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https://www.readbyqxmd.com/read/27603532/mesenchymal-stromal-cell-based-therapies-for-chronic-lung-disease-of-prematurity
#1
Lannae Strueby, Bernard Thébaud
Advances in perinatal care allow the survival of ever more premature infants. By approaching the biological limit of viability, survival free of injury becomes more challenging. As a consequence, bronchopulmonary dysplasia (BPD), the chronic lung disease of prematurity, remains one of the main complications in infants born before 28 weeks' gestation. Currently, there is no treatment for BPD. Recent progress in understanding the biology of stem cells has opened unprecedented therapeutic options to mitigate lung injury and promote lung growth...
September 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27576106/total-parenteral-nutrition-for-the-very-low-birth-weight-infant
#2
Pinkal Patel, Jatinder Bhatia
Preterm infants, especially very low birth weight (VLBW; <1500 g) and extremely low birth weight (ELBW; <1000 g) infants, are susceptible to growth failure in postnatal life if nutritional demands are not met. Poor postnatal growth in preterm infants is associated with adverse neurodevelopmental outcomes during childhood. Early parental nutrition is of paramount importance to provide appropriate protein and energy in VLBW infants when enteral nutrition is not feasible or is suboptimal. An "early and aggressive" approach of parenteral nutrition in preterm infants has been shown to prevent protein catabolism, induce positive nitrogen balance and improve postnatal growth...
August 26, 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/15995025/the-incidence-and-course-of-retinopathy-of-prematurity-findings-from-the-early-treatment-for-retinopathy-of-prematurity-study
#3
William V Good, Robert J Hardy, Velma Dobson, Earl A Palmer, Dale L Phelps, Michelle Quintos, Betty Tung
OBJECTIVES: To estimate the incidence of retinopathy of prematurity (ROP) in the Early Treatment for Retinopathy of Prematurity (ETROP) Study and compare these results with those reported in the Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) Study. METHODS: The ETROP Study, as part of its protocol, screened 6998 infants at 26 centers throughout the United States. Serial eye examinations were conducted for infants born weighing <1251 g, making it possible to estimate the frequency of ROP in different birth weight and gestational age categories...
July 2005: Pediatrics
https://www.readbyqxmd.com/read/15767472/15-year-outcomes-following-threshold-retinopathy-of-prematurity-final-results-from-the-multicenter-trial-of-cryotherapy-for-retinopathy-of-prematurity
#4
RANDOMIZED CONTROLLED TRIAL
Earl A Palmer, Robert J Hardy, Velma Dobson, Dale L Phelps, Graham E Quinn, C Gail Summers, Carol P Krom, Betty Tung
OBJECTIVE: To report the ocular structure and visual acuity outcomes at age 15 years, and the incidence of retinal detachment between 10 and 15 years of age, for patients in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (CRYO-ROP). METHODS: Subjects were 254 survivors from 291 preterm children with birth weights less than 1251 g and severe (threshold) retinopathy of prematurity (ROP) in one or both eyes, who participated in the CRYO-ROP trial...
March 2005: Archives of Ophthalmology
https://www.readbyqxmd.com/read/27142842/oral-dextrose-gel-for-the-treatment-of-hypoglycaemia-in-newborn-infants
#5
REVIEW
Philip J Weston, Deborah L Harris, Malcolm Battin, Julie Brown, Joanne E Hegarty, Jane E Harding
BACKGROUND: Neonatal hypoglycaemia, a common condition, can be associated with brain injury. It is frequently managed by providing infants with an alternative source of glucose, given enterally with formula or intravenously with dextrose solution. This often requires that mother and baby are cared for in separate environments and may inhibit breast feeding. Dextrose gel is simple and inexpensive and can be administered directly to the buccal mucosa for rapid correction of hypoglycaemia, in association with continued breast feeding and maternal care...
May 4, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27797411/antibiotic-use-in-infancy-and-neurocognitive-outcomes-in-children-the-role-of-bacterial-denitrification
#6
Keith Fluegge
Slykerman et al. (1) recently investigated the role of antibiotic use in early life and later adverse neurocognitive outcomes in children. The authors utilized as their cohort 871 mothers and their children at birth from the Auckland Birthweight Collaborative Study. Data on antibiotic use during early life were collected from maternal interview, and behavioral assessments and intelligence test scores were obtained at the ages of 3.5, 7, and 11. The authors reported that those individuals treated with antibiotics experienced more behavioral difficulties and depressive symptomatology during the follow-up periods...
October 31, 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27775765/association-between-antibiotic-use-and-neonatal-mortality-and-morbidities-in-very-low-birth-weight-infants-without-culture-proven-sepsis-or-necrotizing-enterocolitis
#7
Joseph Y Ting, Anne Synnes, Ashley Roberts, Akhil Deshpandey, Kimberly Dow, Eugene W Yoon, Kyong-Soon Lee, Simon Dobson, Shoo K Lee, Prakesh S Shah
Importance: Excessive antibiotic use has been associated with altered bacterial colonization and may result in antibiotic resistance, fungemia, necrotizing enterocolitis (NEC), and mortality. Exploring the association between antibiotic exposure and neonatal outcomes other than infection-related morbidities may provide insight on the importance of rational antibiotic use, especially in the setting of culture-negative neonatal sepsis. Objective: To evaluate the trend of antibiotic use among all hospitalized very low-birth-weight (VLBW) infants across Canada and the association between antibiotic use rates (AURs) and mortality and morbidity among neonates without culture-proven sepsis or NEC...
October 24, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/19117859/reduction-in-the-incidence-of-chronic-lung-disease-in-very-low-birth-weight-infants-results-of-a-quality-improvement-process-in-a-tertiary-level-neonatal-intensive-care-unit
#8
COMPARATIVE STUDY
Howard J Birenbaum, Abby Dentry, Jane Cirelli, Sabah Helou, Maria A Pane, Karen Starr, Clifford F Melick, Linda Updegraff, Cynthia Arnold, Angela Tamayo, Virma Torres, Norma Gungon, Stephen Liverman
OBJECTIVE: Our objective was to reduce the incidence of chronic lung disease by introducing potentially better practices in our delivery room and NICU. METHODS: We compared the incidences of chronic lung disease in infants with birth weights of 501 to 1500 g in 2002 and 2005, after implementation of the changes. Medical records for infants of 501 to 1500 g who were born in 2002 and 2005 were reviewed for maternal characteristics, care of the infant in the delivery room and the NICU (including surfactant usage, duration of ventilation, duration of continuous positive airway pressure therapy, and duration of oxygen treatment), length of stay, and short-term clinical outcomes (eg, pneumothorax, severe intracranial hemorrhage, retinopathy of prematurity, and weight gain)...
January 2009: Pediatrics
https://www.readbyqxmd.com/read/27461200/eating-in-sinc-safe-individualized-nipple-feeding-competence-a-quality-improvement-project-to-explore-infant-driven-oral-feeding-for-very-premature-infants-requiring-noninvasive-respiratory-support
#9
Stacey R Dalgleish, Linda L Kostecky, Noreen Blachly
Oral feeding is a developmental task for all premature infants. often, independent nipple feeding is the last barrier to discharge home from the NICU. A relationship exists between consistent, infant-driven feeding management practices and improved feeding performance. Conversely, a random approach to feeding may contribute to poor short-term and long-term clinical outcomes. We report a quality improvement project that was undertaken across five NICUs in an urban setting. our aim was to safely initiate and advance nipple feeding for very preterm neonates (born at <32 weeks gestation) who had a respiratory morbidity requiring nasal continuous positive airway pressure therapy...
2016: Neonatal Network: NN
https://www.readbyqxmd.com/read/27391563/first-golden-hour-of-life-a-quality-improvement-initiative
#10
Tinisha M Lambeth, Mario A Rojas, Amy P Holmes, Robin B Dail
BACKGROUND: Very low birth-weight (<1500 g) infants are vulnerable to their environment during the first hour after birth. We designed an evidence-based golden hour protocol (GHP) with a goal to stabilize and perform admission procedures within 1 hour of birth at a level IIIB neonatal intensive care unit (NICU). PURPOSE: The aim of this quality improvement project was to ascertain whether an evidence-based GHP would improve care efficiency and short-term outcomes...
August 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27641975/quality-improvement-study-on-new-endotracheal-tube-securing-device-neobar-in-neonates
#11
Prakash K Loganathan, Vrinda Nair, Mike Vine, Linda Kostecky, Derek Kowal, Amuchou Soraisham
OBJECTIVES: To examine the rate of unplanned extubation (UE) after the introduction of NeoBar (endotracheal tube stabilization device) compared to the previous tapping method and to analyze the factors associated with UE in the neonatal intensive care unit (NICU). METHODS: A quality improvement study was conducted in a tertiary NICU between October 2011 and December 2013. In October 2012, after many educational sessions NeoBar was introduced as a tool for securing endotracheal tube...
September 19, 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/24796482/improving-pain-assessment-in-the-nicu-a-quality-improvement-project
#12
Daphne A Reavey, Barbara M Haney, Linda Atchison, Betsi Anderson, Tracy Sandritter, Eugenia K Pallotto
Pain assessment documentation was inadequate because of the use of a subjective pain assessment strategy in a tertiary level IV neonatal intensive care unit (NICU). The aim of this study was to improve consistency of pain assessment documentation through implementation of a multidimensional neonatal pain and sedation assessment tool. The study was set in a 60-bed level IV NICU within an urban children's hospital. Participants included NICU staff, including registered nurses, neonatal nurse practitioners, clinical nurse specialists, pharmacists, neonatal fellows, and neonatologists...
June 2014: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/24874561/systematic-use-of-the-ram-nasal-cannula-in-the-yale-new-haven-children-s-hospital-neonatal-intensive-care-unit-a-quality-improvement-project
#13
Nneka I Nzegwu, Tim Mack, Roseann DellaVentura, Louise Dunphy, Nancy Koval, Orly Levit, Vineet Bhandari
OBJECTIVE: To evaluate the clinical efficacy of the RAM nasal cannula (NC) with different modes of non-invasive ventilation (NIV) in the neonatal intensive care unit (NICU). METHODS: A single center prospective, observational study of infants placed on RAM NC. A small trial (Study 1) was completed in 16 infants on NIV via the RAM NC over a 48-h period to create Summary Statement recommendations. Next, over a 10-month period (Study 2), data were prospectively collected for the outcome of all infants receiving respiratory support with the RAM NC...
April 2015: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/26901619/a-multidisciplinary-quality-improvement-approach-increases-breastmilk-availability-at-discharge-from-the-neonatal-intensive-care-unit-for-the-very-low-birth-weight-infant
#14
Christine Bixby, Cindy Baker-Fox, Crystal Deming, Vijay Dhar, Caroline Steele
BACKGROUND: Mothers of very-low-birth-weight (VLBW) infants often struggle to establish and maintain a milk supply. Children's Hospital of Orange County (CHOC Children's) data from 2005 to 2011 showed that while the total percentage of all neonatal intensive care unit (NICU) babies being discharged on breastmilk had remained stable, the percentage of VLBW babies with breastmilk at discharge had declined. This information resulted in a quality improvement initiative to remove barriers and implement programs shown to have the greatest impact on initiating and sustaining lactation in this patient subset...
March 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/27026025/a-quality-improvement-project-to-reduce-hypothermia-in-infants-undergoing-mri-scanning
#15
Priti G Dalal, Janelle Porath, Uma Parekh, Padmani Dhar, Ming Wang, Michael Hulse, Dennis Mujsce, Patrick M McQuillan
BACKGROUND: Hypothermia prevention strategies during MRI scanning under general anesthesia in infants may pose a challenge due to the MRI scanner's technical constraints. Previous studies have demonstrated conflicting results related to increase or decrease in post-scan temperatures in children. We noted occurrences of post-scan hypothermia in anesthetized infants despite the use of routine passive warming techniques. OBJECTIVE: The aims of our quality improvement project were (a) to identify variables associated with post-scan hypothermia in infants and (b) to develop and implement processes to reduce occurrence of hypothermia in neonatal intensive care unit (NICU) infants undergoing MRI...
July 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/20595716/using-quality-improvement-methods-to-reduce-variation-in-surfactant-administration
#16
Laurel Bookman, Rachel Troy, Martin McCaffrey, Greg Randolph
BACKGROUND: Respiratory distress syndrome and chronic lung disease are prevalent disorders in extremely low-birth-weight infants. Evidence demonstrates that timely surfactant administration improves respiratory outcomes. OBJECTIVE: To assess whether basic quality-improvement methods can reduce the time to initial surfactant dose for premature infants. DESIGN/METHODS: The study was conducted in a 48-bed neonatal intensive care unit (NICU) within a midsize academic centre...
October 2010: Quality & Safety in Health Care
https://www.readbyqxmd.com/read/26702032/slug-bug-quality-improvement-with-orchestrated-testing-leads-to-nicu-clabsi-reduction
#17
MULTICENTER STUDY
Anthony J Piazza, Beverly Brozanski, Lloyd Provost, Theresa R Grover, John Chuo, Joan R Smith, Teresa Mingrone, Susan Moran, Lorna Morelli, Isabella Zaniletti, Eugenia K Pallotto
OBJECTIVE: Reduce central line-associated bloodstream infection (CLABSI) rates 15% over 12 months in children's hospital NICUs. Use orchestrated testing as an approach to identify important CLABSI prevention practices. METHODS: Literature review, expert opinion, and benchmarking were used to develop clinical practice recommendations for central line care. Four existing CLABSI prevention strategies (tubing change technique, hub care monitoring, central venous catheter access limitation, and central venous catheter removal monitoring) were identified for study...
January 2016: Pediatrics
https://www.readbyqxmd.com/read/25262103/the-case-for-quality-improvement-in-the-neonatal-intensive-care-unit
#18
REVIEW
Peter Lachman, Anita Jayadev, Manveer Rahi
Quality improvement (QI) is now a central part of the work of clinicians throughout healthcare. It is based on clear scientific principles, a valid way of measuring change and has theories of reliability and human factors that underpin the interventions. The Neonatal Intensive Care Unit (NICU) is a highly complex adaptive system that lends itself to the application of QI principles. This will require the development of a safety culture that continually seeks to improve. Clinicians and all those who work in NICU will require training in the methodologies of QI and patient safety to effect change...
November 2014: Early Human Development
https://www.readbyqxmd.com/read/27142638/decreasing-infection-in-neonatal-intensive-care-units-through-quality-improvement
#19
J R Bowen, I Callander, R Richards, K B Lindrea
OBJECTIVE: To decrease the incidence of bloodstream infection (BSI) for neonates <29 weeks gestation through quality improvement. DESIGN: Commencing in September 2011, eight neonatal intensive care units (NICUs) in New South Wales and Australian Capital Territory, Australia participated in the Sepsis Prevention in NICUs Group project, a multicentre quality improvement initiative to reduce neonatal infection through implementation of potentially better practices and development of teaching resources...
May 2, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27539482/the-impact-of-a-sepsis-quality-improvement-project-on-neurodisability-rates-in-very-low-birthweight-infants
#20
Jonathan W Davis, David Odd, Sally Jary, Karen Luyt
OBJECTIVE: Very low birthweight (VLBW; <1500 g) infants with late-onset sepsis (LOS) have an increased risk of neurodisability. Care bundles to reduce bloodstream infections in neonatal intensive care unit (NICU) are effective in reducing LOS. Our aim was to determine if a sepsis reduction bundle introduced through a quality improvement project would impact neurodevelopmental outcomes in VLBW infants. DESIGN: Cohort study. SETTING: Level 3 regional NICU in the South West of England...
August 18, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
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