Dexmedetomidine is effective and safe during NIV in infants and young children with acute respiratory failure.

BACKGROUND: Noninvasive ventilation (NIV) is increasingly utilized in infants and young children, though associated with high failure rates due to agitation and poor compliance, mostly if patient-ventilator synchronization is required. METHODS: A retrospective cohort study was carried out in an academic pediatric intensive care unit (PICU). Dexmedetomidine (DEX) was infused as unique sedative in 40 consecutive pediatric patients (median age 16 months) previously showing intolerance and agitation during NIV application. RESULTS: During NIV clinical application both COMFORT-B Score and Richmond Agitation-Sedation Scale (RASS) were serially evaluated. Four patients experiencing NIV failure, all due to pulmonary condition worsening, required intubation and invasive ventilation. 36 patients were successfully weaned from NIV under DEX sedation and discharged from PICU. All patients survived until home discharge. CONCLUSION: Our data suggest that DEX may represent an effective sedative agent in infants and children showing agitation during NIV. Early use of DEX in infants/children receiving NIV for acute respiratory failure (ARF) should be considered safe and capable of improving NIV, thus permitting both lung recruitment and patient-ventilator synchronization.

Near-zero-field magnetoresistance measurements: A simple method to track atomic-scale defects involved in metal-oxide-semiconductor device reliability.

We demonstrate the ability of a relatively new analytical technique, near-zero-field magnetoresistance (NZFMR), to track atomic-scale phenomena involved in the high-field stressing damage of fully processed Si metal-oxide-semiconductor field-effect transistors. We show that the technique is sensitive to both the Pb0 and Pb1 dangling bond centers and that the presence of both centers can be inferred through NZFMR via hyperfine interactions with the central 29Si atoms of the dangling bonds. The NZFMR results also provide evidence for the redistribution of mobile hydrogen atoms at the Si/SiO2 interface and also a potential change in the average dipolar coupling constant between electrons in neighboring defects. This work shows that NZFMR offers significant analytical power for studying technologically relevant semiconductor device reliability problems and has advantages in experimental simplicity over comparable techniques.