scholarly journals THE MEANINGS OF CARING FOR PRE-TERM CHILDREN IN THE VISION OF MALE PARENTS

2016 ◽  
Vol 25 (4) ◽  
Author(s):  
Rachel Leite de Souza Ferreira Soares ◽  
Marialda Moreira Christoffel ◽  
Elisa da Conceição Rodrigues ◽  
Maria Estela Diniz Machado ◽  
Adriana Loureiro da Cunha
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Gender Equity ◽  
Thematic Analysis ◽  
Neonatal Intensive Care ◽  
Paternal Care ◽  
Structured Interviews ◽  
Term Infants ◽  
Ethnographic Approach

ABSTRACT The purposes of the study was to analyze the meanings assigned by the father to the assistance of pre-term infants in a Neonatal Intensive Care Unit and to discuss how these meanings influence paternal care. It is a qualitative study with an ethnographic approach, carried out in a neonatal unit in Rio de Janeiro. Twenty-two fathers whose pre-term infants were hospitalized have been interviewed. Data were collected by means of a field logbook, participative observation and semi-structured interviews. Through thematic analysis, the inferred categories were a) father-child proximity and the permanence at the Neonatal Intensive Care Unit: overcoming obstacles and revealing motivations, b) the inclusion of fathers in caring for pre-term children: limits and possibilities. Nurses should favor the proximity of fathers and newborns to strengthen their relationship. The intensivist care neonatal practice should include strategies to support male parenting in pre-term birth considering the perspective of gender equity.

A Mixed Methods Analysis of Parental Perspectives on Diagnosis and Prognosis of Neonatal Intensive Care Unit Graduates With Cerebral Palsy

2020 ◽  
Vol 35 (5) ◽  
pp. 336-343
Author(s):  
Katherine Guttmann ◽  
John Flibotte ◽  
Sara B. DeMauro ◽  
Holli Seitz
Keyword(s):  
Intensive Care Unit ◽  
Cerebral Palsy ◽  
Content Analysis ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Thematic Analysis ◽  
Neonatal Intensive Care ◽  
Free Text ◽  
Word Count ◽  
Linguistic Inquiry

This study aimed to evaluate how parents of former neonatal intensive care unit patients with cerebral palsy perceive prognostic discussions following neuroimaging. Parent members of a cerebral palsy support network described memories of prognostic discussions after neuroimaging in the neonatal intensive care unit. We analyzed responses using Linguistic Inquiry and Word Count, manual content analysis, and thematic analysis. In 2015, a total of 463 parents met eligibility criteria and 266 provided free-text responses. Linguistic Inquiry and Word Count analysis showed that responses following neuroimaging contained negative emotion. The most common components identified through the content analysis included outcome, uncertainty, hope/hopelessness, and weakness in communication. Thematic analysis revealed 3 themes: (1) Information, (2) Communication, and (3) Impact. Parents of children with cerebral palsy report weakness in communication relating to prognosis, which persists in parents’ memories. Prospective work to develop interventions to improve communication between parents and providers in the neonatal intensive care unit is necessary.

scholarly journals Each Additional Day of Antibiotics Is Associated With Lower Gut Anaerobes in Neonatal Intensive Care Unit Patients

2019 ◽  
Vol 70 (12) ◽  
pp. 2553-2560
Author(s):  
Ashley M Rooney ◽  
Kathryn Timberlake ◽  
Kevin A Brown ◽  
Saumya Bansal ◽  
Christopher Tomlinson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Taxonomic Composition ◽  
Term Infants ◽  
Cross Sectional ◽  
Adjusted Risk ◽  
Treatment Regimens

Abstract Background Discontinuation of inappropriate antimicrobial therapy is an important target for stewardship intervention. The drug and duration-dependent effects of antibiotics on the developing neonatal gut microbiota needs to be precisely quantified. Methods In this retrospective, cross-sectional study, we performed 16S rRNA sequencing on stool swab samples collected from neonatal intensive care unit patients within 7 days of discontinuation of therapy who received ampicillin and tobramycin (AT), ampicillin and cefotaxime (AC), or ampicillin, tobramycin, and metronidazole (ATM). We compared taxonomic composition within term and preterm infant groups between treatment regimens. We calculated adjusted effect estimates for antibiotic type and duration of therapy on the richness of obligate anaerobes and known butyrate-producers in all infants. Results A total of 72 infants were included in the study. Term infants received AT (20/28; 71%) or AC (8/28; 29%) with median durations of 3 and 3.5 days, respectively. Preterm infants received AT (32/44; 73%) or ATM (12/44; 27%) with median durations of 4 and 7 days, respectively. Compositional analyses of 67 stool swab samples demonstrated low diversity and dominance by potential pathogens. Within 1 week of discontinuation of therapy, each additional day of antibiotics was associated with lower richness of obligate anaerobes (adjusted risk ratio [aRR], 0.84; 95% confidence interval [CI], .73–.95) and butyrate-producers (aRR, 0.82; 95% CI, .67–.97). Conclusions Each additional day of antibiotics was associated with lower richness of anaerobes and butyrate-producers within 1 week after therapy. A longitudinally sampled cohort with preexposure sampling is needed to validate our results.

The Characteristics and Outcomes of Cardiopulmonary Resuscitation within the Neonatal Intensive Care Unit Based on Gestational Age and Unit Level of Care

2019 ◽  
Vol 37 (14) ◽  
pp. 1455-1461
Author(s):  
Kaashif A. Ahmad ◽  
Steven G. Velasquez ◽  
Katy L. Kohlleppel ◽  
Cody L. Henderson ◽  
Christina N. Stine ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiopulmonary Resuscitation ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Adverse Outcome ◽  
San Antonio ◽  
Spontaneous Circulation ◽  
Term Infants

Objectives This study aimed to describe the variation of in-neonatal intensive care unit (NICU) cardiopulmonary resuscitation (CPR) characteristics and outcomes across different gestational ages and levels of NICU care. Study Design This is a retrospective cohort study of in-NICU CPR events across 10 NICUs in San Antonio, TX from 2012 through 2017. Results We identified 140 patients experiencing a total of 210 in-NICU CPR events. CPR was performed in 0.23% of Level III and 0.85% of Level IV NICU admissions. Gestational age was inversely related to CPR incidence. The median age at in-NICU CPR was lower for preterm versus term infants (6 vs. 28 days, p = 0.002). With regression modeling, each added minute of chest compression decreased the odds of return to spontaneous circulation by 11%. Conclusion In-NICU CPR incidence rises with decreasing gestational age and increasing level of NICU care. The rate of return of spontaneous circulation decreases significantly with increasing duration of chest compressions. Further study is needed to identify patient factors associated with adverse outcome.

scholarly journals Family organization for the care of children with chronic conditions, discharged from the neonatal intensive care unit

2014 ◽  
Vol 23 (2) ◽  
pp. 318-327 ◽  
Author(s):  
Corina Lemos Jamal Nishimoto ◽  
Elysângela Dittz Duarte
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Chronic Conditions ◽  
Neonatal Intensive Care ◽  
Management Style ◽  
Family Management ◽  
Structured Interviews ◽  
Family Organization ◽  
Children With Chronic Conditions

A qualitative study that aimed to examine family organization for the care of children with chronic conditions, discharged from the Neonatal Intensive Care Unit (NICU). The subjects were 12 relatives of children with chronic health conditions. Data were collected through genograms, ecomaps and semi-structured interviews, developed based on the Family Management Style Framework theoretical model and analyzed using thematic content analysis. The organization of families is related to the ongoing care requirements of the children, considering the routines of care established in the period immediately after discharge from the hospital and continuing up to the present. It was established that families access their social networks to handle the required care.

Abstract 120: Epidemiology and Outcomes of Cardiopulmonary Resuscitation Events in the Neonatal Intensive Care Unit

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Kaashif A Ahmad ◽  
Steven G Velasquez ◽  
Cody L Henderson ◽  
Katy L Kohlleppel ◽  
Jaclyn M LeVan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiopulmonary Resuscitation ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Pulseless Electrical Activity ◽  
Chest Compressions ◽  
Term Infants ◽  
Level Ii ◽  
High Acuity

Introduction: Limited data exists regarding cardiopulmonary resuscitation (CPR) in infants in the Neonatal Intensive Care Unit (NICU). Objectives included determining the incidence, demographics, diagnoses, and outcomes of infants who require CPR across 10 NICUs in San Antonio, Texas. Methods: We conducted a retrospective review of in-NICU CPR events requiring chest compressions for 1 minute from 2012 - 2017. Included NICUs provided the following levels of care: two level IV, two high acuity level III, four low acuity level III, and two level II. Case identification occurred by reviewing death summaries and CPR coding in the electronic medical record. Results: In total, 139 infants (81 or 58% male) required 211 episodes of CPR. CPR incidence per 1000 patient days was 0.68, 0.37, 0.02 and 0 among level IV, high acuity level III, low acuity level III, and level II NICUs, respectively. Median birth weight was 945 (IQR 630, 2243) grams, gestational age at birth 27 (IQR 24, 34) weeks and age at CPR 11 (IQR 1, 42) days. Only 27 events (13%) occurred in term infants. Ninety-three CPR events (44%) had a primary respiratory etiology, 38 (18%) circulatory, 36 (17%) infectious, and 24 (11%) metabolic. Term and preterm infants had significantly different CPR etiologies (p=0.036). Circulatory etiologies were more common in term infants (37% vs 15%) with respiratory etiologies being less common (33.3% vs 46.2%). The most common rhythm documented leading to initiation of CPR was bradycardia (63%), followed by asystole (19%), and pulseless electrical activity (14%). The median duration of CPR was 10 (IQR 4, 25.5) minutes and chest compressions 8 (IQR 3, 18) minutes. While 135 of 211 CPR events (64%) had ROSC, only 22 of 139 patients (16%) survived to hospital discharge. The rate of ROSC among Level IV NICUs was significantly higher than in high acuity level III NICUs (68.2% vs 51.9%, p = 0.034). Conclusions: NICU CPR events occur most commonly in premature infants and are respiratory in origin. Bradycardia is the most common initial rhythm requiring CPR in the NICU. The incidence of CPR and the rate of ROSC are higher in level IV than level III NICUs. Further investigation is needed into factors associated with ROSC for in-NICU CPR.

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