Brain-Oriented Care in the NICU: A Case Study

2014 ◽  
Vol 33 (5) ◽  
pp. 263-267 ◽  
Author(s):  
Lisa Bader
Keyword(s):  
Preterm Infant ◽  
Preterm Infants ◽  
Premature Infants ◽  
Normal Development ◽  
Developmental Outcome ◽  
Medical Field ◽  
Term Infants ◽  
Developmental Care ◽  
The Brain

With the advances of technology and treatment in the field of neonatal care, researchers can now study how the brains of preterm infants are different from full-term infants. The differences are significant, and the outcomes are poor overall for premature infants as a whole. Caregivers at the bedside must know that every interaction with the preterm infant affects brain development—it is critical to the developmental outcome of the infant. The idea of neuroprotection is not new to the medical field but is a fairly new idea to the NICU. Neuroprotection encompasses all interventions that promote normal development of the brain. The concept of brain-oriented care is a necessary extension of developmental care in the NICU. By following the journey of 26-week preterm twin infants through a case study, one can better understand the necessity of brain-oriented care at the bedside.

Kernicterus in Preterm Infants; Lest We Forget (To Turn on the Lights)

PEDIATRICS ◽  
1992 ◽  
Vol 90 (5) ◽  
pp. 757-759
Author(s):  
N. KEVIN IVES
Keyword(s):  
Intensive Care ◽  
Preterm Infant ◽  
Preterm Infants ◽  
Neonatal Jaundice ◽  
Current Issue ◽  
Historical Review ◽  
Term Infants ◽  
Turn On ◽  
Treatment Thresholds ◽  
One Act

Watchko and Oski have a reputation for stimulating debate on the topic of neonatal jaundice. As scriptwriters of "Vigintiphobia: a one-act play,"1 they questioned the `standard practice' applied to the management of jaundice in otherwise healthy term infants. In the current issue of Pediatrics2 they again court controversy by turning their attention to treatment thresholds and the risk of kernicterus in jaundiced preterm infants. We are provided with a thoroughly researched historical review of the risk of kernicterus in the preterm infant from 1950 to the 1990s. The story is presented as a journey of experience from the pre-intensive care era, through the so-called `low bilirubin kernicterus era' (1965 through 1982), to the present.

scholarly journals Menurunkan Skala Nyeri Bayi Prematur melalui Facilitated Tucking disertai ‘Hadir-Berbicara’ sebagai Upaya Penerapan Teori Comfort Kolcaba

2017 ◽  
Vol 5 (2) ◽  
pp. 83
Author(s):  
Nopi Nur Khasanah ◽  
Yeni Rustina
Keyword(s):  
Premature Infants ◽  
Early Life ◽  
Nursing Intervention ◽  
Comfort Level ◽  
High Risk Infant ◽  
Developmental Care ◽  
Central Nerve System ◽  
Nerve System ◽  
Neonatal Ward

<em>Premature infants had been experience of pain in neonatal ward that occur each day during treatment. Nurse need to do an intervention for reduce the scale of pain on premature infants. Pain management have to do at birth because of the repeated painful procedures in early life can affect the development of central nerve system permanently. The objective of this study was to describe the application of Kolcaba Comfort’s theory through facilitated tucking accompanied with ‘being with-talking to’ techniques in premature’s infant at high risk infant care. The method that used was case study by applying the four contexts of comfort’s experience associated with the three types of comfort based on Kolcaba Comfort’s theory in providing nursing care on five premature infants who have some painful procedures. The nursing intervention through facilitated tucking accompanied by ‘being with-talking to’ based on the principles of Kolcaba Comfort’s theory gave a positive result against premature infants’s comfort level. Four from five premature infants are in the level of transcendence which is a type of supreme comfort after the ease and relief. Kolcaba Comfort’s theory can be applied within the scope of neonatal care due in accordance with the developmental care of the infants and could reduce the scale of pain.</em>

Magnetic resonance spectroscopy in preterm infants: association with neurodevelopmental outcomes

2017 ◽  
Vol 103 (3) ◽  
pp. F238-F244 ◽  
Author(s):  
Reina Hyodo ◽  
Yoshiaki Sato ◽  
Miharu Ito ◽  
Yuichiro Sugiyama ◽  
Chikako Ogawa ◽  
...  
Keyword(s):  
White Matter ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Preterm Infants ◽  
Normal Development ◽  
Resonance Spectroscopy ◽  
Neurodevelopmental Outcomes ◽  
Term Infants ◽  
Equivalent Age ◽  
Frontal White Matter

ObjectiveTo compare magnetic resonance spectroscopy (MRS) metabolite ratios in preterm infants at term-equivalent age with those in term infants and to evaluate the association between MRS metabolites and neurodevelopmental outcomes at 18 months corrected age in preterm infants.DesignWe studied infants born at a gestational age <37 weeks and weighing <1500 g during 2009–2013 using MRS at term-equivalent age. Infants with major brain abnormalities were excluded. The ratios of N-acetylaspartate (NAA) to creatine (Cre), NAA to choline-containing compounds (Cho) and Cho to Cre in the frontal white matter and thalamus were measured using multivoxel point-resolved proton spectroscopy sequence. Neurodevelopmental outcomes were assessed at 18 months corrected age.ResultsThirty-three preterm infants and 16 term infants were enrolled in this study. Preterm infants with normal development at 18 months showed significantly lower NAA/Cho ratios in the frontal white matter than term infants. There were no differences in the Cre/Cho ratios between preterm and term infants. At 18 months corrected age, 9 preterm infants with a mild developmental delay showed significantly lower NAA/Cho ratios in the thalamus than 24 preterm infants with normal development.ConclusionsPreterm infants at term-equivalent age showed reduced MRS metabolites (NAA/Cho) compared with term infants. Decreased NAA/Cho ratios in the thalamus were associated with neurodevelopmental delay at 18 months corrected age in preterm infants.

scholarly journals Levels of Neonatal Thyroid Hormone in Preterm Infants and Neurodevelopmental Outcome at 5½ Years: Millennium Cohort Study

2010 ◽  
Vol 95 (11) ◽  
pp. 4898-4908 ◽  
Author(s):  
Caroline Delahunty ◽  
Shona Falconer ◽  
Robert Hume ◽  
Lesley Jackson ◽  
Paula Midgley ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Home Environment ◽  
Premature Infants ◽  
Thyroid Dysfunction ◽  
Neurodevelopmental Outcome ◽  
Millennium Cohort Study ◽  
Term Infants ◽  
Follow Up Study ◽  
Serum T4

Context: Transient hypothyroxinemia is the commonest thyroid dysfunction of premature infants, and recent studies have found adverse associations with neurodevelopment. The validity of these associations is unclear because the studies adjusted for a differing range of factors likely to influence neurodevelopment. Objective: The aim was to describe the association of transient hypothyroxinemia with neurodevelopment at 5.5 yr corrected age. Design: We conducted a follow-up study of a cohort of infants born in Scotland from 1999 to 2001 ≤34 wk gestation. Main Outcome Measures: We measured scores on the McCarthy scale adjusted for 26 influences of neurodevelopment including parental intellect, home environment, breast or formula fed, growth retardation, and use of postnatal drugs. Results: A total of 442 infants ≤34 wk gestation who had serum T4 measurements on postnatal d 7, 14, or 28 and 100 term infants who had serum T4 measured in cord blood were followed up at 5.5 yr. Infants with hypothyroxinemia (T4 level ≤ 10th percentile on d 7, 14, or 28 corrected for gestational age) scored significantly lower than euthyroid infants (T4 level greater than the 10th percentile and less than the 90th percentile on all days) on all McCarthy scales, except the quantitative. After adjustment for confounders of neurodevelopment, hypothyroxinemic infants scored significantly lower than euthyroid infants on the general cognitive and verbal scales. Conclusions: Our findings do not support the view that the hypothyroxinemic state, in the context of this analysis, is harmless in preterm infants. Many factors contribute both to the etiology of hypothyroxinemia and neurodevelopment; strategies for correction of hypothyroxinemia should acknowledge its complex etiology and not rely solely on one approach.

scholarly journals Does birth weight affect neonatal body weight, growth, and physiology in an animal model?

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246954
Author(s):  
Khaled Adjerid ◽  
Christopher J. Mayerl ◽  
Francois D. H. Gould ◽  
Chloe E. Edmonds ◽  
Bethany M. Stricklen ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infant ◽  
Preterm Infants ◽  
Strong Predictor ◽  
Low Birth Weight Infants ◽  
Term Infants ◽  
Functional Deficits ◽  
Weight Growth ◽  
Infant Birth

Infant birth weight affects neuromotor and biomechanical swallowing performance in infant pig models. Preterm infants are generally born low birth weight and suffer from delayed development and neuromotor deficits. These deficits include critical life skills such as swallowing and breathing. It is unclear whether these neuromotor and biomechanical deficits are a result of low birth weight or preterm birth. In this study we ask: are preterm infants simply low birth weight infants or do preterm infants differ from term infants in weight gain and swallowing behaviors independent of birth weight? We use a validated infant pig model to show that preterm and term infants gain weight differently and that birth weight is not a strong predictor of functional deficits in preterm infant swallowing. We found that preterm infants gained weight at a faster rate than term infants and with nearly three times the variation. Additionally, we found that the number of sucks per swallow, swallow duration, and the delay of the swallows relative to the suck cycles were not impacted by birth weight. These results suggest that any correlation of developmental or swallowing deficits with reduced birth weight are likely linked to underlying physiological immaturity of the preterm infant.

scholarly journals Functional features of hemodynamic changes in preterm kids in residual period of development

2018 ◽  
pp. 71-74
Author(s):  
L. E. Vigovskaya ◽  
A. R. Gaynutdinov
Keyword(s):  
Blood Flow ◽  
Preterm Infants ◽  
Premature Infants ◽  
Cerebrovascular Disorders ◽  
Birth Trauma ◽  
Trigger Factor ◽  
Hemodynamic Changes ◽  
Flow Through ◽  
Functional Features ◽  
The Brain

Results of dopplerographic studies have delineate the severity of cerebrovascular disorders in different categories of preterm infants. The most significant hemodynamic changes characteristic for extremely premature infants, regardless of severity of the condition at birth, which is manifested as a decrease in blood flow through the main vessels of the head and neck, especially pronounced disturbances in the venous system of the brain. Birth trauma is a trigger factor in the implementation of hemodynamic disorders of the brain in these patients.

scholarly journals Maternal Participation Program for Enhancing Growth and Neurobehavioral Development of Very and Moderately Preterm Infants: A Case Study

2017 ◽  
Vol 16 (8) ◽  
pp. 523-533
Author(s):  
Nethong NAMPROM ◽  
Wilawan PICHEANSATHIAN ◽  
Usanee JINTRAWET ◽  
Jutamas CHOTIBANG
Keyword(s):  
Preterm Infants ◽  
Controlled Trial ◽  
Potential Outcomes ◽  
Developmental Care ◽  
Neurobehavioral Development ◽  
Monitoring Strategies ◽  
Participation Level ◽  
Moderately Preterm ◽  
Participation Program

A Maternal Participation Program in the context of Thai culture was developed based on the Neonatal Integrative Developmental Care model. A multiple case study design was used to explore the feasibility and acceptability and potential outcomes of implementing the program in a Thai NICU. The potential outcomes were growth and neurobehavioral development of very and moderately preterm infants. This program consisted of education and monitoring strategies including 4 teaching and practice sessions of 6 care practices, which included optimizing nutrition, positioning and handling, safeguarding sleep, promoting a healing environment, minimizing stress, and protecting the skin. The maternal participation program with education strategies was implemented one week after the infant’s admission to an NICU. Strategies to monitor the maternal participation level and to boost maternal participation were used. The maternal participation program was beneficial for 3 Thai mothers. They gave positive feedback regarding the feasibility and acceptability of the program, as well as the readability of the “My Baby” handbook. The level of maternal participation in caring for preterm infants increased after being involved in this program. Additionally, preterm infants’ body weight and neurobehavioral scores dramatically increased. Further studies of this program need to be conducted in a randomized controlled trial design.

Kangaroo Baby Care: Just a Nice Experience or an Important Advance for Preterm Infants?

PEDIATRICS ◽  
1990 ◽  
Vol 85 (4) ◽  
pp. 604-605
Author(s):  
ANDREW WHITELAW
Keyword(s):  
Intensive Care ◽  
Home Care ◽  
Preterm Infant ◽  
Preterm Infants ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Developed Countries ◽  
Important Advance ◽  
Skin Contact ◽  
Skin To Skin

"Kangaroo baby care" or "skin-to-skin contact" describes the practice of holding a preterm infant naked (except for a diaper) between the mother's breasts. The baby's face pokes out of the top of the mother's dress like a baby kangaroo's. Rey and Martinez in Bogota, Colombia1 pioneered the home care of premature infants as small as 1000 g, the mother being taught to hold her baby head-up kangaroo-style to encourage lactation, prevent aspiration, and reduce rejection. Education and motivation of the mother in the care of preterm infants makes obvious sense in the developing world, but kangaroo baby care has also been applied in many developed countries in conjunction with neonatal intensive care rather than as a replacement for incubators and monitors.2-4

Respiratory Syncytial Virus in Otherwise Healthy Prematurely Born Infants: A Forgotten Majority

2018 ◽  
Vol 35 (06) ◽  
pp. 541-544 ◽  
Author(s):  
Bosco Paes
Keyword(s):  
Respiratory Syncytial Virus ◽  
Preterm Infants ◽  
Premature Infants ◽  
Gestational Age ◽  
Burden Of Illness ◽  
Hospital Costs ◽  
Chronic Obstructive ◽  
Term Infants ◽  
Increased Risk ◽  
Syncytial Virus

AbstractHealthy, premature infants ≤35 weeks' gestational age (wGA) are universally recognized to be at an increased risk of perinatal morbidity and mortality. Serious respiratory syncytial virus (RSV) lower respiratory tract infection imposes an additional burden of illness on these infants following hospitalization. Incurred morbidities relative to term infants include longer lengths of hospital stay, admission to intensive care, and need for oxygen and mechanical ventilation, all of which are associated with increased hospital costs. The highest morbidities are experienced by premature infants who are youngest (<3 months' chronological age) and are of lower gestational age. Short- and long-term follow-up indicates that healthy preterm infants both of lower gestational age and who are late preterm have obstructive lung function at baseline, which is further compromised by RSV-related infection during infancy. There is increasing evidence that childhood exposure to an episode of RSV infection may set the stage for an abnormal respiratory function trajectory, which, in adulthood, leads to chronic obstructive pulmonary disease. Healthy premature infants <32 wGA merit RSV prophylaxis based on existing data, whereas moderate- and high-risk preterm infants 32 to 35 wGA should be selectively and cost-effectively targeted for prophylaxis using validated risk scoring tools and country-specific thresholds for funding.

Premature Infant Massage in the NICU

2003 ◽  
Vol 22 (3) ◽  
pp. 39-45 ◽  
Author(s):  
Jodi Beachy
Keyword(s):  
Intensive Care ◽  
Preterm Infant ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Care Setting ◽  
Massage Therapy ◽  
Intensive Care Setting ◽  
Parenting Skills ◽  
Infant Massage ◽  
Developmental Care

Infant massage therapy is an inexpensive tool that should be utilized as part of the developmental care of the preterm infant. Nurses have been hesitant to begin massage therapy for fear of overstimulating the infant and because there has been insufficient research to prove its safety. Recent research, however, has shown that the significant benefits of infant massage therapy far outweigh the minimal risks. When infant massage therapy is properly applied to preterm infants, they respond with increased weight gains, improved developmental scores, and earlier discharge from the hospital. Parents of the preterm infant also benefit because infant massage enhances bonding with their child and increases confidence in their parenting skills. This article discusses the benefits and risks of massage for preterm infants and their families and explains how to implement massage therapy in the neonatal intensive care setting.

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