Parental needs in a neonatal intensive care follow-up clinic

1984 ◽  
Vol 7 ◽  
pp. 122
Author(s):  
Victor Fornari ◽  
Miriam Sherman ◽  
Evelyn Lipper
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care

scholarly journals Patent ductus arteriosus in preterm infants; experience of a tertiary referral neonatal intensive care unit: prevalence, complications, and management

2020 ◽  
Vol 68 (1) ◽  
Author(s):  
Reem M. Soliman ◽  
Fatma Alzahraah Mostafa ◽  
Antoine Abdelmassih ◽  
Elham Sultan ◽  
Dalia Mosallam
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Side Effects ◽  
Patent Ductus Arteriosus ◽  
Neonatal Intensive Care Unit ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Ductus Arteriosus ◽  
Patent Ductus

Abstract Background Patent ductus arteriosus poses diagnostic and therapeutic dilemma for clinicians, diagnosis of persistent PDA, and determination of its clinical and hemodynamic significance are challenging. The aim of this study is to determine the prevalence of PDA in preterm infants admitted to our NICU, to report cardiac and respiratory complications of PDA, and to study the management strategies and their subsequent outcomes. Result Echocardiography was done for 152 preterm babies admitted to neonatal intensive care unit (NICU) on day 3 of life. Eighty-seven (57.2%) preterms had PDA; 54 (62.1%) non-hemodynamically significant PDA (non-hsPDA), and 33 (37.9%) hemodynamically significant PDA. Hemodynamically significant PDA received medical treatment (paracetamol 15 mg/kg/6 h IV for 3 days). Follow-up echocadiography was done on day 7 of life. Four babies died before echo was done on day 7. Twenty babies (68.9%) achieved closure after 1st paracetamol course. Nine babies received 2nd course paracetamol. Follow-up echo done on day 11 of life showed 4 (13.7%) babies achieved successful medical closure after 2nd paracetamol course; 5 babies failed closure and were assigned for surgical ligation. The group of non-hsPDA showed spontaneous closure after conservative treatment. Pulmonary hemorrhage was significantly higher in hsPDA group. Mortality was higher in hsPDA group than non-hsPDA group. Conclusion Echocardiographic evaluation should be done for all preterms suspected clinically of having PDA. We should not expose vulnerable population of preterm infants to medication with known side effects unnecessarily; we should limit medical closure of PDA to hsPDA. Paracetamol offers several important therapeutic advantages options being well tolerated and having more favorable side effects profile.

Family-Centered Care

PEDIATRICS ◽  
1994 ◽  
Vol 93 (6) ◽  
pp. 1023-1024
Author(s):  
Robert D. Cunningham
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
State Government ◽  
Neonatal Intensive Care ◽  
Developmental Outcomes ◽  
Third Parties ◽  
Adverse Impact ◽  
Centered Care ◽  
Family Centered

I read "The Principles for Family-Centered Neonatal Care" with great interest. As a physician who has worked in a state government-operated neonatal intensive care unit follow-up clinic, I agree wholeheartedly with the principle of open and honest communication between parents and professionals, especially regarding poor developmental outcomes. Unfortunately, physicians, despite their own feelings about this issue, may come under pressure from third parties to withhold certain information from families. In my own experiences, I have been drawn aside in private conversations and told that if I continue to tell parents that their child is mentally retarded or has cerebral palsy, it might have an adverse impact on my career.

scholarly journals Cause and Predictors of Neonatal Mortality among Neonates Admitted to the Neonatal Intensive Care Units of Public Hospitals in Eastern Ethiopia: Facilities Based Prospective Follow-up Study

2020 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Causes Of Death ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia

Abstract Background The first month is the most crucial period for child survival. Neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa including Ethiopia. This region shows the least progress to reducing neonatal mortality and it continues to be a significant public health issue. The facilities-based causes and predictors of neonatal death in the neonatal intensive care unit are not well documented in this study setting. Hence, the aim of this study was to determine the causes and predictors of neonatal mortality among infants admitted to the neonatal intensive care units in Eastern Ethiopia. Methods Facilities-based prospective follow-up study was conducted among neonates admitted to the neonatal intensive care units of public hospitals in Eastern Ethiopia from November to December 2018. Data were collected using a pre-tested, structured questionnaire and a follow-up checklist. The main outcomes and causes of death were set by pediatricians and medical residents. Epi-Data 3.1 and Statistical Package for Social Sciences Version 25 software were used for data entry and analysis respectively. Multivariable logistic regression was used to find out the predictors of facilities-based neonatal mortality. Results The proportion of facilities-based neonatal mortality was 20%(95% CI: 16.7-23.8%) The causes of death were complications of preterm birth 28.58%, birth asphyxia 22.45%, infection 18.36%, meconium aspiration syndrome 9.18%, respiratory distress syndrome 7.14% and congenital malformation 4.08%. Low birth weight, preterm births, length of stay in NICU, low 5 minute Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals, Eastern Ethiopia. Conclusion The proportion of facilities-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving timing and quality of ANC is essential for early detection, anticipating high-risk newborns and timely interventions. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could lead to a reduction of neonatal death in this setting.

Development of a NeuroNICU with a Broader Focus on All Newborns at Risk of Brain Injury: The First 2 Years

2018 ◽  
Vol 35 (12) ◽  
pp. 1197-1205 ◽  
Author(s):  
Elisabeth Yan ◽  
Kathi Randall ◽  
Valerie Chock ◽  
Alexis Davis ◽  
Cecelia Glennon ◽  
...  
Keyword(s):  
At Risk ◽  
Intensive Care ◽  
Brain Injury ◽  
Neonatal Intensive Care ◽  
Near Infrared ◽  
Neurologic Injury ◽  
Medical Diagnoses ◽  
Critically Ill Neonates ◽  
Video Eeg

Objective Many critically ill neonates have an existing brain injury or are at risk of neurologic injury. We developed a “NeuroNICU” (neurologic neonatal intensive care unit) to better provide neurologically focused intensive care. Study Design Demographic and clinical variables, services delivered, and patient outcomes were recorded in a prospective database for all neonates admitted to the NeuroNICU between April 23, 2013, and June 25, 2015. Results In total, 546 neonates were admitted to the NeuroNICU representing 32% of all NICU admissions. The most common admission diagnoses were congenital heart disease (30%), extreme prematurity (18%), seizures (10%), and hypoxic–ischemic encephalopathy (9%). Neuromonitoring was common, with near-infrared spectroscopy used in 69%, amplitude-integrated electroencephalography (EEG) in 45%, and continuous video EEG in 35%. Overall, 43% received neurology or neurosurgery consultation. Death prior to hospital discharge occurred in 11%. Among survivors, 87% were referred for developmental follow-up, and among those with a primary neurologic diagnosis 57% were referred for neurology or neurosurgical follow-up. Conclusion The NeuroNICU-admitted newborns with or at risk of brain injury comprise a high percentage of NICU volume; 38% had primary neurologic diagnoses, whereas 62% had medical diagnoses. We found many opportunities to provide brain focused intensive care, impacting a substantial proportion of newborns in our NICU.

scholarly journals Maternal experiences with specificities of prematurity that hinder breastfeeding

2015 ◽  
Vol 24 (1) ◽  
pp. 55-63 ◽  
Author(s):  
Luciana Barbosa Pereira ◽  
Ana Cristina Freitas de Vilhena Abrão ◽  
Conceição Vieira da Silva Ohara ◽  
Circéa Amália Ribeiro
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Qualitative Study ◽  
Neonatal Intensive Care Unit ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Clinical Instability ◽  
Mothers Of Preterm Infants ◽  
Late Start

A qualitative study which has Symbolic Interactionism as theoretical framework and Interpretative Interactionism as its methodological one, aiming to unveil motherly experiences against prematurity peculiarities that hinder breastfeeding during infant's hospitalization at the Neonatal Intensive Care Unit. Were interviewed 13 mothers of preterm infants assisted at an Outpatient Follow-up Clinic of Montes Claros MG, Brazil. Results show that as trying to breastfeed a premature infant, the mother interacts with situations signified by her as obstacles to breastfeeding: the "torment" of their child's hospitalization and clinical instability, the fear of baby's death, its difficulty to suck, the late start of breastfeeding interpreted a something difficult, as a risk to weight. We consider that although breastfeeding a preterm infant is a challenge, appropriate professional conducts and hospital procedures might facilitate it and therefore should be implemented, aiming at promoting, protecting and supporting breastfeeding.

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