644 e-Letters

  • End of Life Decisions - Do we make them wisely?
    anthony cohn

    Hellman, Knigthon et Al and Carter in the accompanying editorial raise many issues dealing with the end of life care of sick newborn babies. Although consensus within multidisciplinary teams in each centre is recorded as being achieved relatively easily, the wide variation between centres in how each deals with the issue of withholding life saving treatments, particularly where there are 'quality of life issues' und...

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  • Incostintencies in defining "Work of breathing"
    Paola Papoff

    We read with great interest the recent article by Shetty et al (Arch Dis Child Fetal Neonatal Ed 2016;0:F1-F4) who showed that continuous positive airway pressure (CPAP) and humidified high-flow nasal cannula (HHFNC) in infants with evolving or established bronchopulmonary dysplasia (BPD) have similar effects on work of breathing (WOB).1 Like many other articles in this field, Shetty's paper unfortunately suffers from in...

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  • Re: The reliability and safety of self-inflating bags for PIP/ PEEP delivery to neonates is all but clear
    Mark Tracy

    Title: Reliance on manikin and bench studies of manual infant resuscitators: the devil is in the detail

    Dear Sirs

    Thank you for the opportunity to respond to Dr Roehr and colleagues' comments on our paper1. Our results in contrast to those of Morley2 and Kelm3 show consistent measured levels of PEEP close to the set values1.

    We feel an important detail has been overlooked in ignoring the manu...

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  • The reliability and safety of self-inflating bags for PIP/ PEEP delivery to neonates is all but clear
    Charles C Roehr

    Dear Sirs, We read with interest the recent work by Dr Tracy and colleagues: "The effectiveness of Ambu neonatal self-inflating bag to provide consistent positive end-expiratory pressure", doi:10.1136/ archdischild-2015-308649 ADC FN&N Ed. 2016.

    We would like to comment on the statement and findings by Tracy et al. Firstly, a strong point of the paper is that the authors have systematically investigated t...

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  • Calling a spade a digging implement
    Robert A Primhak

    May I suggest an alternative term for the egregious "upper extremity" used in the title of Labore and Befell's article. I believe that the body part to which they are referring is also known as an "arm"?

    Conflict of Interest:

    None declared

  • Response to the article: Povidone-iodine pleurodesis for congenital chylothorax of the newborn
    Nadia kasdallah

    To the editor: As part of a review of the literature regarding the use of Povidone iodine (PVI) to perform chemical pleurodesis in the management of congenital chylothorax (CCT), we read with great interest the case reported by Resch et al (1) and their following conclusion: "the risk-benefit assessment of PVI pleurodesis in the treatment of congenital chylothorax does not support its routine use as it may be associate...

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  • Re: Beauty is in the eye of the beholder
    James Wynn

    We appreciate the comments from Fairchild et al., and acknowledge that HRC monitoring has value in their NICU as an additional vital sign that may lead to increased provider attention. Our finding of a significantly lower correlation of HRC and proven sepsis likely stems from the difference in the definition used and highlights both a significant problem with diagnostic testing for neonatal sepsis in general (1) and the p...

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  • Re: Personality of young adults born preterm
    Dieter Wolke

    The correspondence by Greisen & Hansen (...) draws attention to their well conducted controlled study of the personality of very preterm born (VPT) adults in two cohorts in Denmark 1. Their study found like ours 2 higher neuroticism, lower extraversion but also higher agreeableness in adults born preterm compared to those born at term. They concluded in their paper that "overall, our study corroborates the picture of...

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  • Beauty is in the eye of the beholder
    William E. King

    Regarding Coggins' Heart rate characteristic index monitoring for bloodstream infection in an NICU: a 3-year experience:

    Wirschafter[1] has labeled the CDC definition a minimum estimate of infection burden, while labeling antibiotic administration a maximum estimate. The authors refuse to provide metrics such as Specificity and NPV on the grounds that establishing health of the patients was not possible. By...

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  • Proper Use of the Heart Rate Characteristics Monitor in the NICU
    Karen Fairchild

    In the report "Heart rate characteristics index monitoring for bloodstream infection in an NICU: a 3-year experience", Coggins and colleagues make several observations that are important for properly using the HRC (HeRO) monitor in the NICU: 1) Continuous monitoring is more effective than intermittent. Coggins analyzed scores recorded in the medical record every 12 hours, or 8% of the hourly scores; high scores may have...

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