Efficiency of electrocardiogram monitor for positioning the catheter tip in peripherally inserted central catheter placement in neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the efficiency of electrocardiogram (ECG) monitor for positioning the catheter tip in the placement of peripherally inserted central catheter (PICC) in neonates.</p><p><b>METHODS</b>A total of 160 neonates who were admitted to the neonatal intensive care unit (NICU) from January 2015 to December 2017 and underwent the PICC placement via the veins of upper extremity were enrolled. They were randomly divided into an observation group and a control group, with 80 neonates in each group. The neonates in the control group were given body surface measurement and postoperative X-ray localization, while those in the observation group were given body surface measurement, ECG localization, and postoperative X-ray localization. The two groups were compared in terms of general information, one-time success rate of PICC placement, and time spent on PICC placement.</p><p><b>RESULTS</b>There were no significant differences between the two groups in sex composition, gestational age, age in days at the time of PICC placement, disease type, and site of puncture (P>0.05). Compared with the control group, the observation group had a significantly higher one-time success rate of PICC placement (95% vs 79%; P<0.05) and a significantly shorter time spent on PICC placement (P<0.05). Localization under an ECG monitor during PICC placement had a sensitivity of 97% and a specificity of 100%.</p><p><b>CONCLUSIONS</b>During the PICC placement in neonates, the use of ECG monitor to determine the position of catheter tip can improve the one-time success rate of placement and reduce the time spent on placement.</p>

Clinical features of respiratory distress syndrome in neonates of different gestational ages / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study clinical features of respiratory distress syndrome (RDS) in neonates of different gestational ages (GA).</p><p><b>METHODS</b>According to GA, 133 neonates with RDS were classified into GA <34 weeks group (n=66), GA 34-36 weeks group (late preterm neonates; n=31), and GA ≥37 weeks group (full-term neonates; n=36). The mothers' medical history during pregnancy and the condition of the neonates at birth were retrospectively analyzed, and the clinical data were compared between groups.</p><p><b>RESULTS</b>Prenatal corticosteroids supplementation in the GA <34 weeks group was more common than that in the GA 34-36 weeks group (P<0.05). Compared with the GA ≥37 weeks group and the GA 34-36 weeks group, the GA <34 weeks group showed a significantly lower rate of primary diseases, a significantly later time of the development of dyspnea (P<0.05), and a higher rate of intraventricular hemorrhage (P<0.05). Serum albumin levels in the GA <34 weeks group were significantly lower than in the GA ≥37 weeks group (P<0.05). The GA ≥37 weeks group and the GA 34-36 weeks group showed a significantly higher reuse rate of pulmonary surfactant (P<0.05). Use of high-frequency oscillatory ventilation was more common in the GA ≥37 weeks group compared with the GA <34 weeks group (P<0.05).</p><p><b>CONCLUSIONS</b>The clinical features of RDS are different across neonates of different GA, suggesting that the pathogenesis of RDS may be different in neonates of different GA.</p>

Risk factors for patent ductus arteriosus in neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To identify the risk factors for patent ductus arteriosus (PDA) in neonates.</p><p><b>METHODS</b>Fifty infants with PDA and 100 infants without PDA were enrolled. Chi-square test, Student's t test and the linear correlation analysis were used to study the clinical data. Logistic regression analysis was used to investigate the independent risk factors for PDA.</p><p><b>RESULTS</b>The prevalence of PDA was negatively correlated with the gestation age (r=-0.03, P<0.05) and birth weight (r=-0.04, P<0.05). Oxygen inhalation was a protective factor for the development of PDA. Fetal distress, meconium-stained amniotic fluid, oligohydramnios, cord entanglement, 1 minute Apgar score <8, maternal infection and hypoxic-ischemic encephalopathy were the independent risk factors for the development of PDA.</p><p><b>CONCLUSIONS</b>The incidence of PDA can be reduced by preventing maternal infection, premature birth, low birth weight and hypoxia.</p>