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Thesis (Ph. D.)--University of Sydney, 2003. / Includes tables and questionnaires. Title from title screen (viewed Apr. 28, 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Centre for Perinatal Health Services Research, School of Public Health. Includes bibliography. Also available in print form.

M.Cur. / 28-week premature infants are usually born with Respiratory Distress and need ventilator support in order to survive. However, because of all the associated complications of ventilation of premature infants, it is the practice in the NICU's in this studies to extubate these infants as soon as possible to either nasal continuous positive airway pressure (nCPAP) or nasal cannula (nc). For this study the choice of ventilation was High-Frequency Oscillation (HFO). It is known that during HFOV, Fi02 and MAP constitute the oxygenation needed to ventilate these infants. During weaning the Fi02 is reduced to :s 30% and the MAP gradually to :s 8-10 cm H20 to enable extubation. There are not enough guidelines as to the ideal MAP at which to extubate a HFOV 28-week premature infant to nCPAP or nco The purpose of this study was, firstly, to determine the recommended optimal MAP to successfully extubate a 28-week HFOV premature infant to either nCPAP or nc and, secondly, to formulate guidelines and recommendations for use by the attending neonatal nursing staff, doctors and clinicians for optimal nursing and management of the HFOV premature infant. This is a non-experimental quantitative study with a retrospective, descriptive survey, case study design. All 28-week premature infants that were initially ventilated on a HFOV during the period May 2000 to September 2002 in two private Neonatal Intensive Care Units in Gauteng and extubated to nCPAP or nc were incorporated into this study. The study was done in 3 phases. The first involved an in-depth literature survey in which the physiological and biographical variables that were included in the data collection instrument were identified. The second phase involved collecting the data from the infant's medical files, analysing the data and identifying any correlation of the data. In the third phase guidelines and recommendations for neonatal nursing staff, doctors and any attending clinicians were formulated. The initial settings of the HFOV, as well as the settings at a MAP of 8 cm H20, and the settings of the HFOV prior to extubation were recorded and analysed. The premature infant's initial blood gas and peripheral saturation after commencement of ventilation, as well as at a MAP of 8 cm H20 and prior extubation were recorded and analysed. The physiological stability of the premature infants, 12 hours after extubation, formed the criteria of successful extubation and any need for re-intubations was considered failure criteria. There are a lack of protocols and guidelines for neonatal nurses, doctors and clinicians as to guide them in the nursing of HFOV 28-week premature infants. The analysed data assists in drawing up guidelines for nursing the 28-week premature HFOV infant.

An improved digital computer model of the neonatal respiratory system was developed. Using previous models as a basis, important improvements were made in order to accurately simulate infant blood gas chemistry and its effect on respiratory and circulatory control. The model is divided into five physiologic compartments: heart, brain, lungs, tissues, and cerebrospinal fluid compartment. Respiration is a function hydrogen ion concentration in the medulla and oxygen tension and hydrogen ion concentration in the aorta. Cardiac output is a function of oxygen and carbon dioxide tension in the brain and oxygen tension at the tissues. Major improvements in this model include an advanced carbon dioxide dissociation relationship and a complex blood buffer system. It also is able to simulate treatment of respiratory distressed infants with bicarbonate infusion and respirator therapy. In addition, it has a simplified variable time delay. In order to evaluate the model, an attempt was made to simulate an actual infant. Results indicate that while the model is an improvement over previous attempts, it is still deficient in some areas in its ability to simulate actual infants. More comparisons with actual data must be made to accurately evaluate the model. / Master of Science

Thesis (MD)-University of Natal, Durban, 1967.

M.Cur. / Neonates born with respiratory distress require supplementary oxygen. In some cases it is necessary to ventilate these neonates in order to obtain adequate tissue oxygenation. Due to the potential complications of mechanical ventilation it is necessary to extubate the neonate as soon as possible after intubation and administer supplementary oxygen by an alternate method. Any form of oxygen therapy carries the risk of oxygen toxicity. It is therefore essential that the method of oxygen therapy opted for after extubation will result in the infant being weaned in the shortest time possible. In the two NICUs from which the sample was taken for this study, neonates are currently extubated and placed either in a head box, on nasal CP AP or on a nasal cannula, these being the methods used to administer oxygen to a neonate. The decision regarding the method of choice is currently directed by customary practices rather than physiological variables as indicators/criteria of effectiveness. The questions that arise from the research problem are as follows: • Which physiological variables should be considered when faced with the decision regarding the method of oxygen therapy to initiate after extubation of a neonate? • Are there any differences in the effectiveness of the two methods of oxygen therapy, namely headbox and nasal cannula, after extubation of a neonate? The purpose of this study was to compare two methods of oxygen therapy, after extubation of the neonate with respiratory distress syndrome, in an attempt to formulate guidelines; based on physiological variables as criteria/indicators of effectiveness. After analyzing the data, as described in Chapter 4, it became evident that it would not be possible to formulate guidelines. Therefore only a comparison was done between the two methods of oxygen therapy (headbox and nasal cannula,) based on both biographical and physiological variables as criteria/indicators, to determine whether there were any significant differences in the effectiveness of the two methods after extubation of the neonate.

by Lam Kuo. / Year shown on spine: 1997. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1996. / Includes bibliographical references (leaves 107-121). / Acknowledgments / List of Abbreviations / Summary / List of Contents / List of Tables / List of Figures / Chapter Chapter 1 --- Introduction and the objectives of the study --- p.1-6 / Chapter Chapter 2 --- Overviews of Bronchopulmonary Dysplasia (BPD) and bronchodilator therapy -- a literature review --- p.7-29 / Chapter 2.1 --- Overview of Bronchopulmonary Dysplasia (BPD) --- p.7-9 / Chapter 2.2. --- Bronchodilator therapy --- p.10-18 / Chapter 2.2.1 --- Therapeutic value on infants with Bronchiolitis / Chapter 2.2.2. --- Therapeutic value on infants with Bronchopulmonary Dysplasia (BPD) / Chapter 2.3. --- "Three modes of aerosol delivery devices --jet nebuliser , ultrasonic nebuliser and metered dose inhaler" --- p.18-29 / Chapter 2.3.1. --- Jet nebuliser / Chapter 2.3.2. --- Ultrasonic nebuliser / Chapter 2.3.3. --- Metered dose inhaler / Chapter 2.3.4. --- Comparison of the therapeutic efficiency between jet nebuliser， ultrasonic nebuliser and Metered dose inhaler / Chapter 2.3.4.a. --- Comparison of particle size / Chapter 2.3.4.b. --- Comparison of aerosol deposition / Chapter 2.3.4.c. --- Comparison of pulmonary function / Chapter Chapter 3 --- Pulmonary function test in neonates --a literature review --- p.30-40 / Chapter 3.1. --- Overview of pulmonary function test in neonates --- p.30 / Chapter 3.2. --- Assessment of pulmonary function test in neonates --- p.31-40 / Chapter 3.2.1. --- Pulmonary mechanics / Chapter 3.2.1.a. --- Lung compliance / Chapter 3.2.1.b. --- Airway resistance / Chapter 3.2.1.c. --- Functional residual capacity (FRC) / Chapter Chapter 4 --- Subjects and methods --- p.41-48 / Chapter 4.1. --- Subjects --- p.41-42 / Chapter 4.2. --- Methods --- p.42-48 / Chapter 4.2.1. --- Delivery of Salbutamol aerosol / Chapter 4.2.1.1. --- Spontaneously breathing non-ventilated infants (group 1) / Chapter 4.2.1.2. --- Ventilator-dependent infants (group 2) / Chapter 4.2.2. --- Monitoring the clinical parameters / Chapter 4.2.3. --- Measurement of pulmonary function / Chapter 4.2.4. --- Statistics / Chapter Chapter 5 --- Results --- p.49-53 / Chapter 5.1. --- Clinical parameters --- p.50-51 / Chapter 5.2. --- Pulmonary function tests --- p.51-53 / Chapter Chapter 6 --- Discussion --- p.54-61 / Chapter 6.1. --- Non-ventilated group --- p.55-58 / Chapter 6.2. --- Ventilated group --- p.58-61 / Chapter Chapter 7 --- Conclusion --- p.62-63 / Tables and Figures / References

Thesis (M.A.)--Northern Kentucky University, 2008. / Made available through ProQuest. Publication number: AAT 1454478. ProQuest document ID: 1580779071. Includes bibliographical references (p. 25-27)

Thesis (Ph. D.)--University of Missouri--Columbia, 2002. / Typescript. Vita. Includes bibliographical references (leaves 202-211). Also available on the Internet.

A lesão nasal decorrente do uso da ventilação não invasiva (VNI) é um evento adverso cada vez mais comum nas unidades de terapia intensiva neonatais (UTIN) e apresenta consequências a curto e longo prazo. Esta lesão pode resultar em sequelas tanto de ordem estética quanto funcional, limitar o uso da VNI em RN que necessita desse suporte ventilatório, causar desconforto e septicemia; podendo aumentar, desta forma, o tempo de internamento na UTIN. Esta pesquisa tem por objetivo avaliar tecnológica e clinicamente os protetores nasais empregados na VNI de RN internados na UTIN. A metodologia consistiu primeiramente em levantar as possíveis causas da lesão nasal e avaliar os fatores de risco associados ao seu desenvolvimento. Em seguida, foi realizado um ensaio clínico randomizado para comparar os efeitos de três tipos de proteção nasal e das prongas novas e esterilizadas sobre a gravidade da lesão nasal. E por fim, foi realizada a caracterização térmica e estrutural dos protetores nasais após serem envelhecidas com temperatura e umidade no interior da incubadora neonatal. As principais causas da lesão foram relacionadas às características do material, a problemas no equipamento, a fatores assistenciais, neonatais e profissionais. Neste estudo, foram constatados como fatores de risco: a idade gestacional, a massa ao nascer, o tempo total de permanência na VNI, a reutilização deste suporte, o tempo da primeira utilização e da reutilização da VNI, bem como o tempo de internação na UTIN. Não foram observadas diferenças significativas na gravidade da lesão quando comparadas as três proteções estudadas, nem quando utilizadas prongas novas e esterilizadas. Quanto à análise dos materiais, foi constatado que a exposição à temperatura e à umidade alterou a percentagem de cristalinidade e a rugosidade das proteções nasais estudadas. / The nasal injury resulting from the use of non-invasive ventilation (NIV) is an adverse event increasingly common in the newborn intensive care unit (NICU) and shows the short and long term consequences. This lesion can result both aesthetic and functional sequelae, limit the use of NIV in newborns who need this ventilatory support, cause discomfort and septicemia, may thereby increase the length of stay in NICU. This research aims to evaluate technological and clinically nasal protectors used with NIV of newborns admitted to the NICU. The methodology consisted primarily in raising the possible causes of nasal injury and assess the risk factors associated with its development. Then, it was conducted a randomized clinical trial to compare the effects of three kind of nasal protector and new and sterilized prongs on the severity of nasal lesions. And finally, it was performed the thermal and structural characterization of nasal protection after being aged with temperature and humidity inside the neonatal incubator. The main causes of injury were related to characteristics of the material, equipment problems, assistive, neonatal and professional factors. In this study, it was found as risk factors: gestational age, weight at birth, the total time stay in the NIV, the reuse of this support, the time of first use and reuse of NIV and the length of stay in the NICU. They were not observed significant differences in lesion severity when compared the three protectors studied, nor when used new and sterilized prongs. The materials analysis indicated that exposure to temperature and humidity changed the percentage of crystallinity and the roughness of the nasal protections studied.