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Premature infant care

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https://www.readbyqxmd.com/read/29242573/extremely-premature-birth-informed-written-consent-and-the-greek-ideal-of-sophrosyne
#1
Joseph W Kaempf, Kevin Dirksen
Most extremely premature infants die in the intensive care unit or suffer significant neurologic impairment. Many therapies result in unhealthy consequences, and the emotional and financial turmoil for families warrant reappraisal of our motives. Shared decision-making and informed consent in preference-sensitive conditions imply the family: (a) understands the medical problem, (b) grasps the risks and benefits of each therapy, (c) has the opportunity to ask questions and reflect upon options, (d) knows their values and preferences are understood, and (e) accepts or declines therapies without judgment or penalty...
December 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29234146/practices-surrounding-pulmonary-hypertension-and-bronchopulmonary-dysplasia-amongst-neonatologists-caring-for-premature-infants
#2
Gabriel Altit, Henry C Lee, Susan Hintz, Theresa A Tacy, Jeffrey A Feinstein, Shazia Bhombal
OBJECTIVE: Pulmonary hypertension (PH) is associated with bronchopulmonary dysplasia (BPD). Screening strategies, a thorough investigation of co-morbidities, and multidisciplinary involvement prior to anti-PH medications have been advocated by recent guidelines. We sought to evaluate current practices of neonatologists caring for premature infants with PH. DESIGN: Electronic survey of American Academy of Pediatrics neonatology members. RESULTS: Among 306 neonatologist respondents, 38% had an institutional screening protocol for patients with BPD; 83% screened at 36 weeks for premature neonates on oxygen/mechanical ventilation...
December 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29232013/what-are-the-medical-indications-for-providing-extremely-premature-infants-with-intensive-care
#3
EDITORIAL
Niels Lynøe, Gert Helgesson, Niklas Juth
No abstract text is available yet for this article.
December 12, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29229889/admission-of-term-infants-to-the-neonatal-intensive-care-unit-in-a-saudi-tertiary-teaching-hospital-cumulative-incidence-and-risk-factors
#4
Heidi Al-Wassia, Mafaza Saber
BACKGROUND: An increasing number of term infants of appropriate birthweight receive care in neonatal intensive care units (NICUs). OBJECTIVES: This study assessed the prevalence, patterns, and risk factors for admission of term infants to a NICU to identify areas for quality improvement. DESIGN: Cross-sectional analytical study. SETTING: An academic and referral center in Jeddah, Saudi Arabia. PATIENTS AND METHODS: The cases were all term infants (>=37 weeks gestational age) admitted to the NICU between 1 January and 31 December 2015...
November 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29224247/cortisol-and-blood-pressure-levels-decreased-in-fathers-during-the-first-hour-of-skin-to-skin-contact-with-their-premature-babies
#5
Natalia Varela, Réjean Tessier, George Tarabulsy, Tamarha Pierce
AIM: Premature birth is an extremely stressful experience. In 2013 to 2014 we explored the physiological stress responses of fathers during their first skin-to-skin contact with their new baby. METHODS: We recruited 49 fathers whose partners had given birth to a premature baby of up to 33 weeks and three days. The study, in the neonatal intensive care unit (NICU) of a Quebec hospital, measured the physiological stress responses of the fathers before and after they first experienced skin-to-skin contact with their new baby...
December 9, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29212881/risk-of-rotavirus-nosocomial-spread-after-inpatient-pentavalent-rotavirus-vaccination
#6
Annika M Hofstetter, Kirsten Lacombe, Eileen J Klein, Charla Jones, Bonnie Strelitz, Elizabeth Jacobson, Daksha Ranade, M Leanne Ward, Slavica Mijatovic-Rustempasic, Diana Evans, Mary Wikswo, Michael D Bowen, Umesh D Parashar, Daniel C Payne, Janet A Englund
BACKGROUND: Infants born prematurely or with underlying conditions are at increased risk of severe rotavirus disease and associated complications. Given the theoretical risk of nosocomial transmission of vaccine-type rotavirus, rotavirus vaccination is recommended for infants at or after discharge from neonatal care settings. Because the first dose should be administered by 104 days of age, some infants may be age-ineligible for vaccination if delayed until discharge. METHODS: This prospective cohort included infants admitted to an urban academic medical center between birth and 104 days who received care in intensive care settings...
December 6, 2017: Pediatrics
https://www.readbyqxmd.com/read/29211385/bringing-babies-and-breasts-into-workplaces-support-for-breastfeeding-mothers-in-workplaces-and-childcare-services-at-the-australian-national-university
#7
Julie Smith, Sara Javanparast, Lyn Craig
In 1999, two leading Australian academics challenged Australian universities to lead moves to better manage employees' maternity and breastfeeding needs, and 'bring babies and breasts into workplaces'. This paper addresses the question of how universities cope with the need for women to breastfeed, by exploring barriers facing women who combine breastfeeding and paid work at the Australian National University (ANU). Data were collected through online surveys in 2013 using mixed method, case study design, nested within a larger national study...
March 2017: Breastfeeding Review: Professional Publication of the Nursing Mothers' Association of Australia
https://www.readbyqxmd.com/read/29210760/a-pilot-study-of-responses-to-suctioning-among-neonates-on-bubble-nasal-continuous-positive-airway-pressure
#8
Michele Sweet, Debra Armbruster, Erin Bainbridge, Brianna Reiner, Alai Tan, Esther Chipps
BACKGROUND: Maintenance of a patent airway while the neonate is on nasal continuous positive airway pressure (nasal CPAP) requires vigilant monitoring and oral/nasopharyngeal suctioning. Currently, no evidence-based guidelines for safe suctioning in neonates while on bubble nasal CPAP have been published. PURPOSE: (1) To characterize the clinical and behavioral responses of neonates on bubble nasal CPAP in a level III neonatal intensive care unit following routine oral and nasopharyngeal suctioning...
December 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29208882/thrombocytopenia-in-late-onset-neonatal-sepsis-and-its-relationship-with-specific-organism-in-a-tertiary-care-hospital
#9
F Ahmed, A Y Raj, L N Begum
Late onset neonatal sepsis (LONS) is a common complication in the Neonatal Intensive Care Unit (NICU) especially in premature infants, in whom the clinical presentation can be subtle and nonspecific. Thrombocytopenia is an important complication of sepsis. The objective of the present study was to identify the organism-speci?c platelet response in neonate with culture proven LONS. In this retrospective study all the infants with blood culture positive LONS in the neonatal intensive care unit (NICU) at Square Hospitals Ltd...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29208666/epidemiology-of-uk-neonatal-infections-the-neonin-infection-surveillance-network
#10
Benjamin Cailes, Christina Kortsalioudaki, Jim Buttery, Santosh Pattnayak, Anne Greenough, Jean Matthes, Alison Bedford Russell, Nigel Kennea, Paul T Heath
OBJECTIVE: To describe the epidemiology of neonatal infection over the past decade in UK neonatal units. DESIGN: Retrospective analysis of prospectively collected infection surveillance network data from 2005 to 2014. SETTING: 30 neonatal units in the UK. PATIENTS: Newborns on participating neonatal units who had a positive blood, cerebrospinal fluid or urine culture and were treated with at least 5 days of appropriate antibiotics...
December 5, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29198532/impact-of-prolonged-mechanical-ventilation-in-very-low-birth-weight-infants-results-from-a-national-cohort-study
#11
Young-Bin Choi, Juyoung Lee, Jisun Park, Yong Hoon Jun
OBJECTIVE: To evaluate the in-hospital consequences of prolonged respiratory support with invasive mechanical ventilation in very low birth weight infants. STUDY DESIGN: A cohort study was performed using prospectively collected data from 69 neonatal intensive care units participating in the Korean national registry. In total, 3508 very low birth weight infants born between January 1, 2013 and December 31, 2014 were reviewed. RESULTS: The adjusted hazard ratio for death increased significantly for infants who received mechanical ventilation for more than 2 weeks compared with those were mechanically ventilated for 7 days or less...
November 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29197867/topical-coconut-oil-in-very-preterm-infants-an-open-label-randomised-controlled-trial
#12
Tobias Strunk, Sameer Pupala, Julie Hibbert, Dorota Doherty, Sanjay Patole
BACKGROUND: The immature fragile skin of preterm infants represents an inadequate protective barrier. The emollient and anti-infective properties of coconut oil make it a potentially beneficial topical agent for this population. OBJECTIVES: Our aim was to evaluate feasibility, safety, and the effects of topical coconut oil on skin condition in very preterm infants. METHODS: An open-label randomised controlled trial in preterm infants <30 weeks' gestation was conducted...
December 1, 2017: Neonatology
https://www.readbyqxmd.com/read/29194078/stress-from-the-neonatal-intensive-care-unit-to-home-paternal-and-maternal-cortisol-rhythms-in-parents-of-premature-infants
#13
Craig F Garfield, Clarissa D Simon, Joshua Rutsohn, Young S Lee
To examine cortisol diurnal rhythms over the transition from the critical care setting to home for fathers and mothers of very low-birth-weight infants, including how cortisol is associated with psychosocial stress and parenting sense of competence. This cohort study in a level III neonatal intensive care unit and the general community had 86 parents complete salivary collection and self-reported psychosocial measures. Salivary samples were collected 3 times a day on the day before discharge, and on 3 subsequent days at home...
November 30, 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/29191725/bonding-in-neonatal-intensive-care-units-experiences-of-extremely-preterm-infants-mothers
#14
Isabel María Fernández Medina, José Granero-Molina, Cayetano Fernández-Sola, José Manuel Hernández-Padilla, Marcos Camacho Ávila, María Del Mar López Rodríguez
BACKGROUND: The birth of an extremely preterm infant can disrupt normal mother-infant physical contact and the care provided by the mother. This situation has an impact on the process of bonding between the mother and the child. AIM: The objective of this study was to describe and understand the experiences of mothers who have extremely preterm infants admitted in Neonatal Intensive Care Units with regard to their bonding process. METHODS: An interpretive, qualitative research methodology using Gadamer's philosophical hermeneutics was carried out...
November 27, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29185948/pneumopericardium-in-the-neonate
#15
Tiffany L Walker, Dorothy A Shannon
Pneumopericardium occurs when air accumulates in the pericardial sac surrounding the heart and is one of the rarest forms of air leaks in neonates. Because of various advances in neonatal care, including gentler modes of ventilation, surfactant replacement, and antenatal steroids, the incidence of pneumopericardium has decreased. Despite the decrease in incidence of pneumopericardium, most cases arise in premature infants with a history of respiratory distress and mechanical ventilation. Evidence has shown that the incidence is inversely related to birth weight and that pneumopericardium has high mortality and morbidity rates...
November 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/29184588/clinical-outcomes-of-high-risk-infant-follow-up-program-in-a-tertiary-care-centre
#16
Kayvan Mirnia, Forouzan Akrami, Behzad Jodeiry, Mohammad Heidarzadeh, Sima Safavinia
Background: High-risk infant follow-up (HRIF) program is necessary for early detection, timely intervention, and promotion of health outcomes in vulnerable infants, ethically. The present study was carried out to assess the clinical outcomes of the HRIF Program in Alzahra hospital as a tertiary care centre, in Iran. Materials and Methods: In this cohort study, 5840 neonates were born at Alzahra hospital, from June 1, 2011 to 30th February 2012. Among those who were admitted to neonatal intensive care unit (NICU), 253 infants were recruited by census according to HRIs criteria...
November 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/29184049/does-diaphragmatic-electrical-activity-in-preterm-infants-predict-extubation-success
#17
Neetu Singh, Matthew J McNally, Robert A Darnall
BACKGROUND: Despite many advances in respiratory care and mechanical ventilation, neonatologists lack an objective tool to aid in decision making for timely extubation. Electrical activity of the diaphragm (EAdi), a measure of neural respiratory drive and inspiratory load, may be a useful predictor of extubation success in preterm neonates. The objective of this work was to investigate whether peak EAdi could distinguish successful versus failed extubation in mechanically ventilated preterm infants...
November 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29180750/strain-resolved-analysis-of-hospital-rooms-and-infants-reveals-overlap-between-the-human-and-room-microbiome
#18
Brandon Brooks, Matthew R Olm, Brian A Firek, Robyn Baker, Brian C Thomas, Michael J Morowitz, Jillian F Banfield
Preterm infants exhibit different microbiome colonization patterns relative to full-term infants, and it is speculated that the hospital room environment may contribute to infant microbiome development. Here, we present a genome-resolved metagenomic study of microbial genotypes from the gastrointestinal tracts of infants and from the neonatal intensive care unit (NICU) room environment. Some strains detected in hospitalized infants also occur in sinks and on surfaces, and belong to species such as Staphylococcus epidermidis, Enterococcus faecalis, Pseudomonas aeruginosa, and Klebsiella pneumoniae, which are frequently implicated in nosocomial infection and preterm infant gut colonization...
November 27, 2017: Nature Communications
https://www.readbyqxmd.com/read/29175819/decreased-oxygen-exposure-during-transportation-of-newborns
#19
Chayatat Ruangkit, Sasivimon Soonsawad, Thavatchai Tutchamnong, Buranee Swatesutipun
Oxygen is the most common treatment for newborns in need of respiratory support. However, oxygen can cause tissue injury through reactive oxygen species formation, especially in premature infants with reduced antioxidant defences, and may result in short-term and long-term toxic effects in multiple organ systems. Although most hospitals have the capability to tightly control oxygen delivery to hospitalised neonates, in many circumstances, the need is overlooked during infant transport. Lack of awareness of harm or appropriate medical equipment invariably results in excessive oxygen exposure...
November 25, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29174079/laryngeal-mask-airway-for-surfactant-administration-in-neonates-a-randomized-controlled-trial
#20
Kari D Roberts, Roland Brown, Andrea L Lampland, Tina A Leone, Kyle D Rudser, Neil N Finer, Wade D Rich, T Allen Merritt, Adam J Czynski, Julie M Kessel, Sajani M Tipnis, Erin C Stepka, Mark C Mammel
OBJECTIVE: To determine if preterm infants with moderate respiratory distress syndrome on continuous positive airway pressure (CPAP) who received surfactant via a laryngeal mask airway (LMA) would have a decreased rate of intubation and mechanical ventilation compared with those on CPAP who did not receive surfactant. STUDY DESIGN: In this prospective, multicenter, randomized controlled trial, 103 premature infants 280/7-356/7 weeks gestation, ≥1250 g and ≤36 hours old on CPAP requiring fraction of inspired oxygen 0...
November 21, 2017: Journal of Pediatrics
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