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Neonatal intensive carr

Veronica Sanchez, Michelle Maladen-Percy, Jennifer Gustin, Amy Tally, Roger Gibb, Julie Ogle, Dianna C Kenneally, Andrew N Carr
BACKGROUND: Extremely low-birth-weight (ELBW) infants face significant diapering challenges compared with their full-term peers, due to immature musculature, nervous system, and skin development. Advances in medical care has increased an ELBW infant's rate of survival, which creates a growing need for diapers to better serve these infants. Aim of research. The objective of this study was to identify and confirm the requirements for optimal diaper performance from the neonatal intensive care unit nurses' perspective, as well as to assess in-hospital performance to determine if new features improved key developmental care parameters...
June 1, 2018: Clinical Pediatrics
Jeremy P Carr, David P Burgner, Rohan S Hardikar, Jim P Buttery
AIM: Neonatal sepsis remains an important cause of morbidity and mortality, and requires prompt empiric treatment. However, only a minority of babies who receive antibiotics for suspected sepsis have an infection. Antimicrobial exposure in infancy has important short- and long-term consequences. There is no consensus regarding empirical antimicrobial regimens. METHODS: The study included a survey of empiric antimicrobial regimens in all tertiary neonatal intensive care units in Australia and New Zealand in 2013-2014...
July 2017: Journal of Paediatrics and Child Health
David Carr, Elizabeth Helen Barnes, Adrienne Gordon, David Isaacs
BACKGROUND: Antibiotic resistance is a worldwide problem. We describe 25 years of responsible antibiotic use in a tertiary neonatal unit. METHODS: Data on neonatal infections and antibiotic use were collected prospectively from 1990 to 2014 at a single tertiary Sydney neonatal intensive care unit attached to a maternity unit. There are approximately 5500 deliveries and 900 nursery admissions per year. RESULTS: The mean annual rate of late-onset sepsis was 1...
May 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
Eog van Vliet, G H Dijkema, E Schuit, K Y Heida, C Roos, Jam van der Post, E C Parry, L McCowan, D J Lyell, Y Y El-Sayed, D B Carr, A L Clark, Z A Mahdy, M Uma, N C Sayin, G F Varol, B W Mol, M A Oudijk
BACKGROUND: Preterm birth is the leading cause of neonatal mortality and morbidity in developed countries. Whether continued tocolysis after 48 hours of rescue tocolysis improves neonatal outcome is unproven. OBJECTIVES: To evaluate the effectiveness of maintenance tocolytic therapy with oral nifedipine on the reduction of adverse neonatal outcomes and the prolongation of pregnancy by performing an individual patient data meta-analysis (IPDMA). SEARCH STRATEGY: We searched PubMed, Embase, and Cochrane databases for randomised controlled trials of maintenance tocolysis therapy with nifedipine in preterm labour...
October 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Monique Legemaat, Peter J Carr, Roland M van Rens, Monique van Dijk, Irina E Poslawsky, Agnes van den Hoogen
INTRODUCTION: Neonates admitted to a neonatal intensive care unit (NICU) rely highly on intravenous (IV) therapy, for which the peripheral intravenous cannula (PIVC) is the preferred device to allow such therapies to proceed. Placement of a PIVC is a painful procedure and repeated attempts for successful insertion should therefore be limited. We aimed to quantify the incidence, complications, and factors associated with these complications. METHODS: We conducted a prospective observational study to examine PIVC-related complications in level III NICUs of two university medical centers (UMC) in The Netherlands...
July 12, 2016: Journal of Vascular Access
Rehana Bajwa, Jennifer G Kendrick, Roxane Carr
No abstract text is available yet for this article.
July 2014: Canadian Journal of Hospital Pharmacy
Elizabeth A Carr
The purpose of this article is to provide a quick reference for field triage of the sick neonatal foal. Therefore, information is focused toward diagnostics and treatments that can be performed in the field. When evaluating a weak, recumbent, or lethargic foal on a farm, it is often difficult to make a definitive diagnosis. Therefore, the approach should be to treat what is treatable and prevent what is preventable. In many cases, the goal will be to stabilize a foal before referral to a tertiary care facility where more intensive and continuous treatment can be performed...
August 2014: Veterinary Clinics of North America. Equine Practice
Vishal S Kapadia, Lina F Chalak, John E Sparks, James R Allen, Rashmin C Savani, Myra H Wyckoff
OBJECTIVE: To determine whether a limited oxygen strategy (LOX) versus a high oxygen strategy (HOX) during delivery room resuscitation decreases oxidative stress in preterm neonates. METHODS: A randomized trial of neonates of 24 to 34 weeks' gestational age (GA) who received resuscitation was performed. LOX neonates received room air as the initial resuscitation gas, and fraction of inspired oxygen (Fio2) was adjusted by 10% every 30 seconds to achieve target preductal oxygen saturations (Spo2) as described by the 2010 Neonatal Resuscitation Program guidelines...
December 2013: Pediatrics
Vanessa Paquette, Rumi McGloin, Tracie Northway, Pia Dezorzi, Avash Singh, Roxane Carr
BACKGROUND: Extravasation, the inadvertent leakage of intravenous (IV) medication from the vein into the surrounding tissue, is a iatrogenic cause of patient injury. Extravasation has been reported to occur in 0.1% to 6.5% of hospital inpatients. The incidence may be higher among children because they have multiple risk factors, including small and fragile veins, decreased peripheral circulation, capillary leakage, and flexible subcutaneous tissue. OBJECTIVES: To describe the incidence of extravasation at a pediatric tertiary care hospital, to identify the agents causing extravasation, and to describe the use of antidotes to manage identified cases...
September 2011: Canadian Journal of Hospital Pharmacy
Scott A Lorch, Sage Myers, Brendan Carr
Regionalization of health care is a method of providing high-quality, cost-efficient health care to the largest number of patients. Within pediatric medicine, regionalization has been undertaken in 2 areas: neonatal intensive care and pediatric trauma care. The supporting literature for the regionalization of these areas demonstrates the range of studies within this field: studies of neonatal intensive care primarily compare different levels of hospitals, whereas studies of pediatric trauma care primarily compare the impact of institutionalizing a trauma system in a single geographic region...
December 2010: Pediatrics
Michelle Carr Swift, Ingrid Scholten
AIM: This study had two main objectives: (1) to describe the experiences of parents who had a child in the Flinders Medical Centre neonatal unit with a feeding difficulty at 36 weeks gestational age and (2) to develop a preliminary model from the data as an account of the parents' experiences to identify considerations for future and current neonatal unit staff. BACKGROUND: Family centred care is an important part of nursing practice. Research looking individually at the neonatal unit experience and childhood feeding difficulties has found that they can be stressful situations for parents...
January 2010: Journal of Clinical Nursing
Robert L Fine, Jonathan M Whitfield, Barbara L Carr, Thomas W Mayo
Contemporary medical practice in the NICU sometimes leads to conflicts between providers and parents in which the parent demands continuation of life-sustaining treatment that the medical team deems medically inappropriate or futile. Such conflicts can be difficult to resolve and trying for all parties. Here we describe a conflict involving a 25-week-gestation, 825-g newborn with multiple intractable medical problems and resolution of the conflict through ethics consultation under provisions of the Texas Advance Directives Act...
November 2005: Pediatrics
Melissa D Avery, Catherine A Carr, Patricia Burkhardt
A recent trend discouraging or not offering women a choice to labor after a cesarean birth has resulted in higher cesarean birth rates and lower rates of vaginal birth after cesarean birth (VBAC). The few studies describing midwifery practice have demonstrated favorable outcomes; however, the studies are too small to thoroughly evaluate critical outcomes. In this retrospective descriptive study, clinical outcome data were obtained from eight midwifery practices. The aims were to collect, aggregate, and analyze data from multiple midwifery practices and then describe outcomes...
March 2004: Journal of Midwifery & Women's Health
R Carr, N Modi, C Doré
BACKGROUND: The colony stimulating factors (CSFs), granulocyte-macrophage colony stimulating factor (GM-CSF) and granulocyte colony stimulating factor (G-CSF), are naturally occurring cytokines that stimulate the production and antibacterial function of neutrophils and monocytes. Two strategies have been adopted for exploring whether CSFs can provide clinical benefit for preterm infants. The first has investigated their use as a treatment to improve outcome in established systemic infection, especially when complicated by a low neutrophil count...
2003: Cochrane Database of Systematic Reviews
D Richard Lindstrom, Stephen F Conley, Joan C Arvedson, Robert B Beecher, Margaret H Carr
OBJECTIVE: To describe the long-term outcome of a large anterior lingual thyroglossal duct cyst, diagnosed antenatally by ultrasound that completely obstructed the oral cavity and had almost completely replaced the anterior two-thirds lingual musculature. METHODS: Longitudinal observation. RESULTS: Anticipated airway obstruction at birth did not occur. Complete cyst removal occurred at day 2 of life with a rim of lingual muscle observed present only on the left side...
September 2003: International Journal of Pediatric Otorhinolaryngology
S S Mehr, J L Sadowsky, L W Doyle, J Carr
AIM: To determine the incidence and clinical characteristics of sepsis in ventilated infants from an Australian neonatal intensive care unit (NICU) in the late 1990s. METHODS: Demographic data was collected from babies requiring assisted ventilation (AV) over the 6-month period from 1 July to 31 December 1998. Sepsis was divided into early onset sepsis (EOS; " 72 h of age) and late onset sepsis (LOS; >72 h of age), including both definite (culture-proven + abnormal markers) and probable (culture negative + abnormal markers) episodes...
June 2002: Journal of Paediatrics and Child Health
B N Wasserman, N Sondhi, B L Carr
Neonatal endophthalmitis is a rare entity that may be exogenous or endogenous. Pseudomonas aeruginosa is a ubiquitous gram-negative rod that may appear as a nosocomial source of infection in the neonatal intensive care unit. A case of bilateral Pseudomonas-induced endophthalmitis is presented, and a discussion of the case and of the relevant literature follows.
June 1999: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
R Carr, N Modi, C J Doré, R El-Rifai, D Lindo
OBJECTIVE: Preterm neonates undergoing intensive care have high morbidity from sepsis. These infants also frequently develop neutropenia, and when this is associated with sepsis, mortality is high. This study investigates the potential for granulocyte-macrophage colony-stimulating factor (GM-CSF) to effect a clinically relevant increase in neutrophil number when used prophylactically in high-risk preterm neonates, and assesses its safety in this population. DESIGN: In an open, randomized, controlled study, 75 neonates (25 small for gestational age) <32 weeks gestation were randomized to receive GM-CSF (10 microg/kg/d) by subcutaneous injection for 5 days from <72 hours after birth, or to a control group...
April 1999: Pediatrics
P Carré, E Wodey, P Pladys, A Joly, C Ecoffey
Severe acute pulmonary oedema following peranaesthetic laryngospasm in a newborn. The authors report a case of severe acute pulmonary oedema secondary to a laryngeal spasm in a 3-week-old neonate, immediately after induction of anaesthesia with halothane. After emergency tracheal intubation, the infant experienced a severe, life-threatening pulmonary oedema requiring prolonged intensive care. Such a secondary time course is unusual. Usually pulmonary oedema has a favourable outcome after oxygen administration and maintenance of positive expiration pressure, except in the neonate...
1998: Annales Françaises D'anesthèsie et de Rèanimation
J L Kitzmiller, A Elixhauser, S Carr, C A Major, M de Veciana, L Dang-Kilduff, J M Weschler
The purpose of this pilot study was to perform a cost-identification analysis of care for gestational diabetes mellitus (GDM) by determining the direct costs of the diagnostic procedures and treatment used for the outpatient management of GDM (program input costs) and the direct costs of maternal hospitalization after diagnosis of GDM, delivery of the baby, and newborn care (outcome costs). Reimbursed average charges in the Northern California (NoCal) managed care market in 1996 were used to establish the direct costs, and the direct costs were then applied to the elements of care and pregnancy outcomes of three GDM management programs in NoCal, Southern California (SoCal), and New England (NewEng), using prospectively collected data...
August 1998: Diabetes Care
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