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

2017 ◽  
Vol 28 (4) ◽  
pp. 488-501 ◽  
Author(s):  
Manal Kassab ◽  
Afnan A. Alhassan ◽  
Karem H. Alzoubi ◽  
Yousef S. Khader

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.

2017 ◽  
Vol 4 (3) ◽  
pp. 1008
Author(s):  
Darshan K. Raj ◽  
Adarsh E. ◽  
Prema R. ◽  
. Jayaprakash ◽  
Dhanyatha M. ◽  
...  

Background: ROP is a disorder of the developing retinal blood vessels in the premature infant retina. Objective of present study is to determine the number of babies affected with ROP among the premature and low birth weight babies admitted to neonatal intensive care unit or attending neonatal follow up clinic at RRMCH Hospital during a period of one year.Methods: This is a prospective observational study conducted in Rajarajeswari Medical College and Hospital Bangalore for 12 months. All eligible babies were screened at Neonatal Intensive Care Unit where temperature is well controlled and the place to handle any emergencies. The pupils were dilated using 2.5% phenylephrine and 0.5% tropicamide eye drops instilled three times into each eye at intervals of 15 minutes about one hour before the scheduled examination.Results: 100 babies were screened and followed up. The incidence of ROP is 40%. Gestational age (<37weeks) and low birth weight (2500g) are important risk factors for ROP. Our study concluded that ROP is an important complication of prematurity.Conclusions: The present study highlights the magnitude of the problem due to ROP in a tertiary care centre. Meticulous fundus examination with indirect ophthalmoscopy in all preterm babies with gestational age <37weeks and birth weight ≤2500gms is essential non invasive method for early detection of ROP and its progression. 


2017 ◽  
Vol 33 (3) ◽  
pp. 524-532 ◽  
Author(s):  
Elizabeth B. Froh ◽  
Janet A. Deatrick ◽  
Martha A. Q. Curley ◽  
Diane L. Spatz

Background: Very little is known about the breastfeeding experience of mothers of infants born with congenital anomalies and cared for in the neonatal intensive care unit (NICU). Often, studies related to breastfeeding and lactation in the NICU setting are focused on the mothers of late preterm, preterm, low-birth-weight, and very-low-birth-weight infants. Congenital diaphragmatic hernia (CDH) is an anatomic malformation of the diaphragm and affects 1 in every 2,000 to 4,000 live births. Currently, there are no studies examining the health outcomes of infants with CDH and the effect of human milk. Research aim: This study aimed to describe the breastfeeding experience of mothers of infants with CDH cared for in the NICU. Methods: A prospective, longitudinal qualitative descriptive design was used. Phased interviews were conducted with a purposive sample of 11 CDH infant–mother dyads from a level 3 NICU in a children’s hospital. Results: Six themes emerged from the data: (a) hopeful for breastfeeding, (b) latching on . . . to the pump, (c) we’ve already worked so hard, (d) getting the hang of it—it’s getting easier, (e) a good safety net, and (f) finding a way that works for us. Conclusion: For this population of CDH infant–mother dyads, the term breastfeeding is not exclusive to direct feeding at the breast and the mothers emphasized the significance of providing their own mother’s milk through a combination of feeding mechanisms to their infants with CDH.


Author(s):  
Erbu Yarci ◽  
Fuat E. Canpolat

Objective Respiratory distress presented within the first few days of life is life-threatening and common problem in the neonatal period. The aim of this study is to estimate (1) the incidence of respiratory diseases in newborns and related mortality; (2) the relationship between acute neonatal respiratory disorders rates and gestational age, birth weight, and gender; and (3) the incidence of complications associated with respiratory disturbances. Study Design Only inborn patients with gestational age between 230/7 and 416/7 weeks having respiratory distress were included in the study. The data were collected from the medical records and gestational age was based on the menstrual dating. Results There were 8,474 live births between January 1, 2013 and June 30, 2013 in our hospital. A total of 1,367 newborns were hospitalized and oxygen therapy was applied in 903 of them because of respiratory distress. An acute respiratory disorder was found to be in 10.6% (903/8,474) among all live births. Mortality was 0.76% (66/8,474). The incidence of respiratory distress syndrome was 2.8% (n = 242). The occurrence of transient tachypnea of newborn was 3.1% (n = 270). Meconium aspiration syndrome, pneumonia, congenital diaphragmatic hernia, and pulmonary maladaptation and primary persistent pulmonary hypertension rates were 0.1, 0.7, 2.2, and 0%, respectively. Overall, 553 (61%) of the 903 newborns having respiratory diseases had complications. The occurrence of necrotizing enterocolitis, patent ductus arteriosus, bronchopulmonary dysplasia, intraventricular hemorrhage and air leak was 6.8, 19.8, 4.7, 24.9, and 5%, respectively. Conclusion This study offers an epidemiological perspective for respiratory disorders from a single-center level-III neonatal intensive care unit. Although number of births, premature newborns, extremely low birth weight/very low birth weight infants, and complicated pregnancies increase in years, decreasing rates of mortality and complications are very promising. As perinatal and neonatal cares are getting better in every day, we think that more promising results can be achieved over the coming years. Key Points


2015 ◽  
Vol 10 (1) ◽  
pp. 89-93
Author(s):  
R Joshi ◽  
G Baral

Aims: The purpose of this study was to determine the perinatal outcome of the second twin compared to the first one. Methods: This is a hospital based comparative study of 60 pregnant women with twin pregnancy at Paropakar Maternity and Women’s Hospital, Kathmandu from 14 January 2013 to13 April 2013. Apgar score and admission to neonatal intensive care unit of the first and the second twins were studied in relation to the gestational age, chorionicity, mode of delivery, inter-delivery interval and birth weight. Mc Nemars test was used with 0.05 as the level of significance. Results: Among 60 sets of twins, Apgar score of the second twin was found to be lower than the first one (p=0.02) in general and in preterm gestation (p=0.049), dichorionic diamniotic chorionicity (p=0.012), vaginal delivery (p<0.001), inter-delivery interval of <30 minutes (p=0.007) and birth weight discordance of <30 % (p=0.014). Admission to neonatal intensive care unit was not significant (p=0.5). Conclusions: Second twin had low Apgar score and the neonatal admission rate was similar for both twins. 


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