2 results
Using benchmarking to identify inter-centre differences in persistent ductus arteriosus treatment: can we improve outcome?
- Esther J. S. Jansen, Koen P. Dijkman, Richard A. van Lingen, Willem B. de Vries, Daniel C. Vijlbrief, Willem P. de Boode, Peter Andriessen
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- Journal:
- Cardiology in the Young / Volume 27 / Issue 8 / October 2017
- Published online by Cambridge University Press:
- 12 April 2017, pp. 1488-1496
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- Article
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Objective
The aim of this study was to identify inter-centre differences in persistent ductus arteriosus treatment and their related outcomes.
Materials and methodsWe carried out a retrospective, multicentre study including infants between 24+0 and 27+6 weeks of gestation in the period between 2010 and 2011. In all centres, echocardiography was used as the standard procedure to diagnose a patent ductus arteriosus and to document ductal closure.
ResultsIn total, 367 preterm infants were included. All four participating neonatal ICU had a comparable number of preterm infants; however, differences were observed in the incidence of treatment (33–63%), choice and dosing of medication (ibuprofen or indomethacin), number of pharmacological courses (1–4), and the need for surgical ligation after failure of pharmacological treatment (8–52%). Despite the differences in treatment, we found no difference in short-term morbidity between the centres. Adjusted mortality showed independent risk contribution of gestational age, birth weight, ductal ligation, and perinatal centre.
ConclusionsUsing benchmarking as a tool identified inter-centre differences. In these four perinatal centres, the factors that explained the differences in patent ductus arteriosus treatment are quite complex. Timing, choice of medication, and dosing are probably important determinants for successful patent ductus arteriosus closure.
7 - Trophic dynamics
- Edited by Dave Checkley, Scripps Institution of Oceanography, University of California, San Diego, Jürgen Alheit, Yoshioki Oozeki, Claude Roy
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- Book:
- Climate Change and Small Pelagic Fish
- Published online:
- 08 January 2010
- Print publication:
- 20 August 2009, pp 112-157
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- Chapter
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Summary
Summary
Literature on the trophic ecology of small pelagic fish (primarly anchovy Engraulis spp. and sardine Sardinops spp. but including the genera Brevoortia, Clupea, Sardina, Sprattus, and Strangomera) and their interactions with plankton are reviewed using case studies describing research on some economically and ecologically important small pelagic fish from up-welling and temperate non-upwelling ecosystems. Information from morphological studies of the feeding apparatus, field studies on dietary composition and foraging behaviour, and laboratory studies that have provided data for the parameterization of bio-energetic and other models of these small pelagic fish are presented, where available. Two or more small pelagic fish species are described in each case study, and disparities in trophic dynamics between co-occurring anchovy and sardine are consistently seen, supporting the hypothesis that species alternations between the two species could be trophically mediated. Linkages between climate and fish are described for many of the systems, and possible impacts of climate change on some of the species are described.
Introduction
Small pelagic fish are, in general, microphagous planktivores, and their high abundance levels in upwelling systems, in particular, was attributed to their ability to feed directly on phytoplankton and hence benefit from a short and efficient food chain (Ryther, 1969; Walsh, 1981). This two-step food chain hypothesis, with small pelagic fish being regarded as essentially phytophagus and feeding on large, chain forming diatoms such as Chaetoceros and Fragilaria (Yoneda and Yoshida, 1955; Bensam, 1964; Loukashkin, 1970; King and Macleod, 1976) was initially well supported (Longhurst, 1971; Durbin, 1979; Walsh, 1981).