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Neonatal critical care

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https://www.readbyqxmd.com/read/28637741/the-closed-trial-clonidine-compared-with-midazolam-for-sedation-of-paediatric-patients-in-the-intensive-care-unit-study-protocol-for-a-multicentre-randomised-controlled-trial
#1
Antje Neubert, Manuel Alberto Baarslag, Monique van Dijk, Joost van Rosmalen, Joseph F Standing, Yucheng Sheng, Wolfgang Rascher, Deborah Roberts, Jackie Winslade, Louise Rawcliffe, Sara M Hanning, Tuuli Metsvaht, Viviana Giannuzzi, Peter Larsson, Pavla Pokorná, Alessandra Simonetti, Dick Tibboel
INTRODUCTION: Sedation is an essential part of paediatric critical care. Midazolam, often in combination with opioids, is the current gold standard drug. However, as it is a far-from-ideal agent, clonidine is increasingly being used in children. This drug is prescribed off-label for this indication, as many drugs in paediatrics are. Therefore, the CLOSED trial aims to provide data on the pharmacokinetics, safety and efficacy of clonidine for the sedation of mechanically ventilated patients in order to obtain a paediatric-use marketing authorisation...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28622146/relationship-between-various-maternal-conditions-and-lactic-acid-dehydrogenase-activity-in-umbilical-cord-blood-at-birth
#2
Evangelos Patavoukas, Josefina Åberg-Liesaho, Cecilia Pegelow Halvorsen, Birger Winbladh, Eva Wiberg-Itzel
BACKGROUND: Lactic acid dehydrogenase (LDH) is a valuable marker for some of the most important diseases in newborns and the plasma LDH activity in newborns correlates well with conditions such as asphyxia. If LDH should be considered as a useful tool also in obstetric care, key factors associated with maternal health before and during pregnancy which could affect umbilical cord LDH activity need to be known. The aims of this study were to explore relationships between selected maternal conditions and arterial lactic acid dehydrogenase activity (aLDH) in umbilical cord blood at delivery...
June 15, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28621050/maternal-morbidity-and-associated-factors-at-a-tertiary-care-centre-in-karachi-a-critical-analysis
#3
Haleema Akhter Hashmi, Sarwat Umer, Syed Ijlal Ahmed
AIM: The study was conducted to identify maternal morbidity and associated factors such intensive care unit admission and surgical intervention. METHODS: Pregnant and six-week post-partum women without any other comorbidy were recruited from January 2014 to December 2015 from the Department of Gynaecology and Obstetrics at Liaquat National Hospital, Karachi. A structurally designed questionnaire was used to record demographic data and factors related to the management and intervention of maternal conclusions...
June 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28607211/consensus-statement-of-the-indian-academy-of-pediatrics-on-newborn-hearing-screening
#4
Abraham Paul, Chhaya Prasad, S S Kamath, Samir Dalwai, M K C Nair, Waheeda Pagarkar
JUSTIFICATION: Hearing impairment is one of the most critical sensory impairments with significant social and psychological consequences. Reported incidence of congenital hearing loss is 30 per 10,000 children. Evidence-based, standardized national guidelines are needed for professionals to screen for hearing impairment during the neonatal period. PROCESS: The meeting on formulation of national consensus guidelines on developmental disorders was organized by Indian Academy of Pediatrics in Mumbai, on 18th and 19th December, 2015...
June 4, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28606020/neonatal-hearing-screening-in-remote-areas-of-china-a-comparison-between-rural-and-urban-populations
#5
Wu Wenjin, Tang Xiangrong, Li Yun, Lü Jingrong, Chen Jianyong, Wang Xueling, Huang Zhiwu, Wu Hao
Objectives Universal neonatal hearing screening (UNHS) started late in some underdeveloped areas in China, with relatively scarce screening resources and a wide regional distribution. This study aimed to compare the screening performance between rural and urban populations, and to examine the characteristics and problems of UNHS in underdeveloped regions in China. Methods A two-step hearing screening program was used in neonates born in Liuzhou Maternal and Child Health Hospital and in patients who were born in other hospitals, but admitted to the neonatal intensive care unit...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28599674/cluster-randomized-trial-of-a-mhealth-intervention-imtecho-to-improve-delivery-of-proven-maternal-neonatal-and-child-care-interventions-through-community-based-accredited-social-health-activists-ashas-by-enhancing-their-motivation-and-strengthening-supervision
#6
Dhiren Modi, Shrey Desai, Kapilkumar Dave, Shobha Shah, Gayatri Desai, Nishith Dholakia, Ravi Gopalan, Pankaj Shah
BACKGROUND: To facilitate the delivery of proven maternal, neonatal, and child health (MNCH) services, a new cadre of village-based frontline workers, called the Accredited Social Health Activists (ASHAs), was created in 2005 under the aegis of the National Rural Health Mission in India. Evaluations have noted that coverage of selected MNCH services to be delivered by the ASHAs is low. Reasons for low coverage are inadequate supervision and support to ASHAs apart from insufficient skills, poor quality of training, and complexity of tasks to be performed...
June 9, 2017: Trials
https://www.readbyqxmd.com/read/28598866/using-qualitative-research-to-inform-development-of-professional-guidelines-a-case-study-of-the-society-of-critical-care-medicine-family-centered-care-guidelines
#7
Maureen A Coombs, Judy E Davidson, Mark E Nunnally, Mary A Wickline, J Randall Curtis
OBJECTIVES: To explore the importance, challenges, and opportunities using qualitative research to enhance development of clinical practice guidelines, using recent guidelines for family-centered care in the ICU as an example. METHODS: In developing the Society of Critical Care Medicine guidelines for family-centered care in the neonatal ICU, PICU, and adult ICU, we developed an innovative adaptation of the Grading of Recommendations, Assessments, Development and Evaluations approach to explicitly incorporate qualitative research...
June 8, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28597358/working-towards-an-appropriate-use-of-ibuprofen-in-children-an-evidence-based-appraisal
#8
REVIEW
Maurizio de Martino, Alberto Chiarugi, Attilio Boner, Giovanni Montini, Gianluigi L De' Angelis
Ibuprofen is the most widely used non-steroidal anti-inflammatory drug (NSAID) for the treatment of inflammation, mild-to-moderate pain and fever in children, and is the only NSAID approved for use in children aged ≥3 months. Its efficacy and safety profile have led to its increasing use in paediatric care, even without medical prescription. However, an increase of suspected adverse reactions to ibuprofen has been noted in concomitance with the raised, often medically unsupervised, consumption of the drug...
June 9, 2017: Drugs
https://www.readbyqxmd.com/read/28592480/implementing-family-centered-care-through-facilitated-sensemaking
#9
Judy E Davidson, Sidney Zisook
The Society of Critical Care Medicine has released updated recommendations for care of the family in neonatal, pediatric, and adult intensive care units. Translation of the recommendations into practice may benefit from a supporting theoretical framework. Facilitated sensemaking is a mid-range theory built from the same literature that formed the basis for recommendations within the guidelines. The process of facilitated sensemaking may be used to help nurses adopt the SCCM recommendations into practice through the development of caring relationships, promoting family presence, teaching family engagement strategies, and supporting families with communication, information gathering, and participation in decision-making...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28588119/high-flow-nasal-cannula-utilization-in-pediatric-critical-care
#10
Kristen D Coletti, Dayanand N Bagdure, Linda K Walker, Kenneth E Remy, Jason W Custer
BACKGROUND: High-flow nasal cannula (HFNC) is increasingly utilized in pediatrics, delivering humidified air and oxygen for respiratory conditions causing hypoxia and distress. In the neonatal ICU, it has been associated with better tolerance, lower complications, and lower cost. Few data exist regarding indications for use and the epidemiology of disease/pathology that warrants HFNC in the pediatric ICU. METHODS: This study is a retrospective cohort study of patients admitted to a tertiary children's hospital pediatric ICU and placed on HFNC from October 1, 2011 to October 31, 2013...
June 6, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28583583/temporal-changes-of-oxidative-stress-markers-in-escherichia-coli-k1-induced-experimental-meningitis-in-a-neonatal-rat-model
#11
Vijayasree V Giridharan, Lutiana R Simões, Valdemira S Dagostin, Jaqueline S Generoso, Gislaine T Rezin, Drielly Florentino, Jhonata P Muniz, Allan Collodel, Fabricia Petronilho, Joao Quevedo, Tatiana Barichello
Despite advances in antimicrobial therapy and advanced critical care neonatal bacterial meningitis has a mortality rate of over 10% and induces neurological sequelae in 20-50% of cases. Escherichia coli K1 (E. coli K1) is the most common gram-negative organism causing neonatal meningitis and is the second most common cause behind group B streptococcus. We previously reported that an E. coli K1 experimental meningitis infection in neonatal rats resulted in habituation and aversive memory impairment and a significant increase in cytokine levels in adulthood...
June 3, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28580447/association-of-regional-disparity-of-obstetrics-and-gynecologic-services-with-children-and-infants-mortality-rates-a-cross-sectional-study
#12
Sogand Tourani, Mohammad Zarezadeh, Mehdi Raadabadi, Fatemeh Pourshariati
BACKGROUND: Equity in distribution of resources is considered as an important priority in health care systems. Equitable distribution of obstetrics and gynecology (Ob/Gyn) services in the country level is critical in maternal and neonatal health for qualitative promotion of maternal care in pregnancy, delivery, and post-delivery periods. OBJECTIVE: The present study aimed at determining regional disparity of obstetrics and gynecology services and its association with children and infants mortality rates...
March 2017: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/28574294/guidelines-for-the-provision-and-assessment-of-nutrition-support-therapy-in-the-pediatric-critically-ill-patient-society-of-critical-care-medicine-and-american-society-for-parenteral-and-enteral-nutrition
#13
Nilesh M Mehta, Heather E Skillman, Sharon Y Irving, Jorge A Coss-Bu, Sarah Vermilyea, Elizabeth Anne Farrington, Liam McKeever, Amber M Hall, Praveen S Goday, Carol Braunschweig
This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and <18 years) expected to require a length of stay >2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28566819/neonates-with-critical-congenital-heart-defects-impact-of-fetal-diagnosis-on-immediate-and-short-term-outcomes
#14
Sylvia Michael Colaco, Tanuja Karande, Prashant Raviprakash Bobhate, Rashmi Jiyani, Suresh G Rao, Snehal Kulkarni
BACKGROUND: Fetal echocardiography is being increasingly used for prenatal diagnosis of congenital cardiac malformations, but its impact on the neonatal outcomes in low- and middle-income countries is still unknown. AIMS: The objective of this study is to determine the impact of fetal echocardiography on immediate postnatal and short-term outcome in a tertiary pediatric cardiac center. STUDY DESIGN: This is a prospective study. MATERIALS AND METHODS: One hundred consecutive patients with critical congenital heart defects (CHD) requiring active medical or surgical interventions in the 1(st) month of life were included in the study...
May 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28557770/disaster-preparedness-in-neonatal-intensive-care-units
#15
Wanda D Barfield, Steven E Krug
Disasters disproportionally affect vulnerable, technology-dependent people, including preterm and critically ill newborn infants. It is important for health care providers to be aware of and prepared for the potential consequences of disasters for the NICU. Neonatal intensive care personnel can provide specialized expertise for their hospital, community, and regional emergency preparedness plans and can help develop institutional surge capacity for mass critical care, including equipment, medications, personnel, and facility resources...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28545473/defining-disrespect-and-abuse-of-newborns-a-review-of-the-evidence-and-an-expanded-typology-of-respectful-maternity-care
#16
REVIEW
Emma Sacks
Amid increased attention to quality of obstetric care and respectful maternity care globally, insufficient focus has been given to quality of care and respectful care for newborns in the postnatal period. Especially in low and middle income countries, where low utilisation of obstetric and neonatal services is of concern, it is plausible that poor quality of care or mistreatment of newborns or stillborn infants will influence future care seeking, both for the health care needs of the growing infant and for subsequent pregnancies...
May 25, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28532513/barriers-to-utilisation-of-antenatal-care-services-in-south-sudan-a-qualitative-study-in-rumbek-north-county
#17
Calistus Wilunda, Chiara Scanagatta, Giovanni Putoto, Francesca Montalbetti, Giulia Segafredo, Risa Takahashi, Serge André Mizerero, Ana Pilar Betrán
BACKGROUND: Access to adequate antenatal care (ANC) is critical in ensuring a good maternal health and in preventing maternal and neonatal morbidity and mortality. South Sudan has one of the world's poorest health indicators due to a fragile health system and a combination of socio-cultural, economic, and political factors. This study was conducted to identify barriers to utilisation of ANC services in Rumbek North County. METHODS: Using a qualitative design, data were collected through 14 focus group discussions with 169 women and 45 men and 12 key informant interviews with community leaders, staff working in health facilities, and the staff of the County Health Department...
May 22, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28520859/the-role-of-patient-care-items-as-a-fomite-in-healthcare-associated-outbreaks-and-infection-prevention
#18
Hajime Kanamori, William A Rutala, David J Weber
Patient-care items can serve as a source or reservoir for healthcare associated pathogens in hospitals. We reviewed healthcare-associated outbreaks from medical equipment and provided infection prevention recommendations. Multiple healthcare-associated outbreaks via a contaminated patient-care item were identified, including infections with multidrug-resistant organisms. The type of patient-care items implicated as a fomite causing healthcare-associated infections (HAI) has changed over time. Patient populations at risk were most commonly critically ill patients in adult and neonatal ICUs...
May 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28509730/american-college-of-critical-care-medicine-clinical-practice-parameters-for-hemodynamic-support-of-pediatric-and-neonatal-septic-shock
#19
Alan L Davis, Joseph A Carcillo, Rajesh K Aneja, Andreas J Deymann, John C Lin, Trung C Nguyen, Regina S Okhuysen-Cawley, Monica S Relvas, Ranna A Rozenfeld, Peter W Skippen, Bonnie J Stojadinovic, Eric A Williams, Tim S Yeh, Fran Balamuth, Joe Brierley, Allan R de Caen, Ira M Cheifetz, Karen Choong, Edward Conway, Timothy Cornell, Allan Doctor, Marc-Andre Dugas, Jonathan D Feldman, Julie C Fitzgerald, Heidi R Flori, James D Fortenberry, Ana Lia Graciano, Bruce M Greenwald, Mark W Hall, Yong Yun Han, Lynn J Hernan, Jose E Irazuzta, Elizabeth Iselin, Elise W van der Jagt, Howard E Jeffries, Saraswati Kache, Chhavi Katyal, Niranjan Tex Kissoon, Alexander A Kon, Martha C Kutko, Graeme MacLaren, Timothy Maul, Renuka Mehta, Fola Odetola, Kristine Parbuoni, Raina Paul, Mark J Peters, Suchitra Ranjit, Karin E Reuter-Rice, Eduardo J Schnitzler, Halden F Scott, Adalberto Torres, Jacki Weingarten-Abrams, Scott L Weiss, Jerry J Zimmerman, Aaron L Zuckerberg
OBJECTIVES: The American College of Critical Care Medicine provided 2002 and 2007 guidelines for hemodynamic support of newborn and pediatric septic shock. Provide the 2014 update of the 2007 American College of Critical Care Medicine "Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shock." DESIGN: Society of Critical Care Medicine members were identified from general solicitation at Society of Critical Care Medicine Educational and Scientific Symposia (2006-2014)...
June 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28504491/profile-of-spontaneous-demand-for-services-among-infants-younger-than-30-days-old-at-a-children-s-tertiary-care-hospital
#20
Soledad Arbio, Nicolás Brunner, Eugenio Pierro, Susana Rodríguez, Diana Fariña
INTRODUCTION: In recent years, admission of critical newborn infants (NBIs) to the neonatal intensive care unit of Hospital Garrahan (HG) has been limited due to the hospitalization of infants younger than 30 days old through spontaneous demand for services. This is probably a multifactorial situation, and one of its causes is a lack of regionalization, which results in an inadequate use of resources or a distorted use of resources intended for more complex care. OBJECTIVE: To establish the profile of NBIs who make a spontaneous demand for services at HG and to assess the level of care required based on their medical condition...
June 1, 2017: Archivos Argentinos de Pediatría
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