Evaluating the influence of ventilation and ventilation-compression synchronization on chest compression force and depth during simulated neonatal resuscitation.

OBJECTIVES: To investigate the influence of ventilation and ventilation-compression synchronization on compression force and sternal displacement during simulated neonatal cardiopulmonary resuscitation (NCPR) on an infant manikin. METHODS: Five Neonatal Resuscitation Program trained clinicians were recruited to perform simulated NCPR on an infant manikin using two-finger (TF) and two-thumb (TT) compression, with synchronous and asynchronous ventilation, as well as without ventilation. The sternal displacement and force were recorded and analyzed. RESULTS: Synchronous ventilation and compression yielded sternal displacements and forces in the range of 22.8-32.4 mm and 15.0-29.8 N, respectively, while asynchronous ventilation and compression produced depths and forces in the range of 21.2-32.4 mm and 14.0-28.8 N, respectively. CONCLUSIONS: Ventilation exerts a significant influence on sternal displacement and force during simulated NCPR, regardless of the compression method used. Ventilation-compression synchronization, however, is only significant during TF compression with lower compression forces measured during synchronous ventilation than in asynchronous ventilation. This occurs for two reasons: (i) the strong influence of ventilation forces on the lower magnitude compression forces produced during TF compression relative to TT compression and (ii) in asynchronous ventilation, compression and ventilation may occur simultaneously, with inflation and deflation providing an opposing force to the applied compression force.

Unilateral cystic disease of the neonatal kidney: a rare presentation of tuberous sclerosis.

Two renal lesions have been described in tuberous sclerosis, angiomyolipomas and cysts. We report a newborn male infant in whom massive cystic enlargement of one kidney was the first manifestation of the disease.

Maternal immunoglobulin allotype (Gm and Km) and neonatal group B streptococcal infection.

Gm and Km(1) allotypes in 37 mothers of neonates with severe Group B streptococcal (GBS) infection were compared with 115 mothers of non-infected infants, 36 of whom were known to be colonized with GBS. Deficits in G1m(1) and Km(1), and an increased incidence of G2m(23), were found in mothers of infected infants. Km(1) was associated mainly with the phenotype Gm(1, (2), 3, 17; 23; 5, 10, 11, 21) in mothers of infected infants while being uniformly distributed in mothers of non-infected infants. This study would seem, therefore, to support reports of Gm and Km(1) allotype involvement in maternal response to GBS infection and immunity in the new-born.