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Fadi G Mirza, Labib M Ghulmiyyah, Hani Tamim, Maha Makki, Dima Jeha, Anwar Nassar
OBJECTIVE: The human placenta is known to calcify with advancing gestational age, and, in fact, the presence of significant calcifications is one of the components of grade III placenta, typical of late gestation. As such, the presence of significant placental calcifications often prompts obstetric providers to expedite delivery. This practice has been attributed, in part, to the presumed association between grade III placenta and adverse pregnancy outcomes. Such approach, however, can be the source of major anxiety and may lead to unnecessary induction of labor, with its associated predisposition to cesarean delivery as well as a myriad of maternal and neonatal morbidities...
March 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
G M Sant'Anna, Martin Keszler
Protracted mechanical ventilation is associated with increased morbidity and mortality in preterm infants and thus the earliest possible weaning from mechanical ventilation is desirable. Weaning protocols may be helpful in achieving more rapid reduction in support. There is no clear consensus regarding the level of support at which an infant is ready for extubation. An improved ability to predict when a preterm infant has a high likelihood of successful extubation is highly desirable. In this article, available evidence is reviewed and reasonable evidence-based recommendations for expeditious weaning and extubation are provided...
September 2012: Clinics in Perinatology
Abd El-Rahman El-Mashad, Heba El-Mahdy, Doaa El Amrousy, Marwa Elgendy
In this prospective study, we compared the efficacy and side effects of indomethacin, ibuprofen, and paracetamol in patent ductus arteriosus (PDA) closure in preterm neonates. Three hundred preterm neonates with hemodynamically significant PDA (hs-PDA) admitted at our neonatal intensive care unit were enrolled in the study. They were randomized into three groups. Group I (paracetamol group) received 15 mg/kg/6 h IV paracetamol infusion for 3 days. Group II (ibuprofen group) received 10 mg/kg IV ibuprofen infusion followed by 5 mg/kg/day for 2 days...
February 2017: European Journal of Pediatrics
Anna-Karin Edstedt Bonamy, Anna Gudmundsdottir, Rolf F Maier, Liis Toome, Jennifer Zeitlin, Mercedes Bonet, Alan Fenton, Asbjørn Børch Hasselager, Arno van Heijst, Ludwig Gortner, David Milligan, Patrick Van Reempts, Elaine M Boyle, Mikael Norman
BACKGROUND: Spontaneous closure of patent ductus arteriosus (PDA) occurs frequently in very preterm infants and despite the lack of evidence for treatment benefits, treatment for PDA is common in neonatal medicine. OBJECTIVES: The aim of this work was to study regional variations in PDA treatment in very preterm infants (≤31 weeks of gestation), its relation to differences in perinatal characteristics, and associations with bronchopulmonary dysplasia (BPD) and survival without major neonatal morbidity...
2017: Neonatology
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
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...
February 2017: Seminars in Fetal & Neonatal Medicine
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
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
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
Keith Fluegge
No abstract text is available yet for this article.
January 2017: Acta Paediatrica
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...
December 1, 2016: JAMA Pediatrics
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
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
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
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...
January 2017: Indian Journal of Pediatrics
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
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
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
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
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
2016-10-25 00:59:37
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