Abstract 166: Insertion or Replacement of an Advanced Airway is Not Associated With Adverse Outcome in Neonatal Intensive Care Unit Cardiopulmonary Resuscitation

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Kaashif A Ahmad ◽  
Christina N Stine ◽  
Jaclyn M LeVan ◽  
Katy L Kohlleppel ◽  
Steven G Velasquez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiopulmonary Resuscitation ◽  
Neonatal Intensive Care Unit ◽  
Median Time ◽  
Neonatal Intensive Care ◽  
Neonatal Resuscitation ◽  
Advanced Airway ◽  
Significant Difference ◽  
The Impact

Introduction: There is a paucity of data regarding variables that impact the outcome in patients who require cardiopulmonary resuscitation (CPR) in the neonatal intensive care unit (NICU). The impact of initial need or replacement of an existing advanced airway (AA) has not been described in this population. The 2016 Neonatal Resuscitation Program (NRP) places emphasis on AA placement prior to initiating compressions in the delivery room setting. We hypothesized that providers would similarly emphasize airway placement for NICU CPR. Methods: We conducted a retrospective review of patients requiring CPR with chest compressions from 2012 to 2017 across 10 NICUs in San Antonio, Texas. We identified cases by clinician selection of a CPR code and by a review of all patients who died prior to NICU discharge. Results: We review a total of 211 NICU CPR events, 210 of which had complete data regarding the AA. An AA was present at the onset of CPR for 179 (85.2%) of CPR events and an existing airway replaced during CPR for 31 (14.7%) CPR events. All patients without an AA present at onset of CPR had an airway immediately placed. The median time to insertion of AA was 1 minute (IQR 1, 5 minutes). In comparing patients who had an AA present at CPR onset versus absent AA, there was no significant difference in rate of return of spontaneous circulation (ROSC, 63.7% vs 64.5%, p=0.92) or time to ROSC (10.2 vs 12.7 min, p=.66). The median time for replacement of an AA during CPR was 1 minute (IQR 1, 4 minutes). Those with a time to replace the AA of >= 5 minutes had a similar ROSC rate compared to those who had AA replacement in < 5 minutes (75% vs 73.7%, p=.96). The decision to replace an AA during CPR was associated with a non-significant increase in rate of ROSC (74.2% vs 62%, p=0.19) and no significant difference in time to ROSC (11.5 min vs. 10.4 min, p=0.65). Conclusions: The achievement of ROSC or time to ROSC are not impacted by the need to place an initial AA at the onset of CPR or the need to replace the AA during CPR in the NICU. This may be due to the rapid initial placement and replacement of the AA observed in NICU CPR events. These data indicate that NICU CPR providers emphasize rapid AA placement similar to NRP guidelines.

scholarly journals Comparing Neonatal Intensive Care Unit Nursing Support in Mothers With ‎Newborn Abstinence Syndrome (NAS) and Mothers of Healthy Neonates ‎

2019 ◽  
Vol 9 (4) ◽  
Author(s):  
Seyedeh Najmeh Hosseini ◽  
Arash Ghodousi ◽  
Narges Sadeghi ◽  
Somayeh Abbasi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Control Group ◽  
Abstinence Syndrome ◽  
Nursing Support ◽  
Study Results ◽  
Significant Difference ◽  
The Impact

Background: The experience of having neonates in the Neonatal Intensive Care Unit (NICU) is a psychological crisis. It might cause many emotional problems for parents. Entire parental support is among the duties of the healthcare team. Therefore, this study aimed to compare the nursing support received by the mothers with Newborn Abstinence Syndrome (NAS) and the mothers of other neonates admitted to the NICU. Methods: The present cross-sectional descriptive-analytic study was conducted in the selected hospitals in Kerman Province, Iran. In total, 62 mothers with NAS and 61 non-addicted mothers with neonates admitted to the NICU were selected through convenience sampling method. The inclusion criteria were neonates under the care of parents, neonate admitted to the NICU for at least 24 hours, opiate dependence in the case group mothers, and no substance dependence in the control group mothers. The amount of nursing support for mothers having neonates with NAS was compared with that of the control mothers. The study groups were homogenized in terms of the study variables (neonate age, gender, and the duration of hospitalization). The required data were collected by the Nurse-Parent Support Tool (NPST) and analyzed in SPSS. Results: The study results revealed that among the neonates of 123 mothers, 75(60.97%) were boys, and 58(39.02%) were girls. The majority of neonates in both groups were breastfed. The mean±SD age of the mothers in the case and control group were 31.93±7.25 and 28.99±4.36 years, respectively. The nursing support level was desirable in both groups, and no significant difference was found in this regard (P>0.05). Furthermore, the level of nursing support in emotional, information-communication, self-esteem, and quality caregiving support dimensions was desirable in both groups. Conclusion: The obtained results revealed that nurses’ support was desirable in both groups. The prevalence of maternal addiction and the impact of this social harm on neonates who were admitted are essential. Furthermore, families having neonates with NAS need more support from the healthcare staff and nurses, in comparison with healthy parents; thus, the importance of this issue should be addressed in training and briefing courses for nurses.

Exploring the Impact of a Dual Occupancy Neonatal Intensive Care Unit on Staff Workflow, Activity, and Their Perceptions

2018 ◽  
Vol 12 (2) ◽  
pp. 44-54 ◽  
Author(s):  
Margaret Broom ◽  
Zsuzsoka Kecskes ◽  
Sue Kildea ◽  
Anne Gardner
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Walking Distance ◽  
Prospective Longitudinal Study ◽  
Significant Difference ◽  
Prospective Longitudinal ◽  
The Impact ◽  
Family Centered

In 2012, a tertiary neonatal intensive care unit (NICU) transitioned from an open plan (OP) to a dual occupancy (DO) NICU. The DO design aimed to provide a developmental appropriate, family-centered environment for neonates and their families. During planning, staff questioned the impact DO would have on staff workflow and activity. To explore the impact of changing from an OP to a DO NICU, a prospective longitudinal study was undertaken from 2011 to 2014, using observational, time and motion, and surveys methods. Main outcome measures included distance walked by staff, minutes of staff activity, and staff perceptions of the DO design. Results highlighted no significant difference in the distances clinical nurses walked nor time spent providing direct clinical care, whereas technical support staff walked further than other staff in both designs. Staff perceived the DO design created a developmentally appropriate, family-centered environment that facilitated communication and collaboration between staff and families. Staff described the main challenges of the DO design such as effective staff communication, gaining educational opportunities, and the isolation of staff and families compared to the OP design. Our study provides new evidence that DO provides an improved developmentally environment and has similar positive benefits to single-family room for neonates and families. Such design may reduce the larger floor plan’s impact on staff walking distance and work practices. Challenges of staff transition can be minimized by planning and leadership throughout the development and move to a new design.

Endotracheal tube manipulation during cardiopulmonary resuscitation in the neonatal intensive care unit

2021 ◽  
Author(s):  
Kaashif A. Ahmad ◽  
Cody L. Henderson ◽  
Steven G. Velasquez ◽  
Jaclyn M. LeVan ◽  
Katy L. Kohlleppel ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiopulmonary Resuscitation ◽  
Neonatal Intensive Care Unit ◽  
Endotracheal Tube ◽  
Neonatal Intensive Care

Sibling Visiting in a Neonatal Intensive Care Unit

PEDIATRICS ◽  
1983 ◽  
Vol 71 (5) ◽  
pp. 835-838
Author(s):  
Fred Schwab ◽  
Brenda Tolbert ◽  
Stephen Bagnato ◽  
M. Jeffrey Maisels
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Direct Observation ◽  
Neonatal Intensive Care ◽  
Behavioral Patterns ◽  
Control Intervention ◽  
Significant Difference

The effect of sibling visiting in a neonatal intensive care unit was studied. Sixteen siblings of 13 infants were randomly assigned to a visiting or nonvisiting group. Behavioral patterns were measured by questionnaires administered to the parents and by direct observation and interviews with the children. There were no significant changes in the behavior of the children following the birth of their sibling, and there was no significant difference between the behavior scores of the two groups 1 week after the experimental (or control) intervention. The visiting children did not show signs of fear or anxiety during the visit. These data suggest that sibling visiting to a neonatal intensive care unit is not likely to be harmful and might be beneficial to the siblings and their families.

scholarly journals Mothers and fathers in NICU: The impact of preterm birth on parental distress

2016 ◽  
Vol 12 (4) ◽  
pp. 604-621 ◽  
Author(s):  
Chiara Ionio ◽  
Caterina Colombo ◽  
Valeria Brazzoduro ◽  
Eleonora Mascheroni ◽  
Emanuela Confalonieri ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Preterm Birth ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Post Partum ◽  
Event Scale ◽  
Mothers And Fathers ◽  
Negative Feelings ◽  
The Impact

Preterm birth is a stressful event for families. In particular, the unexpectedly early delivery may cause negative feelings in mothers and fathers. The aim of this study was to examine the relationship between preterm birth, parental stress and negative feelings, and the environmental setting of NICU. 21 mothers (age = 36.00 ± 6.85) and 19 fathers (age = 34.92 ± 4.58) of preterm infants (GA = 30.96 ± 2.97) and 20 mothers (age = 40.08 ± 4.76) and 20 fathers (age = 40.32 ± 6.77) of full-term infants (GA = 39.19 ± 1.42) were involved. All parents filled out the Parental Stressor Scale: Neonatal Intensive Care Unit, the Impact of Event Scale Revised, Profile of Mood States, the Multidimensional Scale of Perceived Social Support and the Post-Partum Bonding Questionnaire. Our data showed differences in emotional reactions between preterm and full-term parents. Results also revealed significant differences between mothers and fathers’ responses to preterm birth in terms of stress, negative feelings, and perceptions of social support. A correlation between negative conditions at birth (e.g., birth weight and Neonatal Intensive Care Unit stay) and higher scores in some scales of Impact of Event Scale Revised, Profile of Mood States and Post-Partum Bonding Questionnaire were found. Neonatal Intensive Care Unit may be a stressful place both for mothers and fathers. It might be useful to plan, as soon as possible, interventions to help parents through the experience of the premature birth of their child and to begin an immediately adaptive mode of care.

scholarly journals Incidence, characteristics, and survival following cardiopulmonary resuscitation in the quaternary neonatal intensive care unit

Resuscitation ◽  
2017 ◽  
Vol 110 ◽  
pp. 32-36 ◽  
Author(s):  
Elizabeth E. Foglia ◽  
Robert Langeveld ◽  
Lauren Heimall ◽  
Alyson Deveney ◽  
Anne Ades ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiopulmonary Resuscitation ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care

scholarly journals Chlorhexidine Bathing in a Tertiary Care Neonatal Intensive Care Unit: Impact on Central Line–Associated Bloodstream Infections

2014 ◽  
Vol 35 (2) ◽  
pp. 158-163 ◽  
Author(s):  
Caroline Quach ◽  
Aaron M. Milstone ◽  
Chantal Perpête ◽  
Mario Bonenfant ◽  
Dorothy L. Moore ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Adverse Events ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
The Impact

Background.Despite implementation of recommended best practices, our central line-associated bloodstream infection (CLABSI) rates remained high. Our objective was to describe the impact of chlorhexidine gluconate (CHG) bathing on CLABSI rates in neonates.Methods.Infants with a central venous catheter (CVC) admitted to the neonatal intensive care unit from April 2009 to March 2013 were included. Neonates with a birth weight of 1,000 g or less, aged less than 28 days, and those with a birth weight greater than 1,000 g were bathed with mild soap until March 31, 2012 (baseline), and with a 2% CHG-impregnated cloth starting on April 1, 2012 (intervention). Infants with a birth weight of 1,000 g or less, aged 28 days or more, were bathed with mild soap during the entire period. Neonatal intensive care unit nurses reported adverse events. Adjusted incidence rate ratios (aIRRs), using Poisson regression, were calculated to compare CLABSIs/1,000 CVC-days during the baseline and intervention periods.Results.Overall, 790 neonates with CVCs were included in the study. CLABSI rates decreased during the intervention period for CHG-bathed neonates (6.00 vs 1.92/1,000 CVC-days; aIRR, 0.33 [95% confidence interval (CI), 0.15-0.73]) but remained unchanged for neonates with a birth rate of 1,000 g or less and aged less than 28 days who were not eligible for CHG bathing (8.57 vs 8.62/1,000 CVC-days; aIRR, 0.86 [95% CI, 0.17-4.44]). Overall, 195 infants with a birth weight greater than 1,000 g and 24 infants with a birth weight of 1,000 g or less, aged 28 days or more, were bathed with CHG. There was no reported adverse event.Conclusions.We observed a decrease in CLABSI rates in CHG-bathed neonates in the absence of observed adverse events. CHG bathing should be considered if CLABSI rates remain high, despite the implementation of other recommended measures.

One-Week versus 2-Day Ventilator Circuit Change in Neonates with Prolonged Ventilation: Cost-Effectiveness and Impact on Ventilator-Associated Pneumonia

2014 ◽  
Vol 36 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Shih-Ming Chu ◽  
Mei-Chin Yang ◽  
Hsiu-Feng Hsiao ◽  
Jen-Fu Hsu ◽  
Reyin Lien ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cost Effectiveness ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Ventilator Associated Pneumonia ◽  
Ventilator Circuit ◽  
Mechanical Ventilators ◽  
Prolonged Intubation ◽  
The Impact

ObjectiveTo investigate the impact of 1-week ventilator circuit change on ventilator-associated pneumonia and its cost-effectiveness compared with a 2-day change.DesignAn observational cohort study.SettingA tertiary level neonatal intensive care unit in a university-affiliated teaching hospital in Taiwan.PatientsAll neonates in the neonatal intensive care unit receiving invasive intubation for more than 1 week from July 1, 2011, through December 31, 2013.InterventionWe investigated the impact of 2 ventilator circuit change regimens, either every 2 days or 7 days, on ventilator-associated pneumonia of our cohort.Measurements and Main ResultsA total of 361 patients were maintained on mechanical ventilators for 13,981 days. The 2 groups did not differ significantly in any demographic characteristics. The rate of ventilator-associated pneumonia was comparable between the 2-day group and the 7-day group (8.2 vs 9.5 per 1,000 ventilator-days, P=.439). The durations of mechanical ventilation and hospital stay, and rates of bloodstream infection and mortality, were also comparable between the 2 groups. Switching from a 2-day to a 7-day change policy would save our neonatal intensive care unit a yearly sum of US $29,350 and 525 working hours.ConclusionDecreasing the frequency of ventilator circuit changes from every 2 days to once per week is safe and cost-effective in neonates requiring prolonged intubation for more than 1 week.Infect Control Hosp Epidemiol 2014;00(0): 1–7

scholarly journals Psychological Wellbeing of Parents with Infants Admitted to the Neonatal Intensive Care Unit during SARS-CoV-2 Pandemic

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 755
Author(s):  
Laura Polloni ◽  
Francesco Cavallin ◽  
Elisabetta Lolli ◽  
Rossana Schiavo ◽  
Martina Bua ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Parental Stress ◽  
Neonatal Intensive Care ◽  
Physical Contact ◽  
Psychological Wellbeing ◽  
Depression Symptoms ◽  
Parental Role ◽  
The Impact

The current SARS-CoV-2 disease (COVID-19) pandemic is a sudden major stressor superimposed on pre-existing high distress in parents of infants admitted to the neonatal intensive care unit (NICU). This study aimed to investigate the psychological wellbeing of NICU parents during the COVID-19 pandemic. Forty-four parents of 25 inpatients of the Padua University Hospital NICU were included from June 2020 to February 2021. At 7–14 days postpartum parents completed the Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), Parental Stressor Scale: NICU (PSS:NICU) and an ad-hoc questionnaire measuring parental COVID-19 related stress. About one third of parents reported extreme/high stress and a relevant negative impact on parenthood experience. Less time (82%) and less physical contact (73%) with infants due to COVID-19 preventive measures were the most frequent negative factors. Higher COVID-19 related parental stress was positively associated with anxiety, depression, NICU parental stress, stress related to NICU environment, and parental role alterations. Depression symptoms, stress related to infant condition and parental role alterations were higher in mothers. The pandemic affected parental emotional and relational wellbeing directly through additional stress due to COVID-19 concerns and indirectly through the impact of restrictions on the experience of becoming parents.

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