RESUMO
BACKGROUND: Sustained inflations at initial stabilisation in the delivery suite may reduce the need for intubation and result in a shorter duration of initial ventilation, but have not been compared to routine UK practice. AIMS: To compare the early efficacy of sustained inflation during stabilisation after delivery to UK practice. STUDY DESIGN: A randomised trial was performed of a fifteen second sustained inflation compared to five inflations lasting 2 to 3â¯s, each intervention could be repeated once if no chest rise was apparent. Respiratory function monitoring was undertaken. SUBJECTS: Infants born prior to 34â¯weeks of gestation. OUTCOME MEASURES: The minute volume and maximum end-tidal carbon dioxide level in the first minute after the interventions, the time to the first spontaneous breath after the beginning of stabilisation and the duration of ventilation in the first 48â¯h. RESULTS: There were no significant differences in the minute volume or maximum end tidal carbon dioxide level between the groups. Infants in the sustained inflation group made a respiratory effort sooner (median 3.5 (range 0.2-59) versus median 12.8 (range 0.4-119)â¯s, pâ¯=â¯0.001). The sustained inflation group were ventilated for a shorter duration in the first 48â¯h (median 17 (range 0-48) versus median 32.5 (range 0-48)â¯h, pâ¯=â¯0.025). CONCLUSIONS: A sustained inflation of 15â¯s compared to five two to three second inflations during initial stabilisation was associated with a shorter duration of mechanical ventilation in the first 48â¯h after birth.
Assuntos
Recém-Nascido Prematuro/fisiologia , Terapia Intensiva Neonatal/métodos , Respiração com Pressão Positiva/métodos , Feminino , Humanos , Recém-Nascido , Masculino , Respiração com Pressão Positiva/efeitos adversosRESUMO
Activity concentrations of (226)Ra, (232)Th and (40)K in 45 samples of different building materials used in Iraq were measured using gamma-spectroscopy system based on high-purity germanium detector with an efficiency of 40 %. Radium equivalent activity, air-absorbed dose rate, annual effective dose, external and internal hazard indices and alpha index due to radon inhalation originating from building materials were measured to assess the potential radiological hazard associated with these building materials. The activity concentrations of the natural radionuclides (226)Ra, (232)Th and 40K were found to range from below detection limit (BDL) to 223.7 ± 9, BDL to 93.0 ± 3 and BDL to 343.1 ± 12, respectively. Values of average radium equivalent activity, air-absorbed dose rate, indoor and outdoor annual effective doses, external and internal hazard indices and alpha index ranged from 6.5 to 124.9, 16.2 to 89.5 (nGy h(-1)), 0.08 to 0.44 mSv, 0.02-0.11 mSv, 0.09 to 0.53, 0.13 to 0.69 and 0.03 to 0.62, respectively. These values indicate a low dose. Therefore, the building materials used in the current study are quite safe to be used as building materials.