana Ghadge, Wendy Hague, Henry L Halliday, Michael Hewson, Andrew King, Adrienne Kirby, Neil Marlow, Michael Meyer, Colin Morley, Karen Simmer, Win Tin, Stephen P Wardle, Peter Brocklehurst
BACKGROUND: The clinically appropriate range for oxygen saturation in preterm infants is unknown. Previous studies have shown that infants had reduced rates of retinopathy of prematurity when lower targets of oxygen saturation were used. METHODS: In three international randomized, controlled trials, we evaluated the effects of targeting an oxygen saturation of 85 to 89%, as compared with a range of 91 to 95%, on disability-free survival at 2 years in infants born before 28 weeks' gestation...
May 30, 2013: New England Journal of Medicine
Brian A Darlow, Simone L Marschner, Mark Donoghoe, Malcolm R Battin, Roland S Broadbent, Mark J Elder, Michael P Hewson, Michael P Meyer, Alpana Ghadge, Patricia Graham, Nicolette J McNeill, Carl A Kuschel, William O Tarnow-Mordi
OBJECTIVE: To assess whether an oxygen saturation (Spo2) target of 85%-89% compared with 91%-95% reduced the incidence of the composite outcome of death or major disability at 2 years of age in infants born at <28 weeks' gestation. STUDY DESIGN: A total 340 infants were randomized to a lower or higher target from <24 hours of age until 36 weeks' gestational age. Blinding was achieved by targeting a displayed Spo2 of 88%-92% using a saturation monitor offset by ±3% within the range 85%-95%...
July 2014: Journal of Pediatrics
Denise Rook, Henk Schierbeek, Maximo Vento, Hester Vlaardingerbroek, Anne C van der Eijk, Mariangela Longini, Giuseppe Buonocore, Javier Escobar, Johannes B van Goudoever, Marijn J Vermeulen
OBJECTIVE: To test the hypothesis that an initial fraction of inspired oxygen (FiO2) of 30% during resuscitation of preterm infants results in less oxidative stress and is associated with improved clinical outcomes compared with an FiO2 of 65%. STUDY DESIGN: Preterm infants of gestational age <32 weeks (n = 193) were randomized to start resuscitation with either 30% oxygen (low-oxygen group) or 65% oxygen (high-oxygen group), after which the FiO2 was adjusted based on oxygen saturation values...
June 2014: Journal of Pediatrics
Marrit Smit, Jennifer A Dawson, Angelina Ganzeboom, Stuart B Hooper, Jos van Roosmalen, Arjan B te Pas
OBJECTIVE: To assess whether defined reference ranges of oxygen saturation (SpO₂) and heart rate (HR) of term infants after birth also apply for infants born after midwifery supervised uncomplicated vaginal birth, where delayed cord clamping (DCC) and immediate skin to skin contact (ISSC) is routine management. DESIGN: Prospective observational study. SETTING AND PATIENTS: Infants born vaginally after uncomplicated birth, that is, no augmentation, maternal pain relief or instrumental delivery...
July 2014: Archives of Disease in Childhood. Fetal and Neonatal Edition
J A Dawson, P Bastrenta, F Cavigioli, M Thio, T Ong, M L Siew, S B Hooper, P G Davis
BACKGROUND: Administration of oxygen in the delivery room is informed by oxygen saturation (SpO₂). An oxygen saturation range of 60%-70% is the threshold for administering oxygen in the first minutes after birth. The accuracy of newer generation oximeters to measure SpO₂ has not been compared against the 'gold standard', direct arterial blood oxygen saturation (SaO₂) when SaO₂ is low. The aim of this study was to determine the accuracy and precision of Nellcor and Masimo oximeters to measure SpO₂ when SaO₂ <70%...
July 2014: Archives of Disease in Childhood. Fetal and Neonatal Edition
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