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Karen Whitfield, Claudia Barkeij, Angela North
AIM: To present a case of an extremely premature infant and the role that the specialist neonatal pharmacist has on the quality of care of these patients. METHOD: Interventions and recommendations made by the pharmacists over the admission of a triplet born at 23 weeks and 5 days gestation were recorded. The type of interventions were categorised and classified for risk using a consequence/probability matrix.1 RESULTS: The patient required admission to the intensive care unit and subsequently the special care unit for a period of 163 days before discharge home...
September 2016: Archives of Disease in Childhood
Ola Andersson
No abstract text is available yet for this article.
April 2016: Acta Paediatrica
Matthew A Rysavy, Lei Li, Edward F Bell, Abhik Das, Susan R Hintz, Barbara J Stoll, Betty R Vohr, Waldemar A Carlo, Seetha Shankaran, Michele C Walsh, Jon E Tyson, C Michael Cotten, P Brian Smith, Jeffrey C Murray, Tarah T Colaizy, Jane E Brumbaugh, Rosemary D Higgins
BACKGROUND: Between-hospital variation in outcomes among extremely preterm infants is largely unexplained and may reflect differences in hospital practices regarding the initiation of active lifesaving treatment as compared with comfort care after birth. METHODS: We studied infants born between April 2006 and March 2011 at 24 hospitals included in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Data were collected for 4987 infants born before 27 weeks of gestation without congenital anomalies...
May 7, 2015: New England Journal of Medicine
Maksim Kirtsman, Eugene W Yoon, Cecil Ojah, Zenon Cieslak, Shoo K Lee, Prakesh S Shah
OBJECTIVE: This study aims to evaluate the association between nil-per-os (NPO) days and development of necrotizing enterocolitis (NEC) in extremely preterm neonates (<29 weeks gestational age). STUDY DESIGN: A case-control study of 234 extremely preterm neonates who developed stage II or III NEC and 467 matched control infants admitted to participating sites in the Canadian Neonatal Network between 2010 and 2011 was conducted. The number and percentage of NPO days before the development of NEC was compared with the equivalent period in control infants using logistic regression...
July 2015: American Journal of Perinatology
Tricia J Johnson, Aloka L Patel, Harold R Bigger, Janet L Engstrom, Paula P Meier
BACKGROUND: Necrotizing enterocolitis (NEC) is a costly morbidity in very low birth weight (VLBW; <1,500 g birth weight) infants that increases hospital length of stay and requires expensive treatments. OBJECTIVES: To evaluate the cost of NEC as a function of dose and exposure period of human milk (HM) feedings received by VLBW infants during the neonatal intensive care unit (NICU) hospitalization and determine the drivers of differences in NICU hospitalization costs for infants with and without NEC...
2015: Neonatology
Ryan J Van Lieshout, Michael H Boyle, Saroj Saigal, Katherine Morrison, Louis A Schmidt
OBJECTIVE: To determine the risk for psychiatric disorders among extremely low birth weight (ELBW) survivors in their early to mid-30s and to determine whether those born small for gestational age or those exposed to a full course of antenatal corticosteroids (ACS) were at particularly high risk. METHODS: A prospective, longitudinal, population-based cohort of 84 ELBW survivors and 90 normal birth weight (NBW) control participants born in Ontario, Canada from 1977 to 1982 were assessed by interviewers naive to birth weight status using the Mini-International Neuropsychiatric Interview...
March 2015: Pediatrics
Wannasiri Lapcharoensap, Susan C Gage, Peiyi Kan, Jochen Profit, Gary M Shaw, Jeffrey B Gould, David K Stevenson, Hugh O'Brodovich, Henry C Lee
IMPORTANCE: Bronchopulmonary dysplasia (BPD) remains a serious morbidity in very low-birth-weight (VLBW) infants (<1500 g). Deregionalization of neonatal care has resulted in an increasing number of VLBW infants treated in community hospitals with unknown impact on the development of BPD. OBJECTIVE: To identify individual risk factors for BPD development and hospital variation of BPD rates across all levels of neonatal intensive care units (NICUs) within the California Perinatal Quality Care Collaborative...
February 2015: JAMA Pediatrics
Fermín García-Muñoz Rodrigo, Ana Lucía Díez Recinos, Afredo García-Alix Pérez, Josep Figueras Aloy, Máximo Vento Torres
BACKGROUND: Advances in perinatal care can influence morbidity and mortality in newborns at the limit of viability. Knowledge of these changes over time may help improve clinical decision making, optimize resource allocation and increase quality of care. OBJECTIVES: To evaluate the influence on morbidity and mortality of changes introduced in the perinatal care of preterm infants (22-26 weeks' gestational age, GA) in Spain between two consecutive periods (2002-2006 and 2007-2011)...
2015: Neonatology
Ulrika Adén
No abstract text is available yet for this article.
October 2014: Acta Paediatrica
Bai-Horng Su, Wu-Shiun Hsieh, Chyong-Hsin Hsu, Jui-Hsing Chang, Reyin Lien, Chyi-Her Lin
BACKGROUND: This study compared the current trend in survival rates and morbidity for very low birth weight (VLBW) infants in five Medical Training Centers of Prematurity for the Premature Baby Foundation of Taiwan (PBFT), with the outcomes from the USA, National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN), the Canadian Neonatal Network (CNN), and the Neonatal Research Network of Japan (NRNJ). METHODS: The survival rates of VLBW infants according to gestational age (GA) and major morbidities were compared between networks (Taiwan, USA, Canada, and Japan)...
February 2015: Pediatrics and Neonatology
Ann Hellström, Lois E H Smith, Olaf Dammann
The immature retinas of preterm neonates are susceptible to insults that disrupt neurovascular growth, leading to retinopathy of prematurity. Suppression of growth factors due to hyperoxia and loss of the maternal-fetal interaction result in an arrest of retinal vascularisation (phase 1). Subsequently, the increasingly metabolically active, yet poorly vascularised, retina becomes hypoxic, stimulating growth factor-induced vasoproliferation (phase 2), which can cause retinal detachment. In very premature infants, controlled oxygen administration reduces but does not eliminate retinopathy of prematurity...
October 26, 2013: Lancet
Annie Janvier, John Lantos
When parents voice their dissatisfaction with the neonatal intensive care unit (NICU), it is often not because they think their baby has not received good medical care. Instead, it is often because their needs have not been addressed. Policy statements and pedagogy alike urge professionals to be empathetic, compassionate, honest, and caring. However, these theoretical concepts are generally endorsed without practical suggestions on how to achieve these goals. Negative encounters for parents are generally not about the caregivers' technical expertise or knowledge and often reflect a failure in a different domain...
September 2014: JAMA Pediatrics
Anne-Marie Gibson, Lex W Doyle
Extremely low birth weight (<1000 g birth weight) or extremely preterm (<28 weeks of gestation) infants are surviving in greater numbers as neonatal care advances. Many of these survivors, especially those who develop bronchopulmonary dysplasia, have more respiratory ill health in the first years after discharge home, reduced respiratory function and impaired exercise capacity throughout childhood and into adulthood compared with term-born controls. It is important to establish the long-term respiratory outcomes for the tiniest or most immature survivors as they grow older, since they may contribute disproportionately to rates of chronic obstructive pulmonary disease and respiratory ill-health in adulthood...
April 2014: Seminars in Fetal & Neonatal Medicine
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