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Neonatal intensive care unit

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https://www.readbyqxmd.com/read/28811085/the-use-of-phenobarbital-and-other-anti-seizure-drugs-in-newborns
#1
REVIEW
Mohamed El-Dib, Janet S Soul
Neonatal seizures constitute the most frequent presenting neurologic sign encountered in the neonatal intensive care unit. Despite limited efficacy and safety data, phenobarbital continues to be used near-universally as the first-line anti-seizure drug (ASD) in neonates. The choice of second-line ASDs varies by provider and institution, and is still not supported by sufficient scientific evidence. In this review, we discuss the available evidence supporting the efficacy, mechanism of action, potential adverse effects, key pharmacokinetic characteristics such as interaction with therapeutic hypothermia, logistical issues, and rationale for use of neonatal ASDs...
August 12, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28810610/microbial-investigations-in-throat-swab-and-tracheal-aspirate-specimens-are-beneficial-to-predict-the-corresponding-endotracheal-tube-biofilm-flora-among-intubated-neonates-with-ventilator-associated-pneumonia
#2
Yun Pan, Lizhong Du, Qing Ai, Sijie Song, Xiaoli Tang, Danping Zhu, Jialin Yu
Ventilator-associated pneumonia (VAP) is a common nosocomial infection in neonatal intensive care units with high morbidity and mortality. Bacterial biofilm in the endotracheal tube (ET) provides a notable and persistent source of pathogens that may cause VAP, and thus is important for VAP detection. However, during intubation microbial investigations in ET, samples are unavailable due to the infeasibility of collecting ET samples during intubation of neonates. It is therefore of great importance to find alternative sources of samples that can help identify the ET biofilm flora...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28807835/the-role-of-antimicrobial-stewardship-programmes-in-children-a-systematic-review
#3
REVIEW
André Ricardo Araujo da Silva, Déborah Cardoso Albernaz de Almeida Dias, Amanda Fáris Marques, Clara Biscaia di Biase, Indah K Murni, Angela Dramowski, Mike Sharland, Johanes Huebner, Walter Zingg
The United Nations and the World Health Organization have designated antimicrobial resistance (AMR) as a major health priority and developed action plans to reduce AMR in all healthcare settings. Establishment of institutional antimicrobial stewardship programmes (ASPs) is advocated as a key intervention to reduce antibiotic consumption in hospitals and address high rates of multi-drug resistant (MDR) bacteria. We searched PUBMED and the Cochrane database of systematic reviews (1/2007-3/2017) to identify studies reporting about the effectiveness of ASPs in general paediatric wards and paediatric intensive care units (PICU), on reducing antibiotic consumption, on using broad spectrum/restricted antibiotics, and on antibiotic resistance and healthcare-associated infections (HAIs)...
August 11, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28807643/-use-of-subcutaneous-route-for-comfort-care%C3%A2-in-neonatal-palliative-population-systematic-review-and-survey-of-practices-in-france
#4
N Pouvreau, J Tandonnet, O Tandonnet, L Renesme
INTRODUCTION: Subcutaneous hydration (hypodermoclysis) and drug administration is a widely used method of analgesic therapy in adult palliative care medicine. Very little is known about its use in neonatal medicine. Evidence-based guidelines do not exist due to a lack of data. In this study, the advantages of subcutaneous analgesic therapy in terms of comfort in neonatal palliative care situations were investigated. METHODS: This report details the results of a systematic review associated with a survey in neonatal intensive care units (NICUs) and pediatric palliative care departments (PPCTs) in France...
August 11, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28806579/access-to-emergency-care-services-a-transversal-ecological-study-about-brazilian-emergency-health-care-network
#5
T A H Rocha, N C da Silva, P V Amaral, A C Q Barbosa, J V M Rocha, V Alvares, D G de Almeida, E Thumé, E B A F Thomaz, R C de Sousa Queiroz, M R de Souza, A Lein, N Toomey, C A Staton, J R N Vissoci, L A Facchini
OBJECTIVES: Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). STUDY DESIGN: Cross-sectional ecological study. METHODS: Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs)...
August 11, 2017: Public Health
https://www.readbyqxmd.com/read/28806281/ventilator-associated-pneumonia-in-neonatal-intensive-care-unit-due-to-chryseobacterium-indologenes
#6
Vicente S Antonello, Priscila Daht, Janaína Polli, Milton Gross, Maurício Colvero
Ventilator-associated pneumonia (VAP) represents one of the most common nosocomial infections in neonatal intensive care units, increasing morbidity and mortality, and associated costs. The authors report the case of a neonatal patient with VAP secondary to Chryseobacterium indologenes and a review of the literature. . The most effective empiric treatment for C. indologenes infection remains unclear due to limited data in the literature, and therefore, therapy should be adjusted in accordance with the result of the susceptibility profile...
August 10, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28805942/maternal-and-neonatal-outcomes-following-abnormally-invasive-placenta-a-population-based-record-linkage-study
#7
Heather J Baldwin, Jillian A Patterson, Tanya A Nippita, Siranda Torvaldsen, Ibinabo Ibiebele, Judy M Simpson, Jane B Ford
INTRODUCTION: Abnormally invasive placenta (AIP) involves abnormal adherence of the placenta to the myometrium, and is associated with severe pregnancy complications such as blood transfusion and hysterectomy. Knowledge of outcomes has been limited by small sample sizes and a focus on maternal rather than neonatal outcomes. This study uses population-level data collected over ten years to investigate maternal and neonatal outcomes and trends in incidence of AIP (also known as placenta accreta, increta and percreta)...
August 14, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28804867/sources-of-distress-for-physicians-and-nurses-working-in-swiss-neonatal-intensive-care-units
#8
Sabine D Klein, Hans Ulrich Bucher, Manya J Hendriks, Ruth Baumann-Hölzle, Jürg C Streuli, Thomas M Berger, Jean-Claude Fauchère, On Behalf Of The Swiss Neonatal End-Of-Life Study Group
BACKGROUND: Medical personnel working in intensive care often face difficult ethical dilemmas. These may represent important sources of distress and may lead to a diminished self-perceived quality of care and eventually to burnout. AIMS OF THE STUDY: The aim of this study was to identify work-related sources of distress and to assess symptoms of burnout among physicians and nurses working in Swiss neonatal intensive care units (NICUs). METHODS: In summer 2015, we conducted an anonymous online survey comprising 140 questions about difficult ethical decisions concerning extremely preterm infants...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28803228/utility-of-routine-urine-cmv-pcr-and-total-serum-igm-testing-of-small-for-gestational-age-infants-a-single-center-review
#9
Michael M Espiritu, Sean Bailey, Elena V Wachtel, Pradeep V Mally
BACKGROUND: Due to the extremely low incidence of TORCH (toxoplasmosis, rubella, CMV, herpes simplex virus) infections, diagnostic testing of all small for gestational age (SGA) infants aimed at TORCH etiologies may incur unnecessary tests and cost. OBJECTIVE: To determine the frequency of urine CMV PCR and total IgM testing among infants with birth weight <10% and the rate of test positivity. To evaluate the frequency of alternative etiologies of SGA in tested infants...
August 14, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28802348/alarm-safety-and-alarm-fatigue
#10
REVIEW
Kendall R Johnson, James I Hagadorn, David W Sink
Clinical alarm systems have received significant attention in recent years following warnings from hospital accrediting and health care technology organizations regarding patient harm caused by unsafe practices. Alarm desensitization or fatigue from frequent, false, or unnecessary alarms, has led to serious events and even patient deaths. Other concerns include settings inappropriate to patient population or condition, inadequate staff training, and improper use or disabling. Research on human factors in alarm response and of functionality of medical devices will help clinicians develop appropriate policies, practices, and device settings for clinical alarms in neonatal intensive care units...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802347/using-quality-improvement-tools-to-reduce-chronic-lung-disease
#11
REVIEW
Alan Peter Picarillo, Waldemar Carlo
Rates of chronic lung disease (CLD) in very low birthweight infants have not decreased at the same pace as other neonatal morbidities over the past 20 years. Multifactorial causes of CLD make this common morbidity difficult to reduce, although there have been several successful quality improvement (QI) projects in individual neonatal intensive care units. QI projects have become a mainstay of neonatal care over the past decade, with an increasing number of publications devoted to this topic. A specific QI project for CLD must be based on best available evidence in the medical literature, expert recommendations, or based on work by previous QI initiatives...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802344/creating-a-highly-reliable-neonatal-intensive-care-unit-through-safer-systems-of-care
#12
REVIEW
Patoula G Panagos, Stephen A Pearlman
Neonates requiring intensive care are at high risk for medical errors due to their unique characteristics and high acuity. Designing a safer work environment begins with safe processes. Creating a culture of safety demands the involvement of all organizational levels and an interdisciplinary approach. Adverse events can result from suboptimal communication and lack of a shared mental model. This chapter describes tools to promote better patient safety in the NICU through monitoring adverse events, improving communication and using information technology...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802334/has-quality-improvement-really-improved-outcomes-for-babies-in-the-neonatal-intensive-care-unit
#13
REVIEW
Alan R Spitzer
During the past decade, the emergence of outcome measurement and quality improvement in the neonatal intensive care unit, far more than the introduction of new research approaches or novel therapies, has had a profound effect on improving outcomes for premature neonates. Collection of outcome data, review of those data, and strategies to identify and resolve problems using continuous quality improvement methods can dramatically improve patient outcomes. It is likely that further initiatives in quality improvement will continue to have additional beneficial effects for the neonate...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28801177/uses-and-misuses-of-sodium-bicarbonate-in-the-neonatal-intensive-care-unit
#14
Amélie Collins, Rakesh Sahni
Over the past several decades, bicarbonate therapy continues to be used routinely in the treatment of acute metabolic acidosis in critically ill neonates despite the lack of evidence for its effectiveness in the treatment of acid-base imbalance, and evidence indicating that it may be detrimental. Clinicians often feel compelled to use bicarbonate since acidosis implies a need for such therapy and thus the justification for its use is based on hearsay rather than science. This review summarizes the evidence and refutes the clinical practice of administering sodium bicarbonate to treat metabolic acidosis associated with several specific clinical syndromes in neonates...
August 8, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28801176/caffeine-use-in-the-neonatal-intensive-care-unit
#15
REVIEW
Jalal M Abu-Shaweesh, Richard J Martin
Caffeine is the most frequently used medication in the neonatal intensive care unit. It is used for the prevention and treatment of apnea, although this has been associated with lower incidence of bronchopulmonary dysplasia (BPD) and patent ductus arteriosus as well as intact survival at 18-21 months of life. Although neurodevelopmental advantage was no longer statistically significant at age 5 years, caffeine was associated with sustained improvement in co-ordination and less gross motor impairment than placebo...
August 8, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28800397/association-between-the-7-day-moving-average-for-nutrition-and-growth-in-very-low-birth-weight-infants
#16
Gustave H Falciglia, Karna Murthy, Jane Holl, Hannah L Palac, Yuliya Oumarbaeva, Pratyusha Yadavalli, Donna Woods, Daniel T Robinson
BACKGROUND: Very low birth weight (VLBW) infants remain at risk for postnatal growth restriction. Clinicians may have difficulty identifying growth patterns resulting from nutrition interventions, impeding prompt management changes intended to increase growth velocity. This study aimed to quantify the association between growth and nutrition intake through 7-day moving averages (SDMAs). METHODS: The first 6 weeks of daily nutrition intake and growth measurements were collected from VLBW infants admitted to a level 4 neonatal intensive care unit (2011-2014)...
August 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28800162/feeding-imprinting-the-extreme-test-case-of-premature-infants-born-with-very-low-birth-weight
#17
Moriya Suberi, Iris Morag, Tzipora Strauss, Ronny Geva
Feeding imprinting, considered a survival-enabling process, is not well understood. Infants born very preterm, who first feed passively, are an effective model for studying feeding imprinting. Retrospective analysis of neonatal intensive care unit (NICU) records of 255 infants (Mgestational age  = 29.98 ± 1.64) enabled exploring the notion that direct breastfeeding (DBF) during NICU stay leads to consumption of more mother's milk and earlier NICU discharge. Results showed that DBF before the first bottle feeding is related to shorter transition into oral feeding, a younger age of full oral feeding accomplishment and earlier discharge...
August 11, 2017: Child Development
https://www.readbyqxmd.com/read/28799193/an-analysis-of-the-effects-of-intrapartum-factors-neonatal-characteristics-and-skin-to-skin-contact-on-early-breastfeeding-initiation
#18
Ying Lau, Pyai Htun Tha, Sarah Su Tin Ho-Lim, Lai Ying Wong, Peng Im Lim, Binte Zaini Mattar Citra Nurfarah, Shefaly Shorey
This study aims to determine relationships between intrapartum factors, neonatal characteristics, skin-to-skin contact (SSC), and early breastfeeding initiation after spontaneous vaginal and Caesarean section or operative vaginal birth. A total of 915 mother-newborn dyads were considered in a hypothetical model based on integrated concepts of breastfeeding initiation model, infant learning framework, and attachment theory. Multiple-group path analysis was used to determine whether differences exist between effects of immediate SSC (≤30 min) on early breastfeeding initiation in different modes of birth...
August 10, 2017: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/28799178/retrospective-cohort-study-shows-that-the-risks-for-retinopathy-of-prematurity-included-birth-age-and-weight-medical-conditions-and-treatment
#19
Aliaa Adel Ali, Nancy Gomaa, Ahmed Reda Awadein, Huda Hussein Al-Hayouti, Ahmed Hegazy
AIM: This study described the characteristics and risk factors of neonates who developed retinopathy of prematurity (ROP) and severe treatable ROP in two Egyptian neonatal intensive care units (NICUs). METHODS: This retrospective cohort study comprised 108 preterm neonates who were screened for ROP after being admitted to the two NICUs run by Cairo University Hospital from June 2014 to May 2015. Patients were examined using digital fundus photography and indirect ophthalmoscopy was performed if ROP was detected...
August 11, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28798896/pregnancy-outcomes-in-hiv-infected-women-experience-from-a-tertiary-care-center-in-india
#20
Vatsla Dadhwal, Aparna Sharma, Kavita Khoiwal, Dipika Deka, Plaboni Sarkar, P Vanamail
BACKGROUND AND OBJECTIVES: There is conflicting data on the effect of HIV infection as well as antiretroviral therapy (ART) on pregnancy outcome. The objectives of this study were to compare pregnancy outcomes in women with and without HIV infection, and to evaluate the effect of HAART on pregnancy in HIV-infected women. METHODS: This is a prospective case record analysis of 212 HIV-infected women delivering between 2002 and 2015, in a tertiary health care center in India...
2017: International Journal of MCH and AIDS
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