Colin Morley

..Techniques of positioning and holding neonatal face masks vary. Studies have shown that leak at the face mask is common and often substantial irrespective of operator experience...

..Infants less than 28 weeks gestation should be placed in a polyethylene bag or wrap to keep warm. Chest compressions, when required, remain at 3:1 inflation. The endotracheal tube position must be verified with a carbon dioxide detector...

..To investigate parents' opinions about enrolling their premature baby into several research studies in the few days after birth...

..To present recent data on the role of noninvasive ventilation in the respiratory management of newborn infants...

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..The pressure for the next inflation is modified to ensure the expired tidal volume is close to the set value...

..The aim was to compare resuscitators' estimates of tidal volume (V(T)) and face mask leak with measured values during positive pressure ventilation (PPV) of newborn infants in the delivery room...

..We reviewed videos of 61 extremely preterm infants taken immediately after birth. The majority cried (69%) and breathed (80%) without intervention. Most preterm infants are not apneic at birth...

..It further improves rates of successful extubation and shows promise as an initial method of respiratory support. Further research is required to determine the optimal settings for both nCPAP and NIPPV...

..0005). Effects of PEEP and SI were additive. In ventilated preterm rabbits at birth, combining a SI and PEEP improved FRC formation and uniformity of lung aeration, but PEEP had the greatest influence...

..To describe the interaction of spontaneous breaths, manual ventilation, and tidal volumes (V(T)) during stabilization of infants with congenital diaphragmatic hernia (CDH) in the delivery room...

..Positive pressure ventilation (PPV) via a face mask is an important skill taught using manikins. There have been few attempts to assess the effectiveness of different face mask designs...

..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...

..Use of equipment not specifically recommended in these guidelines has been advocated. We wished to determine how widely this supplementary equipment is used in a geographically defined region...

..Conclusion: These novel techniques deserve further evaluation...

..Low-dose dexamethasone facilitates extubation in chronically ventilator-dependent infants with no obvious short-term complications. The objective of this study was to determine the long-term effects of low-dose dexamethasone...

..93 [0.64] vs. 1.14 [0.86] s). Directly after birth, both preterm and term infants frequently brake their expiration, mostly by crying. Preterm infants use significantly more expiratory breath holds to defend their lung volume...

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..Applying PEEP during resuscitation of very premature infants might be advantageous and merits further investigation...

..To determine the accuracy of heart rate obtained by pulse oximetry (HR(PO)) relative to HR obtained by 3-lead electrocardiography (HR(ECG)) in newborn infants in the delivery room...

..The mean difference between HR assessed by auscultation and palpation ECG and HR using methodology recommended by the Neonatal Resuscitation Programme was 14 and 22 beats per minute respectively...

..Future studies should enrol sufficient infants to detect uncommon serious complications and include long-term follow up to determine important neurodevelopment and pulmonary outcomes...

..Self-inflating resuscitation bags are described as unreliable for this purpose. We measured oxygen concentrations >or=80% delivered through a 240 mL Laerdal self-inflating resuscitation bag and from 5 mm tubing inside a cupped hand...

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..PEEP halved the oxygen requirement compared with no PEEP. Resuscitating premature babies with controlled tidal volumes and PEEP might improve their outcome...

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..We aimed to determine the range of pre-ductal SpO2 in the first minutes of life in healthy newborn infants...

..Data are available in most infants within 90 seconds of birth. Oximetry may be useful in guiding interventions during resuscitation...

..Examples demonstrating its potential usefulness during resuscitations are provided. However, further studies are needed to investigate whether it can help improve short-term and long-term outcomes...

..A case is presented in which an ETCO2 detector was misleading in determining endotracheal tube (ETT) position but useful in determining the efficacy of ventilation in an extremely preterm infant...

..Continuous positive airway pressure is increasingly being used in the care of premature infants. The purpose of this review is to highlight the current controversies in the use of neonatal continuous positive airway pressure...

..Immediately after birth, most very preterm infants, treated with continuous positive airway pressure, frequently prolong their expiration by braking the expiratory flow. ABBREVIATION::..

..Postnatal corticosteroid therapy is controversial. The aim of this study was to determine the short-term effects of low-dose dexamethasone treatment among chronically ventilator-dependent neonates...

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..3 +/- 3.5 ml/kg). PEEP greatly facilitates aeration of the distal airways and the accumulation of FRC and prevents distal airway collapse at end expiration in very preterm rabbit pups mechanically ventilated from birth...

..0 (4.1) s using 35 cm H2O peak inflation pressure. In these rabbits, 10- and 20-s SI increased the inspiratory volume and produced a greater FRC, and a 20-s SI uniformly aerated the lung before ventilation started...

..To examine the use of high frequency ventilation (HFV) to treat newborn infants in Australia and New Zealand and the associated complications and outcomes...

..Previous studies have reported poor correlation between early clinical signs and prognosis...

..Volume targeting aims to produce a more stable tidal volume in order to reduce lung damage and stabilise pCO(2)..

..The goal was to define reference ranges for pulse oxygen saturation (Spo(2)) values in the first 10 minutes after birth for infants who received no medical intervention in the delivery room...

..This practice remains widespread despite clear recommendations to improve this undesirable situation. The attendant risks to infants and prescribers remain. It is time for legislation to be introduced to govern this area...

..To compare four methods of volume recruitment upon initiation of high frequency oscillatory ventilation (HFOV)...

..To determine the accuracy of pulse oximetry measurement of heart rate in the neonatal intensive care unit...

..We conclude that airway pressures and VT are not maintained during closed endotracheal suction with either CMV or HFOV, and choice of equipment and settings will affect the degree of interruption to ventilation...

..To explore the effects of a large volume lung lavage procedure in ventilated infants with meconium aspiration syndrome...

..036), which may indicate differing regional benefit from systemic hypothermia...

..The ability of Laerdal neonatal self-inflating bags fitted with PEEP valves to reliably deliver PEEP is unclear. The aim of this study was to measure the delivered PEEP at different set PEEP levels and inflation rates...

..To determine the additional financial cost to families of babies admitted to the nurseries of The Royal Women's Hospital, Melbourne, Australia...

..8% and retrograde flow was reestablished. Although increasing PEEP improves oxygenation, it adversely affects PBF and PVR shortly after birth, alters the PBF waveform, and reestablishes retrograde flow during diastole...

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..These treatments do not alter the deleterious effects of high levels of PEEP on PBF...

..Use of video recordings of newborn infants to determine: (1) if clinicians agreed whether infants were pink; and (2) the pulse oximeter oxygen saturation (Spo(2)) at which infants first looked pink...

..To compare the effectiveness of open and closed endotracheal suction in recovering thin and thick secretions in normal and injured lungs during conventional and high frequency ventilation...

..98-0.99). Negative tracheal pressure during in vitro ETT suction is directly proportional to applied pressure. This relationship is determined by ETT and catheter dimensions...

..Currently, a lack of reliable methods for assessing lung volume limits clinicians' ability to achieve the optimum volume range...

..Dilute surfactant lavage using two 15-ml/kg aliquots is an effective therapy in the piglet model of meconium aspiration, and should be evaluated in human infants with this condition...