3,699 research outputs found
Increase of Caffeine and Decrease of Corticosteroids for Extremely Low Birthweight Infants with Respiratory Failure from 1997 to 2011
No full textAIM
To compare treatment strategies for respiratory failure in extremely low birth weight (ELBW) infants in Germany in 1997 to Germany, Austria and Switzerland in 2011.
METHODS
A detailed questionnaire about treatment strategies for ELBW infants was sent to all German centres treating ELBW infants in 1997. A follow-up survey was conducted in 2011 in Germany, Austria and Switzerland.
RESULTS
In 1997 and 2011, 63.6% and 66.2% of the hospitals responded. In 2011 the response rate was higher in Switzerland than in Germany, and in university hospitals versus non-university hospitals. Treatment strategies did not differ between university and non-university hospitals as well as NICUs of different sizes in 2011. Differences between Germany, Austria and Switzerland were minimal. Administration of caffeine increased significantly, whereas theophylline and doxapram declined (all p<0.001). While the use of dexamethasone decreased and the use of hydrocortisone increased, the overall use of corticosteroids declined (all p<0.001). Between 1997 and 2011 therapy with inhalations and mucolytics decreased (both p<0.001) whereas the use application of diuretics did not change significantly. In mechanically ventilated infants the application of muscle relaxants and sedation declined significantly (p=0.009 and p<0.001), whereas analgesia use did not change.
CONCLUSION
Treatment strategies for respiratory failure in ELBW infants have changed significantly between 1997 and 2011. This article is protected by copyright. All rights reserved
Less invasive ventilation in extremely low birth weight infants from 1997 to 2011: survey versus evidence.
No full textUNLABELLED
Evidence for target values of arterial oxygen saturation (SaO2), CO2, and pH has changed substantially over the last 20 years. A representative survey concerning treatment strategies in extremely low-birth-weight infants (ELBW) was sent to all German neonatal intensive care units (NICUs) treating ELBW infants in 1997. A follow-up survey was conducted in 2011 and sent to all NICUs in Germany, Austria, and Switzerland. During the observation period, NICUs targeting SaO2 of 80, 85, and 90 % have increased, while units aiming for 94 and 96 % decreased (all p < 0.001). Similarly, NICUs aiming for pH 7.25 or lower increased, while 7.35 or higher decreased (both p < 0.001). Furthermore, more units targeted a CO2 of 50 mmHg (7.3 kPa) or higher (p < 0.001), while fewer targeted 40 or 35 mmHg (p < 0.001). Non-invasive ventilation (NIV) was used in 80.2 % of NICUs in 2011. The most frequently used ventilation modes were synchronized intermittent mandatory ventilation (SIMV) (67.5 %) and intermittent positive pressure ventilation (IPPV) (59.7 %) in 1997 and SIMV (77.2 %) and synchronized intermittent positive pressure ventilation (SIPPV) (26.8 %) in 2011. NICUs reporting frequent or always use of IPPV decreased to 11.0 % (p < 0.001). SIMV (77.2 %) and SIPPV (26.8 %) did not change from 1997 to 2011, while high-frequency oscillation (HFO) increased from 9.1 to 19.7 % (p = 0.018). Differences between countries, level of care, and size of the NICU were minimal.
CONCLUSIONS
Target values for SaO2 decreased, while CO2 and pH increased significantly during the observation period. Current values largely reflect available evidence at time of the surveys.
WHAT IS KNOWN
• Evidence concerning target values of oxygen saturation, CO 2 , and pH in extremely low-birth-weight infants has grown substantially. • It is not known to which extent this knowledge is transferred into clinical practice and if treatment strategies have changed.
WHAT IS NEW
• Target values for oxygen saturation in ELBW infants decreased between 1997 and 2011 while target values for CO 2 and pH increased. • Similar treatment strategies existed in different countries, hospitals of different size, or university versus nonuniversity hospitals in 2011
Less Oxygen, Later Intubation and Reduced Respiratory Pressures for ELBW Infants from 1997 to 2011.
No full textINTRODUCTION
Evidence concerning delivery room management in extremely low birth weight infants (ELBW) has grown substantially within the last 20 years, leading to several guidelines and recommendations. However, it is unknown in which extent local treatment strategies have changed and if they reflect current recommendations.
METHODS
A detailed questionnaire about treatment strategies for ELBW infants was sent to all German neonatal intensive care units (NICUs) treating ELBW infants in 1997. A follow-up survey was conducted in 2011 and sent to all NICUs in Germany, Austria and Switzerland. RESULTS on delivery room management were compared to the first survey.
RESULTS
In 1997 and 2011, 63.6 and 66.2% of the approached hospitals responded. In 2011 similar results were observed between university and non-university hospitals as well as NICUs of different size. Differences between Germany, Austria and Switzerland were minimal. Changes over time were a lower initially applied fraction of inspired oxygen (FiO2) and peak inspiratory pressure (PiP) in 2011 compared to 1997. A longer time of apnea was tolerated before tracheal intubation is performed; the time of apnea was less frequently a sole criterion for intubation and surfactant was applied at lower FiO2 in 2011. The time of no thorax excursions and transport of the infant were considered an indication for intubation in 30.2 and 22.5%, and did not change in the observation period.
CONCLUSION
Treatment strategies for delivery room management in ELBW infants changed significantly between 1997 and 2011 and largely reflect current recommendations
Comparison of treatment strategies for anaemia of prematurity in extremely low birthweight infants between 1997 and 2011.
No full textInterview with Roland Abraham
No full textInterview with Roland Abraham, who is a former director of the Minnesota Extension Service. He is the author of Helping People Help Themselves: Agricultural Extension in Minnesota, 1879 to 1979. Abraham talks about how he got to the university and about the Minnesota Extension Service.Abraham, Roland H.; Pflaum, Ann M.. (1999). Interview with Roland Abraham. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/47871
Comparison of treatment strategies for anaemia of prematurity in extremely low birthweight infants between 1997 and 2011
No full textThe death of William Golding: authorship and creativity in darkness visible and the paper men
No full textIn the seventies and eighties William Golding was deeply responsive to the critical, anti-authorial ethos that followed the publication of Roland Barthes's "La mort de I'auteur" (1968). In Darkness Visible (1979) and The Paper Men (1984) he investigates means by which to reaffirm authorial presence. Working through paradox, he performs the authorial death in these novels, and establishes language’s inadequacy as a means of conveying absolute meaning, authorial "vision," truth or revelation. Having done so he nonetheless gestures towards the divine, towards the possibility of a vatic communication. In this manner the novels work upon principles of contradiction and collapse. What remains is a discourse of hope, promise, desire, without means of substantiating such optimism. Thus Golding might be said to have practiced a form of negative theology, and to have anticipated in this respect some recent trends in literary theory
Variations on the Author
No full text“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Roland Barthes's resurrection of the author and redemption of biography
No full textThe most misunderstood essay in literary theory must be Roland Barthes's 'The Death of the Author' (originally 'La mort de l'auteur', 1968). Repeatedly critics and commentators have taken this satiric jeu d'esprit literally, and have credulously assumed that it is advocating the very position that it is condemning
Recommended from our members
Roland Barthes's resurrection of the author and redemption of biography
No full textThe most misunderstood essay in literary theory must be Roland Barthes's 'The Death of the Author' (originally 'La mort de l'auteur', 1968). Repeatedly critics and commentators have taken this satiric jeu d'esprit literally, and have credulously assumed that it is advocating the very position that it is condemning
- …
