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Neonatal critical care

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https://www.readbyqxmd.com/read/29779927/patent-ductus-arteriosus-the-physiology-of-transition
#1
REVIEW
Poorva Deshpande, Michelle Baczynski, Patrick J McNamara, Amish Jain
The transition from intrauterine to extrauterine life represents a critical phase of physiological adaptation which impacts many organ systems, most notably the heart and the lungs. The majority of term neonates complete this transition without complications; however, dysregulation of normal postnatal adaptation may lead to acute cardiopulmonary instability, necessitating advanced intensive care support. Although not as well appreciated as changes in vascular resistances, the shunt across the DA plays a crucial physiologic role in the adaptive processes related to normal transitional circulation...
May 5, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29777555/impact-of-nicu-oral-feeding-on-neuropsychomotor-outcomes-at-9-months-of-corrected-age-in-chinese-low-birth-weight-preterm-infants-a-retrospective-study
#2
Wenwen Ding, Lijin Zhao, Nan Sheng, Jiali Ma, Ying Zhang
AIMS AND OBJECTIVES: To examine the changes in neuropsychomotor development and investigate the effect of feeding progression in Neonatal Intensive Care Unit (NICU) on neuropsychomotor outcomes in low-birth-weight preterm infants within 9 months of corrected age. BACKGROUND: Low-birth-weight (LBW) preterm infants (<37 weeks of gestation and birth weight < 2500 g) are at a high risk for neuropsychomotor development delay. Therefore, exploring NICU practices related to neuropsychomotor development is important...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29764391/practice-and-outcomes-of-neonatal-resuscitation-for-newborns-with-birth-asphyxia-at-kakamega-county-general-hospital-kenya-a-direct-observation-study
#3
Duncan N Shikuku, Benson Milimo, Elizabeth Ayebare, Peter Gisore, Gorrette Nalwadda
BACKGROUND: About three - quarters of all neonatal deaths occur during the first week of life, with over half of these occurring within the first 24 h after birth. The first minutes after birth are critical to reducing neonatal mortality. Successful neonatal resuscitation (NR) has the potential to prevent these perinatal mortalities related to birth asphyxia. This study described the practice of NR and outcomes of newborns with birth asphyxia in a busy referral hospital. METHODS: Direct observations of 138 NRs by 28 healthcare providers (HCPs) were conducted using a predetermined checklist adapted from the national pediatric resuscitation protocol...
May 15, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29762868/candidemia-in-children-epidemiology-prevention-and-management
#4
REVIEW
Elpis Mantadakis, Zoe Dorothea Pana, Theoklis Zaoutis
Candidemia is the leading cause of invasive fungal infections in hospitalized children. The highest rates of candidemia have been recorded in neonates and infants <1 year of age. Candidemia is more frequent in neonates and young infants than in adults, and is associated with better clinical outcomes, but higher inpatient costs. Over the last 10 years, a declining trend has been noted in the incidence of pediatric candidemia in the US and elsewhere due to the hospital-wide implementation of central-line insertion and maintenance bundles that emphasize full sterile barrier precautions, chlorhexidine skin preparation during line insertion, meticulous site and tubing care, and daily discussion of catheter necessity...
May 15, 2018: Mycoses
https://www.readbyqxmd.com/read/29759850/differences-in-prehospital-patient-assessments-for-pediatric-versus-adult-patients
#5
Sriram Ramgopal, Jonathan Elmer, Jeremiah Escajeda, Christian Martin-Gill
OBJECTIVE: To evaluate whether completion of vital signs assessments in pediatric transports by emergency medical services (EMS) differs by patient age. STUDY DESIGN: We reviewed records by 20 agencies in a regional EMS system in Southwestern Pennsylvania between April 1, 2013 and December 31, 2016. We abstracted demographics, vital signs (systolic blood pressure, heart rate, respiratory rate), clinical, and transport characteristics. We categorized age as neonates (≤30 days), infants (1 month to <1 year), toddler (1 to <2 years), early childhood (2 to <6 years), middle childhood (6 to <12 years), adolescent (12 to <18 years), and adult (≥18 years)...
May 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29755961/correlation-and-interchangeability-of-venous-and-capillary-blood-gases-in-non-critically-ill-neonates
#6
Ratna N G B Tan, Steffen C Pauws, Evelyne van Loon, Vivanne E H J Smits, Enrico Lopriore, Arjan B Te Pas
Background: Venous blood gas (VBG) is frequently used in the neonatal unit as alternative for capillary blood gas (CBG). However, studies reporting correlation are conflicting and data on interchangeability in neonates are lacking. Objective: We investigated the correlation and interchangeability of the components between VBG and CBG in infants admitted to the neonatal intensive care unit. Methods: In a prospective study in the neonatal unit in Leiden University Medical Center (Netherlands), simultaneously VBG and CBG were withdrawn in neonates when both venous puncture and intravenous access as blood gas monitoring was indicated...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29754749/comparison-of-oral-and-axillary-temperatures-in-intubated-pediatric-patients
#7
Danielle Wood, Mary Heitschmidt, Louis Fogg
PURPOSE: Accurate body temperature measurement is essential in providing timely care to critically ill patients. Current practice within the Pediatric ICU (PICU) at a Midwestern academic medical center is to obtain axillary temperatures in endotracheally intubated patients. According to research, axillary temperatures have greater variance than other forms of temperature measurement. Research in adult patients show that oral temperature measurement in endotracheally intubated patients is acceptable as the heated gases from the ventilator has no significant effect on measured temperatures...
May 10, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29750952/glucostabilizer%C3%A2-software-guided-insulin-dosing-improves-intrapartum-glycemic-management-in-women-with-diabetes
#8
Cheryl Dinglas, Jolene Muscat, Tracy Adams, Virginia Peragallo-Dittko, Anthony Vintzileos, Hye J Heo
BACKGROUND: During labor, maintenance of maternal euglycemia is critical to decrease the risk of neonatal hypoglycemia and associated morbidities. When continuous intravenous insulin infusion is needed, standardized insulin dosing charts have been used for titration of insulin to maintain glucose in target range. GlucoStabilizer™ is a software-guided insulin dosing system that calculates the dose of intravenous insulin needed based on metabolic parameters, target glucose concentration, and an individual's response to insulin...
May 8, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29750744/experience-and-prognosis-of-systemic-neonatal-thrombosis-at-a-level-iii-nicu
#9
Sevim Unal, Deniz Gönülal, Betül Siyah Bilgin, Vildan Koşan Çulha, Neşe Yarali
OBJECTIVE: The objective of this article was to evaluate neonates diagnosed systemic thrombosis and their outcomes. METHODS: We retrospectively evaluated data of neonatal systemic thrombosis between January 2011 and December 2016. RESULTS: Among 4376 hospitalized, 30 neonates (0.69%) were diagnosed systemic thrombosis. Their mean birth weight was 2422±1152 g (680 to 4750 g), gestational age was 35±5.4 weeks (25 to 41 wk). There were 25 neonates (83...
May 10, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29750358/a-population-based-cost-effectiveness-study-of-early-genetic-testing-in-severe-epilepsies-of-infancy
#10
Katherine B Howell, Stefanie Eggers, Kim Dalziel, Jessica Riseley, Simone Mandelstam, Candace T Myers, Jacinta M McMahon, Amy Schneider, Gemma L Carvill, Heather C Mefford, Ingrid E Scheffer, A Simon Harvey
OBJECTIVE: The severe epilepsies of infancy (SEI) are a devastating group of disorders that pose a major care and economic burden on society; early diagnosis is critical for optimal management. This study sought to determine the incidence and etiologies of SEI, and model the yield and cost-effectiveness of early genetic testing. METHODS: A population-based study was undertaken of the incidence, etiologies, and cost-effectiveness of a whole exome sequencing-based gene panel (targeted WES) in infants with SEI born during 2011-2013, identified through electroencephalography (EEG) and neonatal databases...
May 11, 2018: Epilepsia
https://www.readbyqxmd.com/read/29747317/-value-of-procalcitonin-in-predicting-the-severity-and-prognosis-of-neonates-with-septicemia
#11
J Zhang, D Qu, X X Ren, X D Cui, J Fu
Objective: To explore the value of procalcitonin(PCT) in predicting the severity and prognosis of neonates with septicemia. Methods: The clinical data of the hospitalized neonates over the age of 72 hours with double positive blood cultures from December 1st, 2011 to September 30, 2017 at the neonatal intensive care unit of Children's Hospital Affiliated to Capital Institute of Pediatrics was analyzed retrospectively. Results: A total of 75 neonates were included in the study. There was a significant negative correlation between PCT and neonatal critical illness score ( r =-0...
April 24, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29746151/determinants-of-successful-direct-breastfeeding-at-hospital-discharge-in-high-risk-premature-infants
#12
Lara Casey, Sandra Fucile, Kimberly E Dow
BACKGROUND: Despite a mother's intention to breastfeed, there are many barriers to feeding preterm infants that decrease breastfeeding rates. OBJECTIVE: The objective of this research was to determine factors associated with successful direct breastfeeding (DBF) of the preterm infant at hospital discharge. MATERIALS AND METHODS: A retrospective chart review of 69 preterm (<34 weeks' gestational age) infants in the neonatal intensive care unit, whose mothers intended to breastfeed, was conducted...
May 10, 2018: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/29742551/exploring-research-topics-and-trends-in-nursing-related-communication-in-intensive-care-units-using-social-network-analysis
#13
Youn-Jung Son, Soo-Kyoung Lee, SeJin Nam, Jae Lan Shim
This study used social network analysis to identify the main research topics and trends in nursing-related communication in intensive care units. Keywords from January 1967 to June 2016 were extracted from PubMed using Medical Subject Headings terms. Social network analysis was performed using Gephi software. Research publications and newly emerging topics in nursing-related communication in intensive care units were classified into five chronological phases. After the weighting was adjusted, the top five keyword searches were "conflict," "length of stay," "nursing continuing education," "family," and "nurses...
May 4, 2018: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/29740183/epidemiology-of-patient-monitoring-alarms-in-the-neonatal-intensive-care-unit
#14
Taibo Li, Minoru Matsushima, Wendy Timpson, Susan Young, David Miedema, Munish Gupta, Thomas Heldt
OBJECTIVE: To characterize the rate of monitoring alarms by alarm priority, signal type, and developmental age in a Level-IIIB Neonatal Intensive Care Unit (NICU) population. STUDY DESIGN: Retrospective analysis of 2,294,687 alarm messages from Philips monitors in a convenience sample of 917 NICU patients, covering 12,001 patient-days. We stratified alarm rates by alarm priority, signal type, postmenstrual age (PMA) and birth weight (BW), and reviewed and adjudicated over 21,000 critical alarms...
May 8, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29735232/the-effect-of-team-configuration-on-the-incidence-of-adverse-events-in-pediatric-critical-care-transport
#15
Emily Colyer, Megan Sorensen, Shirley Wiggins, Leeza Struwe
OBJECTIVE: Specialty pediatric transport teams are widely used for pediatric interfacility transport in the United States, with little industry consensus on optimal team configuration. The aim of this study is to assess the quality of the nurse/paramedic specialty team configuration as indirectly measured by the rate of adverse events in these transports. METHODS: Retrospective analysis of pediatric transport data from a hospital-based dedicated pediatric/neonatal transport team was conducted for patients transported in 2016...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29732182/drugs-pharmacokinetics-during-veno-venous-extracorporeal-membrane-oxygenation-in-pediatrics
#16
REVIEW
Matteo Di Nardo, Enno Diederick Wildschut
Data evaluating pharmacokinetic/pharmacodynamic (PK/PD) aspect in the pediatric population are scarce especially regarding the pediatric intensive care unit. Dosing of frequently used drugs (sedatives, analgesics, antibiotics and cardiovascular drugs) are mainly based on non "pediatric intensive care unit (PICU)" patients, and sometimes are translated from adult patients. Among PICU patients, the most complex patients are the ones who are critically ill and are receiving mechanical circulatory/respiratory support for cardiac and/or respiratory failure...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29731786/an-update-work-of-pulse-oximetry-screening-for-detecting-critical-congenital-heart-disease-in-the-newborn
#17
A Taksande, R Meshram, A Lohakare, S Purandare, U Biyani, J Vagha
Background: Congenital Heart Disease (CHD) is the commonest group of congenital malformations and affects 7-8 per 1000 live born newborns. Nevertheless, it is estimated that more than 50% of babies with undiagnosed CHD are not detected by routine neonatal cardiac examination. Aim: To find the incidence of CHD in newborns and to determine the accuracy of pulse oximetry for detecting clinically unrecognized critical congenital heart disease (CCHD) in the newborns...
July 2017: Images in Paediatric Cardiology
https://www.readbyqxmd.com/read/29723923/a-humidifier-in-the-invasive-mode-during-non-invasive-respiratory-support-could-increase-condensation-and-thereby-impair-airway-patency
#18
Rutger C Flink, Anton H van Kaam, Frans H de Jongh
AIM: Humidifying non-invasively ventilated preterm infants is critical to prevent dehydration of respiratory mucosa, but over humidification can result in impaired airway patency and lung mechanics. This neonatal bench study investigated the humidity delivered using invasive and non-invasive humidification modes during nasal continuous positive airway pressure. METHODS: The study was conducted at the neonatal intensive care unit of Emma Children's Hospital, the Netherlands, in March 2014...
May 3, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29720117/a-comparison-of-practices-distributions-and-determinants-of-birth-attendance-in-two-divisions-with-highest-and-lowest-skilled-delivery-attendance-in-bangladesh
#19
Gulam Muhammed Al Kibria, Vanessa Burrowes, Allysha Choudhury, Atia Sharmeen, Swagata Ghosh, Anna Kalbarczyk
BACKGROUND: Delivery by skilled birth attendants (SBAs) is strongly recommended to reduce maternal and neonatal mortality. The percentage of births attended by SBAs is low in Bangladesh (42% in 2014), though this rate varies widely by divisions, with the highest 58% in Khulna and only 27% in Sylhet. Comparing and critically analyzing the practices, distributions and determinants of delivery attendance in two divisions with the highest and lowest SBA attendance could help to understand the differences and to employ the findings of the high-performing division to the low-performing division...
May 2, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29713209/adoption-of-the-american-academy-of-pediatrics-neonatal-hyperbilirubinemia-guidelines-and-its-effect-on-blood-exchange-transfusion-rate-in-a-tertiary-care-center-in-amman-jordan
#20
Manar Al-Lawama, Eman Al-Rimawi, Rawan Al-Shibi, Eman Badran
Introduction: Severe neonatal hyperbilirubinemia can cause mortality and serious morbidities. When phototherapy fails, neonates with severe hyperbilirubinemia should undergo double volume blood exchange transfusion (BET). As this procedure carries a significant risk of mortality and morbidity, adopting guidelines for the treatment of neonatal hyperbilirubinemia is critical to avoid hyperbilirubinemia toxicity and also the complication of an unindicated procedure. Methods: This study investigated the causes, complications, and trend of BET rate in our unit over a 13-year period...
2018: Journal of Blood Medicine
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