Administration of rescue surfactant by laryngeal mask airway: lessons from a pilot trial.

Objectives: To determine if surfactant can be effectively administered to larger preterm babies by laryngeal mask airway (LMA), reducing the need for supplemental oxygen.

Study Design: Enrollment criteria: birth weight > 1200 g, < 72 hours old, treated with nasal continuous positive airway pressure (nCPAP) for respiratory distress syndrome, with fraction of inspired oxygen (Fio2) requirement between 0.30 and 0.

Hypothermia increases interleukin-6 and interleukin-10 in juvenile endotoxemic mice.

Objective: To develop a juvenile mouse model to establish effects of in vivo hypothermia on expression of the inflammation-modulating cytokines tumor necrosis factor-alpha, interleukin-1beta, interleukin-6, and interleukin-10. Although induced hypothermia is neuroprotective in some patients, the mechanisms of protection are not well understood and concerns remain over potential detrimental effects, particularly in the setting of infection. We previously showed that in vitro hypothermia increases production of tumor necrosis factor-alpha and interleukin-1beta in lipopolysaccharide-treated monocytes.

Responding to compliance changes in a lung model during manual ventilation: perhaps volume, rather than pressure, should be displayed.

Objective: The standard technique for positive-pressure ventilation is to regulate the breath size by varying the pressure applied to the bag. Investigators have argued that consistency of peak inspiratory pressure is important. However, research shows that excessive tidal volume delivered with excessive pressure injures preterm lungs, which suggests that inspiratory pressure should be varied during times of changing compliance, such as resuscitation of newborns or treatment after surfactant delivery.