Pain prevention in term neonates: randomised trial for three methods Introduction: Every newborn infant is screened for hypothyroidism and phenilketonuria by blood sampling, during the first week of life, but there is not a simple and efficient method to reduce pain during the procedure. Objectives: Prospective randomized trial, to assess if the administration of oral glucose, paracetamol or EMLA, given individually, can reduce the pain caused in newborns by heel prick, in an outpatient setting. Methods: Double-blind study in which seventy six healthy newborns at term were randomly assigned to receive placebo, oral glucose, EMLA in the heel, or oral paracetamol. Heel prick was performed to get a blood sample, and pain was measured by two independent observers, using two scales (NIPS and PIPP). Results: NIPS <4: placebo (9/19 = 47%), glucose (16/19 = 84%), paracetamol (8/19 = 42% and EMLA (12/19 = 63%); PIPP < 8: placebo (9/19 = 47%), oral glucose (12/19 = 63%), paracetamol (5/19 = 26%) and EMLA (8/19 = 42%). With the use of oral glucose we found RAR: 0.37 (IC 95% 0.09-0.64), RRR: 44% (IC 95% 6-67%), NNT: 2.7 (IC 95% 1.5-11). Conclusions: The best results were obtained with the use of oral glucose, being statistically significant with only one of the scales. The administration of paracetamol or EMLA did not reduce pain. Other complementary and/or combined methods, added to oral glucose, should be considered daily to diminish this painful experience in thousands of children.

Brain death (BD) is a condition determined by the complete and irreversible absence of brain functions. Maintenance of vital functions creates an opportunity for organ donation. A retrospective study was carried out in 7 pediatric intensive care units of Argentina (from 1/1/2013 to 9/30/2016) to determine the incidence of clinical and certified BD, and the proportion of effective transplantations. Among deceased patients, 19.14% (147/768) met the clinical requirements for BD, and the main cause of BD was multiple trauma. BD was certified in 13.4% of deceased patients (103); an electroencephalogram and an apnea test were the most commonly used ancillary methods. Organ maintenance time was 24 hours. A total of 87 families were approached for donation; 59 were rejected (they were not suitable or refused). Effective donors accounted for 25% (26/103) of patients with certified BD and 72 patients received solid organs.

No abstract

No abstract