scholarly journals Parents’ Acute Illnesses, Hospitalizations, and Medication Changes During the Difficult First Year After Infant or Child NICU/PICU Death

2016 ◽  
Vol 35 (1) ◽  
pp. 75-82 ◽  
Author(s):  
Dorothy Brooten ◽  
JoAnne M. Youngblut ◽  
Carmen Caicedo ◽  
Teresa del Moral ◽  
G. Patricia Cantwell ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Stressful Life Event ◽  
Child Death ◽  
Pediatric Intensive Care ◽  
First Year ◽  
Multiple Gestation ◽  
Gastrointestinal Problems ◽  
Medication Changes

Background and Objectives: Infant/child death is described as a most stressful life event; however, there are few reports of effects on parent physical health during the first year after the death. The study’s purpose is to examine the patterns of parent acute illnesses, hospitalizations, and medication changes over 1 to 13 months after neonatal intensive care unit (NICU) or pediatric intensive care unit (PICU) infant/child death in 3 racial/ethnic groups. Methods: Secondary analyses were conducted with longitudinal data on parent health and functioning 1 to 13 months after infant/child NICU/PICU death. Parents (176 mothers, 73 fathers; 44% Hispanic, 35% black non-Hispanic, and 21% white non-Hispanic) of deceased infants/children were recruited from 4 children’s hospitals and state death records. Inclusion criteria—parents understood English or Spanish and had a deceased neonate/child ≤ 18. Exclusion criteria —deceased newborn from multiple gestation pregnancy, child in foster care, child’s injury due to suspected abuse, or parent death in illness/injury event. Parents reported numbers and types of acute illnesses, hospitalizations, and medication changes 1 to 13 months postdeath. Results: Parents’ acute illnesses, hospitalizations, and medication changes were greatest between months 1 and 6, with relative quiescence in months 7 to 10, and an increase in months 11 to 13. Mothers (aged 32 ± 7.8 years) reported 300 acute illnesses (primarily colds/flu, headaches, anxiety/depression, and infections) and 89 hospitalizations (primarily infections, chest pain, and gastrointestinal problems). Fathers (aged 37 ± 8.8 years) reported 104 acute illnesses (colds/flu and headaches) and 9 hospitalizations. Conclusion: After infant/child NICU/PICU death, mothers had greater morbidity than fathers, with no significant differences by race/ethnicity. Parents’ health needs to be monitored in months 1 to 6 and months 11 to 13, and interventions targeted to parents in these months.

Back Transfer of Infants with Tracheostomies: A Regional Center Experience

2021 ◽  
Author(s):  
Mohammad A. Attar ◽  
Rachael A. Pace ◽  
Robert E. Schumacher
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Pediatric Intensive Care ◽  
Patient Characteristics ◽  
First Year ◽  
Regional Center ◽  
Transferred Patients ◽  
First Year Of Life ◽  
Back Transfer

AbstractWe describe our center's experience with the back transfer of infants following tracheostomies. We conducted a retrospective cohort study of infants transferred to pediatric critical care units of our regional center with conditions originating in the neonatal period who underwent tracheostomy during the hospitalization within their first year of life between 2006 and 2017. Recovering patients are discharged home or transferred back to the referring hospitals. We evaluated patient characteristics, destination of discharge and type of pulmonary support at discharge, and mechanical ventilation (MV) or tracheotomy masks (TM). Of the 139 included patients, 72% were transferred to the neonatal intensive care unit, 21% to the pediatric cardiothoracic unit, and 7% to the pediatric intensive care unit. Their median gestational age was 35 weeks. They were admitted at a median 22 days of life and lived at a median distance of 56 miles from our center. Furthermore, 34 infants (24%) were back transferred closer to their homes (23 with MV and 11 with TM), and 84 (60%) were discharged home (53 on MV and 31 on TM). Twenty-one patients (15%) died in the hospital (before discharge or transfer). Back transferred patients on MV had a significantly shorter duration between tracheostomy and transfer compared with those discharged home from our center: MV (median = 22 vs. 103 days, p < 0.0001) and TM (median = 13 vs. 35 days, p < 0.0001). Back transfer of infants with tracheostomies closer to their homes was associated with a significantly shorter hospitalization and more efficient use of the subspecialized resources at the RC.

Resuscitation and Withdrawal of Therapy in Pediatric Intensive Care

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 961-963
Author(s):  
RICHARD B. MINK ◽  
MURRAY M. POLLACK
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Life Support ◽  
Pediatric Intensive Care ◽  
New Haven ◽  
Hammersmith Hospital ◽  
Hospital Deaths ◽  
Withdrawal Of Therapy ◽  
Haven Hospital

Although issues concerning withdrawal and limitation of life support are commonly discussed,1-6 actual practices in pediatrics are largely unknown and are limited to neonatal intensive care unit (ICU) studies. In the neonatal ICUs at Yale-New Haven Hospital and at Hammersmith Hospital, 14% and 30%, respectively, of all deaths followed withdrawal of care.7,8 In adult ICUs, limitation and/or withdrawal of therapy is common,9 and in one investigation, resuscitation was not attempted immediately before ICU death in nearly two-thirds of cases.10 Nonetheless, many physicians believe that most hospital deaths occur only after all resuscitative attempts have failed,6,11,12 and others believe that resuscitative efforts neither are indicated nor desirable in many cases.1,13

scholarly journals Parents’ Report of Child’s Response to Sibling’s Death in a Neonatal or Pediatric Intensive Care Unit

2013 ◽  
Vol 22 (6) ◽  
pp. 474-481 ◽  
Author(s):  
JoAnne M. Youngblut ◽  
Dorothy Brooten
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Qualitative Interviews ◽  
Pediatric Intensive Care ◽  
School Age Children ◽  
School Age ◽  
English Speaking ◽  
Race Ethnicity

Background Research on sibling death in a pediatric/neonatal intensive care unit is limited, despite many qualitative differences from deaths at home or in hospitals’ general care areas and has overlooked cultural differences. Objectives To describe parents’ reports of children’s responses to a sibling’s death in a neonatal or pediatric intensive care unit via qualitative interviews at 7 months after the death. Methods English-speaking (n = 19) and Spanish-speaking (n = 8) parents of 24 deceased infants/children described responses of their 44 surviving children: 10 preschool, 19 school-age, and 15 adolescent. Parents’ race/ethnicity was 48% black, 37% Hispanic, 15% white. Ten siblings died in the neonatal unit and 14 in the pediatric intensive care unit. Semistructured interviews in parents’ homes were audio recorded, transcribed verbatim, and analyzed with content analysis. Results Six themes about surviving children emerged. Changed behaviors were reported by parents of school-age children and adolescents. Not understand what was going on was reported primarily by parents of preschoolers. Numbers of comments in the 4 remaining themes are as follows: maintaining a connection (n = 9), not having enough time with their siblings before death and/or to say goodbye (n = 6), believing the sibling is in a good place (n = 6), not believing the sibling would die (n = 4). Comments about girls and boys were similar. White parents made few comments about their children compared with black and Hispanic parents. The pattern of comments differed by whether the sibling died in the neonatal or the pediatric intensive care unit. Conclusions Children’s responses following a sibling’s death vary with the child’s sex, parents’ race/ethnicity, and the unit where the sibling died. Children, regardless of age, recognized their parents’ grief and tried to comfort them.

scholarly journals Publisher Correction: Neonatal intensive care unit (NICU) exposures exert a sustained influence on the progression of gut microbiota and metabolome in the first year of life

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Polly Soo Xi Yap ◽  
Chun Wie Chong ◽  
Azanna Ahmad Kamar ◽  
Ivan Kok Seng Yap ◽  
Yao Mun Choo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gut Microbiota ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
First Year ◽  
First Year Of Life

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Simulating a Vertical Evacuation of a NICU and PICU to Examine the Relationship Between Training and Preparedness

2021 ◽  
pp. 1-3
Author(s):  
Ramon E. Gist ◽  
Pia Daniel ◽  
Nizar Tejani ◽  
Andrew Grock ◽  
Adam Aluisio ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Disaster Preparedness ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Full Scale ◽  
University Hospital ◽  
Evaluation Tool ◽  
Vertical Evacuation

Abstract Objective: The aim of this study was to implement pediatric vertical evacuation disaster training and evaluate its effectiveness by using a full-scale exercise to compare outcomes in trained and untrained participants. Methods: Various clinical and nonclinical staff in a tertiary care university hospital received pediatric vertical evacuation training sessions over a 6-wk period. The training consisted of disaster and evacuation didactics, hands-on training in use of evacuation equipment, and implementation of an evacuation toolkit. An unannounced full-scale simulated vertical evacuation of neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) patients was used to evaluate the effectiveness of the training. Drill participants completed a validated evaluation tool. Pearson chi-squared testing was used to analyze the data. Results: Eighty-four evaluations were received from drill participants. Forty-three (51%) of the drill participants received training and 41 (49%) did not. Staff who received pediatric evacuation training were more likely to feel prepared compared with staff who did not (odds ratio, 4.05; confidence interval: 1.05-15.62). Conclusions: There was a statistically significant increase in perceived preparedness among those who received training. Recently trained pediatric practitioners were able to achieve exercise objectives on par with the regularly trained emergency department staff. Pediatric disaster preparedness training may mitigate the risks associated with caring for children during disasters.

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