To B or not to B. The rationale for quantifying B-lines in paediatric lung diseases.

The evaluation of the lung by ultrasound is an adjunct tool to the clinical assessment. Among different hallmarks at lung ultrasound, B-lines are well known artifacts which are not correlated to identifiable structures but can be used as an instrument for pathological classification. Multiple B-lines are the sonographic sign of lung interstitial syndrome with a direct correlation between the number of B-lines and the severity of the interstitial involvement of lung disease. In neonatology and paediatrics, the quantitative assessment of B-lines is questionable as opposed to in adult medical care. Counting B-lines is an attempt to enrich the clinical assessment and clinical information, and not simply arrive at a dichotomous answer. A semiquantitative or quantitative B-lines assessment was shown to correlate with fluid overload and demonstrated prognostic implications in specific neonatal and paediatric conditions. In neonatology, the count of B-lines is used to predict the need for admission in neonatal intensive care unit and the need for exogenous surfactant treatment. In paediatrics, the B-lines count has the role of quantifying hypervolemia in infants and children receiving dialysis. B-lines as predictors of length of stay in the paediatric intensive care unit after cardiac surgery, as a marker of disease severity in bronchiolitis, or as an indicator of lung involvement from SARS-CoV-2 infection are speculative and not yet supported by solid evidence. Lung ultrasound with the quantitative B-lines assessment is promising. The current evidence allows to use the quantification of B-lines in a limited number of neonatal and paediatric diseases.

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The Role of Lung Ultrasound in the Management of the Critically Ill Neonate—A Narrative Review and Practical Guide

Children ◽

10.3390/children8080628 ◽

2021 ◽

Vol 8 (8) ◽

pp. 628

Author(s):

Lukas Aichhorn ◽

Erik Küng ◽

Lisa Habrina ◽

Tobias Werther ◽

Angelika Berger ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Ionizing Radiation ◽

Neonatal Intensive Care Unit ◽

Critically Ill ◽

Neonatal Intensive Care ◽

Lung Ultrasound ◽

Narrative Review ◽

Respiratory Condition

Lung ultrasound makes use of artifacts generated by the ratio of air and fluid in the lung. Recently, an enormous increase of research regarding lung ultrasound emerged, especially in intensive care units. The use of lung ultrasound on the neonatal intensive care unit enables the clinician to gain knowledge about the respiratory condition of the patients, make quick decisions, and reduces exposure to ionizing radiation. In this narrative review, the possibilities of lung ultrasound for the stabilization and resuscitation of the neonate using the ABCDE algorithm will be discussed.

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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

Dhaka Shishu (Children) Hospital Journal ◽

10.3329/dshj.v35i2.49688 ◽

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

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Serratia marcescens outbreak in a neonatal intensive care unit: crucial role of implementing hand hygiene among external consultants

BMC Infectious Diseases ◽

10.1186/s12879-014-0734-6 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 25

Author(s):

Carlotta Montagnani ◽

Priscilla Cocchi ◽

Laura Lega ◽

Silvia Campana ◽

Klaus Peter Biermann ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hand Hygiene ◽

Neonatal Intensive Care Unit ◽

Serratia Marcescens ◽

Crucial Role ◽

Neonatal Intensive Care ◽

External Consultants

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

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692011000200011 ◽

2011 ◽

Vol 19 (2) ◽

pp. 301-308 ◽

Cited By ~ 6

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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