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Neonatology care

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https://www.readbyqxmd.com/read/28068438/variation-in-performance-of-neonatal-intensive-care-units-in-the-united-states
#1
Jeffrey D Horbar, Erika M Edwards, Lucy T Greenberg, Kate A Morrow, Roger F Soll, Madge E Buus-Frank, Jeffrey S Buzas
Importance: Hospitals use rates from the best quartile or decile as benchmarks for quality improvement aims, but to what extent these aims are achievable is uncertain. Objective: To determine the proportion of neonatal intensive care units (NICUs) in 2014 that achieved rates for death and major morbidities as low as the shrunken adjusted rates from the best quartile and decile in 2005 and the time it took to achieve those rates. Design, Setting, and Participants: A total of 408 164 infants with a birth weight of 501 to 1500 g born from January 1, 2005, to December 31, 2014, and cared for at 756 Vermont Oxford Network member NICUs in the United States were evaluated...
January 9, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28063822/-hospital-discharge-criteria-for-very-low-birth-weight-newborns
#2
Isabel Benavente Fernández, María Dolores Sánchez Redondo, Jose Luis Leante Castellanos, Alejandro Pérez Muñuzuri, Segundo Rite Gracia, Cèsar W Ruiz Campillo, Ester Sanz López, Manuel Sánchez Luna
Hospital discharge criteria for the pre-term newborn are mainly based on physiological competences (thermoregulation, respiratory stability, and feeding skills), although family support and ability to care for the baby, as well as a well-planned discharge are also cornerstones to ensure a successful discharge. In this article, the Committee of Standards of the Spanish Society of Neonatology reviews the current hospital discharge criteria in order for it to be useful as a clinical guide in Spanish neonatal units...
January 4, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28063339/the-experiences-and-needs-of-healthcare-professionals-facing-perinatal-death-a-scoping-review
#3
REVIEW
Shefaly Shorey, Beate André, Violeta Lopez
BACKGROUND: Globally, perinatal death is on a decline. However, its impact on the healthcare profession is huge. The existing literature focuses on examining perinatal death from parents' perspectives and patient death from the perspectives of nurses and a few doctors in critical care, oncology, and neonatology in the West. Due to the unique setting of maternity units where death is not routinely anticipated, as well as distinctive socio-cultural views surrounding death, there is a need to comprehensively review literature examining the impact of perinatal death on the perspectives of healthcare professionals working in maternity units...
December 28, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28059902/does-quality-improvement-work-in-neonatology-improve-clinical-outcomes
#4
Dan L Ellsbury, Reese H Clark
PURPOSE OF REVIEW: Quality improvement initiatives in neonatology have been promoted as an important way of improving outcomes of newborns. The purpose of this review is to examine the effectiveness of recent quality improvement work in improving the outcomes of infants requiring neonatal intensive care. RECENT FINDINGS: Quality improvement collaboratives and single-center projects demonstrate improvement of clinical processes and outcomes in neonatology that impact both preterm and term infants...
January 5, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28041869/-palliative-care-after-neonatal-intensive-care-contributions-of-leonetti-law-and-remaining-challenges
#5
P Kuhn, L Dillenseger, N Cojean, B Escande, C Zores, D Astruc
The 2005 enactment of the "Patients' rights and end-of-life care" act, known as the Leonetti law, has been accompanied by practical changes in the processes of withdrawal and withholding of active life-sustaining treatments. This law has also promoted the implementation of palliative care in perinatal medicine to avoid unreasonable therapeutic interventions and to preserve the dying patient's quality of life and human dignity. Recently, a new law has been voted by the French National Assembly and new reflections on the ethical aspects of the end of life in neonatal medicine should resume again within the French Society of Neonatology in the working group on ethical issues in neonatology...
December 29, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28040456/exhaled-breath-condensate-analysis-from-intubated-newborns-by-nano-hplc-coupled-to-high-resolution-ms
#6
A S Kononikhin, N L Starodubtseva, V V Chagovets, A Y Ryndin, A A Burov, I A Popov, A E Bugrova, R A Dautov, A O Tokareva, Y L Podurovskaya, O V Ionov, V E Frankevich, E N Nikolaev, G T Sukhikh
Invasiveness of examination and therapy methods is a serious problem for intensive care and nursing of premature infants. Exhaled breath condensate (EBC) is the most attractive biofluid for non-invasive methods development in neonatology for monitoring the status of intubated infants. The aim of the study was to propose an approach for EBC sampling and analysis from mechanically ventilated neonates. EBC collection system with good reproducibility of sampling was demonstrated. Discovery-based proteomic and metabolomic studies were performed using nano-HPLC coupled to high resolution MS...
December 23, 2016: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28009323/-to-a-question-of-treining-of-the-neonatologists-in-residency
#7
T Klimenko, E Serdceva, T Sandulak, A Zakrevskyy, O Karapetyan
: In recent years, the world and in Ukraine neonatology evolved into high-tech and quickly progressive section of the medicine, therefore preparation of experts is very important problem. Residency is the form of specialization of doctors on corresponding clinical chairs for reception of high qualifications of neonatology for possibility of competent rendering of competent and highly specialized medical care to newborns in hospitals of 3rd level. Term of training in residency is 2 years...
November 2016: Georgian Medical News
https://www.readbyqxmd.com/read/28007511/-neonatal-palliative-care-at-home-contribution-of-the-regional-pediatric-palliative-care-team
#8
N Cojean, C Strub, P Kuhn, L Calvel
The "patients' rights and end-of-life care" act, known as the Leonetti law, has allowed implementation of palliative care in neonatology as an alternative to unreasonable therapeutic interventions. A palliative care project can be offered to newborns suffering from intractable diseases. It must be focused on the newborn's quality of life and comfort and on family support. Palliative care for newborns can be provided in the delivery room, in the neonatal unit, and also at home. Going home is possible but requires medical support...
December 19, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27989403/-speaking-about-life-and-death-in-neonatology-how-can-communication-with-families-be-optimized
#9
T Pennaforte, A Moussa, A Janvier
Technological progress and improved clinical knowledge have increased survival of neonates who would previously have died. Survival is sometimes accompanied by a risk of short- or long-term adverse outcomes, which may lead to complex decisions about withholding or withdrawing life-sustaining interventions. These decisions are among the most difficult decisions in pediatric practice. They also involve communicating with parents and are emotionally charged. Many articles examining end-of-life decisions in neonatology state the need for healthcare providers to be caring, compassionate, and human without offering clear, practical advice...
December 15, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27955652/early-skin-to-skin-contact-or-incubator-for-very-preterm-infants-study-protocol-for-a-randomized-controlled-trial
#10
Laila Kristoffersen, Ragnhild Støen, Hilde Rygh, Margunn Sognnæs, Turid Follestad, Hilde S Mohn, Ingrid Nissen, Håkon Bergseng
BACKGROUND: Skin-to-skin care immediately following delivery is a common practice for term infants and has been shown to improve cardiorespiratory stability, facilitate early bonding, and promote breastfeeding. Since 2007, the use of skin-to-skin care has been practiced for preterm infants from 32 weeks of gestation in the delivery room at St. Olav's University Hospital. In the present study we aim to investigate whether skin-to-skin care following delivery is safe, and how it affects early and late outcomes compared to standard care for very preterm infants...
December 12, 2016: Trials
https://www.readbyqxmd.com/read/27924467/indian-pediatric-postgraduate-s-perspective-on-future-career-intentions
#11
Latha M Sneha, Manipriya Ravindran, Rekha Kumar, Padmasani Venkatraman, Julius Scott, LakshmiNarayan Kannan
OBJECTIVE: To determine the factors that influence Pediatric residents to pursue a subspecialty career and establish their choice of future workplace. METHODS: The present questionnaire based study was conducted during a National level pediatric post graduate exam refresher course in Chennai, India and involved Pediatric residents from all parts of India. Datas was analysed with the statistical package for social sciences (SPSS, version 18.0). RESULTS: Seventy five respondents participated in the study...
December 7, 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27915314/programs-for-detecting-and-treating-retinopathy-of-prematurity-role-of-the-neonatal-team
#12
Sudhanshu Grover, Deeksha Katoch, Mangat R Dogra, Praveen Kumar
High quality perinatal-neonatal care can prevent severe Retinopathy of Prematurity (ROP) in most cases. Preterm infants who do develop retinopathy can also have good visual outcomes if screening and treatment are done timely. National Neonatology Forum published clinical practice guidelines for timely screening and treatment of ROP in neonatal care units in the country in 2010. It is also listed as one of the condition under Rashtriya Bal Swasthya Karyakram for early identification and early intervention, and is currently a focus area under the National Program for Control of Blindness...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27887680/emergency-video-telemedicine-consultation-for-newborn-resuscitations-the-mayo-clinic-experience
#13
Jennifer L Fang, Christopher A Collura, Robert V Johnson, Garth F Asay, William A Carey, Douglas P Derleth, Tara R Lang, Beth L Kreofsky, Christopher E Colby
OBJECTIVE: To describe the Mayo Clinic experience with emergency video telemedicine consultations for high-risk newborn deliveries. PATIENTS AND METHODS: From March 26, 2013, through December 31, 2015, the Division of Neonatal Medicine offered newborn telemedicine consultations to 6 health system sites. A wireless tablet running secure video conferencing software was used by the local care teams. Descriptive data were collected on all consultations. After each telemedicine consult, a survey was sent to the neonatologist and referring provider to assess the technology, teamwork, and user satisfaction...
December 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27810117/simulation-and-debriefing-in-neonatology-2016-mission-incomplete
#14
REVIEW
Louis P Halamek
Simulation can be an effective tool to facilitate the acquisition and maintenance of the cognitive, technical and behavioral skills necessary to carry out our mission in neonatology: the delivery of safe, effective and efficient care to our patients. Prominent examples of successful implementation of simulation within neonatology include the Neonatal Resuscitation Program, the International Pediatric Simulation Society, and the International Network for Simulation-Based Pediatric Innovation, Research and Education...
November 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27801485/what-are-the-prognostic-factors-in-the-delivery-of-the-second-twin
#15
Dhia Mekki, Mechaal Mourali, Lassad Mekaouer, Faouzia Hemila, Chiraz El Fekih
Objective To evaluate the prognosis of the second twin according to different criteria (presentation, mode of delivery , term, weight, weight difference between twins ,twin to twin delivery time interval, studying the Apgar scores at birth and neonatal morbidity and mortality. Materials and Methods This is a retrospective study of 183 parturients carrying twin pregnancies collected at the department of Obstetrics-Gynecology in Mahmoud Matri Hospital (Ariana) over a period of 9 years ( 1st January 2001 to 31st December, 2009 ) ...
May 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/27793420/measuring-and-communicating-meaningful-outcomes-in-neonatology-a-family-perspective
#16
REVIEW
Annie Janvier, Barbara Farlow, Jason Baardsnes, Rebecca Pearce, Keith J Barrington
Medium- and long-term outcomes have been collected and described among survivors of neonatal intensive care units for decades, for a number of purposes: (1) quality control within units, (2) comparisons of outcomes between NICUs, (3) clinical trials (whether an intervention improves outcomes), (4) end-of-life decision-making, (5) to better understand the effects of neonatal conditions and/or interventions on organs and/or long-term health, and finally (6) to better prepare parents for the future. However, the outcomes evaluated have been selected by investigators, based on feasibility, availability, cost, stability, and on what investigators consider to be important...
December 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27773712/perinatal-regionalization-a-geospatial-view-of-perinatal-critical-care-united-states-2010-2013
#17
Mary D Brantley, Nicole L Davis, David A Goodman, William M Callaghan, Wanda D Barfield
BACKGROUND: Perinatal services exist today as a dyad of maternal and neonatal care. When perinatal care is fragmented or unavailable, excess morbidity and mortality may occur in pregnant women and newborns. OBJECTIVE: The objective of the study was to describe spatial relationships between women of reproductive age, individual perinatal subspecialists (maternal-fetal medicine and neonatology), and obstetric and neonatal critical care facilities in the United States to identify gaps in health care access...
October 20, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27753631/the-first-cry-of-the-child
#18
Michael A van Manen
Vociferous, shrill, and piercing-the first cry of the newborn infant signals that a new and separate life has begun. Separated from the body of the mother, the newborn cry serves to call for care, support, and protection. Yet, what is it that is expressed in the first cry? Or is the cry not really a matter of expression at all? In what sense may the cry be meaningful? Although we may be able to explain the function of the cry, we are puzzled by the enigma of its meaning. In this study, the science of the first cry is complemented with its physiognomy and genesis...
October 16, 2016: Qualitative Health Research
https://www.readbyqxmd.com/read/27746077/-criteria-for-hospital-discharge-of-the-healthy-term-newborn-after-delivery
#19
Segundo Rite Gracia, Alejandro Pérez Muñuzuri, Ester Sanz López, José Luis Leante Castellanos, Isabel Benavente Fernández, César W Ruiz Campillo, M Dolores Sánchez Redondo, Manuel Sánchez Luna
Criteria for newborn hospital discharge have to include physiological stability and family competence to provide newborn care at home. In this document, the Committee of Standards of the Spanish Society of Neonatology reviews the minimum criteria to be met before hospital discharge of a term newborn infant. We include a review of hospital discharge criteria for the late preterm infants, as these infants are often not hospitalised and remain with their mother after birth. A shortened hospital stay (less than 48h after delivery) for healthy term newborns can be considered, but it is not appropriate for every mother and newborn...
October 13, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/27743509/remote-vital-parameter-monitoring-in-neonatology-robust-unobtrusive-heart-rate-detection-in-a-realistic-clinical-scenario
#20
Nikolai Blanik, Konrad Heimann, Carina Pereira, Michael Paul, Vladimir Blazek, Boudewijn Venema, Thorsten Orlikowsky, Steffen Leonhardt
Vital parameter monitoring of term and preterm infants during incubator care with self-adhesive electrodes or sensors directly positioned on the skin [e.g. photoplethysmography (PPG) for oxygen saturation or electrocardiography (ECG)] is an essential part of daily routine care in neonatal intensive care units. For various reasons, this kind of monitoring contains a lot of stress for the infants. Therefore, there is a need to measure vital parameters (for instance respiration, temperature, pulse, oxygen saturation) without mechanical or conductive contact...
December 1, 2016: Biomedizinische Technik. Biomedical Engineering
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