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Comparison of intra-procedural pain between a novel continuous arteriovenous exchange and conventional pull-push techniques of partial exchange transfusion in neonates: a randomized controlled trial

Journal of Perinatology volume 34, pages 693–697 (2014)Cite this article

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Abstract

Objective:

We compared intra-procedural neonatal pain, agitation and sedation scale (N-PASS) scores between a novel ‘continuous arteriovenous exchange’ (CAVE) and conventional pull-push (PP) techniques of partial exchange transfusion (PET) among neonates with polycythemia.

Study Design:

Neonates >32-0/7 weeks gestation, requiring PET for polycythemia, were randomized to PP or CAVE techniques. The procedure was video-recorded and edited to mask the technique. Intra-procedural N-PASS scores assigned by two trained and masked neonatal fellows were compared.

Result:

Twenty-two neonates were randomized to CAVE (n=12) or PP (n=10) method. The area under curve for cumulative N-PASS scores was significantly lesser in CAVE group (mean difference−11.9 (95% CI=−4.2, −19.6), P=0.005)). Decrease in hematocrit and complications of PET were comparable. Time for PET was longer with CAVE technique (16 (9, 29) min vs 10 (6, 12) min, P=0.016).

Conclusion:

CAVE technique of PET was associated with lesser procedure-related pain (N-PASS scores) as compared with PP technique among neonates >32 weeks gestation.

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Acknowledgements

We gratefully acknowledge the contributions of Dr Gagan Mahajan and Dr Sudhanshu Grover for doing the N-PASS scoring of the videos.

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Authors and Affiliations

  1. Department of Paediatrics, Neonatal Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India

    S Patil, S S Saini, P Kumar & R Shah

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  1. S Patil
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  2. S S Saini
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  3. P Kumar
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  4. R Shah
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Correspondence to P Kumar.

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The authors declare no conflict of interest.

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Patil, S., Saini, S., Kumar, P. et al. Comparison of intra-procedural pain between a novel continuous arteriovenous exchange and conventional pull-push techniques of partial exchange transfusion in neonates: a randomized controlled trial. J Perinatol 34, 693–697 (2014). https://doi.org/10.1038/jp.2014.89

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