Background
Current cardiorespiratory monitoring equipment can cause injuries and infections in neonates with fragile skin. Impulse-radio ultra-wideband (IR-UWB) radar was recently demonstrated to be an effective contactless vital sign monitor in adults. The purpose of this study was to assess heart rates (HRs) and respiratory rates (RRs) in the neonatal intensive care unit (NICU) using IR-UWB radar and to evaluate its accuracy and reliability compared to conventional electrocardiography (ECG)/impedance pneumography (IPG).
Methods
The HR and RR were recorded in 34 neonates between 3 and 72 days of age during minimal movement (51 measurements in total) using IR-UWB radar (HRRd, RRRd) and ECG/IPG (HRECG, RRIPG) simultaneously. The radar signals were processed in real time using algorithms for neonates. Radar and ECG/IPG measurements were compared using concordance correlation coefficients (CCCs) and Bland-Altman plots.
Results
From the 34 neonates, 12,530 HR samples and 3,504 RR samples were measured. Both the HR and RR measured using the two methods were highly concordant when the neonates had minimal movements (CCC = 0.95 between the RRRd and RRIPG, CCC = 0.97 between the HRRd and HRECG). In the Bland-Altman plot, the mean biases were 0.17 breaths/min (95% limit of agreement [LOA] -7.0–7.3) between the RRRd and RRIPG and -0.23 bpm (95% LOA -5.3–4.8) between the HRRd and HRECG. Moreover, the agreement for the HR and RR measurements between the two modalities was consistently high regardless of neonate weight.
Conclusions
A cardiorespiratory monitor using IR-UWB radar may provide accurate non-contact HR and RR estimates without wires and electrodes for neonates in the NICU.
PurposeThis study investigated the clinical presentations of symptomatic Clostridium difficile infection (CDI) in children.MethodsWe reviewed the medical records of 43 children aged <20 years who showed either positive C. difficile culture or C. difficile toxin test results between June 2010 and April 2014.ResultsOf the 43 patients (mean age 6.7 years), 22 were boys. Sixteen patients (37.2%) showed both positive C. difficile culture and toxin test results. Seventeen out of 43 children (39.5%) had preexisting gastrointestinal diseases, and 26 children had other medical conditions that were risk factors for CDI. Twenty-eight children had a history of antibiotic treatment for >3 days, and the most frequently prescribed antibiotic was amoxicillin-clavulanate (35.7%). Twenty-eight patients were diagnosed with CDI despite taking probiotic supplements, most commonly Lactobacillus acidophilus (53.6%). The most common symptom was diarrhea (72.1%) at the time CDI was diagnosed. C. difficile was eradicated in 11 patients (25.6%) after treatment with oral metronidazole for 10-14 days, and in the two patients (4.6%) who required two courses of oral metronidazole. Sixteen patients (37.2%) showed clinical improvement without any treatment.ConclusionThis study showed the various clinical characteristics of CDI in children and that preexisting clinical conditions favored the development of CDI. In addition, CDI was found to occur in a number of patients even after probiotic prophylaxis given in conjunction with antibiotic therapy.
Despite the many comorbidities and high mortality rate in preterm infants with patent ductus arteriosus (PDA), therapeutic strategies vary depending on the clinical setting, and most studies of the related risk factors are based on small sample populations. We aimed to compare the performance of artificial intelligence (AI) analysis with that of conventional analysis to identify risk factors associated with symptomatic PDA (sPDA) in very low birth weight infants. This nationwide cohort study included 8369 very low birth weight (VLBW) infants. The participants were divided into an sPDA group and an asymptomatic PDA or spontaneously close PDA (nPDA) group. The sPDA group was further divided into treated and untreated subgroups. A total of 47 perinatal risk factors were collected and analyzed. Multiple logistic regression was used as a standard analytic tool, and five AI algorithms were used to identify the factors associated with sPDA. Combining a large database of risk factors from nationwide registries and AI techniques achieved higher accuracy and better performance of the PDA prediction tasks, and the ensemble methods showed the best performances.
The 2020 Korean pediatric cardiopulmonary resuscitation (CPR) guideline is the medical recommendation derived on the basis of scientific evidence for pediatric basic life support (PBLS). This is based on the scientific consensus and treatment recommendations provided by the International Liaison Committee on Resuscitation in 2020, which provides the CPR guideline. Studies published for PBLS were additionally considered. 1 The evidence of revised items that are of high clinical importance and require further consideration were reviewed in an acceptable adaptation or hybrid format and meta-analysis or scoping review was used.
MAJOR CHANGES IN 2020 PBLS GUIDELINECompared with the 2015 guideline, 2 the changes in the 2020 PBLS guideline are as follows.
Endotracheal intubation or supraglottic airway (SGA) insertion versus bag mask ventilation (BMV)The use of BMV is recommended rather than endotracheal intubation or SGA insertion for pediatric out-of-hospital cardiac arrest (OHCA) (Class IIb, Level C-LD). For pediatric in-hospital cardi-S66 www.ceemjournal.org 2020 CPR guidelines: pediatric basic life support ac arrest, there is no comparable evidence for applying endotracheal intubation or SGA insertion and BMV to date.
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