scholarly journals Relationship of the cranial ultrasound results – neurosonography – with the outcomes of psychomotor development of very premature infants

2019 ◽  
Vol 64 (5) ◽  
pp. 33-37
Author(s):  
E. S. Sakharova ◽  
E. S. Keshishyan ◽  
G. A. Аlyamovskaya
Keyword(s):  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Clinical Symptoms ◽  
Periventricular Leukomalacia ◽  
Neurological Status ◽  
Extremely Low Birth Weight ◽  
Psychomotor Development ◽  
Cranial Ultrasound ◽  
Psychomotor Skills ◽  
Ultrasound Monitoring

This article analyzes the neurosonography results and compares with neurological symptoms in premature infants with very low and extremely low birth weight. The authors retrospectively assessed the cranial ultrasound results from neonatal intensive care units and outpatient hospitals. Group 1: monthly cranial ultrasound despite of clinical symptoms and psychomotor development; Group 2: only according to indications - in case of deterioration of neurological status or a decrease in the psychomotor skills development. The neurological outcome was compared with intracranial lesions identified in the neonatal period (intraventricular hemorrhage, periventricular leukomalacia etc.). It was found that continuous ultrasound monitoring was not required in the absence of clinical and laboratory signs of neurological distress, since the results of the study, including deviation from the norm, did not affect the treatment tactics. Only presence of clinical symptoms required treatment.

scholarly journals Analyses of pathological cranial ultrasound findings in neonates that fall outside recent indication guidelines: results of a population-based birth cohort: survey of neonates in Pommerania (SNiP-study)

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Judith Weise ◽  
Matthias Heckmann ◽  
Hagen Bahlmann ◽  
Till Ittermann ◽  
Heike Allenberg ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Periventricular Leukomalacia ◽  
Population Based ◽  
Cranial Ultrasound ◽  
Group I ◽  
Ultrasound Findings ◽  
Group Ii ◽  
Current Guidelines ◽  
Population Based Survey

Abstract Background Recent guidelines recommend a cranial ultrasound (CU) in neonates born at < 30 weeks gestation, admitted to the neonatal intensive care unit (NICU), or with a CU indication. Here, we addressed the need to extend these recommendations. Methods We retrospectively reviewed 5107 CUs acquired in the population-based Survey of Neonates in Pomerania, conducted in 2002 to 2008. Neonates with conspicuous CUs that were ≥ 30 weeks gestation without recent indications for CU were identified and assigned to the following groups: with (I) or without (II) admission to neonatal care. We designated CU conspicuities as mild (MC) or significant (SC), and we investigated related neurodevelopment during follow-up. Results Of 5107 neonates, 5064 were born at ≥30 weeks gestation and of those, 4306 received CUs without any indication for this examination. We found conspicuities in 7.7% (n = 47/610) of group I (n = 30 MC, n = 17 SC), and 3.2% (n = 117/3696) of group II (n = 100 MC, n = 17 SC). In group II, SC comprised, e.g., bilateral cysts, partial agenesis of the corpus callosum, and periventricular leukomalacia. Follow-up was available in 75% of infants in group II with MCs and SCs; of these, 12.8% had an abnormal neurological follow-up. Conclusions We detected a high number of conspicuities in neonates without a CU indication. However, we could not demonstrate that ultrasound findings were associated with the neurological follow-up or any advantage to an earlier diagnosis. Our data did not support extending current guidelines or a general CU screening policy for all neonates.

Continued improvement in morbidity reduction in extremely premature infants

2020 ◽  
pp. fetalneonatal-2020-319961
Author(s):  
Joseph Kaempf ◽  
Mindy Morris ◽  
Eileen Steffen ◽  
Lian Wang ◽  
Michael Dunn
Keyword(s):  
Intensive Care ◽  
Quality Improvement ◽  
Lung Disease ◽  
Premature Infants ◽  
Chronic Lung Disease ◽  
Neonatal Intensive Care ◽  
Periventricular Leukomalacia ◽  
Morbidity Rate ◽  
Major Morbidity ◽  
Morbidity Score

ObjectiveProvide a progress report updating our long-term quality improvement collaboration focused on major morbidity reduction in extremely premature infants 23–27 weeks.Methods10 Vermont Oxford Network (VON) neonatal intensive care units (NICUs) (the POD) sustained a structured alliance: (A) face-to-face meetings, site visits and teleconferences, (B) transparent process and outcomes sharing, (C) utilisation of evidence-based potentially better practice toolkits, (D) family integration and (E) benchmarking via a composite mortality–morbidity score (Benefit Metric). Morbidity-specific toolkits were employed variably by each NICU according to local priorities. The eight major VON morbidities and the risk-adjusted Benefit Metric were compared in two epochs 2010–2013 versus 2014–2018.Results5888 infants, mean (SD) gestational age 25.8 (1.4) weeks, were tracked. The POD Benefit Metric significantly improved (p=0.03) and remained superior to the aggregate VON both epochs (p<0.001). Four POD morbidities significantly improved through 2018 – chronic lung disease (48%–40%), discharge weight <10th percentile (32%–22%), any late infection (19%–17%) and periventricular leukomalacia (4%–2%). In epoch 2, 34% of survivors had none of the eight major morbidities, while 36% had just one. Mortality did not change.ConclusionsInter-NICU collaboration, process and outcomes sharing and potentially better practice toolkits sustain improvement in 23–27 week morbidity rates, notably chronic lung disease, extrauterine growth restriction and the lowest zero-or-one major morbidity rate reported by a quality improvement collaboration. Unrevealed biological and cultural variables affect morbidity rates, countless remain unmeasured, thus duplication to other quality improvement groups is challenging. Understanding intensive care as innumerable interactions and constant flux that defy convenient linear constructs is fundamental.

scholarly journals Fluconazole Prophylaxis of Candida Infections in Preterm Neonates

2019 ◽  
Vol 19 (3) ◽  
pp. 117-126
Author(s):  
A Boselova ◽  
J Nikolinyova ◽  
L Casnocha Lucanova ◽  
M Zibolen
Keyword(s):  
Neonatal Intensive Care ◽  
Clinical Symptoms ◽  
Fungal Infections ◽  
Extremely Low Birth Weight ◽  
Preterm Neonates ◽  
Fungal Colonization ◽  
Mortality And Morbidity ◽  
Drug Of Choice ◽  
Causes Of Mortality ◽  
Fluconazole Prophylaxis

Abstract Infections belong to the most serious health problems in neonates. Invasive candidiases are one of the leading causes of mortality and morbidity in Neonatal intensive care units (NICUs). A more cautious approach is adequate when dealing with fungal infections in premature neonates. Sometimes it is necessary to cure an infection at the very beginning just before manifestation of clinical symptoms. Neonatal colonization due to Candida albicans or non-albicans Candidae predisposes to invasive candidiasis. Pregnancies complicated by preterm delivery should be considered for screening and treatment of maternal Candida colonization to decrease the occurrence of neonatal fungal colonization and its consequences. It is important to prevent infection to spread among patients and avoid complications. Prophylaxis in neonates must be safe and effective. Most authors prefer selective prophylaxis. Fluconazole is the drug of choice for prophylaxis in extremely low birth weight (ELBW) neonates. The prophylaxis is beneficial especially in NICUs with high rates of invasive candidiases. The authors describe benefits and trends in prophylaxis. They also summarize evidence on timing, dosing, and effect of fluconazole prophylaxis.

scholarly journals Cutaneous Chemical Burns Associated With Chlorhexidine-Alcohol Solution in an Extremely Preterm Infant

2020 ◽  
Vol 34 (1-2) ◽  
pp. 103-104 ◽  
Author(s):  
Lee Shi Zhen ◽  
Khoo Ngeh Poh
Keyword(s):  
Intensive Care Unit ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Alcohol Solution ◽  
Extremely Low Birth Weight ◽  
Chemical Burns ◽  
Skin Preparation ◽  
Low Birth Weight Infant ◽  
Extremely Preterm ◽  
Intravascular Devices

Safe cutaneous antisepsis in neonatal intensive care unit is imperative. Chlorhexidine-based solution is commonly used for skin preparation prior to the placement of intravascular devices. However, in premature infants, its usage has not been standardized. We present a case of chemical burns secondary to the use of chlorhexidine-alcohol skin preparation solution in an extremely low birth weight infant.

scholarly journals The survival rate of extremely low birth weight infants improved in Guangdong Province, China

2021 ◽  
Author(s):  
Fan Wu ◽  
Chun-Hong Jia ◽  
Zhou-Shan Feng ◽  
Xiao-Jun Lin ◽  
Qi-Liang Cui ◽  
...  
Keyword(s):  
Overall Survival ◽  
Birth Weight ◽  
Survival Rate ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Periventricular Leukomalacia ◽  
Extremely Low Birth Weight ◽  
Overall Survival Rate ◽  
Low Birth Weight Infants

Abstract Background With the increase in extremely low birth weight (ELBW) infants, their outcomes received special attention. However, in China, studies of the outcomes of ELBW infants are rare. Methods The hospitalized records of ELBW infants discharged from twenty-six neonatal intensive care units were reviewed and analyzed. Results A total of 2575 ELBW infants were enrolled and the overall survival rate was 55.11%. From 2008 to 2017, the number of ELBW infants increased rapidly from 91 to 466, and the survival rate improved steadily from 41.76–62.02%. The survival rate rose with increasing BW, the ascending level of regional economic development and specialist hospitals. The incidence of complications was neonatal respiratory distress syndrome (85.2%), bronchopulmonary dysplasia (63.7%), retinopathy of prematurity (39.3%), intraventricular hemorrhage (29.4%), necrotizing enterocolitis (12.0%), and periventricular leukomalacia (8.0%). Among the 1156 nonsurvivors, 90.0% of infants died during the neonatal period (≤ 28 days), and the other died after the neonatal period. A total of 768 ELBW infants died after medical care withdrawal, with economic factors and expected outcome being important causes. Conclusion The number of ELBW infants is increasing in China, and the overall survival rate is still low but is improving steadily.

scholarly journals The Survival Rate of Extremely Low Birth Weight Infants Improved in Guangdong Province, China

2022 ◽  
Author(s):  
Chun-Hong Jia ◽  
Zhou-Shan Feng ◽  
Xiao-Jun Lin ◽  
Qi-Liang Cui ◽  
Sha-Sha Han ◽  
...  
Keyword(s):  
Overall Survival ◽  
Birth Weight ◽  
Survival Rate ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Periventricular Leukomalacia ◽  
Extremely Low Birth Weight ◽  
Overall Survival Rate ◽  
Low Birth Weight Infants

Abstract Background With the increase in extremely low birth weight (ELBW) infants, their outcomes received special attention. However, in China, studies of the outcomes of ELBW infants are rare. Methods The hospitalized records of ELBW infants discharged from twenty-six neonatal intensive care units were reviewed and analyzed. Results A total of 2575 ELBW infants were enrolled and the overall survival rate was 55.11%. From 2008 to 2017, the number of ELBW infants increased rapidly from 91 to 466, and the survival rate improved steadily from 41.76–62.02%. The survival rate rose with increasing BW, the ascending level of regional economic development and specialist hospitals. The incidence of complications was neonatal respiratory distress syndrome (85.2%), bronchopulmonary dysplasia (63.7%), retinopathy of prematurity (39.3%), intraventricular hemorrhage (29.4%), necrotizing enterocolitis (12.0%), and periventricular leukomalacia (8.0%). Among the 1156 nonsurvivors, 90.0% of infants died during the neonatal period (≤ 28 days), and the other died after the neonatal period. A total of 768 ELBW infants died after medical care withdrawal, with economic factors and expected outcome being important causes. Conclusion The number of ELBW infants is increasing in China, and the overall survival rate is still low but is improving steadily.

Point of Care Neurosonogram in Neonates - Utility and Prognostic Value

2019 ◽  
Vol 2 ◽  
pp. 1
Author(s):  
Bhushita Lakhkar ◽  
M. M. Patil ◽  
Bhavana Lakhkar ◽  
Bhushan Lakhkar
Keyword(s):  
Neonatal Intensive Care ◽  
Point Of Care ◽  
Color Doppler ◽  
Periventricular Leukomalacia ◽  
Birth Asphyxia ◽  
Common Finding ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Doppler Study

Objective The study aimed to utilize the neurosonographic findings in neonates in early diagnosis, prediction of their long-term outcome, parental counseling, and early intervention. Methods The study was carried out in neonatal intensive care unit (NICU) of Shri BM Patil Medical College and Hospital. All preterms and term babies with neurological clinical findings were included in the study. Neurosonogram was done within first 7 days in preterms and when indicated in terms. Philips HD11XE ultrasound and color Doppler unit were used with a small footprint probe. Color Doppler images for vessels were performed for screening of vascular changes. Results A total of 215 babies were included, of which 80 (32%) were term and the rest were preterm. Mean weight of term babies was 2.8 kg and that of preterm was 1.2 kg.Among term babies, 78% showed ultrasound abnormality, and among preterm, 42%showed abnormalities. Among term babies, 60% and, among preterms, 30% had birth asphyxia. Periventricular leukomalacia was the most common and earliest finding followed by thalamic hyperechogenicity and intracranial hemorrhage. Intraventricular hemorrhage was more common in preterm babies. Other common finding in NICU was meningitis which was more common in pretrms. Among congenital anomalies, corpus callosal agenesis was more common. Conclusions Point of care ultrasonography along with Doppler study is very useful and safe to use in NICUs. It helps in diagnosis, patient management as well as prediction of many short- and long-term outcomes.

STUDI FENOMENOLOGI: DUKUNGAN PADA IBU DALAM PERAWATAN BAYI PREMATUR DI RUANG RAWAT INTENSIF NEONATUS

2019 ◽  
Vol 7 (3) ◽  
pp. 198-205
Author(s):  
Anafrin Yugistyowati
Keyword(s):  
Intensive Care ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Discharge Planning ◽  
Premature Baby ◽  
Field Note ◽  
Analyse Data ◽  
Using Data ◽  
Care Ward ◽  
Intensive Care Ward

Background: The premature birth of infants is a process that leads to physical unpreparedness, sources of stress, and traumatize effects for the parents. Mostly mothers showed unpleasant memories that interfered the parents’ ability to take care of their premature baby. Objective: This study aimed  to obtain in-depth understanding of mother’s support in neonatal  intensive care ward. Methods: This is a qualitative research using phenomenology approach involving eight participants. Data were collected through in-depth interview using data recording, interview protocol, and field note. Colaizzi method was used to analyse data. Results: Two research themes were gained from data analysis, the source and the type of support for mother with premature infants’ care. Conclusion: This study recommends for nurses to assist parents by discussing any problems and to facilitate bonding mother and baby through implementation continuum of discharge planning.   Keywords: Care for Premature Infants, Neonatal Intensive Care Ward, Supporting Mothers

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