Clinical Innovations Near the Boundary of Viability—The Artificial Womb

2018 ◽  
pp. 264-284
Author(s):  
Ryan M. Antiel ◽  
Alan W. Flake
Keyword(s):  
Premature Infant ◽  
Infant Death ◽  
Normal Development ◽  
Clinical Success ◽  
Premature Neonate ◽  
Postnatal Life ◽  
Ethical Challenges ◽  
Extreme Prematurity ◽  
The Difference ◽  
Extremely Premature Infant

Extreme prematurity is the leading cause of infant death and morbidity. And, despite advances in neonatal medicine and surgery, the rate of prematurity has risen. The urgent need for a better way to support the extremely premature infant led to the development of an extrauterine system to better bridge the transition from fetal to postnatal life. The goal of this “artificial womb” is to maintain prenatal physiology in the extremely premature neonate to support normal development and reduce the complications associated with prematurity. This chapter discusses the development and applications of the artificial womb, as well as the limitations of this technology. It explores three current ethical challenges: ectogenesis, the boundary of viability, and the difference between physiological and clinical success.

scholarly journals Using a behavior analytics approach to change nursing care of extremely premature infants: A pilot study

2018 ◽  
Vol 9 (5) ◽  
pp. 14
Author(s):  
Jenn Gonya ◽  
Jessica Niski ◽  
Nicole Cistone
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pilot Study ◽  
Neonatal Intensive Care Unit ◽  
Premature Infant ◽  
Premature Infants ◽  
Nursing Care ◽  
Neonatal Intensive Care ◽  
Extremely Premature Infant

The neonatal intensive care unit (NICU) is, inherently, a trauma environment for the extremely premature infant. This trauma is often exacerbated by nurse caregiving practices that can be modified and still remain effective. Our study explored how behavior analytics could be used to implement an intervention known as Care by Cues and how the intervention might, ultimately, impact infant physiologic stability.

Management of an Extremely Premature Infant in the Out-of-Hospital Environment

2011 ◽  
Vol 16 (2) ◽  
pp. 303-307 ◽  
Author(s):  
William Sanders ◽  
Ryan Fringer ◽  
Robert Swor
Keyword(s):  
Premature Infant ◽  
Hospital Environment ◽  
Extremely Premature Infant

scholarly journals Ultrasound-guided intrapleural positioning of pleural catheters: influence on immediate lung expansion and pleurodesis in patients with recurrent malignant pleural effusion

2017 ◽  
Vol 43 (3) ◽  
pp. 190-194
Author(s):  
Pedro Henrique Xavier Nabuco de Araujo ◽  
Ricardo Mingarini Terra ◽  
Thiago da Silva Santos ◽  
Rodrigo Caruso Chate ◽  
Antonio Fernando Lins de Paiva ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Clinical Success ◽  
Interquartile Range ◽  
University Teaching ◽  
Lung Expansion ◽  
Median Volume ◽  
Catheter Tip ◽  
The Difference ◽  
Pleural Catheter

ABSTRACT Objective: To evaluate the role of intrapleural positioning of a pleural catheter in early lung expansion and pleurodesis success in patients with recurrent malignant pleural effusion (RMPE). Methods: This was a retrospective study nested into a larger prospective cohort study including patients with RMPE recruited from a tertiary university teaching hospital between June of 2009 and September of 2014. The patients underwent pleural catheter insertion followed by bedside pleurodesis. Chest CT scans were performed twice: immediately before pleurodesis (iCT) and 30 days after pleurodesis (CT30). Catheter positioning was categorized based on iCT scans as posterolateral, anterior, fissural, and subpulmonary. We used the pleural volume on iCT scans to estimate early lung expansion and the difference between the pleural volumes on CT30 and iCT scans to evaluate radiological success of pleurodesis. Clinical pleurodesis success was defined as no need for any other pleural procedure. Results: Of the 131 eligible patients from the original study, 85 were included in this nested study (64 women; mean age: 60.74 years). Catheter tip positioning was subpulmonary in 35 patients (41%), anterior in 23 (27%), posterolateral in 17 (20%), and fissural in 10 (12%). No significant differences were found among the groups regarding early lung expansion (median residual pleural cavity = 377 mL; interquartile range: 171-722 mL; p = 0.645), radiological success of pleurodesis (median volume = 33 mL; interquartile range: −225 to 257 mL; p = 0.923), and clinical success of pleurodesis (85.8%; p = 0.676). Conclusions: Our results suggest that the position of the tip of the pleural catheter influences neither early lung expansion nor bedside pleurodesis success in patients with RMPE.

scholarly journals Development of the Premature Infant Nose Throat-Model (PrINT-Model)—An Upper Airway Replica of a Premature Neonate for the Study of Aerosol Delivery

2008 ◽  
Vol 64 (2) ◽  
pp. 141-146 ◽  
Author(s):  
Stefan Minocchieri ◽  
Juerg Martin Burren ◽  
Marc Aurel Bachmann ◽  
Georgette Stern ◽  
Johannes Wildhaber ◽  
...  
Keyword(s):  
Premature Infant ◽  
Upper Airway ◽  
Premature Neonate ◽  
Aerosol Delivery

A Clinical Study of Formocresol Pulpotomy versus Root Canal Therapy of Vital Primary Incisors

2008 ◽  
Vol 32 (3) ◽  
pp. 211-214 ◽  
Author(s):  
Naser Asl Aminabadi ◽  
Ramin Mostofi Zadeh Farahani ◽  
Esrafil Balayi Gajan
Keyword(s):  
Root Canal ◽  
Root Resorption ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Clinical Indication ◽  
Radiographic Evaluation ◽  
Spontaneous Pain ◽  
Pathologic Finding ◽  
Root Canal Therapy ◽  
The Difference

Objectives: Pulpotomy of primary incisors is a serious challenge due to the lack of a distinct boundary between the coronal and the radicular pulp and the inaccuracy of the clinical indication criteria. The aim of the present study is the clinical and radiographic evaluation of pulpotomy versus root canal therapy(RCT) of vital primary incisors. Study design: A total of 100 incisors in 50 patients (female: 27, male: 23)aged 3-4 years were allocated to formocresol pulpotomy (45 teeth) and RCT (46 teeth) using zinc oxideeugenol. The radiographic and clinical evaluation of treatment outcomes was performed at 12 and 24 months post-operatively. A history of spontaneous pain, missing restorations, recurrent caries, mobility and percussion sensitivity, parulis or fistula, erythema, and swelling were recorded. Data analysis was performed based on two sample proportional test. Results: The clinical success rate was 86.9% for pulpotomy and 95.6% for RCT (P>0.05). The radiographic assessment exhibited no pathologic signs in 76.08% of pulpotomy group and 91.3% of RCT group and the difference was statistically significant (P<0.05). The most common pathologic finding was periodontal widening followed by external/internal root resorption. Periapical radiolucency and fistula in pulpotomized teeth was significantly higher than in RCT-treated teeth(P<0.05) Conclusions: It may be concluded that the root canal therapy of vital primary incisors may be efficiently substituted for the pulpotomy of these teeth.

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