Performance of a radiometer transcutaneous oxygen monitor in a neonatal-intensive-care unit.

1980 ◽  
Vol 26 (5) ◽  
pp. 629-633 ◽  
Author(s):  
G Graham ◽  
M A Kenny

Abstract We evaluated the performance of the Radiometer TCM-1 Transcutaneous Oxygen Monitor in a Class III neonatal-intensive-care unit during an 11-month clinical trial (in excess of 4000 h) in which we monitored 115 infants ranging in gestational age from 25 to 43 weeks and in birthweight from 595 to 4220 g. In vitro transcutaneous partial pressure of oxygen (ptcO2) measurements were accurate within 1% of the theoretical value and precise (1.4% CV at 156 mmHg) at 44 degrees C. Determinations at other temperature were less accurate except in rare instances when specific patient-associated ptcO2/paO2 bias was identified. In vitro comparison of ptcO2 (y) and arterial partial pressure of oxygen (paO2) (x) measurements agreed well (y = 0.90x + 6.9, r = 0.94) except when infants were less than 24 h old. In this latter group the ptcO2/paO2 ratio usually exceeded 1.0 and fluctuated unpredictably. ptcO2 measurements on infants less than 24 h old had to be interpreted cautiously. In general, the ptcO2 and paO2 measurements agreed sufficiently well for the physicians to use them as the basis for directing patient care.

1980 ◽  
Vol 26 (5) ◽  
pp. 629-633
Author(s):  
G Graham ◽  
M A Kenny

Abstract We evaluated the performance of the Radiometer TCM-1 Transcutaneous Oxygen Monitor in a Class III neonatal-intensive-care unit during an 11-month clinical trial (in excess of 4000 h) in which we monitored 115 infants ranging in gestational age from 25 to 43 weeks and in birthweight from 595 to 4220 g. In vitro transcutaneous partial pressure of oxygen (ptcO2) measurements were accurate within 1% of the theoretical value and precise (1.4% CV at 156 mmHg) at 44 degrees C. Determinations at other temperature were less accurate except in rare instances when specific patient-associated ptcO2/paO2 bias was identified. In vitro comparison of ptcO2 (y) and arterial partial pressure of oxygen (paO2) (x) measurements agreed well (y = 0.90x + 6.9, r = 0.94) except when infants were less than 24 h old. In this latter group the ptcO2/paO2 ratio usually exceeded 1.0 and fluctuated unpredictably. ptcO2 measurements on infants less than 24 h old had to be interpreted cautiously. In general, the ptcO2 and paO2 measurements agreed sufficiently well for the physicians to use them as the basis for directing patient care.


2017 ◽  
Vol 38 (12) ◽  
pp. 1430-1434 ◽  
Author(s):  
Axel Kramer ◽  
Didier Pittet ◽  
Romana Klasinc ◽  
Stefan Krebs ◽  
Torsten Koburger ◽  
...  

BACKGROUNDFor alcohol-based hand rubs, the currently recommended application time of 30 seconds is longer than the actual time spent in clinical practice. We investigated whether a shorter application time of 15 seconds is microbiologically safe in neonatal intensive care and may positively influence compliance with the frequency of hand antisepsis actions.METHODSWe conducted in vitro experiments to determine the antimicrobial efficacy of hand rubs within 15 seconds, followed by clinical observations to assess the effect of a shortened hand antisepsis procedure under clinical conditions in a neonatal intensive care unit (NICU). An independent observer monitored the frequency of hand antisepsis actions during shifts.RESULTSAll tested hand rubs fulfilled the requirement of equal or even significantly higher efficacy within 15 seconds when compared to a reference alcohol propan-2-ol 60% (v/v) within 30 seconds. Microbiologically, reducing the application time to 15 seconds had a similar effect when compared to 30-second hand rubbing, but it resulted in significantly increased frequency of hand antisepsis actions (7.9±4.3 per hour vs 5.8±2.9 per hour; P=.05).CONCLUSIONTime pressure and workload are recognized barriers to compliance. Therefore, reducing the recommended time for hand antisepsis actions, using tested and well-evaluated hand rub formulations, may improve hand hygiene compliance in clinical practice.Infect Control Hosp Epidemiol 2017;38:1430–1434


2021 ◽  
Vol 15 (06) ◽  
pp. 870-876
Author(s):  
Yulan Yang ◽  
Weiyuan Wu ◽  
Lu Ding ◽  
Lin Yang ◽  
Jinzhen Su ◽  
...  

Introduction: Fungemia in preterm infants results in high mortality and morbidity. The genotypes, drug susceptibilities of Candida pelliculosa strains, and clinical features of two outbreaks of neonatal candidemia caused by C. pelliculosa were analyzed, in order to provide evidence for the outbreaks and characteristics of C. pelliculosa neonatal candidemia. Methodology: The strains were genotyped by pulsed-field gel electrophoresis to investigate their genetic relatedness. The broth microdilution method was used to determine in vitro susceptibility of the isolates to antifungal drugs. Clinical features of the infected patients were collected to analyze the risks for C. pelliculosa infection. Results: Fourteen neonates, hospitalized in the neonatal intensive care unit from November 2012 to October 2013, were infected by C. pelliculosa. All 14 patients were cured after treatment with fluconazole and discharged without any complications. The C. pelliculosa isolates from the 14 patients were clustered into two groups, indicating that the outbreaks were caused by two types of strains. Eight of nine strains isolated from the 2013 outbreak were clustered into the same group, while one isolate was grouped together with five isolates from the 2012 outbreak. In vitro experiments demonstrated high antifungal activity of fluconazole, voriconazole, amphotericin B, and 5-fluorocytosine to C. pelliculosa. The common symptoms of C. pelliculosa candidaemia were fever, cyanosis, polypnea, hypoactivity, and apnea. Conclusions: The current study revealed high in vitro susceptibility of C. pelliculosa to antifungals. As C. pelliculosa candidaemia cannot be characterized by clinical symptoms and routine blood testing alone, monitoring unusual strains isolated from immunodeficient hosts is very important to prevent possible outbreaks.


2018 ◽  
Vol 5 (2) ◽  
pp. 436
Author(s):  
Chandrashekar G. Shettigar ◽  
Sanchita Shettigar

Background: Candidemia has become an increasingly major problem in neonatal intensive care unit (NICU) which is associated with high mortality and morbidity. In this study we evaluated the epidemiology of Candidemia in neonates who were admitted to NICU and their in vitro susceptibility to commonly used antifungal drugs.Methods: This was a retrospective study of candidemia in NICU from October 2014 to September 2017. The isolates were identified as per standard mycological techniques and antifungal susceptibility was determined by disk diffusion method.Results: Out of 563 blood culture analyzed, 54(9.59%) culture yielded Candida in their blood. The non albicans Candida (NAC) species were the predominant organism for candidemia in neonates, accounting for 35 (64.81%) and the remaining 19 (35.18%) isolates were of C. albicans. Among the NAC species, the maximum isolates were of C. krusei (31.48%) followed by C. glabrata (22.22%). Non albican Candida were more resistant to azole group of antifungal, especially commonly used antifungal like fluconazole (51.43%). Among NAC species, C. glabrata was most resistant and C. tropicalis was least resistant organism. Prematurity <34 weeks, very low birth weight (<1500gm), prolonged use of broad spectrum antibiotic therapy, prolonged use of central venous catheter, mechanical ventilation, parenteral nutrition, prolonged NICU stays and concomitant bacterial sepsis were significantly associated with Candida infection in blood stream. NAC species were also associated with high mortality rate.Conclusions: Increased incidences of candidemia along with emergence of NAC species have become an important health care issue. Therefore, knowledge of local epidemiological data on candidemia is essential which will guide on therapeutic decision making. 


2019 ◽  
Vol 4 (6) ◽  
pp. 1507-1515
Author(s):  
Lauren L. Madhoun ◽  
Robert Dempster

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.


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