scholarly journals Role of neurosonography in neonates with clinically suspected intracranial pathology

2019 ◽  
Vol 7 (6) ◽  
pp. 2302
Author(s):  
Abhishek Gahlot ◽  
Anil Joshi
Keyword(s):  
Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Periventricular Leukomalacia ◽  
Preterm Neonates ◽  
Neurodevelopmental Outcomes ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Grade 3 ◽  
Ischemic Encephalopathy

Background: Preterm neonates have a higher mortality and morbidity because of their greater risk for intracranial hemorrhage (ICH), hypoxic ischemic encephalopathy(HIE) which can lead to poor neurodevelopmental outcomes. The present study was conducted to evaluate neonates with clinically suspected intracranial pathology by neurosonography.Methods: Included neonates were those with clinically suspected intracranial pathology admitted to neonatal intensive care unit of the Bharati Vidyapeeth Medical College and Hospital (Deemed to be University), Sangli from October 2018 till December 2018. First cranial neurosonography was done between first and third day, second between 7th and 10th day of birth. HIE also known as Periventricular leukomalacia (PVL) grading was done using the De Varies et al, grading. Severity of ICH was graded according to Papile and Burstein classification(1978).Results: Of the total 60 neonates, 61.7% were preterm and rest at term. Mean APGAR score at 1 minute was 8.6 (range 5 to 10) and at 5 minutes was 9.58 (range 8 to 10). Mean ventricular index at the first assessment was 26.78% and 26.89% at the second assessment. Grade 1 HIE was found in 17 neonates on first assessment, and two had grade 2 HIE. Second assessment revealed grade 1 HIE in 20 neonates and grade 2 in two. First assessment revealed two neonates with grade 1 and grade 2 ICH, out of which one grade 2 ICH worsened to grade 3. Two neonates were found to have corpus callosal agenesis.Conclusions: Transcranial neurosonography stands as an excellent and reliable investigation of choice for neonates to detect HIE,ICH and intracranial congenital anomalies.

Shifting focus toward healthcare-associated bloodstream infections: The need for neonatal intensive care unit–specific NHSN definitions

2019 ◽  
pp. 1-6 ◽  
Author(s):  
Sonali D. Advani ◽  
Thomas S. Murray ◽  
Christina M. Murdzek ◽  
Michael J. Aniskiewicz ◽  
Matthew J. Bizzarro
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Bloodstream Infections ◽  
Mucosal Barrier ◽  
Preterm Neonates ◽  
Site Specific ◽  
Mortality And Morbidity ◽  
Healthcare Associated

Abstract Objective: Healthcare-associated bloodstream infections (HABSIs) are a significant cause of mortality and morbidity in the neonatal intensive care unit (NICU) population. Our objectives were to review the epidemiology of HABSIs in our NICU and to examine the applicability of National Healthcare Safety Network (NHSN) definitions to the NICU population. Methods: We performed a retrospective review of all neonates admitted to the 54-bed, level IV NICU at Yale-New Haven Children’s Hospital with a HABSI between January 1, 2013, and December 31, 2018. Clinical definitions per NICU team and NHSN site-specific definitions used for source identification were compared using the McNemar χ2 test. Results: We identified 86 HABSIs with an incidence rate of 0.80 per 1,000 patient days. Only 13% of these were CLABSIs. Both CLABSIs and non–catheter-related bloodstream infections occurred primarily in preterm neonates, but the latter were associated with a significantly higher incidence of comorbidities and the need for respiratory support. The NHSN definitions were less likely to identify a source compared to the clinical definitions agreed upon by our NICU treating team (P < .001). Furthermore, 50% of patients without an identified source of infection by NHSN definitions were bacteremic with a mucosal barrier injury organism, likely from gut translocation. Conclusions: HABSIs occur primarily in premature infants with comorbidities, and CLABSIs account for a small proportion of these infections. With the increasing focus on HABSI prevention, there is a need for better NHSN site-specific definitions for the NICU population to prevent misclassification and direct prevention efforts.

scholarly journals ASSOCIATION OF THE IMPACT OF POSTNATAL NUTRITION ON THE GROWTH OF PRETERM INFANTS <34 WEEKS GESTATIONAL AGE FROM BIRTH TO DISCHARGE

2020 ◽  
pp. 63-67
Author(s):  
JITENDRA SINGH FAUJDAR ◽  
KALPANA SINGH ◽  
RAJVEER SINGH YADAV ◽  
JITENDRA KUMAR GUPTA ◽  
MUNISH KAKKAR ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Nutritional Supplement ◽  
Preterm Neonates ◽  
Preterm Baby ◽  
Medical College ◽  
Gandhi Medical College ◽  
The Impact

Objectives: The objectives of the study were to measure the actual daily amount of each nutrient (protein, glucose, and fat) energy and fluid as per current ESPGHAN guidelines for preterm infants and to analyze the role of nutrients at different gestational age on growth and weight of preterm infants. Material and Methods: An observational and prospective cohort study was conducted from January 1, 2018, to December 31, 2018. This study included all preterm infants born <34 weeks gestational age admitted in the neonatal intensive care unit during this period at Mahatma Gandhi Medical College and Hospital. A total of 120 preterm neonates were studied. Results: There were mean weight, length, and head circumference continues to rise till the study end. Mean energy at birth was also continues to rise till the end. Conclusion: In the study, proper nutritional supplement as per ESPHAGEN guidelines was used for the development of preterm infant. The study showed that there were statistically significant results with anthropometry parameters with preterm baby growth in all domains.

scholarly journals Feeding Intolerance in Preterm Neonates in Neonatal Intensive Care Unit, Padma General hospital, Dhaka

2017 ◽  
Vol 8 (1) ◽  
pp. 178-180
Author(s):  
Md Atiqul Islam ◽  
Sheuly Begum ◽  
BH Nazma Yasmeen ◽  
Jesmin Ahmed ◽  
Md Mahdi Amin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
General Hospital ◽  
Enteral Feeding ◽  
Neonatal Intensive Care ◽  
Clinical Symptoms ◽  
Preterm Neonates ◽  
Feeding Intolerance ◽  
Medical College

Background : Premature infants frequently suffer from feeding intolerance and is highly associated to morbidity and mortality. It is a great challenge which have to face all the neonatologist. Feeding intolerance can be defined by difficulty in ingestion or digestion of the milk that causes a disruption in the enteral feeding plan due to the manifestation of some clinical symptoms. These symptoms include gastric residuals, emesis, abdominal distention, visible bowel loops, and change in the character of stool etc.Objective : To determine the frequency of feeding intolerance in hospitalized preterm neonates.Methods : This prospective study was carried out on preterm neonates admitted at neonatal intensive care unit of Padma General Hospital from 1st January 2016 to 31st December 2016. Inclusion criteria included Preterm infants of both genders from day 0 to day 28 of life and with gestational age (GA) of 28 to 36 weeks (estimated by 1st day of maternal last menstrual period). Diagnosis of feeding intolerance depends on presence of one or more signs that leading to interruption of the enteral feeding regime of the preterm.Results : The incidence of feeding intolerance in hospitalized preterm was 4.2%Conclusion : The percentage of feeding intolerance in our study is 4.2% of the preterm neonate.Northern International Medical College Journal Vol.8(1) July 2016: 178-180

scholarly journals Clinical Profile and Outcome of Asphyxiated Newborn in a Medical College Teaching Hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Kiran Panthee ◽  
Kiran Sharma ◽  
Balkrishna Kalakheti ◽  
Kul Thapa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Survival Rate ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
College Teaching ◽  
Inclusion Criteria ◽  
Mortality And Morbidity ◽  
Medical College

Introduction: Perinatal asphyxia, a major topic in neonatology, is a severe condition which has a high impact on neonatal mortality and morbidity and neurological and intellectual development of the infant. It is defined by WHO as "failure to initiate and sustain breathing at birth". It is estimated that around four million babies are born asphyxiated and among those one million die and an equal number of babies develop serious neurological consequences ranging from cerebral palsy and mental retardation to epilepsy. This study was done to identify the occurrence, clinical profile and, immediate outcome of perinatal asphyxia in Lumbini Medical College Teaching Hospital.   Methods: It was a retrospective study where 82 cases who fulfilled the inclusion criteria were included between December 2014 to November 2015. Inclusion criteria included newborns with: a) Apgar score equal to or less than six at five minutes, b) requirement of  more than one minute of positive pressure ventilation, c) signs of fetal distress (heart rate of less than 100 beats per minute, late decelerations).   Results: Out of total 425 neonatal intensive care unit (NICU) admissions, 82 (19.3%) cases were of asphyxia among which 56 were inborn and 26 were referred from outside. Of those 82 cases, 47 (57.3%) cases developed hypoxic ischemic encephalopathy (HIE); HIE stage I had good outcome with survival rate of 95% and HIE stage III had poor outcome with survival rate of only 25%.   Conclusion: Despite advances in management of neonates, perinatal asphyxia is still the leading cause of neonatal intensive care unit admission and mortality and morbidity in neonates.

Role of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of Newborn (PPHN) - Should it Be Withdrawn from Market of Bangladesh due to Threat of being Misuses

2020 ◽  
Vol 35 (2) ◽  
pp. 100-104
Author(s):  
Maksudur Rahman ◽  
Mohammad Abdullah Al Mamun ◽  
MAK Azad Chowdhury ◽  
Abu Sayeed Munsi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cardiac Intensive Care Unit ◽  
Cross Sectional ◽  
Cardiac Intensive Care ◽  
Hospital Protocol

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104

Early Arterial Lactate and Prediction of Outcome in Preterm Neonates Admitted to a Neonatal Intensive Care Unit

2003 ◽  
Vol 83 (3) ◽  
pp. 171-176 ◽  
Author(s):  
Floris Groenendaal ◽  
Caroline Lindemans ◽  
Cuno S.P.M. Uiterwaal ◽  
Linda S. de Vries
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Preterm Neonates ◽  
Prediction Of Outcome ◽  
Arterial Lactate

scholarly journals The role of the nurse in the neonatal intensive care unit: between the ideal, the real and the possible

2011 ◽  
Vol 19 (2) ◽  
pp. 301-308 ◽  
Author(s):  
Liciane Langona Montanholi ◽  
Miriam Aparecida Barbosa Merighi ◽  
Maria Cristina Pinto de Jesus
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Public And Private ◽  
Public And Private Hospitals ◽  
The City ◽  
Social Phenomenology ◽  
The Ideal

The nurse is one of the professionals responsible for the care directed toward the physical, mental and social development of newborns in the Neonatal Intensive Care Unit. This study aimed to comprehend the experience of nurses working in a Neonatal Intensive Care Unit. Data collection was performed in 2008, through interviews with 12 nurses working in public and private hospitals of the city of São Paulo. The units of meaning identified were grouped into three categories: Developing actions; Perceiving their actions and Expectations. The analysis was based on social phenomenology. It was concluded that the overload of activities, the reduced number of staff, the lack of materials, equipment and the need for professional improvement are the reality of the work of the nurse in this sector. To supervise the care is the possible; integral care of the newborn, involving the parents, is the ideal desired.

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