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https://www.readbyqxmd.com/read/29773072/formal-procedure-to-facilitate-the-decision-to-withhold-or-withdraw-life-sustaining-interventions-in-a-neonatal-intensive-care-unit-a-seven-year-retrospective-study
#1
G Sorin, R Vialet, B Tosello
BACKGROUND: Neonatal deaths are often associated with the complex decision to limit or withdraw life-sustaining interventions (LSIs) rather than therapeutic impasses. Despite the existence of a law, significant disparities in clinical procedures remain. This study aimed to assess deaths occurring in a Neonatal Intensive Care Unit (NICU) and measure the impact of a traceable Limitation or Withdrawal of Active Treatment (LWAT) file on the treatment of these newborns. METHODS: In this monocentric retrospective study, we reviewed all consecutive neonatal deaths occurring during two three-year periods among patients in the NICU at the North Hospital of Marseille: cohort 1 (from 2009 to 2011 without the LWAT file) and cohort 2 (from 2013 to 2015 after introduction of the LWAT file)...
May 17, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29768662/immersion-in-water-during-labour-and-birth
#2
REVIEW
Elizabeth R Cluett, Ethel Burns, Anna Cuthbert
BACKGROUND: Water immersion during labour and birth is increasingly popular and is becoming widely accepted across many countries, and particularly in midwifery-led care settings. However, there are concerns around neonatal water inhalation, increased requirement for admission to neonatal intensive care unit (NICU), maternal and/or neonatal infection, and obstetric anal sphincter injuries (OASIS). This is an update of a review last published in 2011. OBJECTIVES: To assess the effects of water immersion during labour and/or birth (first, second and third stage of labour) on women and their infants...
May 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29741208/induction-of-labour-for-improving-birth-outcomes-for-women-at-or-beyond-term
#3
REVIEW
Philippa Middleton, Emily Shepherd, Caroline A Crowther
BACKGROUND: Beyond term, the risks of stillbirth or neonatal death increase. It is unclear whether a policy of labour induction can reduce these risks. This Cochrane review is an update of a review that was originally published in 2006 and subsequently updated in 2012 OBJECTIVES: To assess the effects of a policy of labour induction at or beyond term compared with a policy of awaiting spontaneous labour or until an indication for birth induction of labour is identified) on pregnancy outcomes for infant and mother...
May 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29723903/nonmedically-indicated-induction-of-labor-compared-with-expectant-management-in-nulliparous-women-aged-35-years-or-older
#4
Tetsuya Kawakita, Katherine Bowers, Jane C Khoury
OBJECTIVE:  This article compares maternal and neonatal outcomes in women aged ≥ 35 years who experienced nonmedically indicated induction of labor (NMII) versus expectant management. STUDY DESIGN:  This was a retrospective cohort study of nulliparas aged ≥ 35 years with a singleton and cephalic presentation who delivered at term. Outcomes were compared between women who underwent NMII at 37, 38, 39, and 40 weeks' gestation and those with expectant management that week...
May 3, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29721677/value-of-abdominal-ultrasound-in-management-of-necrotizing-enterocolitis-a-systematic-review-and-meta-analysis
#5
Maarten Janssen Lok, Hiromu Miyake, Alison Hock, Alan Daneman, Agostino Pierro, Martin Offringa
PURPOSE: Necrotizing enterocolitis (NEC) remains a life-threatening disease among infants in the NICU. Early diagnosis and careful monitoring are essential to improve outcomes. Abdominal ultrasound (AUS) seems a promising addition to current diagnostic modalities, but its clinical utility is uncertain. The aim of this study was to identify AUS features associated with definite NEC (i.e. Bell stage ≥ II), failed medical treatment, surgery, and death. METHODS: Embase, MEDLINE, Web of Science and CINAHL databases were searched for studies that addressed any NEC-related AUS feature in relation to any of the four outcomes...
May 2, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29718540/obesity-gestational-diabetes-and-macrosomia-are-associated-with-increasing-rates-of-early-term-induction-of-labour-at-the-canberra-hospital
#6
Jonathan T McGuane, Lori Grlj, Michael J Peek
BACKGROUND: Early-term delivery is an important cause of short-term neonatal morbidity and associated high healthcare costs, with possible additional long-term developmental ramifications. As a form of 'iatrogenic' delivery, induction of labour (IOL) is a potentially modifiable contributor to this burden. AIMS: To determine patterns of, and primary indication for, early-term IOL, as well as temporal trends in this primary indication and differences from other modes of delivery with respect to maternal factors and maternal/neonatal outcomes...
May 2, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29715700/lung-ultrasound-findings-in-congenital-pulmonary-airway-malformation
#7
Nadya Yousef, Mostafa Mokhtari, Philippe Durand, Francesco Raimondi, Fiorella Migliaro, Alexandra Letourneau, Pierre Tissières, Daniele De Luca
BACKGROUND AND OBJECTIVE:  Congenital pulmonary airway malformation (CPAM) is a group of rare congenital malformations of the lung and airways. Lung ultrasound (LU) is increasingly used to diagnose neonatal respiratory diseases since it is quick, easy to learn, and radiation-free, but no formal data exist for congenital lung malformations. We aimed to describe LU findings in CPAM neonates needing neonatal intensive care unit (NICU) admission and to compare them with a control population...
May 1, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29708764/human-milk-biomarkers-of-secretory-activation-in-breast-pump-dependent-mothers-of-premature-infants
#8
Rebecca Hoban, Aloka L Patel, Clarisa Medina Poeliniz, Ching Tat Lai, Judy Janes, Donna Geddes, Paula P Meier
OBJECTIVE: Mothers of premature infants confront barriers to coming to volume (CTV; ≥500 mL/day mother's own milk [MOM] by postpartum day 14), a strong predictor of continued MOM provision at neonatal intensive care unit (NICU) discharge. We sought to determine concentrations of secretory activation biomarkers (MOM sodium, total protein, lactose, and citrate) during the first 14 postpartum days and to describe relationships among these biomarkers, pumped MOM volume, CTV, and pumping frequency...
April 30, 2018: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/29692477/use-of-plan-do-study-act-cycles-to-decrease-incidence-of-neonatal-hypothermia-in-the-labor-room
#9
Subhash Chandra Shaw, Amit Devgan, Sushila Anila, Neha Anushree, Himadri Debnath
Background: Body temperature of a neonate continues to be under-documented, under-recognized, and under-managed, even though studies have shown that neonatal hypothermia increases mortality and morbidity. We aimed to reduce neonatal hypothermia (body temperature <36.5 °C) at 1 h following normal vaginal delivery in term and late preterm neonates in delivery room from 50% at baseline to less than 10% by 6 weeks. Methods: We implemented a quality improvement (QI) initiative using the rapid-cycle Plan-Do-Study-Act approach (PDSA) improvement model and the project was conducted from 15 Jan 2017 to 25 Feb 2017...
April 2018: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/29681180/amniocentesis-compared-with-antenatal-corticosteroids-prior-to-early-term-scheduled-cesarean-delivery
#10
Kelly B Zafman, Nathan S Fox
OBJECTIVE: There are a variety of maternal or fetal conditions that require late preterm or early term delivery. In cases where early delivery is indicated, optimal management is not always clear. Historically, obstetricians used amniocentesis to document fetal lung maturity, but recently, many have transitioned to administration of antenatal corticosteroids (ACS). The objective of this study was to compare neonatal outcomes between women undergoing amniocentesis or receiving ACS prior to scheduled cesarean delivery (CD) less than 39 weeks...
April 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29656254/review-of-national-methodologies-for-rivers-hydromorphological-assessment-a-comparative-approach-in-france-romania-and-croatia
#11
REVIEW
Liliana Zaharia, Gabriela Ioana-Toroimac, Gabriela-Adina Moroşanu, Andreea-Cristina Gălie, Marinela Moldoveanu, Ivan Čanjevac, Philippe Belleudy, Mladen Plantak, Nenad Buzjak, Neven Bočić, Cédric Legout, Sylvain Bigot, Nicu Ciobotaru
Conducting hydromorphological assessments for evaluating the ecological status of rivers is a key requirement of the Directive 2000/60/EC (Water Framework Directive - WFD) within European Union (EU) Member States. This paper aims at understanding how this requirement was implemented, through an original comparative review of methodologies for rivers' hydromorphological assessment in three EU Member States, which joined the EU at different times, and with many differences in terms of hydrographic features, socio-economic and water management systems: France, Romania, and Croatia...
April 12, 2018: Journal of Environmental Management
https://www.readbyqxmd.com/read/29648985/feasibility-of-telemetric-intracranial-pressure-monitoring-in-the-neuro-intensive-care-unit
#12
Alexander Lilja-Cyron, Jesper Kelsen, Morten Andresen, Kåre Fugleholm, Marianne Juhler
Intracranial pressure (ICP) monitoring is crucial in the management of acute neurosurgical conditions such as traumatic brain injury (TBI). However, pathological ICP may persist beyond the admission to the neuro intensive care unit (NICU). We investigated the feasibility of telemetric ICP monitoring in the NICU, as this technology provides the possibility of long-term ICP assessment beyond NICU discharge. In this prospective investigation, we implanted telemetric ICP sensors (Raumedic Neurovent-P-tel) instead of conventional, cabled ICP sensors in patients undergoing decompressive craniectomy...
March 16, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29625857/decrease-of-premature-mothers-stress-levels-in-the-intensive-care-unit
#13
B Villamizar-Carvajal, C Vargas-Porras, J R García-Corzo
OBJECTIVE: To determine the effectiveness of the 'Creating Opportunities for Parent Empowerment' (COPE) programme in reducing stress levels in mothers of preterm infants in the neonatal intensive care unit (NICU). METHODS: Clinical trial performed in Colombia, including mothers of infants younger than 34 weeks of gestation, hospitalized, without a history of premature delivery. The mothers with psychiatric illnesses, language disorders, history of use of psychoactive substances and whose newborns had a congenital malformation were excluded...
April 3, 2018: Enfermería Intensiva
https://www.readbyqxmd.com/read/29622720/infant-pulmonary-function-testing-and-phenotypes-in-severe-bronchopulmonary-dysplasia
#14
Edward G Shepherd, Brian J Clouse, Kathryn A Hasenstab, Swetha Sitaram, Daniel T Malleske, Leif D Nelin, Sudarshan R Jadcherla
BACKGROUND: The definition of severe bronchopulmonary dysplasia (sBPD) is based on respiratory support needs. The management of a patient with sBPD remains empirical and is highly variable among providers. Our objective in this study was to test the hypothesis that infant pulmonary function testing (iPFT) would reveal distinct phenotypes in patients with established sBPD during the initial NICU stay. METHODS: A prospective cohort study with data prospectively collected on infants with sBPD from May 1, 2003, to June 30, 2016...
April 5, 2018: Pediatrics
https://www.readbyqxmd.com/read/29618272/does-fortification-of-pasteurized-donor-human-milk-increase-the-incidence-of-necrotizing-enterocolitis-among-preterm-neonates-a-randomized-controlled-trial
#15
Bethou Adhisivam, Dilesh Kohat, Vasanthan Tanigasalam, Vishnu Bhat, Nishad Plakkal, C Palanivel
OBJECTIVE: To compare the effect of fortified pasteurized donor human milk (PDHM) versus unfortified PDHM on the incidence of necrotizing enterocolitis (NEC) and immediate outcome among preterm neonates. METHODS: This randomized controlled trial (RCT) conducted in a tertiary care teaching hospital, south India included 80 healthy preterm neonates randomized to two groups (Group A and B). Neonates in Group A and B were fed with fortified PDHM and unfortified PDHM respectively...
April 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29614894/management-of-fetal-growth-restriction-using-the-contraction-stress-test-a-case-control-study
#16
Hiroaki Tanaka, Fumi H Furuhashi, Kuniaki Toriyabe, Takeshi Matsumoto, Shoich Magawa, Masafumi Nii, Junko Watanabe, Kayo Tanaka, Takashi Umekawa, Yuki Kamimoto, Tomoaki Ikeda
PURPOSE: Fetal growth restriction (FGR) is a concerning health issue. However, studies on FGR management are limited due to its rarity. We aimed to evaluate the efficacy of the contraction stress test (CST) for FGR management. MATERIALS AND METHODS: A case-control retrospective study design. Our institute innovated CST in FGR management in 2017. We included women in their 33rd-40th week of pregnancy with a diagnosis of FGR and retrospectively divided them into groups: the CST group (FGR management with CST) and no CST group (FGR management without CST) before and after CST development...
April 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29588819/an-agent-based-architecture-for-high-risk-neonate-management-at-neonatal-intensive-care-unit
#17
Jaleh Shoshtarian Malak, Reza Safdari, Hojjat Zeraati, Fatemeh Sadat Nayeri, Niloofar Mohammadzadeh, Seide Sedighe Seied Farajollah
Background: In recent years, the use of new tools and technologies has decreased the neonatal mortality rate. Despite the positive effect of using these technologies, the decisions are complex and uncertain in critical conditions when the neonate is preterm or has a low birth weight or malformations. There is a need to automate the high-risk neonate management process by creating real-time and more precise decision support tools. Objective: To create a collaborative and real-time environment to manage neonates with critical conditions at the NICU (Neonatal Intensive Care Unit) and to overcome high-risk neonate management weaknesses by applying a multi agent based analysis and design methodology as a new solution for NICU management...
January 2018: Electronic Physician
https://www.readbyqxmd.com/read/29579758/glucose-gel-in-infants-at-risk-for-transitional-neonatal-hypoglycemia
#18
Kartikeya Makker, Rana Alissa, Christopher Dudek, Laura Travers, Carmen Smotherman, Mark L Hudak
OBJECTIVE:  To evaluate whether glucose gel as a supplement to feedings in infants admitted to the newborn nursery at risk for neonatal hypoglycemia (NH) reduces the frequency of transfer to a higher level of care for intravenous dextrose treatment. STUDY DESIGN:  We revised our newborn nursery protocol for management of infants at risk for NH to include use of 40% glucose gel (200 mg/kg). Study population included late preterm, small and large for gestational age infants, and infants of diabetic mothers...
March 26, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29519568/dressed-for-success-silver-impregnated-nanocrystalline-dressing-for-initial-treatment-of-giant-omphalocele
#19
Dean B Percy, Candace Haddock, Vivian Ma, Amie Nowak, Julia Panczuk, Sonia Butterworth
OBJECTIVE: The purpose of this study was to describe outcomes and resource utilization in patients treated with twice-weekly silver impregnated (SI) nanocrystalline dressings for initial non-operative management of giant omphalocele (GO). METHODS: A retrospective review of patients with GO treated with SI dressings was undertaken. Clinical parameters, cost, and complications were recorded. RESULTS: Five patients with GO were treated with SI dressings between 2014 and 2016...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29514600/low-incidence-of-multidrug-resistant-bacteria-and-nosocomial-infection-due-to-a-preventive-multimodal-nosocomial-infection-control-a-10-year-single-centre-prospective-cohort-study-in-neurocritical-care
#20
Vera Spatenkova, Ondrej Bradac, Daniela Fackova, Zdenka Bohunova, Petr Suchomel
BACKGROUND: Nosocomial infection (NI) control is an important issue in neurocritical care due to secondary brain damage and the increased morbidity and mortality of primary acute neurocritical care patients. The primary aim of this study was to determine incidence of nosocomial infections and multidrug-resistant bacteria and seek predictors of nosocomial infections in a preventive multimodal nosocomial infection protocol in the neurointensive care unit (NICU). The secondary aim focused on their impact on stay, mortality and cost in the NICU...
March 7, 2018: BMC Neurology
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