SLOW INFUSIONS OF GENTAMICIN ARE ASSOCIATED WITH HIGH VARIABILITY IN PEAK GENTAMICIN CONCENTRATIONS IN LOW GESTATION AGE (GA) NEONATES

IntroductionDelayed gentamicin delivery through intravenous lines has been reported.Delay is expected to be greater in smaller neonates when the flow rate of carrier intravenous fluid and dose volumes are low.AimTo investigate the effects of neonate GA and weight on gentamicin peak concentrations after 30 minute infusion or bolus administrations.MethodsNeonates admitted to Dunedin Neonatal Intensive Care Unit in 2008 and 2010 who received gentamicin (2008: 30 minute infusion; 2010: slow bolus) in the first three days of life were included. Peak concentrations were compared and correlations between concentration and weight were investigated over GA bands.ResultsThere were 151 neonates in 2010 and 118 neonates in 2008. Median (range) GA was 38 weeks (24–42) in 2010 and 34.7 weeks (23.4–42.1) in 2008. Median (range) weight was 3.25kg (0.51–5.65) in 2010 and 2.67kg (0.49–5.11) in 2008. Peak gentamicin concentrations (mg/L) were 8.15±0.098 (at 1.2±0.32h) in 2010 and 9.92±0.17 (at 1.34±0.4h) in 2008. A test for equal variances showed peak concentrations were more variable in 2008 (p0.05).ConclusionsPeak concentrations were more variable following 30 minute infusions and were positively correlated with GA or weight for neonates with GA.

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Number and Frequency of Routinely Applied Painful Procedures in University Neonatal Intensive Care Unit

Clinical Nursing Research ◽

10.1177/1054773817744324 ◽

2017 ◽

Vol 28 (4) ◽

pp. 488-501 ◽

Cited By ~ 2

Author(s):

Manal Kassab ◽

Afnan A. Alhassan ◽

Karem H. Alzoubi ◽

Yousef S. Khader

Keyword(s):

Intensive Care Unit ◽

Cohort Study ◽

Intensive Care ◽

Birth Weight ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Procedural Pain ◽

Gestation Age ◽

Low Birth Weight Babies ◽

Adhesive Removal

Neonates at the neonatal intensive care unit (NICU) are at high risk for procedural pain exposure. This study describes the type and frequency of procedures in neonates admitted to University Intensive Care Unit. This was a prospective cohort study of 150 neonates admitted to the NICU during the first 7 days of life at a governmental hospital. The type and frequency of procedures were evaluated using a tool which included the type and number of procedures performed per shift. A total of 14,008 painful procedures were performed on neonates with an average of 97.11 painful procedures per baby and 13.9/day for each baby. Adhesive removal (21.3%) was the most frequently performed procedure. The number of painful procedures was inversely correlated with gestation age ( p < .001) and birth weight ( p < .001). The number of painful procedures performed on neonates is high, particularly for neonates with small gestational age and low birth weight babies.

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The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_persp-19-00097 ◽

2019 ◽

Vol 4 (6) ◽

pp. 1507-1515

Author(s):

Lauren L. Madhoun ◽

Robert Dempster

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Hospital Discharge ◽

Neonatal Intensive Care ◽

Oral Feeding ◽

Medical Attention ◽

Primary Role ◽

Speech Language Pathologists ◽

The Family

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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