CPAP Versus NIPPV Postextubation in Preterm Neonates: A Comparative-Effectiveness Study.

Background And Objectives: Nasal intermittent positive pressure ventilation (NIPPV) has been shown to be superior to nasal continuous positive airway pressure (CPAP) postextubation in preterm neonates. However, studies have not permitted high CPAP pressures or rescue with other modes. We hypothesized that if CPAP pressures >8 cmH2O and rescue with other modes were permitted, CPAP would be noninferior to NIPPV.

A survey of minimally invasive surfactant therapy in Canada.

Introduction: Minimally invasive surfactant therapy (MIST) can be used to treat neonatal respiratory distress syndrome in neonatal intensive care units (NICUs). Clinical and institutional variances in MIST utilization persist globally with little published research regarding MIST utilization in Canada. Therefore, the objective of this study was to survey MIST utilization in NICUs in Canada.

Airway injury and pneumomediastinum associated with less invasive surfactant administration in a premature neonate: a case report.

Background: The use of less invasive surfactant administration (LISA)/minimally invasive surfactant therapy (MIST) has increased due to its potential advantage over traditional surfactant delivery methods through an endotracheal tube. Known complications for this procedure include failure of the first attempt at insertion, desaturation, and bradycardia. To the best of our knowledge, this is the first reported case of pneumomediastinum and subcutaneous emphysema following LISA.

Impact of Catheter Choice on Procedural Success of Minimally Invasive Surfactant Therapy.

Objective: Surfactant delivery via a thin endotracheal catheter during spontaneous breathing; a technique called minimally invasive surfactant therapy (MIST) is an alternative to intubation and surfactant administration. Procedural details among different centers vary, with marked differences in the choice of catheter to instill surfactant. Studies report use of feeding catheters, multiaccess suction catheters, vascular catheters, and more recently custom-built catheters for this purpose.

Duration of and trends in respiratory support among extremely preterm infants.

Objective: To evaluate annual trends in the administration and duration of respiratory support among preterm infants.

Design: Retrospective cohort study.

Setting: Tertiary neonatal intensive care units in the Canadian Neonatal Network.

High-volume surfactant administration using a minimally invasive technique: Experience from a Canadian Neonatal Intensive Care Unit.

Background: Surfactant delivery via a thin endotracheal catheter during spontaneous breathing, a technique called minimally invasive surfactant therapy (MIST), is an alternative to intubation and surfactant administration. There is paucity of data regarding the administration of high-volume surfactant using this technique.

Methods: We conducted a retrospective cohort study to review the safety, efficacy, and procedural details pertaining to the delivery of 5 mL/kg of BLES® via MIST approach.

Survey of noninvasive respiratory support practices in Canadian neonatal intensive care units.

Aim: To evaluate practice variation with respect to noninvasive respiratory support (NRS) use across Canadian neonatal intensive care units (NICUs).

Methods: A web-based survey was sent to all site investigators of the 30 level 3 NICUs participating in the Canadian Neonatal Network. The survey inquired about the use of five commonly described NRS modes.

Evaluation of a practice guideline for the management of respiratory distress syndrome in preterm infants: A quality improvement initiative.

Background: The use of mechanical ventilation to treat respiratory distress syndrome in preterm infants has been associated with the development of bronchopulmonary dysplasia. As part of a quality improvement initiative to reduce the incidence of bronchopulmonary dysplasia in preterm infants, a new practice guideline for the management of respiratory distress syndrome was developed and adopted into practice in a neonatal intensive care unit in February 2012.

Objective: To evaluate the effects of implementing the new guideline in regard to the use of mechanical ventilation and surfactant, and the incidence of bronchopulmonary dypslasia.

A Pilot Randomized Trial Comparing Weaning From Mechanical Ventilation on Pressure Support Versus Proportional Assist Ventilation.

Objectives: Despite protocols incorporating spontaneous breathing trials, 31% of ICU patients experience difficult or prolonged weaning from mechanical ventilation. Nonfatiguing modes such as pressure support ventilation are recommended. Proportional assist ventilation provides assistance in proportion to patient effort, which may optimize weaning.

Students' experiences of electronic health records in practice.

Aim: The purpose of the study was to investigate nursing and midwifery students' experiences of electronic health records (EHRs) in practice.

Background: As EHRs are increasingly being implemented in the NHS, student nurses and midwives are gaining experience in their use.

Method: Three focus groups were conducted on a university campus in England: one with midwifery students (n = 6); one with mental health nursing students (n = 5); and one with adult nursing students (n = 6).

A survey of student nurses' and midwives' experiences of learning to use electronic health record systems in practice.

Aim: The study aimed to investigate student nurses' and midwives' experiences of learning to use electronic health records (EHR) in practice.

Background: Good record keeping and documentation are integral to nursing and midwifery practice. As EHRs become more widespread, student nurses and midwives need opportunities to access and learn how to use them in practice.