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Neonatal clinical guides

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https://www.readbyqxmd.com/read/29436355/care-of-the-neonate-on-nasal-continuous-positive-airway-pressure-a-bedside-guide
#1
Jennifer M Guay, Dru Carvi, Deborah A Raines, Wendy A Luce
Respiratory distress continues to be a major cause of neonatal morbidity. Current neonatal practice recommends the use of nasal continuous positive airway pressure (nCPAP) in the immediate resuscitation and continued support of neonates of all gestations with clinical manifestations of respiratory distress. Despite the many short- and long-term benefits of nCPAP, many neonatal care units have met resistance in its routine use. Although there have been numerous recent publications investigating the use and outcomes of various modes of nCPAP delivery, surfactant administration, mechanical ventilation, and other forms of noninvasive respiratory support (high-flow nasal cannula, nasal intermittent positive pressure ventilation), there has been a relative lack of publications addressing the practical bedside care of infants managed on nCPAP...
January 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29433814/acute-symptomatic-seizures-in-term-neonates-etiologies-and-treatments
#2
Janet S Soul
Acute symptomatic seizures caused by either diffuse or focal perinatal hypoxic-ischemic insults and intracranial hemorrhage in term newborns make up the large majority of all neonatal seizures. Acute seizures are one of the most common neurological disorders in term newborns who require admission to the neonatal intensive care unit. Despite elucidation of seizure pathogenesis in this population using animal models, treatment is limited by a lack of good evidence-based guidelines because of a paucity of rigorously conducted clinical trials or prospective studies in human newborns...
February 6, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29426317/barriers-and-enablers-to-skin-to-skin-contact-at-birth-in-healthy-neonates-a-qualitative-study
#3
Amala James Alenchery, Joanne Thoppil, Carl Denis Britto, Jimena Villar de Onis, Lavina Fernandez, P N Suman Rao
BACKGROUND: Skin to skin contact (SSC) at birth is the standard of care for newborns without risk factors. However, implementation of SSC at birth has been far from optimal. A qualitative study was undertaken to determine the barriers, enablers and potential solutions to implementation of SSC at birth in healthy newborn infants in a level III neonatal-care facility in Bangalore, India. METHODS: Consultants and residents/postgraduates (PG) from the departments of Obstetrics (n = 19) and Pediatrics (n = 14) and nurses (n = 8) in the labor room (LR) participated in the study...
February 9, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29394221/functional-recovery-in-critically-ill-children-the-weecover-multicenter-study
#4
Karen Choong, Douglas Fraser, Samah Al-Harbi, Asm Borham, Jill Cameron, Saoirse Cameron, Ji Cheng, Heather Clark, Tim Doherty, Nora Fayed, Jan-Willem Gorter, Margaret Herridge, Mary Khetani, Kusum Menon, Jamie Seabrook, Racquel Simpson, Lehana Thabane
OBJECTIVES: To evaluate functional outcomes and evaluate predictors of an unfavorable functional outcome in children following a critical illness. DESIGN: Prospective observational longitudinal cohort study. SETTING: Two tertiary care, Canadian PICUs: McMaster Children's Hospital and London Health Sciences. PATIENTS: Children 12 months to 17 years old, admitted to PICU for at least 48 hours with one or more organ dysfunction, were eligible...
February 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29369374/fragile-lives-with-fragile-rights-justice-for-babies-born-at-the-limit-of-viability
#5
Manya J Hendriks, John D Lantos
There is an inconsistency in the ways that doctors make clinical decisions regarding the treatment of babies born extremely prematurely. Many experts now recommend that clinical decisions about the treatment of such babies be individualized and consider many different factors. Nevertheless, many policies and practices throughout Europe and North America still appear to base decisions on gestational age alone or on gestational age as the primary factor that determines whether doctors recommend or even offer life-sustaining neonatal intensive care treatment...
January 25, 2018: Bioethics
https://www.readbyqxmd.com/read/29357751/navigating-the-dangerous-terrain-of-moral-distress-understanding-response-patterns-in-the-nicu
#6
Sally Thorne, Laura Konikoff, Helen Brown, Susan Albersheim
Moral distress is a well-recognized and ubiquitous aspect of health care professional practice in the neonatal intensive care unit (NICU) context. We used interpretive description methodology to guide a critical exploration of the dynamics of moral distress experience as reflected in the accounts of 28 health care professionals working in this setting. We learned about the kinds of clinical scenarios which triggered distressing experiences, and that the organizational and relational context of clinical work constituted a complex and dynamic working environment that profoundly affected both the individual and the collective experiences with moral distress in these situations...
January 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29357046/translational-neonatology-research-transformative-encounters-across-species-and-disciplines
#7
Mie S Dam, Per T Sangild, Mette N Svendsen
This paper explores the laborious and intimate work of turning bodies of research animals into models of human patients. Based on ethnographic research in the interdisciplinary Danish research centre NEOMUNE, we investigate collaboration across species and disciplines, in research aiming at improving survival for preterm infants. NEOMUNE experimental studies on piglets evolved as a platform on which both basic and clinical scientists exercised professional authority. Guided by the field of multi-species research, we explore the social and material agency of research animals in the production of human health...
January 22, 2018: History and Philosophy of the Life Sciences
https://www.readbyqxmd.com/read/29286529/unanticipated-difficult-airway-management-in-children-the-consensus-statement-of-the-paediatric-anaesthesiology-and-intensive-care-section-and-the-airway-management-section-of-the-polish-society-of-anaesthesiology-and-intensive-therapy-and-the-polish-so
#8
Wojciech Walas, Dawid Aleksandrowicz, Maria Borszewska-Kornacka, Tomasz Gaszyński, Ewa Helwich, Marek Migdał, Andrzej Piotrowski, Grażyna Siejka, Tomasz Szczapa, Alicja Bartkowska-Śniatkowska
Tracheal intubation may be defined as an artificial airway established in order to provide mechanical ventilation of the lungs during surgical procedures under general anaesthesia, treatment in an intensive care unit, as well as in emergency situations. Difficulties encountered during intubation may cause hypoxia, hypoxic brain injury and, in extreme situations, may result in the patient's death. There may be unanticipated and anticipated difficult airway. Children form a specific group of patients as there are significant differences in both anatomy and physiology...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29261707/field-evaluation-of-hiv-point-of-care-testing-for-early-infant-diagnosis-in-cape-town-south-africa
#9
Lorna Dunning, Max Kroon, Nei-Yuan Hsiao, Landon Myer
BACKGROUND: Early infant HIV diagnosis (EID) coverage and uptake remains challenging. Point-of-care (POC) testing may improve access and turn-around-times, but, while several POC technologies are in development there are few data on their implementation in the field. METHODS: We conducted an implementation study of the Alere q Detect POC system for EID at two public sector health facilities in Cape Town. HIV-exposed neonates undergoing routine EID testing at a large maternity hospital and a primary care clinic received both laboratory-based HIV PCR testing per local protocols and a POC test...
2017: PloS One
https://www.readbyqxmd.com/read/29233074/-you-have-to-take-action-changing-knowledge-and-attitudes-towards-newborn-care-practices-during-crisis-in-south-sudan
#10
Samira Sami, Kate Kerber, Barbara Tomczyk, Ribka Amsalu, Debra Jackson, Elaine Scudder, Alexander Dimiti, Janet Meyers, Kemish Kenneth, Solomon Kenyi, Caitlin E Kennedy, Kweku Ackom, Luke C Mullany
Highest rates of neonatal mortality occur in countries that have recently experienced conflict. International Medical Corps implemented a package of newborn interventions in June 2016, based on the Newborn health in humanitarian settings: field guide, targeting community- and facility-based health workers in displaced person camps in South Sudan. We describe health workers' knowledge and attitudes toward newborn health interventions, before and after receiving clinical training and supplies, and recommend dissemination strategies for improved uptake of newborn guidelines during crises...
November 2017: Reproductive Health Matters
https://www.readbyqxmd.com/read/29228972/impact-of-prematurity-and-nutrition-on-the-developing-gut-microbiome-and-preterm-infant-growth
#11
Alex Grier, Xing Qiu, Sanjukta Bandyopadhyay, Jeanne Holden-Wiltse, Haeja A Kessler, Ann L Gill, Brooke Hamilton, Heidie Huyck, Sara Misra, Thomas J Mariani, Rita M Ryan, Lori Scholer, Kristin M Scheible, Yi-Horng Lee, Mary T Caserta, Gloria S Pryhuber, Steven R Gill
BACKGROUND: Identification of factors that influence the neonatal gut microbiome is urgently needed to guide clinical practices that support growth of healthy preterm infants. Here, we examined the influence of nutrition and common practices on the gut microbiota and growth in a cohort of preterm infants. RESULTS: With weekly gut microbiota samples spanning postmenstrual age (PMA) 24 to 46 weeks, we developed two models to test associations between the microbiota, nutrition and growth: a categorical model with three successive microbiota phases (P1, P2, and P3) and a model with two periods (early and late PMA) defined by microbiota composition and PMA, respectively...
December 11, 2017: Microbiome
https://www.readbyqxmd.com/read/29217722/successfully-implementing-and-embedding-guidelines-to-improve-the-nutrition-and-growth-of-preterm-infants-in-neonatal-intensive-care-a-prospective-interventional-study
#12
Mark J Johnson, Alison A Leaf, Freya Pearson, Howard W Clark, Borislav D Dimitrov, Catherine Pope, Carl R May
OBJECTIVES: We aimed to improve the nutritional care of preterm infants by developing a complex (multifaceted) intervention intended to translate current evidence into practice. We used the sociological framework of Normalization Process Theory (NPT), to guide implementation in order to embed the new practices into routine care. DESIGN: A prospective interventional study with a before and after methodology. PARTICIPANTS: Infants <30 weeks gestation or <1500 g at birth...
December 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/29212522/a-systematic-review-of-neonatal-treatment-intensity-scores-and-their-potential-application-in-low-resource-setting-hospitals-for-predicting-mortality-morbidity-and-estimating-resource-use
#13
Jalemba Aluvaala, Gary S Collins, Michuki Maina, James A Berkley, Mike English
BACKGROUND: Treatment intensity scores can predict mortality and estimate resource use. They may therefore be of interest for essential neonatal care in low resource settings where neonatal mortality remains high. We sought to systematically review neonatal treatment intensity scores to (1) assess the level of evidence on predictive performance in predicting clinical outcomes and estimating resource utilisation and (2) assess the applicability of the identified models to decision making for neonatal care in low resource settings...
December 7, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#14
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29187358/vitamin-d-supplementation-during-pregnancy-state-of-the-evidence-from-a-systematic-review-of-randomised-trials
#15
Daniel E Roth, Michael Leung, Elnathan Mesfin, Huma Qamar, Jessica Watterworth, Eszter Papp
Objectives To estimate the effects of vitamin D supplementation during pregnancy on 11 maternal and 27 neonatal/infant outcomes; to determine frequencies at which trial outcome data were missing, unreported, or inconsistently reported; and to project the potential contributions of registered ongoing or planned trials.Design Systematic review and meta-analysis of randomised controlled trials; systematic review of registered but unpublished trials.Data sources Medline, Embase, PubMed, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from inception to September 2017; manual searches of reference lists of systematic reviews identified in the electronic search; and online trial registries for unpublished, ongoing, or planned trials...
November 29, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29173777/surgical-excision-is-the-treatment-of-choice-for-cervical-lymphatic-malformations-with-mediastinal-expansion
#16
Nader Ghaffarpour, Carmen Mesas Burgos, Tomas Wester
BACKGROUND: Lymphatic malformations (LMs) in the mediastinum are uncommon. However, cervical LMs may expand into the mediastinum. The aim of this study was to review our experience with the management of patients with LMs involving the mediastinum and to propose a treatment algorithm to guide the management of these rare malformations. MATERIAL AND METHODS: This was a descriptive retrospective chart review of all patients with LMs involving the mediastinum treated at our Institution between 2009 and 2015...
October 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29170288/midwife-or-doctor-local-opinion-leader-to-implement-a-national-guideline-in-babies-on-postnatal-wards-design-protocol-of-a-cluster-randomised-blinded-controlled-trial
#17
Jane Marie Alsweiler, Caroline A Crowther, Jane E Harding
INTRODUCTION: Neonatal hypoglycaemia is a common condition that can cause developmental delay. Treatment of neonatal hypoglycaemia with oral dextrose gel has been shown to reverse hypoglycaemia and reduce admissions to neonatal intensive care for hypoglycaemia. An evidence-based clinical practice guideline was written to guide the use of dextrose gel to treat neonatal hypoglycaemia in New Zealand. However, it is unclear what clinical discipline might most effectively lead the implementation of the guideline recommendations...
November 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29163364/telomere-length-in-preterm-infants-a-promising-biomarker-of-early-adversity-and-care-in-the-neonatal-intensive-care-unit
#18
Livio Provenzi, Giunia Scotto di Minico, Roberto Giorda, Rosario Montirosso
Preterm infants present an immature neurobehavioral profile at birth, even in absence of severe brain injuries and perinatal complications. As such, they require a long-lasting hospitalization in the Neonatal Intensive Care Unit (NICU), which is thought to grant at-risk newborns' survival, but still entails a number of physical, painful, and socio-emotional stressors. Hence, preterm birth and NICU stay represent an early adverse experience, which has been linked to detrimental consequences for neurological, neuro-endocrinal, behavioral, and socio-emotional development, as well as to disease later in life...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29132336/study-protocol-the-labor-progression-study-laps-does-the-use-of-a-dynamic-progression-guideline-in-labor-reduce-the-rate-of-intrapartum-cesarean-sections-in-nulliparous-women-a-multicenter-cluster-randomized-trial-in-norway
#19
Stine Bernitz, Rebecka Dalbye, Pål Øian, Jun Zhang, Torbjørn Moe Eggebø, Ellen Blix
BACKGROUND: The increasing rate of intrapartum cesarean sections is subject of attention and concern as it is associated with adverse outcomes. Labor dystocia is one of the most frequent indications for cesarean sections even though there is no consensus on criteria for labor dystocia. Traditionally the progression of labor follows guidelines based on Friedman's curve from the mid 1950s. In 2010 Zhang presented a new labor curve and a dynamic guideline for labor progression based on contemporary research...
November 13, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29100554/intersociety-policy-statement-on-the-use-of-whole-exome-sequencing-in-the-critically-ill-newborn-infant
#20
REVIEW
Alessandro Borghesi, Maria Antonietta Mencarelli, Luigi Memo, Giovanni Battista Ferrero, Andrea Bartuli, Maurizio Genuardi, Mauro Stronati, Alberto Villani, Alessandra Renieri, Giovanni Corsello
The rapid advancement of next-generation sequencing (NGS) technology and the decrease in costs for whole-exome sequencing (WES) and whole-genome sequening (WGS), has prompted its clinical application in several fields of medicine. Currently, there are no specific guidelines for the use of NGS in the field of neonatal medicine and in the diagnosis of genetic diseases in critically ill newborn infants. As a consequence, NGS may be underused with reduced diagnostic success rate, or overused, with increased costs for the healthcare system...
November 3, 2017: Italian Journal of Pediatrics
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