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https://www.readbyqxmd.com/read/29353257/ethical-dilemmas-of-recording-and-reviewing-neonatal-resuscitation
#1
REVIEW
Maria C den Boer, Mirjam Houtlosser, Henriëtte Anje van Zanten, Elizabeth E Foglia, Dirk P Engberts, Arjan B Te Pas
Neonatal resuscitation is provided to approximately 3% of neonates. Adequate ventilation is often the key to successful resuscitation, but this can be difficult to provide. There is increasing evidence that inappropriate respiratory support can have severe consequences. Several neonatal intensive care units have recorded and reviewed neonatal resuscitation procedures for quality assessment, education and research; however, ethical dilemmas sometimes make it difficult to implement this review process. We reviewed the literature on the development of recording and reviewing neonatal resuscitation and have summarised the ethical concerns involved...
January 20, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29341045/approach-to-infants-born-through-meconium-stained-amniotic-fluid-evolution-based-on-evidence
#2
Munmun Rawat, Sushma Nangia, Praveen Chandrasekharan, Satyan Lakshminrusimha
Meconium-stained amniotic fluid (MSAF) during delivery is a marker of fetal stress. Neonates born through MSAF often need resuscitation and are at risk of meconium aspiration syndrome (MAS), air leaks, hypoxic-ischemic encephalopathy, extracorporeal membrane oxygenation (ECMO), and death. The neonatal resuscitation approach to MSAF has evolved over the last three decades. Previously, nonvigorous neonates soon after delivery were suctioned under the vocal cords with direct visualization technique using a meconium aspirator...
January 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29325592/magnesium-sulphate-for-fetal-neuroprotection-to-prevent-cerebral-palsy-mag-cp-implementation-of-a-national-guideline-in-canada
#3
Dane A De Silva, Anne R Synnes, Peter von Dadelszen, Tang Lee, Jeffrey N Bone, Laura A Magee
BACKGROUND: Evidence supports magnesium sulphate (MgSO4) for women at risk of imminent birth at < 32-34 weeks to reduce the likelihood of cerebral palsy in the child. MAGnesium sulphate for fetal neuroprotection to prevent Cerebral Palsy (MAG-CP) was a multifaceted knowledge translation (KT) strategy for this practice. METHODS: The KT strategy included national clinical practice guidelines, a national online e-learning module and, at MAG-CP sites, educational rounds, focus group discussions and surveys of barriers and facilitators...
January 11, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29320801/fatigue-during-chest-compression-using-a-neonatal-patient-simulator
#4
Diego Enriquez, Javier Meritano, Birju A Shah, Clara Song, Edgardo Szyld
OBJECTIVE:  The objective of this study was to evaluate chest compression (CC) quality and operator fatigue during CC, with coordinated ventilation, on a neonatal simulator and to explore its association with provider aerobic activity and body mass index. METHODS:  This was a prospective observational experimental study on pediatricians, neonatologists, and neonatal nurses who frequently deliver newborns and who have signed the informed consent. Subjects performed CC coordinated with ventilations at a ratio of 3:1 for 10 minutes on a neonatal mannequin...
January 10, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29315458/implementation-and-effectiveness-of-a-video-based-debriefing-programme-for-neonatal-resuscitation
#5
C Skåre, T E Calisch, E Saeter, T Rajka, A M Boldingh, B Nakstad, D E Niles, J Kramer-Johansen, T M Olasveengen
BACKGROUND: Approximately 5%-10% of newly born babies need intervention to assist transition from intra- to extrauterine life. All providers in the delivery ward are trained in neonatal resuscitation, but without clinical experience or exposure, training competency is transient with a decline in skills within a few months. The aim of this study was to evaluate whether neonatal resuscitations skills and team performance would improve after implementation of video-assisted, performance-focused debriefings...
January 7, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29304139/early-neonatal-mortality-and-neurological-outcomes-of-neonatal-resuscitation-in-a-resource-limited-setting-on-the-thailand-myanmar-border-a-descriptive-study
#6
Sophie Janet, Verena I Carrara, Julie A Simpson, Nant War War Thin, Wah Wah Say, Naw Ta Mlar Paw, Kesinee Chotivanich, Claudia Turner, Jane Crawley, Rose McGready
BACKGROUND: Of the 4 million neonatal deaths worldwide yearly, 98% occur in low and middle-income countries. Effective resuscitation reduces mortality and morbidity but long-term outcomes in resource-limited settings are poorly described. This study reports on newborn neurological outcomes following resuscitation at birth in a resource-limited setting where intensive newborn care including intubation is unavailable. METHODS: Retrospective analysis of births records from 2008 to 2015 at Shoklo Malaria Research Unit (SMRU) on the Thailand-Myanmar border...
2018: PloS One
https://www.readbyqxmd.com/read/29289490/positive-end-expiratory-pressure-during-resuscitation-at-birth-in-very-low-birth-weight-infants-a-randomized-controlled-pilot-trial
#7
Ratchada Kitsommart, Kittaya Nakornchai, Buranee Yangthara, Ratchada Jiraprasertwong, Bosco Paes
BACKGROUND: There is limited evidence of the effect of positive end-expiratory pressure (PEEP) during resuscitation soon after birth. Premature neonates may experience respiratory distress from surfactant insufficiency and providing PEEP after the very first breath, may improve outcomes following appropriate resuscitation. The objective of this study was to evaluate the short term respiratory outcomes after positive pressure ventilation (PPV) with PEEP in preterm infants at birth. METHODS: A prospective randomized-controlled, pilot trial was conducted...
December 9, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29287132/fetal-echocardiography-for-planning-perinatal-and-delivery-room-care-of-neonates-with-congenital-heart-disease
#8
Laura Sanapo, Jay D Pruetz, Maciej Słodki, M Beth Goens, Anita J Moon-Grady, Mary T Donofrio
Fetal echocardiography facilitates the prenatal diagnosis of infants with congenital heart disease (CHD) and through sequential examinations, allows assessment of fetal hemodynamics and cardiovascular status from the time of diagnosis to delivery. Fetal cardiologists have created diagnostic protocols aimed at risk stratifying severity and potential postnatal compromise in fetuses with CHD, and identifying those who may require special intervention at birth or within the first days of life. In this article, we review fetal cardiovascular physiology, the progression of CHD in utero and fetal echocardiographic findings used for risk stratification of newborns with CHD, as well as some of the basic principles of planning for the neonatal resuscitation and initial transitional care of these complex newborns...
December 2017: Echocardiography
https://www.readbyqxmd.com/read/29286910/selective-iugr-in-dichorionic-twins-what-can-doppler-assessment-and-growth-discordancy-say-about-neonatal-outcomes
#9
Paola Algeri, Matteo Frigerio, Maria Lamanna, Petya Vitanova Petrova, Sabrina Cozzolino, Maddalena Incerti, Salvatore Andrea Mastrolia, Nadia Roncaglia, Patrizia Vergani
OBJECTIVE: The aim of the present study was to assess, in a population of dichorionic twin pregnancies with selective growth restriction, the effect of inter-twin differences by use of Doppler velocimetry and fetal growth discordancy on perinatal outcomes. METHODS: This was a retrospective study including dichorionic twin pregnancies from January 2008 to December 2015 at the Department of Obstetrics and Gynecology of Fondazione MBBM. Only dichorionic twin pregnancies affected by selective intrauterine growth restriction (IUGR) delivering at ≥24 weeks were included in the study...
December 29, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29232665/the-laryngeal-mask-airway-and-its-use-in-neonatal-resuscitation-a-critical-review-of-where-we-are-in-2017-2018
#10
Satvik Chaitanya Bansal, Stefano Caoci, Eugene Dempsey, Daniele Trevisanuto, Charles Christoph Roehr
Studies using videotape recordings and respiratory function monitoring have shown that both face mask (FM) application and endotracheal tube (ETT) placement represent a challenge for resuscitators. Hence, there is a strong need for devices that can largely be used independently of individual operator training levels, in order to ensure more reliable support in time-critical situations, such as neonatal resuscitation. The laryngeal mask airway device (LMA) has evolved as a potentially very valuable tool. We conducted a systematic review of studies evaluating the use of the LMA in neonatal resuscitation...
December 13, 2017: Neonatology
https://www.readbyqxmd.com/read/29214159/quality-of-care-during-neonatal-resuscitation-in-kakamega-county-general-hospital-kenya-a-direct-observation-study
#11
Duncan N Shikuku, Benson Milimo, Elizabeth Ayebare, Peter Gisore, Gorrette Nalwadda
Background: Birth asphyxia is the leading cause of neonatal mortality in Kenya. Quality care during neonatal resuscitation (NR) can contribute to a reduction in neonatal mortality related to birth asphyxia by 30 percent. This study assessed the quality of care (QoC) during NR for newborns with birth asphyxia. Methods: Direct observations of 138 newborn resuscitations were done in labor ward and maternity theatre. Twenty-eight healthcare providers were observed 3-5 times using a structured checklist...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29173319/impact-of-the-neonatal-resuscitation-program-recommended-low-oxygen-strategy-on-outcomes-of-infants-born-preterm
#12
COMPARATIVE STUDY
Vishal S Kapadia, Charitharth V Lal, Venkat Kakkilaya, Roy Heyne, Rashmin C Savani, Myra H Wyckoff
OBJECTIVE: To evaluate the impact of the Neonatal Resuscitation Program (NRP)-recommended low oxygen strategy (LOX) on neonatal morbidities, mortality, and neurodevelopmental outcomes in neonates born preterm. STUDY DESIGN: In March 2011, Parkland Hospital changed from a high oxygen strategy (HOX) of resuscitation with initial 100% oxygen and targeting 85%-94% oxygen saturation for delivery room resuscitation to a LOX with initial 21% oxygen and titrating oxygen to meet NRP-recommended transitional target saturations...
December 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29170287/maternal-and-neonatal-outcomes-of-vaginal-breech-delivery-for-singleton-term-pregnancies-in-a-carefully-selected-cameroonian-population-a-cohort-study
#13
Julius Sama Dohbit, Pascal Foumane, Joel Noutakdie Tochie, Fadimatou Mamoudou, Mazou N Temgoua, Ronni Tankeu, Veronica Aletum, Emile Mboudou
BACKGROUND AND OBJECTIVES: Vaginal breech delivery (VBD) is known to be associated with more perinatal and maternal complications. Very few studies on the subject have been carried out in poor-resource settings. The aim of this study was to determine maternal and neonatal outcomes in carefully selected cases of VBD for singleton term pregnancies in a tertiary centre in Cameroon. DESIGN: A retrospective cohort study. SETTING: A tertiary hospital in Yaounde, Cameroon...
November 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29144999/communicating-out-loud-midwifery-students-experiences-of-a-simulation-exercise-for-neonatal-resuscitation
#14
Mary Carolan-Olah, Gina Kruger, Vera Brown, Felicity Lawton, Melissa Mazzarino, Vidanka Vasilevski
Midwifery students feel unprepared to deal with commonly encountered emergencies, such as neonatal resuscitation. Clinical simulation of emergencies may provide a safe forum for students to develop necessary skills. A simulation exercise, for neonatal resuscitation, was developed and evaluated using qualitative methods. Pre and post-simulation questions focussed on student confidence and knowledge of resuscitation. Data were analysed using a thematic analysis approach. Pre-simulation questions revealed that most students considered themselves not very confident/unsure about their level of confidence in undertaking neonatal resuscitation...
October 23, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/29122802/emergency-obstetric-care-provision-in-southern-ethiopia-a-facility-based-survey
#15
Mitchell Windsma, Tienke Vermeiden, Floris Braat, Andualem Mengistu Tsegaye, Asheber Gaym, Thomas van den Akker, Jelle Stekelenburg
OBJECTIVES: To assess the provision of basic emergency obstetric and newborn care (BEmONC), knowledge of high-risk pregnancies and referral capacity at health centres in Southern Ethiopia. DESIGN: A facility-based survey, using an abbreviated version of the Averting Maternal Death and Disability needs assessment tool for emergency obstetric and newborn care. Modules included infrastructure, staffing, number of deliveries, maternal and perinatal mortality, BEmONC signal functions, referral capacity and knowledge of risk factors in pregnancy...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29117772/initial-neonatal-resuscitation-skill-retention-after-the-implementation-of-the-novel-24-7-hybridlab%C3%A2-learning-system
#16
Ausrele Kudreviciene, Ruta Jolanta Nadisauskiene, Rasa Tameliene, Algimantas Tamelis, Irena Nedzelskiene, Paulius Dobozinskas, Dinas Vaitkaitis
Ensuring long-term retention of the acquired practical skills is one of the major aims of a medical school. This depends on the application of training techniques and their combinations. In order to standardize the teaching process, to acquire and maintain a broad array of technical, professional, and interpersonal skills and competencies, and to improve the retention of practical skills, we developed a new training technique - the HybridLab® learning method. It consists of an e-learning platform, hands-on simulation, carefully elaborated learning algorithms (DRAKON), peer-to-peer teaching, and assessment and feedback by peers, and later - by a remote instructor...
November 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29099872/a-pilot-randomized-controlled-trial-of-ekg-for-neonatal-resuscitation
#17
Anup Katheria, Kathy Arnell, Melissa Brown, Kasim Hassen, Mauricio Maldonado, Wade Rich, Neil Finer
BACKGROUND: The seventh edition of the American Academy of Pediatrics Neonatal Resuscitation Program recommends the use of a cardiac monitor in infants that need resuscitation. Previous trials have shown that EKG heart rate is available before pulse rate from a pulse oximeter. To date no trial has looked at how the availability of electrocardiogram (EKG) affects clinical interventions in the delivery room. OBJECTIVE: To determine whether the availability of an EKG heart rate value and tracing to the clinical team has an effect on physiologic measures and related interventions during the stabilization of preterm infants...
2017: PloS One
https://www.readbyqxmd.com/read/29077174/clinical-significance-of-dynamic-measurements-of-seric-tnf-%C3%AE-hmgbl-and-nse-levels-and-aeeg-monitoring-in-neonatal-asphyxia
#18
X-H Zhang, B-L Zhang, S-M Guo, P Wang, J-W Yang
OBJECTIVE: This study investigates the clinical value of monitoring blood levels of tumor necrosis factor-α (TNF-α), high mobility group protein Bl (HMGBl), and neuron-specific enolase (NSE), and examining an amplitude-integrated electroencephalogram (aEEG) for the diagnosis and short-term prognosis of brain damage caused by neonatal asphyxia. PATIENTS AND METHODS: Sixty full-term neonates born in Yidu Central Hospital from January to December 2015 were enrolled in the study...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29025527/-being-a-mother-after-35-years-will-it-be-different
#19
Bárbara Marques, Francisca Palha, Edgar Moreira, Sandra Valente, Margarida Abrantes, Joana Saldanha
INTRODUCTION: Advanced maternal age is defined as maternity after 35 years old and is associated with more complications during pregnancy and neonatal period as well as decreased fertility. This study aims to examine the relationship between advanced maternal age and their maternal and fetal consequences, as well as maternal perception of the risk of pregnancy after 35 years old. MATERIAL AND METHODS: Observational, retrospective and comparative study, between two groups: advanced maternal age group (aged ≥ 35 years) and non-advanced maternal age group (age < 35 years), conducted between March and June 2015...
September 29, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28988159/chest-compression-during-sustained-inflation-versus-3-1-chest-compression-ventilation-ratio-during-neonatal-cardiopulmonary-resuscitation-a-randomised-feasibility-trial
#20
Georg M Schmölzer, Megan O Reilly, Caroline Fray, Sylvia van Os, Po-Yin Cheung
BACKGROUND: Current neonatal resuscitation guidelines recommend 3:1 compression:ventilation (C:V) ratio. Recently, animal studies reported that continuous chest compressions (CC) during a sustained inflation (SI) significantly improved return of spontaneous circulation (ROSC). The approach of CC during SI (CC+SI) has not been examined in the delivery room during neonatal resuscitation. HYPOTHESIS: It is a feasibility study to compare CC+SI versus 3:1 C:V ratio during neonatal resuscitation in the delivery room...
October 7, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
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