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Neonatology care

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https://www.readbyqxmd.com/read/28332892/outcomes-in-continuing-pregnancies-diagnosed-with-a-severe-fetal-abnormality-and-implication-of-antenatal-neonatology-consultation-a-10-year-retrospective-study
#1
Laura Hostalery, Barthélémy Tosello
PURPOSE: To describe a population choosing to continue their pregnancy despite a severe fetal abnormality and to evaluate the role of antenatal neonatology consultation in perinatal decision-making. METHODS: A 10-year (2005-2015) retrospective descriptive study in a single Multidisciplinary Prenatal Diagnosis Center in South France. A series of pregnancies with severe fetal abnormalities were collected by a person outside the decision making process and/or the child's care...
March 23, 2017: Fetal and Pediatric Pathology
https://www.readbyqxmd.com/read/28289851/withdrawal-of-artificial-nutrition-and-hydration-in-neonatal-intensive-care-parents-and-healthcare-practitioners-views
#2
Véronique Fournier, Elisabeth Belghiti, Laurence Brunet, Marta Spranzi
Withdrawing Artificial Nutrition and Hydration (WANH) in the neonatal intensive care units (NICUs) has long been controversial. In France, the practice has become a legal option since 2005. But even though, the question remains as to what the stakeholders' experience is, and whether they consider it ethically appropriate. In order to contribute to the debate, we initiated a study in 2009 to evaluate parental and health care professionals (HCP) perspectives, after they experienced WAHN for a newborn. The study included 25 cases from 5 different clinical neonatology departments...
March 13, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28268184/feeding-premature-neonates-kinship-and-species-in-translational-neonatology
#3
Mie S Dam, Sandra M Juhl, Per T Sangild, Mette N Svendsen
Kinship, understood as biogenetic proximity, between a chosen animal model and a human patient counterpart, is considered essential to the process of 'translating' research from the experimental animal laboratory to the human clinic. In the Danish research centre, NEOMUNE, premature piglets are fed a novel milk diet (bovine colostrum) to model the effects of this new diet in premature infants. Our ethnographic fieldwork in an experimental pig laboratory and a neonatal intensive care unit (NICU) in 2013-2014 shows that regardless of biogenetics, daily practices of feeding, housing, and clinical care hold the potential for stimulating and eroding kinship relations between human and nonhuman actors...
February 28, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28260530/do-systematic-reviews-on-pediatric-topics-need-special-methodological-considerations
#4
Mufiza Farid-Kapadia, Lisa Askie, Lisa Hartling, Despina Contopoulos-Ioannidis, Zulfiqar A Bhutta, Roger Soll, David Moher, Martin Offringa
BACKGROUND: Systematic reviews are key tools to enable decision making by healthcare providers and policymakers. Despite the availability of the evidence based Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA-2009 and PRISMA-P 2015) statements that were developed to improve the transparency and quality of reporting of systematic reviews, uncertainty on how to deal with pediatric-specific methodological challenges of systematic reviews impairs decision-making in child health...
March 6, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28202129/-concerns-about-neonates-discharged-against-medical-advice-from-the-neonatal-intensive-care-unit
#5
Ning-Ning Qiao, Ming-Hua Gong, Zhen-Ai Jin
Discharge against medical advice (DAMA) conflicts with the purpose of disease treatment in children. Some research has shown that there are high proportions of extremely preterm infants and infants with asphyxia or congenital malformation in neonates with DAMA. This suggests that the sustainable development of neonatology needs cooperation and co-development with obstetrics, neonatal surgery, and radiology to reduce the rate of DAMA. With reference to the current status of research in both China and other countries, this article reviews the causes for DAMA and the strategies for reducing the rate of DAMA, in order to provide a theoretical basis for effectively reducing the rate of DAMA from the neonatal intensive care unit, improving treatment outcomes of the neonates, and increasing hospitals' comprehensive benefits...
February 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28168998/neonatologist-training-in-communication-and-palliative-care
#6
Natalia Henner, Renee D Boss
Neonatologists receive highly varied and largely inadequate training to acquire and maintain communication and palliative care skills. Neonatology fellows often need to give distressing news to families and frequently face unique communication challenges. While several approaches to teaching these skills exist, practice opportunities through simulation and role play will likely provide the most effective learning.
February 3, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28162789/primary-palliative-care-in-neonatal-intensive-care
#7
Krishelle L Marc-Aurele, Nancy K English
This article explores the 2014 Institute of Medicine׳s recommendation concerning primary palliative care as integral to all neonates and their families in the intensive care setting. We review trends in neonatology and barriers to implementing palliative care in intensive care settings. Neonatal primary palliative care education should address the unique needs of neonates and their families. The neonatal intensive care unit needs a mixed model of palliative care, where the neonatal team provides primary palliative care and the palliative subspecialist consults for more complex or refractory situations that exceed the primary team׳s skills or available time...
February 2, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28153478/perfusion-index-and-pulse-oximetry-screening-for-congenital-heart-defects
#8
Federico Schena, Irene Picciolli, Massimo Agosti, Antonio Alberto Zuppa, Gianvincenzo Zuccotti, Luciana Parola, Giulia Pomero, Giorgio Stival, Markus Markart, Silvia Graziani, Luigi Gagliardi, Cristina Bellan, Simona La Placa, Giuseppe Limoli, Gabriella Calzetti, Andrea Guala, Enza Bonello, Fabio Mosca
OBJECTIVE: To evaluate the efficacy of combined pulse oximetry (POX) and perfusion index (PI) neonatal screening for severe congenital heart defects (sCHD) and assess different impacts of screening in tertiary and nontertiary hospitals. STUDY DESIGN: A multicenter, prospective study in 10 tertiary and 6 nontertiary maternity hospitals. A total of 42 169 asymptomatic newborns from among 50 244 neonates were screened; exclusion criteria were antenatal sCHD diagnosis, postnatal clinically suspected sCHD, and neonatal intensive care unit admission...
January 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28151492/counting-unplanned-extubations-marked-variation-among-neonatologists
#9
S Mbi Ndakor, M U Nelson, J M B Pinheiro
OBJECTIVE: To assess if neonatologists detect and count unplanned extubations (UEs) uniformly. STUDY DESIGN: An Institutional Review Board-exempted anonymous web-based survey of neonatology attending and fellow members of the AAP Neonatal-Perinatal Medicine section was administered. Respondents were queried on practices concerning UE; they were then presented with different case scenarios and asked if they would count the event as a UE. RESULTS: Of the 509 respondents, 61% track UE rates...
February 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28091756/-recommendation-on-temperature-management-after-cardiopulmonary-arrest-and-severe-traumatic-brain-injury-in-childhood-beyond-the-neonatal-period-statement-of-the-german-society-for-neonatology-and-pediatric-intensive-care-medicine%C3%A2-gnpi-and-the-scientific-working
#10
S Brenner, C Eich, G Rellensmann, M U Schuhmann, T Nicolai, F Hoffmann
The available data on the effectiveness of therapeutic hypothermia in different patient groups are heterogeneous. Although the benefits have been proven for some collectives, recommendations for the use of hypothermia treatment in other groups are based on less robust data and conclusions by analogy. This article gives a review of the current evidence of temperature management in all age groups and based on this state of knowledge, recommends active temperature management with the primary aim of strict normothermia (36-36...
February 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28068438/variation-in-performance-of-neonatal-intensive-care-units-in-the-united-states
#11
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...
March 6, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28063822/-hospital-discharge-criteria-for-very-low-birth-weight-newborns
#12
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
#13
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
#14
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
#15
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...
February 2017: 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
#16
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...
March 15, 2017: 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
#17
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. Plan of the residency training offered by the department of neonatology Kharkiv medical academy of postgraduate education consists of sections on the basic speciality, adjacent clinical disciplines and additional programs...
November 2016: Georgian Medical News
https://www.readbyqxmd.com/read/28007511/-neonatal-palliative-care-at-home-contribution-of-the-regional-pediatric-palliative-care-team
#18
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...
February 2017: 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
#19
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...
February 2017: 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
#20
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
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