Neonatal Magnesemia in Preterm Neonates Unexposed to Maternal MgSO4 Administration and in Neonates Exposed for Fetal Neuroprotection or Maternal Eclampsia Prevention.

Abstract Objective - To compare neonatal magnesemia in the first fifteen days of neonatal life between three groups: a control group not exposed to MgSO4, a neuroprotection group, and an eclampsia prevention group, and to explore its’ associations with child outcomes. Design - Retrospective single-centre cohort study. Setting - Tertiary care setting. Population - Infants admitted at the neonatal intensive care unit born between 24 and 32 weeks’ gestation, regardless of etiology of preterm birth.Methods - Linear mixed regression of neonatal magnesemia on exposure group and day of life. Generalised estimating equations models of child outcomes on neonatal magnesemia according to exposure group and day of life. Main outcome measures - Neonatal magnesemia (mmol/l). Results - Neonatal magnesemia is significantly higher in the preeclampsia group compared to the control and neuroprotection group. On the day of birth, this is irrespective of maternal magnesemia (preeclampsia vs control group), and the maternal total dose or duration of MgSO4 administration (preeclampsia vs neuroprotection group). No differences were found in short-term composite outcome between the three groups. Conclusions - We found mean differences in neonatal magnesemia between children not exposed to MgSO4 antenatally, children exposed for fetal neuroprotection, and children exposed for maternal eclampsia prevention. A 4g loading and 1g/h maintenance dose, for fetal neuroprotection and eclampsia prevention, appears to be safe on the short term for the neonate.

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Impact of Computerized Provider Order Entry on Total Parenteral Nutrition in the Neonatal Intensive Care Unit

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-21.4.339 ◽

2016 ◽

Vol 21 (4) ◽

pp. 339-345 ◽

Cited By ~ 4

Author(s):

Kyle A. Franco ◽

Keliana O'Mara

Keyword(s):

Parenteral Nutrition ◽

Neonatal Intensive Care ◽

Intervention Group ◽

Preterm Neonates ◽

Control Group ◽

Order Entry ◽

Serum Electrolyte ◽

Computerized Provider Order Entry ◽

Electrolyte Disturbances ◽

Before And After

OBJECTIVES: To determine if computerized provider order entry (CPOE) implementation impacts the time it takes for preterm neonates to reach their parenteral macronutrient goals. METHODS: Retrospective review of neonates <1750 g receiving parenteral nutrition (PN) before and after the implementation of CPOE. Primary outcome was the attainment of parenteral macronutrient goals. Secondary outcomes included time to attainment, the frequency of electrolyte abnormalities, and the incidence of required adjustments made to PN orders by verification pharmacists. RESULTS: Goal PN was achieved by 12/47 (25.5%) intervention vs. 2/44 (4.5%) control group infants (p < 0.05). This goal was attained in 10.8 ± 7.5 days in the intervention group and 10 ± 4.2 days in the control group (p = 0.90). Goal protein was reached by 74.5% of CPOE patients vs. 36.4% of controls, p < 0.05. Lipid goals were achieved by 98% vs. 100% (p = 0.33) of patients and were attained at an average of 1.5 ± 0.8 days vs. 2.0 ± 1.1 days (p < 0.05). Abnormal serum electrolyte values occurred more frequently in the control group (0.79 vs. 1.12/day PN). Adjustments by a verification pharmacist were required in 5.6% of CPOE compared with 30.4% of control group orders (p < 0.05). CONCLUSIONS: CPOE parenteral nutrition increased the proportion of preterm neonates attaining overall macronutrient goals. With CPOE, protein goals were reached by more patients and goal lipids were achieved faster. This system also decreased the number of pharmacist interventions during verification of PN orders and appeared to positively impact the incidence of serum electrolyte disturbances.

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Effectiveness of Hand Hygiene Video cum Demonstration on Knowledge and Practice, among Mothers of Neonates Admitted in NICU

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/571 ◽

2021 ◽

Vol 10 (33) ◽

pp. 2799-2802

Author(s):

Sangithaa Varsha G. ◽

Geetha D ◽

Anita David

Keyword(s):

Intensive Care ◽

Hand Hygiene ◽

Neonatal Intensive Care ◽

Tertiary Care ◽

Hospital Environment ◽

Control Group ◽

Study Group ◽

Care Hospital ◽

Post Test ◽

Knowledge And Practice

BACKGROUND Proper hand hygiene is the single most important, simplest, and least expensive means of reducing the prevalence of health care association infection (HAIs) and nosocomial infection. Several studies have demonstrated that hand washing virtually eradicates the carriage of infections in intensive care units (ICUs). For more than 150 years, hand hygiene has been researched in the hospital environment as a way of preventing transmission of bacteria, infection and death. The purpose of this study was to import the significance of the hand hygiene and to improve the skills in performing hand hygiene among mothers of neonates admitted in neonatal intensive care unit (NICU) at tertiary care hospital. METHODS A self structured knowledge questionnaire (KQ), practice questionnaire (PQ) and practice checklist (PC) was administered. The one to one method video on hand hygiene was played by using a laptop for about 15 minutes as an intervention with demonstration done by investigator and return demonstration was done by mothers, post test was conducted on 3rd day and 5th day followed by the intervention. RESULTS The mean scores of knowledge showed improvement in post test than the pre test in both the groups, but there was an increase in practice mean score between the groups which showed an improvement in the study group, it was higher than the control group which was statistically significant at P < 0.001. Overall, there were minimal positive correlations between the level of knowledge and practice for the study group in post-test and post-test II. Minimum positive correlation was evident but there was no significance. CONCLUSIONS This study concludes that it enhanced the knowledge on hand hygiene among mothers of neonates and it helped mothers to understand the importance of hand hygiene, when to do, how to do, why to do. Thus, it expected directly or indirectly to reduce the infection rate among neonates admitted in NICU. Further, the nurses have a great responsibility in ensuring parents adherence to hand hygiene. KEY WORDS Mothers of Neonate in NICU, Hand Hygiene, Video cum Demonstration, Mothers KPC.

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Morbidity and mortality profile of preterm neonates admitted in neonatal intensive care unit of a tertiary care centre in Western Uttar Pradesh, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193154 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1859

Author(s):

Najia Hassan ◽

Sujaya Mukhopadhyay ◽

Sneha Mohan

Keyword(s):

Risk Factors ◽

Neonatal Intensive Care ◽

Tertiary Care ◽

Preterm Neonates ◽

Pregnancy Induced Hypertension ◽

Care Centre ◽

Maternal Risk Factors ◽

Tertiary Care Centre ◽

Maternal Risk ◽

Induced Hypertension

Background: Preterm birth is a major cause of mortality and morbidity for newborns. Complications of prematurity are becoming more common as more survivors are spending time in Neonatal intensive care unit.Methods: A retrospective hospital based clinical observational study was conducted in NICU in Sharda hospital, a tertiary care centre in Greater Noida. Data regarding neonates′ age, sex, clinical presentation, maternal risk factors, complications and outcome were recorded.Results: A total of 133 preterm neonates were enrolled in the study. Maternal risk factors like Pregnancy induced hypertension (PIH) was seen in 19.5% cases, Urinary tract infection in 15% and Antepartum haemorrhage in 14.2% cases. Among the complications of prematurity, RDS was noted in 38.3% cases, Hyperbilirubinemia in 16.5% and feed intolerance in 15% cases. Sepsis was present in 3% of the preterm. Mortality rate was 7.5%. Most common cause of death was RDS.Conclusions: Pregnancy induced hypertension and Antepartum haemorrhage were important maternal risk factors for prematurity. Respiratory distress syndrome and perinatal asphyxia were the important causes of mortality in the present study.

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Effect of Taping of Thoracic and Abdominal Muscles on Pelvic Alignment and Forward Reach Distance Among Stroke Subjects: A Randomized Controlled Trial

Annals of Neurosciences ◽

10.1177/0972753119887321 ◽

2019 ◽

Vol 26 (3-4) ◽

pp. 10-16

Author(s):

Megha Mehta ◽

Abraham M. Joshua ◽

Suruliraj Karthikbabu ◽

Zulkifli Misri ◽

Bhaskaran Unnikrishnan ◽

...

Keyword(s):

Tertiary Care ◽

Control Group ◽

P Value ◽

Abdominal Muscles ◽

Care Hospital ◽

Physiotherapy Treatment ◽

Short Term ◽

Randomized Controlled ◽

Conventional Physiotherapy ◽

Experimental Group

Introduction: The objective of this study was to find the immediate as well as short-term effect on pelvic alignment and forward arm reach distance in sitting among stroke patients following thoracic spine and abdominal muscles taping along with conventional therapy. Methods: Thirty subjects with stroke attending the physiotherapy programme at Department of Physiotherapy at a tertiary care hospital underwent this randomized controlled experimental study. Subjects in the experimental group received taping, along with conventional physiotherapy treatment, for restricting thoracic kyphosis and facilitating abdominal muscles. Subjects in the control group received only conventional physiotherapy treatment. To assess the change in pelvic alignment and forward arm reach distance while sitting, Palpation MeterTM (PALMTM) and sit and reach test were used, respectively. Results: In the experimental group, pelvic obliquity was corrected (4.1 ± 0.94) and anterior pelvic tilt revealed improvement (4.9 ± 2.1, p value < 0.001). In the control group, no improvement in pelvic alignment was recorded. Improvement in forward arm reach distance was similar in both groups ( p value = 0.804). Conclusion: Taping as an adjunctive treatment method to physiotherapy can cause immediate as well as short-term improvement of pelvic alignment in sitting, following stroke. It also, immediately improves the sit and reach distance in the same population.

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TO STUDY THE INCIDENCE AND RISK FACTORS OF RETINOPATHY OF PREMATURITY IN A TERTIARY CARE HOSPITAL IN NORTHERN INDIA

10.36106/gjra/4907071 ◽

2021 ◽

pp. 48-50

Author(s):

Kajaldeep Kaur ◽

Gursharn Singh

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Tertiary Care ◽

Preterm Neonates ◽

Care Hospital ◽

Northern India ◽

Retinal Examination

BACKGROUND: Retinopathy of prematurity (ROP) is a multifactorial retinal vaso-proliferative disorder which remains a leading cause of childhood blindness worldwide despite improvements in neonatal care and management guidelines. This study was conducted to determine the incidence of ROP among preterm neonates and to determine the risk factors. METHODS: All preterm infants with birth weight <1750 gm and gestation <34 weeks were screened for ROP at 4 weeks of birth for rst screening. Prenatal and postnatal risk factors, neonatal problems, treatment given, procedures and interventions done during stay in neonatal intensive care unit were recorded as per the proforma. The data from the study was systematically collected, compiled and statistically analyzed with SPSS Statistics-26 version to draw relevant conclusions. RESULTS: The incidence of ROP in 89 infants who were screened was 44%. The mean gestational age of babies with ROP was 32 weeks. In our study, pneumonia, apnea, sepsis, thrombocytopenia, NEC, shock, acidosis, IVH, BPD, the use of Bubble CPAP, Venti-CPAP and mechanical ventilator, the vasopressor use and blood transfusion were signicant risk factors. CONCLUSIONS: The incidence of ROP was signicantly higher in babies <34 weeks. It was observed in our that lower the birth weight and lower the gestational age, higher is the risk for the development of ROP. Careful and timed retinal examination of all at risk infants will minimize the development of ROP and later on blindness.

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Doxapram Use for Apnoea of Prematurity in Neonatal Intensive Care

International Journal of Pediatrics ◽

10.1155/2013/251047 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 11

Author(s):

S. A. Prins ◽

S. J. A. Pans ◽

M. M. van Weissenbruch ◽

F. J. Walther ◽

S. H. P. Simons

Keyword(s):

Intensive Care ◽

Neonatal Intensive Care ◽

Periventricular Leukomalacia ◽

Ductus Arteriosus ◽

Neonatal Morbidity ◽

Preterm Neonates ◽

Short Term ◽

Prospective Trials ◽

Care Outcome

Apnoea of prematurity is treated with noninvasive respiratory therapy and methylxanthines. For therapy unresponsive apnoea doxapram is often prescibed in preterm neonates. The duration, dosage and route of administration of doxapram together with its efficacy was evaluated in two Dutch neonatal intensive care. Outcome concerning short-term safety and neonatal morbidity were evaluated. During 5 years, 122 of 1,501 admitted newborns <32 weeks of gestational age received doxapram. 64.8% of patients did not need intubation after doxapram. 25% of treated neonates were <27 weeks of gestation. A positive response to doxapram therapy on apnoea was associated with longer duration of doxapram usage (P<0.001), lower mean doses (P<0.003), and less days of intensive care (median 33 versus 42 days;P<0.002). No patients died during doxapram therapy. Incidence of necrotizing enterocolitis, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity, persistent ductus arteriosus, or worsening of pulmonary condition did not increase during doxapram therapy. Doxapram is frequently used for apnoea of prematurity, despite a lack of data on short-term efficacy and long-term safety. Until efficacy and safety are confirmed in prospective trials, doxapram should be used with caution.

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Morbidities and Outcome of a Neonatal Intensive Care in Western Nepal

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v15i2.18203 ◽

2017 ◽

Vol 15 (2) ◽

pp. 141-145 ◽

Cited By ~ 3

Author(s):

Sudhir Adhikari ◽

Kalipatanam Seshagiri Rao ◽

Ganesh B.K. ◽

Namraj Bahadur

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Neonatal Mortality ◽

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Tertiary Care ◽

Neonatal Hyperbilirubinemia ◽

Preterm Neonates ◽

Risk Of Mortality

Background: Neonatal mortality rate of developing countries is declining over decades. In the recent years increasing number of preterm and high risk neonates have facilities for tertiary care treatment. The aim of the study was to assess the morbidities and outcome of neonatal intensive care admissions.Methods: It was a retrospective observational study carried out in neonatal intensive care unit of the Manipal Teaching Hospital, Pokhara, Nepal from January 2014 to December 2015. Neonatal details including place of delivery, birth weight, gestation, diagnosis at admission, hospital course and final outcome were recorded in predesigned proforma. Risk of mortality was calculated using odds ratio and 95% confidence interval. Results: There were total 1708 admission during study period and inborn as well as out born neonates were equally admitted. Neonatal hyperbilirubinemia (37.1%), neonatal sepsis 532 (31.2%), prematurity, 314 (18.4%) perinatal asphyxia 112 (6.6%), meconium aspiration syndrome 79 (4.6%) and intrauterine growth restriction 49 (2.8%) were main indications for hospitalization. A total of 1410 (82.6%) the patients were discharged after treatment, 167 (9.7) left against medical advice, 115 (6.7%) died in hospital and 16 (1%) cases were referred. Preterm neonates had twice the risk of mortality than term neonates (OR =2.1664). Birth weight < 2500 grams had three times more risk of neonatal mortality than normal birth weight (OR =3.0783).Conclusions: Neonatal hyperbilirubinemia, prematurity and neonatal sepsis were common morbidities inneonatal intensive care unit.

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Correlation of nucleated red blood cell count with neonatal intensive care unit admission

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20204551 ◽

2020 ◽

Vol 7 (11) ◽

pp. 2225

Author(s):

Sambedna . ◽

Amit Kumar ◽

Rita Chakore

Keyword(s):

Cord Blood ◽

Neonatal Intensive Care ◽

Perinatal Asphyxia ◽

Health Centre ◽

Tertiary Care ◽

Control Group ◽

Study Group ◽

Cord Blood Sample ◽

Nicu Admission ◽

Retrospective Comparative Study

Background: Perinatal asphyxia should be diagnosed, when baby goes on to develop hypoxic ischemic encephalopathy which has shown to be much more reliable indicator of long term handicap than any other perinatal markers like non reassuring FHR, Apgar score, meconium stained amniotic fluid and blood acid base status of fetus. Since NRBC is related to hematopoietic response to hypoxia it predicts the chance of neurological sequelae and NICU admission. The aim of our study to analyze the significant relationship of NRBC count and NICU admission.Methods: This was a retrospective comparative study conducted in department of OBG, Patna medical college and Hospital between December 2013 to November 2015 in tertiary care health centre. Umbilical cord blood samples were collected from 100 newborns with asphyxia at birth out of which 56 were admitted in NICU taken as study group and rest 44 asphyxiated babies were not admitted in NICU were taken as control group. NRBC per 100 WBC was counted in Cord blood sample from all babies.Results: This shows that average count of NRBC/100 WBC in the study with NICU admission was 27.37+7.25. Average count in the study group with no NICU admission was 23.93+6.04. The difference was statistically significant (p<0.05).Conclusions: This study concludes that NRBC count correlate well with fetal asphyxia and finally NICU admission. Early detection leads to decrease neurological morbidity and mortality among survivors.

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Short-term Outcome of Low Birth Weight Preterm Infants with Necrotizing Enterocolitis: A Prospective Cohort Study

Journal of Neonatal Surgery ◽

10.21699/jns.v7i4.802 ◽

2018 ◽

Vol 7 (4) ◽

pp. 42

Author(s):

Pradyumna Pan

Keyword(s):

Survival Rate ◽

Preterm Infants ◽

Necrotizing Enterocolitis ◽

Gestational Age ◽

Tertiary Care ◽

Preterm Neonates ◽

High Morbidity ◽

Short Term ◽

Term Outcome ◽

Stage 1

Aim: The purpose of this study was to analyze the nature of the disease, the surgical procedures, complications, and survival of preterm infants with necrotizing enterocolitis (NEC) from two tertiary care referral neonatal intensive units in central India.Materials and Methods: A prospective study of a cohort of 110 preterm neonates with gestational age less than 36 weeks and weight less than 1600 g infants diagnosed to have NEC were followed for 90 days. All the neonates were born between January 2015 and December 2017 and treated at two neonatal intensive care units. Infants with sepsis, congenital gastrointestinal anomalies, major cardiac problems, and intraventricular hemorrhage were excluded.Results: Mean gestational age in this cohort was 32.40 ± 3.87 weeks, and the mean age of NEC onset was 13.04 ± 3.54 postnatal days. There were 39 neonates with Stage 1, 45 with Stage 2, and 26 with stage 3 NEC. Pneumoperitoneum, positive paracentesis and progressive clinical deterioration were the indications for laparotomy. The most common complications were sepsis 97/110 (88.18%). Post-operative complications occurred in 22 (84.61%) infants, wound infection in 19 (73.07%), intestinal stricture in 9 (34.61%), wound dehiscence in 7 (26.92%), stoma stenosis in 3 (11.53%), ileostomy prolapse in 2 (7.69%), and burst abdomen in 1 (3.84 %). The overall 90-day survival rate was 87.27% (96/110), and the post-operative survival rate was 46.15% (12/26). The age of gestation, weight, and extent of the disease were the main risk factor for mortality.Conclusion: The short-term outcomes for Stage 3 NEC were associated with high morbidity and mortality. The outlook for infants with Stage 1 and 2 NEC was favorable.

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Does mother scented simulated hand promote comfort, reduce pain, and distress among mechanically ventilated preterm neonates during invasive procedures?

Journal of Health Sciences ◽

10.17532/jhsci.2021.1402 ◽

2021 ◽

Author(s):

Zohour Ibrahim Rashwan ◽

Gehan Maher Khamis

Keyword(s):

Standard Care ◽

Neonatal Intensive Care ◽

Comfort Level ◽

Preterm Neonates ◽

Control Group ◽

Invasive Procedures ◽

Endotracheal Suctioning ◽

Mechanically Ventilated ◽

Quasi Experimental ◽

Heel Prick

Introduction: Breakthrough technologies in the neonatal intensive care unit (NICU) revolutionized neonates’ quality of care. Mother scented simulated hand (MSSH) is an ergonomically designed supportive hand that uses the power of touch to simulate the feeling of being held and cuddled. This study aimed to determine the effect of MSSH on promoting comfort among mechanically ventilated preterm neonates during invasive procedures.Methods: A quasi-experimental, pre-posttest two groups study was carried out in NICU in Smouha, Alexandria. A sample of 62 mechanically ventilated neonates was randomly assigned to two equal groups; the study group wrapped with a warm MSSH during the invasive procedures while the control group received standard care of NICU. Two observers independently rated the neonates’ level of comfort, distress, and pain during endotracheal suctioning (ETS) and heel prick using COMFORTneo scale.Results: It is revealed that the mechanically ventilated neonates had a significantly higher comfort level with MSSH than the standard care during and after both ETS and heal break (p < 0.001 for each). The neonates had significantly lower distress and pain scores when encircled by MSSH during invasive procedures than standard care (p < 0.001 for NRS distress and p < 0.001 for NRS distress).Conclusion: Wrapping the preterm neonates with a warm MSSH promotes comfort and reduces their pain and distress during invasive procedures, especially when their mothers are not physically available.

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