BACKGROUND: Hammock positioning is now frequently used with preterm infants admitted to ICUs. However, few studies have investigated the extent to which hammock positioning reduces pain and improves the sleep-wakefulness state compared with traditional positioning. METHODS: Twenty-six clinically stable newborns with gestational ages from 30 to 37 weeks who were breathing spontaneously were randomly assigned to 2 groups: a hammock-positioning group (n ‫؍‬ 13), in which newborns were placed in hammocks in the lateral position, and a traditional-positioning group (n ‫؍‬ 13), in which they were kept nested, also in the lateral position. The following variables were evaluated at the beginning and the end of the treatment: pain (with the Premature Infant Pain Profile, and Neonatal Facial Coding System), sleep-wakefulness state (with the Brazelton Neonatal Behavioral Assessment Scale), heart rate, breathing frequency, and peripheral S pO 2. RESULTS: The subjects in the hammock-positioning group showed an improvement in pain compared with the traditional-positioning group(Premature Infant Pain Profile score, 2.62 ؎ 1.89 vs 2.31 ؎ 1.97, ⌬P ‫؍‬ .008) and sleep-wakefulness state score (2.08 ؎ 0.64 vs 1.23 ؎ 0.44, ⌬ P < .001), reduced heart rate (151.69 ؎ 5.44 vs 142.77 ؎ 5.18 beats/min, ⌬ P < .001), breathing frequency (52.31 ؎ 4.05 vs 50.23 ؎ 2.55 beats/min, ⌬ P ‫؍‬ .024), and increased peripheral S pO 2 (94.69 ؎ 2.14 vs 98.00 ؎ 1.22%, ⌬ P < .001). CONCLUSIONS: Hammock positioning was an effective treatment option to reduce pain and improve sleep-wakefulness state. It also helped to reduce heart rate and breathing frequency, and to increase peripheral S pO 2 , which made it a treatment option for preterm infants.

Alveolar recruitment maneuver in mechanic ventilation pediatric intensive care unit children A manobra de recrutamento alveolar em crianças submetidas à ventilação mecânica em unidade de terapia intensiva pediátrica REVIEW ARTICLE INTRODUCTION Mechanic ventilation (MV) is considered a valuable tool to treat respiratory failure and decrease mortality in critically ill patients. Recent changes were introduced regarding how acute hypoxemic respiratory failure children are ventilated. However, experimental trials evidenced a relationship between inappropriate ventilatory measures and delayed improvement or even worsening of acute lung injury (ALI). (1-3) Additionally, clinical trials showed that less aggressive ventilatory strategies improve survival. (4,5

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Coronavirus is a new virus, the lack of immunity in the population means that COVID 19 has the potential to spread extensively. The current data seem to show that we are all susceptible to catching this disease,which includes, patients and healthcare staff (1).