Family integrated care in single family rooms for preterm infants and late-onset sepsis: a retrospective study and mediation analysis

2020 ◽  
Vol 88 (4) ◽  
pp. 593-600 ◽  
Author(s):  
Nicole R. van Veenendaal ◽  
Sophie R. D. van der Schoor ◽  
Wieke H. Heideman ◽  
Judith J. M. Rijnhart ◽  
Martijn W. Heymans ◽  
...  
2021 ◽  
Vol 9 ◽  
Author(s):  
Mengyang Yang ◽  
Juan Du ◽  
Qin Yang ◽  
Wenyan Dou ◽  
Min Jiang ◽  
...  

The aim of this study was to investigate the influence of family integrated care (FICare) on the intestinal microbiome of preterm infants with necrotizing enterocolitis and enterostomy. This was a prospective pilot study at Beijing Children's Hospital. Premature infants with an enterostomy who met the enrollment criteria were divided into the 2-week FICare and non-FICare groups (non-randomly). We collected their fecal samples and subjected the intestinal microbiomes to 16S rRNA gene sequencing. Operational taxonomic units (OTU) were analyzed to assess the intestinal microbiome richness, and we then carried out α-diversity, β-diversity, and species clustering analyses and a linear discriminant analysis (LDA) effect size (LEfSe) analysis to identify the differences in the microbial communities between the two groups. There were 12 patients enrolled in the study (FICare, n = 7; non-FICare, n = 5). There were no significant between-group differences in demographic characteristics, or in the relative abundances of phyla and genera. The major bacterial phyla were Proteobacteria, Firmicutes, and Actinobacteria, and Serratia, Enterococcus, Cronobacter, and Bifidobacterium dominated at the genus level. The α-diversity analysis indicated that the intestinal flora was more diverse in the non-FICare group than the FICare group (p < 0.05). However, most of the other indicators did not suggest a difference between the two groups. There was a high proportion of shared OTUs between the two groups, and the PCoA and clustering analyses indicated that the two groups were difficult to distinguish, indicating that the intestinal microbiomes were relatively similar between the groups. In summary, short-term FICare had no significant positive effect on the establishment of intestinal flora diversity in premature infants with necrotizing enterocolitis and enterostomy. The trial was registered in the Chinese Clinical Trial Registry (ChiCTR-OPN-17011801).


2020 ◽  
Vol 32 (2) ◽  
pp. 149-165
Author(s):  
Linda S. Franck ◽  
Chandra Waddington ◽  
Karel O’Brien

2021 ◽  
Author(s):  
Rebecca Anne Carman ◽  
Claire Adams ◽  
Mary Sharp ◽  
Daniel McAullay ◽  
Rhonda Marriott ◽  
...  

Abstract BackgroundThe premature birth of an infant coupled with admission to a Neonatal Intensive Care Unit (NICU) can pose complex psychosocial challenges to parents and the family unit. Measures designed to counteract the effects of restricted visitation and prolonged separation from the infant within the NICU setting have led to the development of the Family Integrated Care model; emphasis in this program is placed on the active participation of the parent alongside the healthcare team in providing direct care to the preterm infant. The aim of this systematic review is to explore the perceptions and experiences of parents and families of preterm infants who have used a Family Integrated Care program during hospitalisation in a NICU. MethodsA systematic literature search will be performed on six electronic databases (Medline, CINAHL, Embase, PsycINFO, Web of Science, and Scopus) to identify relevant articles which meet the a priori inclusion criteria. A hand-search of the reference lists of all articles taken to full text review will supplement the search. The search will be limited to peer-reviewed, primary research articles written in English only; nil publication date restrictions will be applied. Two independent reviewers will screen all retrieved articles, perform the full-text review, critically appraise the included articles, and extract the data. Where consensus cannot be reached, a third reviewer will be consulted. To assess the quality of included studies and the risk of bias, the Critical Appraisal Skills Programme checklist will be used. Data will be extracted using a data extraction tool developed by the review team and piloted for use by two independent reviewers. A thematic analysis and narrative synthesis of the review findings will follow. DiscussionThis review will importantly describe the experiences of parents and families of preterm infants using a Family Integrated Care program delivered within a NICU; review findings will be used to inform the associated program protocols in a Perth (Western Australia) based NICU and be disseminated via a peer-reviewed publication. Systematic review registration: PROSPERO, Submission ID: 243818.


Author(s):  
M.R. Alturk ◽  
H. Salama ◽  
H. Al Rifai ◽  
M. Al Qubaisi ◽  
S. Alobaidly

BACKGROUND: Early empiric antibiotic exposure appears to negatively influence feeding tolerance in preterm infants. However, the effect of prolonged antibiotic treatment is unknown. The objective of this study was to investigate whether prolonged antibiotics impact the time to full enteral feed in infants less than 29 weeks of gestational age with negative blood cultures. METHODS: Retrospective data for infants less than 29 weeks gestation age were retrieved from the PEARL-Peristat perinatal registry in Qatar. Exclusion criteria were major congenital anomalies, conditions requiring surgery in the first 10 days of life, positive blood cultures in the first 48 hours of life, and death within the first week of life. Antibiotic courses were categorized as prolonged if continued more than 48 hours. The primary outcome was the duration of total parenteral nutrition. RESULTS: Of 199 study infants, 185 (92.9%) underwent antibiotic treatment for >  48 hours despite negative blood cultures. The median duration of parenteral nutrition was not significantly different between the prolonged and short antibiotic groups (25 and 22 days, respectively; p = 0.139). Infants with prolonged antibiotic courses experienced non-significantly higher levels of necrotizing enterocolitis (7.1% and 18.4%, respectively), bronchopulmonary dysplasia (28.6% and 45.4%, respectively), and retinopathy of prematurity (14.3% and 38.4%, respectively). There were no differences in the late-onset sepsis rate (78.6% and 82.1%, respectively) and the in-hospital death rate (7.1% and 7.6%, respectively). CONCLUSIONS: Prolonged antibiotic treatment in infants less than 29 weeks gestation with negative blood cultures has no significant impact on the time to full enteral feed.


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