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Neonatal critical care

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https://www.readbyqxmd.com/read/27918253/placental-growth-factor-alone-or-in-combination-with-soluble-fms-like-tyrosine-kinase-1-as-an-aid-to-the-assessment-of-women-with-suspected-pre-eclampsia-systematic-review-and-economic-analysis
#1
Geoff K Frampton, Jeremy Jones, Micah Rose, Liz Payne
BACKGROUND: Pre-eclampsia (PE) prediction based on blood pressure, presence of protein in the urine, symptoms and laboratory test abnormalities can result in false-positive diagnoses. This may lead to unnecessary antenatal admissions and preterm delivery. Blood tests that measure placental growth factor (PlGF) or the ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to PlGF could aid prediction of PE if either were added to routine clinical assessment or used as a replacement for proteinuria testing...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27915323/the-role-of-neonatal-nurses-in-the-prevention-of-retinopathy-of-prematurity
#2
Geetanjli Kalyan, Sarah Moxon
The main risk factors for preterm babies developing retinopathy of prematurity (ROP) are poorly administered supplemental oxygen, infections, poor weight gain and transfusion of blood products, meaning ROP is sensitive to the quality of neonatal inpatient care provided, especially the nursing care. Nurses are the primary caregivers in neonatal units and play a critical role in preventing ROP related blindness. We discuss the role of the neonatal nurse in prevention of ROP based on a framework of five dimensions of care: specialist knowledge, clinical advocacy, leadership and mentorship, service management and counselling...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27915312/role-of-retinopathy-of-prematurity-rop-tertiary-centers-of-excellence-in-capacity-building
#3
Padmaja Kumari Rani, D Balakrishnanan, T R Padhi, Subhadra Jalali
Tertiary Centres of Excellence in India have been at the forefront of the efforts against Retinopathy of Prematurity (ROP) - associated blindness. The epidemic of blindness from ROP; however, has now spread rapidly into large parts of interiors of developing countries due to improved newborn care facilities. Due to their knowledge and experience of more than a decade, these centres of excellence, both from child care and Ophthalmology care, now need to come forward in substantial measures and need to be supported by funds and programs so that concerns of neonatal eye-health, training, screening, prevention and treatment can get integrated and embedded into newborn critical care and health programs...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27907898/obstetrical-and-perinatal-outcomes-following-blastocyst-transfer-compared-to-cleavage-transfer-a-systematic-review-and-meta-analysis
#4
W P Martins, C O Nastri, L Rienzi, S Z van der Poel, C R Gracia, C Racowsky
STUDY QUESTION: Is blastocyst transfer safe when compared to cleavage stage embryo transfer regarding obstetric and perinatal outcomes? SUMMARY ANSWER: The clinical equipoise between blastocyst and cleavage stage embryo transfer remains as the evidence associating blastocyst transfer with some adverse perinatal outcomes is of low/very low quality. WHAT IS KNOWN ALREADY: Extended embryo culture to the blastocyst stage provides some theoretical advantages and disadvantages...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27906197/treatment-and-follow-up-of-venous-thrombosis-in-the-neonatal-intensive-care-unit-a-retrospective-study
#5
J C Bohnhoff, S A DiSilvio, R K Aneja, J R Shenk, Y A Domnina, B S Brozanski, M Good
OBJECTIVE: The critically ill, premature patients of neonatal intensive care units are susceptible to venous thrombosis, an adverse event associated with short- and long-term morbidity. Venous thrombosis is frequently treated with low-molecular-weight heparins (LMWHs) such as enoxaparin, but optimal dosing of LMWH must balance the morbidity of venous thrombosis with the potential adverse affects of anticoagulation. The optimal dosing of enoxaparin for premature infants is unclear. The objective of this study was to describe enoxaparin therapy and follow-up in critically ill neonates diagnosed with venous thrombosis...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27904815/pneumorrhachis-resulting-in-transient-paresis-after-picc-line-insertion-into-the-ascending-lumbar-vein
#6
Russell Payne, Emily P Sieg, Arabinda Choudhary, Mark Iantosca
Obtaining intravascular access in the neonatal intensive care unit (NICU) is not only critical but also technically challenging. Malposition of the catheter tip is a known and well-documented complication. Specifically, peripherally inserted central venous catheter (PICC) line insertion into the ascending lumbar vein can lead to neurological dysfunction and, in some cases, even death. We present the first reported case of pneumorrhachis (PR) following PICC line insertion into the ascending lumbar vein. Our patient presented with lower extremity weakness and imaging confirmed the presence of air within the spinal canal...
October 17, 2016: Curēus
https://www.readbyqxmd.com/read/27904643/effects-of-nesting-and-swaddling-on-the-sleep-duration-of-premature-infants-hospitalized-in-neonatal-intensive-care-units
#7
Zahra Abdeyazdan, Maryam Mohammadian-Ghahfarokhi, Zohreh Ghazavi, Majid Mohammadizadeh
BACKGROUND: In neonatal intensive care unit (NICU), neonatal sleep is disrupted due to different factors. Due to the critical role of sleep in premature infants' brain development, this study aimed to investigate the effect of nesting and swaddling on the sleep duration of premature infants hospitalized in NICUs. MATERIALS AND METHODS: In a crossover clinical trial, 42 preterm infants who met the inclusion criteria were enrolled. They were randomly assigned to two groups of nest-swaddle and swaddle-nest...
September 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27902658/understanding-negative-predictive-value-of-diagnostic-tests-used-in-clinical-practice
#8
Reba A Umberger, Linda A Hatfield, Patricia M Speck
Nurses review, evaluate, and use diagnostic test results on a routine basis. However, the skills necessary to evaluate a particular test using statistical outcome measures is often lacking. The purpose of this article is to examine and interpret the underlying principles for use of the statistical outcomes of diagnostic screening tests (sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values, with a discussion about use of SpPIn [Specificity, Positive test = rule in], and SnNOut [Sensitivity, Negative test = rule out]) in advanced nursing clinical practice...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27894556/benchmarking-pain-assessment-rate-in-critical-care-transport
#9
Ryan J Reichert, M David Gothard, Hamilton P Schwartz, Michael T Bigham
The purpose of this study is to determine the rate of pain assessment in pediatric neonatal critical care transport (PNCCT). The GAMUT database was interrogated for an 18-month period and excluded programs with less than 10% pediatric or neonatal patient contacts and less than 3 months of any metric data reporting during the study period. We hypothesized pain assessment during PNCCT is superior to prehospital pain assessment rates, although inferior to in-hospital rates. Sixty-two programs representing 104,445 patient contacts were analyzed...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27875999/helping-babies-breathe-hbb-training-what-happens-to-knowledge-and-skills-over-time
#10
Akash Bang, Archana Patel, Roopa Bellad, Peter Gisore, Shivaprasad S Goudar, Fabian Esamai, Edward A Liechty, Sreelatha Meleth, Norman Goco, Susan Niermeyer, William Keenan, Beena D Kamath-Rayne, George A Little, Susan B Clarke, Victoria A Flanagan, Sherri Bucher, Manish Jain, Nilofer Mujawar, Vinita Jain, Janet Rukunga, Niranjana Mahantshetti, Sangappa Dhaded, Manisha Bhandankar, Elizabeth M McClure, Waldemar A Carlo, Linda L Wright, Patricia L Hibberd
BACKGROUND: The first minutes after birth are critical to reducing neonatal mortality. Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation program for low resource settings. We studied the impact of initial HBB training followed by refresher training on the knowledge and skills of the birth attendants in facilities. METHODS: We conducted HBB trainings in 71 facilities in the NICHD Global Network research sites (Nagpur and Belgaum, India and Eldoret, Kenya), with a 6:1 ratio of facility trainees to Master Trainers (MT)...
November 22, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27875283/does-persistent-inflammatory-catabolic-syndrome-exist-in-critically-ill-neonates
#11
Nicole Ellis, Caitlin Hughes, Vera Mazurak, Chloe Joynt, Bodil Larsen
BACKGROUND: Persistent inflammatory catabolic syndrome (PICS) has not been described in the infant population. This study proposes a definition of PICS in critically ill infants. METHODS: A published adult criterion of PICS was modified using anthropometric and biochemical reference ranges for infants. A prospective chart review of admissions to a tertiary surgical neonatal intensive care unit (NICU) was performed over 65 days. Demographic, anthropometric, biochemical, and other clinical variables such as length of stay and medication use were collected daily throughout admission...
October 10, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27857787/a-study-of-neurosonogram-abnormalities-clinical-correlation-with-neurosonogram-findings-and-immediate-outcome-of-high-risk-neonates-in-neonatal-intensive-care-unit
#12
Niranjan Nagaraj, Pramod Kumar Berwal, Anusha Srinivas, Ramnarayan Sehra, Sarika Swami, Prathyusha Jeevaji, Gotam Swami, Lokesh Choudary, Ayush Berwal
BACKGROUND: Neonatal sonography of the brain is now an essential part of newborn care, particularly in high risk and unstable premature infants. Cranial ultrasound is the most available and easily repeatable imaging technique for the neonatal brain showing brain development and the most frequently occurring forms of cerebral injury in the preterm and terms. This study aims to assess the importance of cranial ultrasound as an investigatory modality for high-risk neonates and to find out the morphology of various cerebral lesions and correlate clinically...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27856076/hospital-wide-comparison-of-health-care-associated-infection-among-8-intensive-care-units-a-retrospective-analysis-for-2010-2015
#13
DongMei Yue, Caiping Song, Bo Zhang, Zhiyong Liu, Jin Chai, Yang Luo, Hao Wu
BACKGROUND: Exploring the distribution of nosocomial pathogens among different categories of intensive care units (ICUs) is critical to improving the management of health care-associated infection (HAI). Despite both single- and multicenter studies, the nature of the variations of HAIs within various ICUs remains inadequately evaluated. METHODS: Data on HAIs at our hospital during the period January 2010-December 2015 were collected from 8 ICUs, namely, respiratory, cardiovascular, neurology, neonatal, hematology, emergency, cardiothoracic surgery, and neurosurgery ICUs, at a tertiary hospital...
November 14, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27846121/experiences-of-new-graduate-nurses-working-in-a-neonatal-intensive-care-setting-a-systematic-review-protocol-of-qualitative-evidence
#14
Jann Foster, Christine Taylor, Tiffany Patterson, Kim Psaila
The overall objective of this systematic review is to identify, critically appraise and synthesize the experiences of new graduate nurses in the neonatal intensive care unit (NICU). The specific review question is: what are the experiences of new graduate nurses working in a NICU setting?
October 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27828930/neonatal-icu-system-safety-a-pilot-test-for-medication-error-by-using-fuzzy-grey-relational-analysis
#15
Xin Zhang, Shih-Yu Lee, Jingli Chen, Huaping Liu
This study analyzed risk factors for medication/near-miss errors in the neonatal intensive care unit by using Grey Relational Analysis based on self-incident reports from staff nurses. The ASSESS-ERR Medication System Worksheet was used. A total of 156 medication/near-miss errors were found across 5 stages of the medication use process. The order prescribing stage had the most errors. The highest systemic risk factors were critical drug information missing; environmental, staffing, and workflow problems; and lack of staff education...
November 8, 2016: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/27826706/clinical-associations-of-early-dysnatremias-in-critically-ill-neonates-and-infants-undergoing-cardiac-surgery
#16
Jon Kaufman, Daniel Phadke, Suhong Tong, Jennifer Eshelman, Sarah Newman, Christopher Ruzas, Eduardo M da Cruz, Suzanne Osorio
: Dysnatremias (DN) are common electrolyte disturbances in cardiac critical illness and are known risk factors for adverse outcomes in certain populations. Little information exists on DN in children with cardiac disease admitted to the cardiac intensive care unit (CICU) after undergoing cardiac surgery, either corrective or palliative. The aim was to determine the incidence and adverse outcomes associated with DN in neonates and infants undergoing cardiac surgery. Retrospective cohort and single center study performed at Children's Hospital Colorado from May 2013 to May 2014, in children under 1 year old admitted to the CICU after undergoing surgery for congenital or acquired cardiac disease...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27823995/analysis-of-in-hospital-neonatal-death-in-the-tertiary-neonatal-intensive-care-unit-in-china-a-multicenter-retrospective-study
#17
Chen-Hong Wang, Li-Zhong Du, Xiao-Lu Ma, Li-Ping Shi, Xiao-Mei Tong, Hong Liu, Guo-Fang Ding, Bin Yi, Xin-Nian Pan, Dan-Ni Zhong, Ling Liu, Mei Li, Cui-Qing Liu, Shi-Wen Xia, Hong-Yun Wang, Ling He, Kun Liang, Xiao-Yu Zhou, Shu-Ping Han, Qin Lyu, Yin-Ping Qiu, Ruo-Bing Shan, De-Zhi Mu, Xiao-Hong Liu, Si-Qi Zhuang, Jing Guo, Li Liu, Jia-Jun Zhu, Hong Xiong
BACKGROUND: Globally, the proportion of child deaths that occur in the neonatal period remains a high level of 37-41%. Differences of cause in neonate death exist in different regions as well as in different economic development countries. The specific aim of this study was to investigate the causes, characteristics, and differences of death in neonates during hospitalization in the tertiary Neonatal Intensive Care Unit (NICU) of China. METHODS: All the dead neonates admitted to 26 NICUs were included between January l, 2011, and December 31, 2011...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27821118/the-intensive-care-lifeboat-a-survey-of-lay-attitudes-to-rationing-dilemmas-in-neonatal-intensive-care
#18
C Arora, J Savulescu, H Maslen, M Selgelid, D Wilkinson
BACKGROUND: Resuscitation and treatment of critically ill newborn infants is associated with relatively high mortality, morbidity and cost. Guidelines relating to resuscitation have traditionally focused on the best interests of infants. There are, however, limited resources available in the neonatal intensive care unit (NICU), meaning that difficult decisions sometimes need to be made. This study explores the intuitions of lay people (non-health professionals) regarding resource allocation decisions in the NICU...
November 8, 2016: BMC Medical Ethics
https://www.readbyqxmd.com/read/27810974/using-a-simple-point-prevalence-survey-to-define-appropriate-antibiotic-prescribing-in-hospitalised-children-across-the-uk
#19
Myriam Gharbi, Katja Doerholt, Stefania Vergnano, Julia Anna Bielicki, Stéphane Paulus, Esse Menson, Andrew Riordan, Hermione Lyall, Sanjay Valabh Patel, Jolanta Bernatoniene, Ann Versporten, Maggie Heginbothom, Herman Goossens, Mike Sharland
BACKGROUND: The National Health Service England, Commissioning for Quality and Innovation for Antimicrobial Resistance (CQUIN AMR) aims to reduce the total antibiotic consumption and the use of certain broad-spectrum antibiotics in secondary care. However, robust baseline antibiotic use data are lacking for hospitalised children. In this study, we aim to describe, compare and explain the prescription patterns of antibiotics within and between paediatric units in the UK and to provide a baseline for antibiotic prescribing for future improvement using CQUIN AMR guidance...
November 3, 2016: BMJ Open
https://www.readbyqxmd.com/read/27795833/timing-and-cause-of-perinatal-mortality-for-small-for-gestational-age-babies-in-south-africa-critical-periods-and-challenges-with-detection
#20
Tina Lavin, David B Preen, Robert Pattinson
BACKGROUND: Little information exists on timing and cause of death for small-for-gestational-age (SGA) babies in low-and-middle-income-countries (LMICs), despite evidence from high-income countries suggesting critical periods for SGA babies. This study explored the timing and cause of stillbirth and early neonatal mortality (END, <7 days) by small-for-gestational age in three provinces in South Africa. In South Africa, the largest category of perinatal deaths is unexplained stillbirth, of which up to one-quarter have intra-uterine growth restriction...
2016: Maternal Health, Neonatology and Perinatology
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