scholarly journals Bedside surgery in the newborn infants: survey of the Italian society of pediatric surgery

2020 ◽  
Vol 46 (1) ◽  
Author(s):  
Gloria Pelizzo ◽  
Pietro Bagolan ◽  
Francesco Morini ◽  
Mariagrazia Aceti ◽  
Daniele Alberti ◽  
...  
Keyword(s):  
Pediatric Surgery ◽  
Neonatal Intensive Care ◽  
Ductus Arteriosus ◽  
Central Italy ◽  
Newborn Infants ◽  
Venous Catheter ◽  
Italian Society ◽  
Neonatal Intensive Care Units ◽  
Preterm Neonates ◽  
General Data

Abstract Introduction This is the report of the first official survey from the Italian Society of Pediatric Surgery (ISPS) to appraise the distribution and organization of bedside surgery in the neonatal intensive care units (NICU) in Italy. Methods A questionnaire requesting general data, staff data and workload data of the centers was developed and sent by means of an online cloud-based software instrument to all Italian pediatric surgery Units. Results The survey was answered by 34 (65%) out of 52 centers. NICU bedside surgery is reported in 81.8% of the pediatric surgery centers. A lower prevalence of bedside surgical practice in the NICU was reported for Southern Italy and the islands than for Northern Italy and Central Italy (Southern <Northern<Central, p < 0.03). The most frequent clinical characteristics of neonates was preterm neonates with birthweight < 1200 g, with cardiorespiratory instability and/or ventilatory dependence. The most frequently selected indications to surgery were pneumothorax, pleural effusion, pericardial effusion, central venous catheter (CVC) positioning, intestinal perforation, patent ductus arteriosus ligation and congenital diaphragmatic hernia. More than 60% of respondents report no institutional recommendations and dedicated informed consent on bedside surgical procedures. The lack of dedicated areas and infrastructures is considered a relative contraindication to the performance of bedside surgery. Conclusion Bedside surgery is performed in the majority of the Italian pediatric surgery centers included in this census. The introduction of a national set of surgery guidelines would be widely welcomed.

Predictors of PDA Treatment in Preterm Neonates Who Had Received Prophylactic Indomethacin

2017 ◽  
Vol 35 (05) ◽  
pp. 509-514 ◽  
Author(s):  
Yasser ElSayed ◽  
Cecil Ojah ◽  
Ruben Alvaro ◽  
Prakesh Shah ◽  
Michael Dunn ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Ductus Arteriosus ◽  
Neonatal Intensive Care Units ◽  
Preterm Neonates ◽  
Surfactant Treatment ◽  
Surgical Ligation ◽  
Extremely Preterm ◽  
Maternal Hypertension

Objective To identify clinical factors those predict the need for patent ductus arteriosus (PDA) treatment in preterm neonates who had received prophylactic indomethacin. Patients and Methods Preterm neonates with <28 weeks' gestational age admitted to level III neonatal intensive care units (NICUs) in Canada between 2010 and 2015 and who had received prophylactic indomethacin were included. Primary outcome was surgical ligation of PDA, while secondary outcomes were any PDA treatment and common neonatal morbidities. Results Of the 7,024 eligible neonates, 843 (12%) neonates had received prophylactic indomethacin. Of them, 84 neonates (10%) required surgical ligation while 367 neonates (44%) received medical or surgical treatment for PDA. Logistic regression analyses identified gestational age (odds ratio [OR]: 0.71, 95% confidence interval [CI]: 0.58–0.87) and outborn status (OR: 2.07, 95% CI: 1.09–3.93) as predictors for surgical ligation. Maternal hypertension (OR: 0.57, 95% CI: 0.37–0.89), rupture of membranes (ROM) ≥24 hours (OR: 0.68, 95% CI: 0.48–0.96), and surfactant treatment (OR: 1.70, 95% CI: 1.09–2.66) were predictors for medical or surgical treatment of PDA. Conclusion In extremely preterm neonates who had received prophylactic indomethacin, gestational age and outborn status were predictors for surgical ligation of PDA, while maternal hypertension, ROM ≥24 hours, and surfactant treatment were associated with the medical or surgical treatment of PDA.

Childbearing culture: a prominent context in the process of maternal role attainment in Iranian mothers with preterm neonates

2021 ◽  
pp. 1-12
Author(s):  
Mona Alinejad-Naeini ◽  
Hamid Peyrovi ◽  
Mahnaz Shoghi
Keyword(s):  
Cultural Context ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Preterm Neonates ◽  
Maternal Role ◽  
Cultural Perceptions ◽  
Factors Affecting ◽  
Purposeful Sampling ◽  
Biological Event ◽  
Maternal Role Attainment

Abstract Transition to the role of mothering is one of the most important events in a woman’s life. While childbirth is a biological event, pregnancy and the experiences around it are more influenced by social structure, which is shaped by cultural perceptions and practices. The aim of this study was to explore cultural context during maternal role attainment in neonatal intensive care units (NICUs) in Iran. The study was part of a grounded theory study on how the mothers of preterm neonates go through maternal role attainment. Data collection was carried out by purposeful sampling from 20 participants (15 mothers of preterm neonates and 5 NICU nurses). Data were analysed according to Corbin and Strauss’s (2015) approach. Four categories of childbearing culture emerged: ‘The necessity of childbearing’, ‘Childbearing rituals’, ‘Maternal persistent presence’ and ‘Attitudes and religious beliefs’. The findings showed that the special beliefs and practices in Iranian culture affected all of the participants’ reactions to mothering process. Culture is one of the most important factors affecting the development of motherhood in Iran. In order to provide sensitive and culturally appropriate care, nurses should be aware of the general impact of cultural norms and values on the process of maternal role attainment and strive to meet the cultural needs of all mothers.

Centrally inserted central catheters in preterm neonates with weight below 1500 g by ultrasound-guided access to the brachio-cephalic vein

2020 ◽  
pp. 112972982094017
Author(s):  
Giovanni Barone ◽  
Mauro Pittiruti ◽  
Gina Ancora ◽  
Giovanni Vento ◽  
Francesca Tota ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Neonatal Intensive Care ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Cephalic Vein ◽  
Preterm Neonates ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Vein Catheterization

Objective: Central venous access in critically ill newborns can be challenging. Ultrasound-guided brachio-cephalic vein catheterization is a relatively new procedure, recently introduced in several neonatal intensive care units. The aim of this study is to evaluate the safety and feasibility of such a technique in preterm babies. Design: Retrospective analysis of prospectively collected data on ultrasound-guided central venous catheter insertion in preterm neonates. Setting: Neonatal intensive care unit. Patients: Critically ill preterm neonates with weight below 1500 g requiring a central access. Interventions: Ultrasound-guided brachio-cephalic vein catheterization. Main Results: Thirty centrally inserted catheters were placed in 30 neonates. The success rate of the procedure was 100%. No case of accidental arterial or pleural puncture was registered during the study period. Conclusion: The brachio-cephalic vein can be safely catheterized in preterm newborns requiring intensive care after appropriate training.

scholarly journals Identifying medication errors in neonatal intensive care units: a two-center study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kaveh Eslami ◽  
Fateme Aletayeb ◽  
Seyyed Mohammad Hassan Aletayeb ◽  
Leila Kouti ◽  
Amir Kamal Hardani
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Medication Errors ◽  
Medical Records ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Neonatal Intensive Care Units ◽  
Preterm Neonates ◽  
Cross Sectional ◽  
Quality Of Prescribing

Abstract Background This study aimed to assess the types and frequency of medication errors in our NICUs (neonatal intensive care units). Methods This descriptive cross-sectional study was conducted on two neonatal intensive care units of two hospitals over 3 months. Demographic information, drug information and total number of prescriptions for each neonate were extracted from medical records and assessed. Results A total of 688 prescriptions for 44 types of drugs were checked for the assessment of medical records of 155 neonates. There were 509 medication errors, averaging (SD) 3.38 (+/− 5.49) errors per patient. Collectively, 116 neonates (74.8%) experienced at least one medication error. Term neonates and preterm neonates experienced 125 and 384 medication errors, respectively. The most frequent medication errors were wrong dosage by physicians in prescription phase [WU1] (142 errors; 28%) and not administering medication by nurse in administration phase (146 errors; 29%). Of total 688 prescriptions, 127 errors were recorded. In this regard, lack of time and/or date of order were the most common errors. Conclusions The most frequent medication errors were wrong dosage and not administering the medication to patient, and on the quality of prescribing, lack of time and/or date of order was the most frequent one. Medication errors happened more frequently in preterm neonates (P < 0.001). We think that using computerized physician order entry (CPOE) system and increasing the nurse-to-patient ratio can reduce the possibility of medication errors.

scholarly journals Neonatologist performed echocardiography (NPE) in Italian neonatal intensive care units: a national survey

2019 ◽  
Vol 45 (1) ◽  
Author(s):  
Iuri Corsini ◽  
◽  
Benjamim Ficial ◽  
Stefano Fiocchi ◽  
Federico Schena ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Ductus Arteriosus ◽  
Neonatal Intensive Care Units ◽  
Formal Training ◽  
On Line ◽  
Critically Ill Neonates ◽  
Line Survey

Abstract Background Neonatologist performed echocardiography (NPE) has increasingly been used to assess the hemodynamic status in neonates. Aim of this survey was to investigate the utilization of NPE in Italian neonatal intensive care units (NICUs). Methods We conducted an on-line survey from June to September 2017. A questionnaire was developed by the Italian neonatal cardiology study group and was sent to each Italian NICU. Results The response rate was 77%. In 94% of Italian NICUs functional echocardiography was used by neonatologists, cardiologists or both (57, 15 and 28% respectively). All the respondents used NPE in neonates with patent ductus arteriosus and persistent pulmonary hypertension, 93% in neonates with hypotension or shock, 85% in neonates with perinatal asphyxia, 78% in suspicion of cardiac tamponade, and 73% for line positioning. In 30% of center, there was no NPE protocol. Structural echocardiography in stable and critically ill neonates was performed exclusively by neonatologists in 46 and 36% of center respectively. Conclusions NPE is widely used in Italian NICUs by neonatologists. Structural echocardiography is frequently performed by neonatologists. Institutional protocols for NPE are lacking. There is an urgent need of a formal training process and accreditation to standardize the use of NPE.

Indian Health Service—By One Who Provides It

PEDIATRICS ◽  
1974 ◽  
Vol 53 (6) ◽  
pp. 950-950
Author(s):  
Henry M. Sondheimer
Keyword(s):  
Health Service ◽  
Neonatal Intensive Care ◽  
Close Contact ◽  
Newborn Infants ◽  
Neonatal Intensive Care Units ◽  
Indian Health Service ◽  
Transit System ◽  
Indian Health ◽  
Sick Newborn ◽  
Seriously Ill

As one of the "young, highly idealistic physicians, just out of internship or residency . . ." and currently in the Indian Health Service, I read the Commentaries of Drs. Mortimer and Kemberling with great interest. Although it is unfair to extrapolate from my experiences at one hospital to the entire Indian Health Service, I believe a practicing pediatrician in the field may comment. Dr. Mortimer may be surprised to hear that sick newborn infants at our hospital are cared for not by aides but by physicians in close contact with the Arizona Newborn Transit System in Phoenix (250 miles away), and that seriously ill newborns are transferred to one of the two neonatal intensive care units in Phoenix under the auspices of this system.

Through the Looking Glass—Or, Look Before You Leap

PEDIATRICS ◽  
1982 ◽  
Vol 70 (6) ◽  
pp. 1001-1003
Author(s):  
GEORGE CASSADY
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Newborn Infants ◽  
Neonatal Intensive Care Units ◽  
Careful Study ◽  
Chest Tubes ◽  
Newborn Intensive Care ◽  
Deep Thought ◽  
Looking Glass

Nurses are now so active in newborn intensive care units that exchange transfusions, lumbar punctures, vascular catheterizations, placement of chest tubes, and many other complex and complicated but time-consuming procedures need no longer burden the busy physician. According to the neonatologists in charge, specially educated nurses are independently performing these and many other tasks in most neonatal intensive care units (NICUs). Assuming that similar practices exist in those units not assessed and that nurses are in fact doing what the neonatologists say they are, these amazing observations deserve careful study and deep thought by all who care for newborn infants.

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