NIRS improves hemodynamic monitoring and detection of risk for cerebral injury: cases in the neonatal intensive care nursery

2018 ◽  
Vol 33 (10) ◽  
pp. 1802-1810 ◽  
Author(s):  
Valerie Y. Chock ◽  
Gabriel F. T. Variane ◽  
Alexandre Netto ◽  
Krisa P. Van Meurs
Keyword(s):  
Intensive Care ◽  
Hemodynamic Monitoring ◽  
Neonatal Intensive Care ◽  
Cerebral Injury ◽  
Intensive Care Nursery

Individualized Developmental Care in the Neonatal Intensive Care Nursery

2008 ◽  
Vol 17 (3) ◽  
pp. 84-93
Author(s):  
Kathleen A. VandenBerg ◽  
Erin Sundseth Ross
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Advanced Practice ◽  
Developmental Care ◽  
Medical Interventions ◽  
Speech Language Pathologist ◽  
Developmentally Supportive Care ◽  
Intensive Care Nursery ◽  
Infant Brain Development

Abstract Advances in medical care have improved the success of medical interventions in treating high-risk and premature infants, but long-term developmental outcomes are less positive. The neonatal intensive care unit (NICU) setting influences infant brain development and organization, as well as the parent-infant relationship. One advanced-practice role for a speech-language pathologist (SLP) is that of a newborn developmental specialist (NDS). The NDS working in the NICU understands the influence of medical, environmental, and caregiving interactions on the neurologic and neurobehavioral organization of the infant. The NICU setting advanced practice skills are grounded in an individualized, developmentally supportive care model, such as the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Neurodevelopmental assessment focuses on the competence of the infant. The developmental assessment and intervention strategies are individualized to support the infant's own goal strivings. In this framework, interactions with infants become modified to increase competence and organization. The SLP working in the NICU is in a unique position to facilitate communication between the infant and the parent, as well as between the infant and professional caregivers. The SLP can help the parent interpret and respond appropriately to the infant's communication by focusing on non-verbal stress and stability cues, and by planning all interactions with a goal of co-regulation. Interactions with infants and families in this Model in the NICU have beneficial lifelong implications.

Endocrinology of labour

1991 ◽  
Vol 3 (1) ◽  
pp. 47-66 ◽  
Author(s):  
John RG Challis ◽  
Simon C Riley ◽  
Kaiping Yang
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Management Strategy ◽  
Neonatal Intensive Care ◽  
Preterm Labour ◽  
Tertiary Care ◽  
Contributory Factor ◽  
Mortality And Morbidity ◽  
Intensive Care Nursery ◽  
The Cost

Preterm labour, defined as delivery before 37 weeks of completed pregnancy, continues to present a major problem in clinical obstetrics and remains the major contributory factor to the perinatal mortality and morbidity statistics. While it is now possible, with recent advances in neonatal care, to take infants delivered very prematurely and provide them with the lifelines that will ensure their ultimate discharge from the neonatal intensive care nursery, the cost of this form of management – in terms both of health care funds and of emotion – is extraordinarily high. Hence there remains a strong rationale for attempting to understand the underlying biochemistry and physiology of labour in order to develop methods of recognizing the patient in true preterm labour, and of developing better strategies to prevent or to manage this condition. In the best of our neonatal intensive care settings, survival of the infant born at 28–30 weeks’ gestation, or greater than 1500 grams, may be greater than 90%. Thus, the clinical management strategy may be directed more towards sustaining intrauterine life for 4–6 weeks in those patients presenting in preterm labour before this time in order to gain time for intrauterine maturation of these fetuses before they are delivered to the tertiary care NICU setting.

Outcomes of Developmental Care in an Australian Neonatal Intensive Care Nursery

2003 ◽  
Vol 22 (6) ◽  
pp. 17-23 ◽  
Author(s):  
Michele Prentice ◽  
Colleen Stainton
Keyword(s):  
Intensive Care ◽  
Parenteral Nutrition ◽  
Neonatal Intensive Care ◽  
Exogenous Surfactant ◽  
Feeding Intolerance ◽  
Care Model ◽  
Chart Audit ◽  
Developmental Care ◽  
Intensive Care Nursery ◽  
Care Outcomes

Objective: To evaluate the outcomes of implementation of a developmental care model in an Australian tertiary NICU.Study Design: A retrospective chart audit was used to determine the differences between predevelopmental and developmental care outcomes for infants, parents, the unit, and nursing.Sample: Two subsets of infants were selected for comparison: one of infants receiving predevelopmental care (n = 42) and another of infants receiving developmental care (n = 42).Results: Infants receiving developmental care required less time on total parenteral nutrition, required less exogenous surfactant, and had less documented feeding intolerance. Changes were observed in ambience and in the use of space for providing parent-infant care. Also observed was the individualized expertise of nursing staff and of parents.

scholarly journals Recommendations for hemodynamic Monitoring for Critically Ill Children – Expert Consensus Statement issued by the Cardiovascular Dynamics Section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

2020 ◽  
Author(s):  
Yogen Singh ◽  
Javier Urbano Villaescusa ◽  
Eduardo M. da Cruz ◽  
Shane M Tibby ◽  
Gabriella Bottari ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Hemodynamic Monitoring ◽  
European Society ◽  
Neonatal Intensive Care ◽  
Expert Consensus ◽  
Critically Ill Children ◽  
Evidence Based ◽  
Cardiovascular Dynamics ◽  
Hemodynamic Assessment

Abstract Background: Cardiovascular instability is common in critically-ill children. There is scarcity of published high-quality studies to develop meaningful evidence-based hemodynamic monitoring guidelines and hence, with the exception of management of shock, currently there are no published guidelines for hemodynamic monitoring in children. The European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Cardiovascular Dynamics section aimed to provide expert consensus recommendations on hemodynamic monitoring in critically ill children.Methods: Creation of a panel of experts in cardiovascular hemodynamic assessment and hemodynamic monitoring and review of relevant literature - a literature search was performed, and recommendations were developed through discussions managed following a Quaker-based consensus technique and evaluating appropriateness using a modified blind RAND/UCLA voting method. The AGREE statement was followed to prepare this document.Results: Of 100 suggested recommendations across 12 subgroups concerning hemodynamic monitoring in critically ill children, 72 reached “strong agreement”, 20 “weak agreement” and 2 had “no agreement”. Six statements were considered as redundant after rephrasing of statements following first round of voting. The agreed 72 recommendations were then coalesced into 36 detailing four key areas of hemodynamic monitoring in the main manuscript. Due to lack of published evidence to develop evidence-based guidelines, most of the recommendations are based upon expert consensus.Conclusions: These expert consensus-based recommendation may be used to guide clinical practice for hemodynamic monitoring in critically-ill children and they may serve as a basis for highlighting gaps in the knowledge base to guide further research in hemodynamic monitoring.

scholarly journals Organization and management of nursing services in NICU, levels of transport

2022 ◽  
Vol 4 (4) ◽  
pp. 151-153
Author(s):  
Onaisa Aalia Mushtaq ◽  
Javaid Ahmad Mir ◽  
Bushra Mushtaq
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Nursing Care ◽  
Neonatal Intensive Care ◽  
Life Support ◽  
Respiratory Support ◽  
Organization And Management ◽  
Nursing Services ◽  
Intensive Care Nursery ◽  
Critically Ill Neonates

Neonatal Intensive Care is defined as, “care for medically unstable and critically ill newborns requiring constant nursing, complicated surgical procedures, continual respiratory support, or other intensive interventions.” A NICU is a unit that provides high quality skilled care to critically ill neonates by offering facilities for continuous clinical, biochemical and radio logical monitoring and use of life support systems with the aim of improving survival of these babies. Intermediate care includes care of ill infants requiring less constant nursing care, but does not exclude respiratory support. Care of ill infants requiring less constant nursing care, but does not exclude respiratory support. When an intensive care nursery is available, the intermediate nursery serves as a “step down unit” from the intensive care area.

scholarly journals Recommendations for hemodynamic monitoring for critically ill children—expert consensus statement issued by the cardiovascular dynamics section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Yogen Singh ◽  
Javier Urbano Villaescusa ◽  
Eduardo M. da Cruz ◽  
Shane M. Tibby ◽  
Gabriella Bottari ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Hemodynamic Monitoring ◽  
European Society ◽  
Neonatal Intensive Care ◽  
Expert Consensus ◽  
Critically Ill Children ◽  
Evidence Based ◽  
Cardiovascular Dynamics ◽  
Hemodynamic Assessment

Abstract Background Cardiovascular instability is common in critically ill children. There is a scarcity of published high-quality studies to develop meaningful evidence-based hemodynamic monitoring guidelines and hence, with the exception of management of shock, currently there are no published guidelines for hemodynamic monitoring in children. The European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Cardiovascular Dynamics section aimed to provide expert consensus recommendations on hemodynamic monitoring in critically ill children. Methods Creation of a panel of experts in cardiovascular hemodynamic assessment and hemodynamic monitoring and review of relevant literature—a literature search was performed, and recommendations were developed through discussions managed following a Quaker-based consensus technique and evaluating appropriateness using a modified blind RAND/UCLA voting method. The AGREE statement was followed to prepare this document. Results Of 100 suggested recommendations across 12 subgroups concerning hemodynamic monitoring in critically ill children, 72 reached “strong agreement,” 20 “weak agreement,” and 2 had “no agreement.” Six statements were considered as redundant after rephrasing of statements following the first round of voting. The agreed 72 recommendations were then coalesced into 36 detailing four key areas of hemodynamic monitoring in the main manuscript. Due to a lack of published evidence to develop evidence-based guidelines, most of the recommendations are based upon expert consensus. Conclusions These expert consensus-based recommendations may be used to guide clinical practice for hemodynamic monitoring in critically ill children, and they may serve as a basis for highlighting gaps in the knowledge base to guide further research in hemodynamic monitoring.

Parent Dissatisfaction With Neonatal Intensive Care Unit Care and Suggestions for Improvements

PEDIATRICS ◽  
1993 ◽  
Vol 92 (5) ◽  
pp. 724-724
Author(s):  
JEROLD F. LUCEY
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Social Workers ◽  
Neonatal Intensive Care ◽  
Present Situation ◽  
Intensive Care Unit Care ◽  
Special Group ◽  
Intensive Care Nursery ◽  
Family Centered

The article, "The Principles for Family-Centered Neonatal Care," in this issue is unique. I believe it is the first article we've published that is authored by a group of parents. This special group of parents whose infants were cared for in intensive care nurseries was selected because of their previous attempts in the lay literature to communicate with the medical establishment through newspapers, association newsletters, books, or television interviews. They are unhappy with the present situation, and they want to see change. Ross Laboratories sponsored a 2-day meeting of some of these parents with a small group of neonatologists. pediatricians, social workers, and intensive care nursery nurses.

Newborn Risk Factors and Costs of Neonatal Intensive Care

PEDIATRICS ◽  
1981 ◽  
Vol 68 (3) ◽  
pp. 313-321 ◽  
Author(s):  
Ciaran S. Phibbs ◽  
Ronald L. Williams ◽  
Roderic H. Phibbs
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Average Cost ◽  
Neonatal Intensive Care ◽  
Medical Information ◽  
Surgical Intervention ◽  
Assisted Ventilation ◽  
Skewed Distribution ◽  
Intensive Care Nursery ◽  
Measures Of Risk

To understand the sources of the high costs of neonatal intensive care, financial and medical information on 1,185 admissions to an intensive care nursery was gathered. Multiple regression analysis showed that a significant portion of the variation in individual costs was explained by three measures of risk: low birth weight, surgical intervention, and assisted ventilation. There was a highly skewed distribution of costs. Nearly half of all admissions had none of the above risk factors, had an average cost of about $2,000, and accounted for only 13% of the total costs for the whole sample. In contrast, less than one quarter of the admissions had two or more of the risk factors, had an average cost of $19,800, and accounted for nearly 60% of the total costs. Models that predict costs and length of stay on a basis of seven risk factors were developed to allow for differences in patient populations.

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