Venous Thromboembolism in Premature Neonates

Author(s):  
Prem Fort ◽  
Kisha Beg ◽  
Marisol Betensky ◽  
Amy Kiskaddon ◽  
Neil A. Goldenberg

AbstractWhile the incidence of venous thromboembolism (VTE) is lower among children than adults, the newborn period is one of two bimodal peaks (along with adolescence) in VTE incidence in the pediatric population. Most VTE cases in neonates occur among critically ill neonates being managed in the neonatal intensive care unit, and most of these children are born premature. For this reason, the presentation, diagnosis, management, and outcomes of VTE among children born premature deserve special emphasis by pediatric hematologists, neonatologists, pharmacists, and other pediatric health care providers, as well as by the scientific community, and are described in this review.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Khushboo Qaim Ali ◽  
Sajid Bashir Soofi ◽  
Ali Shabbir Hussain ◽  
Uzair Ansari ◽  
Shaun Morris ◽  
...  

Abstract Background Simulators are an extensively utilized teaching tool in clinical settings. Simulation enables learners to practice and improve their skills in a safe and controlled environment before using these skills on patients. We evaluated the effect of a training session utilizing a novel intubation ultrasound simulator on the accuracy of provider detection of tracheal versus esophageal neonatal endotracheal tube (ETT) placement using point-of-care ultrasound (POCUS). We also investigated whether the time to POCUS image interpretation decreased with repeated simulator attempts. Methods Sixty neonatal health care providers participated in a three-hour simulator-based training session in the neonatal intensive care unit (NICU) of Aga Khan University Hospital (AKUH), Karachi, Pakistan. Participants included neonatologists, neonatal fellows, pediatric residents and senior nursing staff. The training utilized a novel low-cost simulator made with gelatin, water and psyllium fiber. Training consisted of a didactic session, practice with the simulator, and practice with intubated NICU patients. At the end of training, participants underwent an objective structured assessment of technical skills (OSATS) and ten rounds of simulator-based testing of their ability to use POCUS to differentiate between simulated tracheal and esophageal intubations. Results The majority of the participants in the training had an average of 7.0 years (SD 4.9) of clinical experience. After controlling for gender, profession, years of practice and POCUS knowledge, linear mixed model and mixed effects logistic regression demonstrated marginal improvement in POCUS interpretation over repeated simulator testing. The mean time-to-interpretation decreased from 24.7 (SD 20.3) seconds for test 1 to 10.1 (SD 4.5) seconds for Test 10, p < 0.001. There was an average reduction of 1.3 s (β = − 1.3; 95% CI: − 1.66 to − 1.0) in time-to-interpretation with repeated simulator testing after adjusting for the covariates listed above. Conclusion We found a three-hour simulator-based training session had a significant impact on technical skills and performance of neonatal health care providers in identification of ETT position using POCUS. Further research is needed to examine whether these skills are transferable to intubated newborns in various health settings. Trial registration ClinicalTrials.gov Identifier: NCT03533218. Registered May 2018.


2000 ◽  
Vol 19 (3) ◽  
pp. 13-21 ◽  
Author(s):  
Diane Holditch-Davis ◽  
Margaret Shandor Miles

The purpose of this article is to let mothers tell the stories of their neonatal intensive care unit (NICU) experiences and to determine how well these experiences fit the Preterm Parental Distress Model. Interviews were conducted with 31 mothers when their infants were six months of age corrected for prematurity and were analyzed using the conceptual model as a framework. The analysis verified the presence in the data of the six major sources of stress indicated in the Preterm Parental Distress Model: (1) pre-existing and concurrent personal and family factors, (2) prenatal and perinatal experiences, (3) infant illness, treatments, and appearance in the NICU, (4) concerns about the infant’s outcomes, (5) loss of the parental role, and (6) health care providers. The study indicates that health care providers, and especially nurses, can have a major role in reducing parental distress by maintaining ongoing communication with parents and providing competent care for their infants.


2003 ◽  
Vol 22 (4) ◽  
pp. 39-45 ◽  
Author(s):  
Margo Charchuk ◽  
Christy Simpson

When a newborn is admitted to a neonatal intensive care unit the parents may experience a variety of emotions, including a heightened sense of loyalty to their child. While health care providers are working to meet the medical needs of their patients, parents need to find ways to fulfill this sense of loyalty and to express it via hope. Through sharing the experience of having a child in the NICU, I examine hope and loyalty as critical features of parents’ NICU experience, explaining why these emotions need to be acknowledged and encouraged by health care professionals.


2020 ◽  
Vol 34 (4) ◽  
pp. 196-198
Author(s):  
Pardeep Dhingra

Background: Having a newborn baby admitted in the neonatal intensive care unit (NICU) can be a stressful experience for the parents. Objectives: This study was planned to know the following: 1. The concerns of parents whose babies were admitted in NICU 2. Parental satisfaction level about the services provided 3. Assessment of parents for their understanding and knowledge at discharge Study Design: Semiqualitative interview. Participants: Parents of 100 (56 M, 44 F) neonates. Intervention: We subjected them to a semiqualitative interview on the day of discharge of their newborn infant. Questionnaire consisted of parent’s understanding regarding NICU and health care providers, their perspective about the possible cause of illness in their baby along with competence and communication skills of health care providers. Parental satisfaction about the services was assessed by the short assessment of patient satisfaction (SAPS). They were assessed for their anxiety and depression levels by hospital anxiety and depression scale (HADS). They were assessed for their knowledge about care of baby at home after discharge by patient knowledge questionnaire (PKQ). Results: Parents of 44% babies had no prior idea about NICU and why babies need to be admitted. In total, 48% mothers and 36% fathers had clinically significant anxiety levels as assessed by HADS. Many parents complained about lack of communication about their babies illness, its cause, duration of treatment, and prognosis. Both parents scored the caregivers on borderline scores on the SAPS. At discharge only 13% knew the correct dose and duration of medicines prescribed. PKQ scores varied from 5 to 20. Almost all parents emphasized the need for more space, resting place for mothers, and better communication by doctors. Conclusions: This study reveals a significant communication gap between health care providers and parents. Concerns of parents have to be addressed to have their full participation in newborn care.


2020 ◽  
Author(s):  
Haideh Heidari ◽  
Nasrin Mehrnoush ◽  
Mansoureh Karimollahi

Abstract Background: Spiritual care in line with the holistic and comprehensive care is the important need for families with children who are hospitalized in an intensive care unit. Objectives: This study aimed to explore perceptions of health care providers' regarding the spiritual care of parents with a newborn in the neonatal intensive care unit in Iran.Materials/Patients and Methods: This study was conducted using qualitative content analysis which includes open coding, creating classification, and abstraction. Eight nurses and one doctor were chosen to be interviewed by a purposeful sampling method.Results: Based on data analysis three categories of nurses' support need for spiritual care and the necessity of changes in structural conditions were identified.Conclusions: Hospital administrators must adopt measures to change the neonatal intensive care unit circumstances. Also, it is mandated that nurse managers plan training about the importance of providing spiritual care to patients and families.


2020 ◽  
Author(s):  
Endalkachew Mengesha ◽  
Desalegne Zelellw ◽  
Likawunt Asfaw ◽  
Mulugeta Tesfa ◽  
Mitiku Debela ◽  
...  

Abstract Background: Neonatal intensive care settings are important to save the lives of sick neonates; however, parents are challenged by many stressful conditions during their stay outside the rooms of intensive care units. Therefore, this study aimed to explore the lived experiences of parents in a neonatal intensive care unit at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Northwest Ethiopia. Methods: In this study, a phenomenological qualitative approach was used to explore parental experience and data were collected using in-depth interviews from purposively selected parents. In addition, a thematic approach was used to analyze the data using Open Code Software Version 4.02. Results: In this study, parents found to developed psychological problems like anxiety, stress, worry, hopelessness and state of confusion. Emotional related conditions were anger, crying, sadness, frustration, dissatisfaction, regret, disappointment, feeling bad, self-blaming, nervousness, disturbance and lack of self-control. Parents expressed that health care providers showed indiscipline, lack of commitment and not cooperative at all. Conclusion: Parents of neonates in the intensive care unit were challenged due to a shortage of money and traveling a long distance. Psychological and emotional factors were identified as major stressors of parents during their stay in the NICU. Hence, providing psycho-emotional supports, strengthening parents–healthcare providers’ interaction, and scale up neonatal intensive care unit service into the primary health care unit are recommended.


Author(s):  
Michelle Helliwell

The goal of this study was to investigate the information needs of parents in a neonatal intensive care unit environment (NICU), and to uncover any gaps in the information exchange between parents and health care providers as perceived by parents of NICU patients. Brenda Dervin's sense-making theory was employed to test the idea that health care providers (HCPs) offered information . . .


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