Score for Neonatal Acute Physiology: Validation in Three Kaiser Permanente Neonatal Intensive Care Units

PEDIATRICS ◽  
1995 ◽  
Vol 96 (5) ◽  
pp. 918-922 ◽  
Author(s):  
Gabriel J. Escobar ◽  
Allen Fischer ◽  
De Kun Li ◽  
Robert Kremers ◽  
Mary Anne Armstrong
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Hospital Mortality ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Severity Of Illness ◽  
Predictive Ability ◽  
Neonatal Intensive Care Units ◽  
Total Hospital ◽  
Total Hospital Stay

Background. Measurement of the severity of illness is a research area of growing importance in neonatal intensive care. Most severity of illness scales have been developed in tertiary care settings. Their applicability in community neonatal intensive care units has not been tested. Objectives. Our goal was to assess the operational characteristics of the score for neonatal acute physiology (SNAP): the relationship to birth weight, the length of total hospital stay, and in-hospital mortality. Methods. We assigned SNAP scores prospectively to all inborn admissions at three community neonatal intensive care units during an 11-month period. Data on other neonatal predictors (eg, birth weight and the presence of congenital heart disease) were also collected. We measured in-hospital mortality, the experience of interhospital transport to a higher level of care, and total hospital stay. Results. We found that the SNAP's relationship to birth weight was similar to previous reports. The SNAP's perinatal extension is a reliable predictor of newborn in-hospital mortality, with an area under the receiver operator characteristic curve of 0.95. The SNAP is also a good predictor of total hospital length of stay, whether by itself (by which it can explain 31% of the total stay) or in combination with other variables. Its predictive ability is better among infants of low birth weight (<2500 g) than among those of normal birth weight (≥2500 g). The SNAP's predictive power was most limited among infants admitted to rule out sepsis. The predictive ability of a model containing birth weight, the SNAP, and transport status was not improved by the inclusion of two major diagnostic categories, the presence of congenital heart disease or complex illness. Conclusion. Although it has definite limitations among infants who weigh 2500 g or more, the SNAP is a potent tool for outcomes research. Modification of some of its parameters could result in a multifunctional scale suitable for use with all birth weights.

Device-associated pneumonia of very low birth weight infants in Polish Neonatal Intensive Care Units

2016 ◽  
Vol 61 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Jadwiga Wójkowska-Mach ◽  
T. Allen Merritt ◽  
Maria Borszewska-Kornacka ◽  
Joanna Domańska ◽  
Ewa Gulczyńska ◽  
...  
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Neonatal Intensive Care Units ◽  
Low Birth Weight Infants

Morbidity and Mortality Among Low Birth Weight Infants Exposed to an Intravenous Vitamin E Product, E-Ferol

PEDIATRICS ◽  
1989 ◽  
Vol 83 (2) ◽  
pp. 244-249
Author(s):  
Janet B. Arrowsmith ◽  
Gerald A. Faich ◽  
Dianne K. Tomita ◽  
Joel N. Kuritsky ◽  
Franz W. Rosa
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Vitamin E ◽  
Low Birth Weight ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Morbidity And Mortality ◽  
Neonatal Intensive Care Units ◽  
Low Birth Weight Infants ◽  
Intravenous Vitamin

In April 1984, the US FDA was notified of an unusual clinical syndrome consisting of ascites, liver and renal failure, thrombocytopenia, and death among low birth weight infants exposed to an intravenous vitamin E preparation, E-Ferol. The product, which had not been tested for safety prior to marketing, was voluntarily withdrawn from the market in early April. To further investigate the reported associations, the FDA conducted a retrospective cohort study among seven neonatal intensive care units where the product had been used. Standardized abstraction forms were completed for infants admitted to a unit between Nov 1, 1983, and April 30, 1984. Included in the study were 379 infants weighing 2,000 g or less and surviving at least two days; 148 (39%) had been exposed to E-Ferol. Compared with the unexposed infants, the exposed infants were more likely to die and to have ascites, hepatomegaly, thrombocytopenia, and a combination of clinical events similar to the syndrome initially reported. We conclude that the use of E-Ferol in these neonatal intensive care units was associated with increased morbidity and mortality among exposed infants.

Holding the Very Low Birth Weight Infant: Skin-to-Skin Techniques

2005 ◽  
Vol 24 (1) ◽  
pp. 7-14 ◽  
Author(s):  
Theresa Kledzik
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Intensive Care Units ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Neonatal Intensive Care Units ◽  
Low Birth Weight Infant ◽  
Skin To Skin

Skin-to-skin holding has been reported as a valuable intervention for preterm infants for over a decade. However, many neonatal intensive care units are not practicing this therapy and cite lack of protocols and techniques as a barrier. This article describes in detail the nursing considerations and techniques involved to successfully implement skin-to-skin holding for very low birth weight, technology-dependent infants. NICU protocols can be derived from this article.

scholarly journals Critérios clínicos e insumos utilizados no banho de recém-nascidos pré-termo de muito baixo peso

2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Samara Cecilia Sabino Pereira Da silva ◽  
Elizandra Cassia Da Silva Oliveira ◽  
Ana Virginia Rodrigues Verissimo ◽  
Katia Maria Mendes ◽  
Regina Celia De Oliveira
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Tap Water ◽  
Neonatal Intensive Care Units ◽  
Clinical Criteria ◽  
Terapia Intensiva

Objetivo: identificar os critérios clínicos e insumos utilizados para a administração do primeiro banho em recém-nascido prematuro de muito baixo peso internado em unidades de terapia intensiva neonatal.Métodos: estudo descritivo, com abordagem quantitativa. Com base no Método Canguru/Ministério da saúde, realizado em cinco unidades de terapia intensiva neonatal; população composta por 82 profissionais da equipe de enfermagem. Resultados: os critérios clínicos não apontados na avaliação foram 19,5% para a saturação de oxigênio, 23,2% frequência cardíaca e 29,3% frequência respiratória. Os insumos utilizados na realização do primeiro banho: água de torneira aquecida 56,1%, com controle bacteriológico 52,4%, sabão líquido 89,0%, com pH neutro em 76,8%. Conclusão: a não observância dos sinais clínicos e os insumos inadequados para a realização do banho do recém-nascido prematuro de muito baixo peso pode colocar em risco a segurança do paciente; emergindo adequações para fortalecimento da prática clínica da enfermagem.Descritores: Recém-Nascido de Muito Baixo Peso; Unidades de Terapia Intensiva Neonatal; Enfermagem Neonatal; Banhos. Objective: To identify the clinical criteria and inputs used for the administration of the first bath in a very low birth weight premature newborns in neonatal intensive care units. Methods: descriptive study, with a quantitative approach based on the Kangaroo/Ministry of Health Method, carried out in five neonatal intensive care units; population composed of 82 professionals from the nursing team. Results: The clinical criteria not mentioned in the evaluation were 19.5% for oxygen saturation, 23.2% heart rate and 29.3% respiratory rate. The inputs used in the first bath: heated tap water (56.1%), with bacteriological control (52.4%), liquid soap (89.0%), with neutral pH (76.8%). Conclusion: Failure to observe clinical signs and inadequate supplies for bathing the very low birth weight premature newborn can put patient safety at risk; emerging adaptations to strengthen clinical nursing practice.Descriptors: Infant, Very Low Weight; Neonatal Intensive Care Units; Neonatal Nursing; Baths. Objetivo: Identificar los criterios clínicos y los insumos utilizados para la administración del primer baño en recién nacidos prematuros de muy bajo peso al nacer en unidades de cuidados intensivos neonatales. Métodos: Estudio descriptivo, con enfoque cuantitativo, basado en el Método Canguro/Ministerio de Salud, realizado en cinco unidades de cuidados intensivos neonatales; población compuesta por 82 profesionales del equipo de enfermería. Resultados: Los criterios clínicos no mencionados en la evaluación fueron 19.5% para la saturación de oxígeno, 23.2% de frecuencia cardíaca y 29.3% de frecuencia respiratoria. Los insumos utilizados en el primer baño: agua caliente del grifo (56.1%), con control bacteriológico (52.4%), jabón líquido (89.0%), con pH neutro (76.8%). Conclusión: El incumplimiento de los signos clínicos y los suministros inadecuados para bañar al recién nacido prematuro de muy bajo peso pueden poner en riesgo la seguridad del paciente; adaptaciones emergentes para fortalecer la práctica clínica de enfermería.Descriptores: Infantil, Muy Bajo Peso; Unidades de Cuidados Intensivos Neonatales; Enfermería Neonatal; Baños.

scholarly journals Cytomegalovirus Infection among Infants in Neonatal Intensive Care Units, California, 2005 to 2016

2019 ◽  
Vol 37 (02) ◽  
pp. 146-150
Author(s):  
Chinh Tran ◽  
Mihoko V. Bennett ◽  
Jeffrey B. Gould ◽  
Henry C. Lee ◽  
Tatiana M. Lanzieri
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Hospital Stay ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Length Of Hospital Stay ◽  
Neonatal Intensive Care Units ◽  
Cmv Infection ◽  
Vlbw Infants

Aim The main purpose of this article is to assess trends in cytomegalovirus (CMV) infection reported among infants in California neonatal intensive care units (NICUs) during 2005 to 2016. Study Design The California Perinatal Quality Care Collaborative collects data on all very low birth weight (VLBW, birth weight ≤ 1,500 g) and acutely ill infants > 1,500 g, representing 92% of NICUs in California. We compared clinical characteristics and length of hospital stay among infants with and without reported CMV infection (CMV-positive viral culture or polymerase chain reaction). Results During 2005 to 2016, CMV infection was reported in 174 VLBW infants and 145 infants > 1,500 g, or 2.7 (range: 1.5–4.7) and 1.2 (range: 0.8–1.7) per 1,000 infants, respectively (no significant annual trend). Among infants > 1,500 g, 12 (8%) versus 4,928 (4%) of those reported with versus without CMV infection died (p < 0.05). The median hospital stay was significantly longer among infants reported with versus without CMV infection for both VLBW infants (98 vs. 46 days) and infants > 1,500 g (61 vs. 14 days) (p < 0.001). Conclusion Reports of CMV infection remained stable over a 12-year period. Although we were not able to assess whether infection was congenital or postnatal, CMV infection among infants > 1,500 g was associated with increased mortality.

Surveillance swabbing for MRSA on neonatal intensive care units – is weekly nasal swabbing the best option?

2012 ◽  
Vol 13 (4) ◽  
pp. 120-124 ◽  
Author(s):  
Donovan Duffy ◽  
Mehdi Garbash ◽  
Mike Sharland ◽  
Nigel Kennea
Keyword(s):  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Birth Weight ◽  
Intensive Care Units ◽  
Gestational Age ◽  
Optimal Strategy ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Nasal Swabs ◽  
Surveillance Specimens

Most paediatric meticillin resistant Staphylococcus aureus (MRSA) infections occur in neonatal units, but evidence for ongoing MRSA surveillance is lacking and practice varies. The aim of this study was to determine the optimal strategy for neonatal MRSA screening according to swab site, gestational age and birth weight. MRSA detection on simultaneous weekly nasal and groin surveillance swabs and suspected infected sites was determined for all admissions to a tertiary neonatal unit over eight years. Twenty one thousand, seven hundred and thirty six surveillance specimens were examined (3,784 admissions). Infants colonised with MRSA were smaller and of lower gestational age compared with uncolonised infants ( p<0.0001). Infants initially positive on groin swabs alone (13/68; 19%) were of significantly greater gestational age and weight at birth compared with infants initially positive on nose swabs/both nose and groin swabs (55/68; 80%). Infants initially identified on groin swabs were all subsequently detected on nasal swabs or discharged within two weeks of age. 18/86 (21%) of MRSA cases were initially detected on swabbing suspected infected sites. Surveillance swabbing identified 43% of infants before MRSA bacteraemia. Eighty five per cent of colonised infants would be detected by weekly nasal swabs and by swabbing suspected infected sites. Groin swabs detect a small number of bigger mature babies who are discharged before two weeks of age.

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