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Nasal high frequency oscillatory ventilation

Daniele De Luca and Valentina Dell'Orto review the physiological rationale and preliminary evidence for this additional approach to non-invasive ventilation. If it is effective, nasal high frequency oscillatory ventilation (NHFOV) should combine the theoretical advantages of high-frequency ventilation and of nasal CPAP. Reported neonatal experience is largely short term and describes 111 patient experiences, with a generally positive experience in terms of safety and some evidence of improved carbon dioxide elimination. So far there is little evidence to clarify what role it has and little information to assist in the planning of ventilation settings. Presently 4 trials have been registered. There is clearly a need for more clinical research and a cautious approach to exploring this technique. See page 565

Quality improvement

Jonathan Davis and colleagues implemented a sepsis reduction care bundle in their neonatal unit in Bristol between 2006 and 2007. Bloodstream sepsis due to coagulase negative staphylococcus species almost halved from 26.7 % during the years prior to the introduction (2002–2007) to 14.1% in the …

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