scholarly journals Disease pattern and Biochemical profile as a predictor of outcome of Critically sick neonates in a Neonatal Intensive Care Unit

2020 ◽  
Vol 10 (2) ◽  
pp. 381-385
Author(s):  
Mir Mohammad Yusuf ◽  
BH Nazma Yasmeen ◽  
MAK Azad Chowdhury
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Severe Infection ◽  
Biochemical Profile ◽  
Acid Base ◽  
Disease Pattern ◽  
Acute Neurological Deterioration

Background: Neonatal Intensive Care Unit (NICU) is predominately concerned with the management of critically sick neonates having acute life threatening conditions. Usually neonates having respiratory distress, acute neurological deterioration, severe infection and prematurity contribute the major admission in a NICU. Objective: To find out the disease pattern and biochemical profile as a predictor of outcome of critically sick neonates in NICU. Methods: This observational prospective study was carried out at NICU of Dhaka Shishu (Children) Hospital from January 2015 to July 2015. Total 121 neonates were enrolled according to inclusion criteria and analyzed some important biochemical profile specially electrolyte and blood gas status as a part of proper management as well as to predict their outcome. Results: Among critically sick neonates, perinatal asphyxia was common disorder followed by sepsis. Biochemical profile specially electrolyte and acid-base disruption play important role to the outcome of critically sick neonates. Low pH, low potassium and high base-deficit level were found to have worse outcome. Conclusion: Perinatal asphyxia constitutemajor cause of admission ofcritically sick neonates. Early detection of electrolyte and acid-base status is helpful to care and overall survival of these neonates. Mortality was the highest among neonatal sepsis followedby perinatal asphyxia. Metabolic acidosis and hypokalemia were the predictor of outcome of such critically sick neonates. Northern International Medical College Journal Vol.10 (2) Jan 2019: 381-385

Characteristics of Acute Kidney Injury in Neonatal Age At - Intensive Care Unit

2015 ◽  
Vol 69 (1) ◽  
pp. 20-25
Author(s):  
Silvana Naunova-Timovska
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Kidney Injury ◽  
Predisposing Factor ◽  
Neonatal Kidney ◽  
Neonatal Population

Abstract Introduction. Acute kidney injury is a serious condition which damages the kidney as a central mediator of the homeostasis of bodily fluids and electrolytes. It is not a rare problem in the intensive care units, particularly in the neonatal population. Perinatal asphyxia is a common predisposing factor associated with neonatal kidney injury. The aim of this study was to determine the characteristics of acute kidney injury in newborns from neonatal intensive care unit and to explore the association with perinatal asphyxia. Methods. The study was conducted at the Children’s University Hospital in Skopje, R. Macedonia. It was a clinical, prospective study. In the period of two years (January 2013 to December 2014) 29 patients hospitalized at the Neonatal Intensive Care Unit (NICU) with documented neonatal kidney injury were analyzed. Medical data records of admitted neonates with kidney injury were analyzed. The material was statistically analyzed using methods of descriptive statistics. Results. We evaluated 29 neonates with documented acute kidney injury who at the period of 2 years were treated in NICU. The prevalence of kidney injury was 6.4%. Most of involved neonates were born at term (66%). Prerenal injury was evaluated in 80% of cases. Perinatal asphyxia was the most common predisposing factors for kidney injury in our study, revealed in 56% of cases with predominance of term-infants and male gender. Sepsis was present in 44% of cases, prematurity in 34%, and congenital malformation in 27% of cases. Mortality rate was 27.5% and it was higher in patients with assisted ventilation and sepsis. Conclusion. Perinatal asphyxia is a dominant predisposing factor associated with neonatal kidney injury. Often, the occurrence of kidney damage in the neonatal population is multifactorial (more than 40%) and caused by several associated comorbidities

scholarly journals Clinical and biochemical profile of neonatal seizures admitted in neonatal intensive care unit of a tertiary care hospital

2021 ◽  
Author(s):  
Mohanram V. ◽  
Arulraj Russelian ◽  
Palpandi V.
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Biochemical Profile ◽  
Neonatal Seizures ◽  
The Common

Background: Several factors contribute to seizures among neonates. To avoid complications from under recognition of clinical seizures and the adverse effects of medications administered, the diagnosis and management of neonatal seizures necessitate an interprofessional approach. Present study was done to study the clinical and biochemical profile of neonates with seizures admitted to a tertiary care hospital, Chennai.Methods: A cross sectional study was conducted where all the neonates from birth to 28 days of life who got admitted in the neonatal intensive care unit (NICU) of a tertiary care hospital-Shri Sathya Sai medical college and research institute were included in the study. Baseline characteristics of all the babies were noted on the prescribed proforma. Thorough physical examination was done and seizures were diagnosed by clinical observation. Clinical details of each seizure episode were recorded like age at onset of seizures, duration of seizure, number and type of seizure.Results: In the present study, 50 neonates satisfying the inclusion and exclusion criteria were included in the study. The main mode of delivery was normal vaginal delivery (50%) followed by LSCS (40%) and assisted delivery (10%). 54% were male and 46% were female and majority of babies were delivered at term i.e., 72% and 28% were pre term babies. The mean day of onset of seizures in the present study was 3.18±2.09. Based on day of onset of seizures, with in 24 hrs (28%), 24 hrs to 72 hrs (46%), 4th day to 1 week (22%), more than 1 week (4%). Based on type of seizure 64% had subtle type, 26% had tonic type and 10% had clonic type of seizures. In this study, 24% had hypoglycemia, and 10 (20%) had hypocalcemia, 14% in the present study had hyponatremia, and 2 (4%) had hypomagnesemia, 2 (4%) had hypernatremia, 6% had combination of hypocalcemia and hypoglycemia.Conclusions: Hypocalcemia, hypoglycemia, hyponatremia were the common biochemical abnormalities observed in our study. Subtle seizures were the common type of seizures observed among both pre term and term infants.

scholarly journals Clinical Profile of Neonates with Respiratory Distress in a Tertiary Care Hospital

2019 ◽  
Vol 57 (220) ◽  
Author(s):  
Anita Lamichhane ◽  
Kiran Panthee ◽  
Sharmila Gurung
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Sample Size ◽  
Neonatal Intensive Care ◽  
Tertiary Care Hospital ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Care Hospital

Introduction: Respiratory distress in newborns is a very common reason for admission in Neonatal Intensive Care Unit which may be transient or pathological; morbidity is high if not prompted for early diagnosis and treatment. The present study is undertaken to find out the clinical profile of neonates with respiratory distress in infants in a tertiary care hospital in western Nepal. Methods: A descriptive cross-sectional study was carried out in a tertiary care hospital in the western region of Nepal from April 2017 to March 2018 after approval from the institutional review committee. Sample size was calculated and consecutive sampling was done to reach the sample size. Data were collected from the study population after taking consent and entered in a predesigned proforma. It was then entered in a Statistical Package for Social Sciences, data analysis was done to find frequency and proportion for binary data. Results: Tachypnea was the most common presentation 77 (69.36%). Out of 1694 live deliveries during the study period, the prevalence of respiratory distress was 6.55 % in the total live deliveries while 30.83 % in admitted cases in Neonatal Intensive Care Unit. Survival rate was 95.50% while mortality rate accounted for 4.50%. Conclusions: Perinatal asphyxia accounted for the commonest cause of respiratory distress. To lessen the morbidity and mortality of the neonates with respiratory distress it is advocated that we practice proper and timely neonatal resuscitation, recognize the risk factors as early as possible so that perinatal asphyxia can be minimized.      

Magnitude and determinants of newborn mortality in neonatal intensive care unit hospitals in Ethiopia: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Gizachew Tadele Tiruneh ◽  
Tesega Mengistu Birhanu ◽  
Abdurahaman Seid ◽  
Mahteme Haile Workneh ◽  
Dareskedar Getie ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Mortality ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Meta Analysis ◽  
Mode Of Delivery ◽  
Early Age ◽  
Initiation Of Breastfeeding

Abstract Background: In Ethiopia, the neonatal mortality rate has not shown significant changes over time and is among the highest in the world. Exploring the magnitude and the causes of neonatal mortality in the hospital where neonatal intensive care unit is functioning could be supremely important to step towards improving the quality of neonatal care services. Therefore, this review aimed to explore the pooled magnitude and determinates of neonatal mortality in the neonatal intensive care unit hospitals in Ethiopia. Methods : The research team retrieved global peer-reviewed journal articles available as electronic databases including PubMed, Popline, and Scopus databases. Google Scholar, institutional repositories, and Google were used to retrieve grey literature. Random-effects meta-analysis model was used to pool the estimates of the magnitude of mortality among studies. The results were presented as the pooled estimates (odds ratio and proportion) with 95% confidence intervals, at less than 0.05 significant levels. Results: In this review, 10 studies were included with a total of 8,729 neonates. Of these, 1,779 (20.4%) neonates died in the neonatal intensive care unit. The pooled neonatal mortality rate was 19.0% (95% CI: 14.0-25.0). The neonatal mortality is three times higher among early age (OR: 2.80; 95% CI: 1.45-5.40) and preterm newborns (OR: 3.27; 95% CI: 2.12-5.07) than their counterparts. Early age of the newborn, prematurity, low birth weight, perinatal asphyxia, mode of delivery, hypothermia, late initiation of breastfeeding, and having antenatal care visits were the main determinants for neonatal mortality. Likewise, perinatal asphyxia, hyaline membrane disease, respiratory distress syndrome, and prematurity were identified as the most determinant and statistically associated with the death of premature neonates admitted to intensive care units. Conclusion: Neonatal mortality in the intensive care unit is high. It is unacceptably high amongst early and preterm neonates. Special care for preterm and early age newborns, timely initiation of breastfeeding, exclusive breastfeeding, and appropriate mode of delivery, essential obstetric and newborn care, and promoting antenatal visits are recommended to reduce neonatal mortality. Protocol registration: The protocol was registered at the International prospective register of systematic reviews (PROSPERO) with registration number CRD42019123195.

scholarly journals CLINICAL PROFILE AND OUTCOME OF NEONATES ADMITTED TO A SECONDARY-LEVEL NEONATAL INTENSIVE CARE UNIT IN NORTH INDIA

2017 ◽  
Vol 10 (9) ◽  
pp. 339 ◽  
Author(s):  
Shagufta Yousuf ◽  
Showkat Hussain Tali ◽  
Iftikhar Hussain
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Newborn Care ◽  
Secondary Level ◽  
North India ◽  
Tertiary Level ◽  
Clinical Profiles

  Objectives: The objective of this study was to evaluate the performance of a secondary-level neonatal intensive care unit (NICU).Methods: A total of 336 neonates were enrolled in the study. Their clinical profiles at admission and final outcomes were recorded in a predesigned pro forma.Results: Hyperbilirubinemia, sepsis, and perinatal asphyxia were the most common reasons for admission. Eighty-five percentage of the neonates could be managed in secondary-level newborn unit with comparable mortality and mortality to a tertiary-level newborn care unit.Conclusion: Strengthening of secondary newborn care units is a viable option that will help to decrease the burden of tertiary-level NICUs.

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.

scholarly journals Therapeutic Hypothermia in Asphyxiated Neonates: Experience from Neonatal Intensive Care Unit of University Hospital of Marrakech

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
F. M. R. Maoulainine ◽  
M. Elbaz ◽  
S. Elfaiq ◽  
G. Boufrioua ◽  
F. Z. Elalouani ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Therapeutic Hypothermia ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Treatment Protocol ◽  
University Hospital ◽  
Control Group ◽  
Long Term Follow Up

Introduction. Therapeutic hypothermia (TH) is now recommended for the treatment neonates with hypoxic-ischemic encephalopathy (HIE). This treatment protocol is applied in our department since June 2012. The aim of this study is to report the first experience with head cooling in asphyxiated neonates in Morocco. Patients and Methods. Prospective study of newborns admitted for HIE from July 18, 2012, to May 15, 2014, in Neonatal Intensive Care Unit (NICU) of Mohamed VI University Hospital. The results were studied by comparing a newborn group who received hypothermia to a control group. Results. Seventy-two cases of neonates with perinatal asphyxia were admitted in the unit. According to inclusion criteria thirty-eight cases were eligible for the study. Only 19 cases have received the hypothermia protocol for different reason; the arrival beyond six hours of life was the main cause accounting for 41%. Complications of asphyxia were comparable in both groups with greater pulmonary hypertension recorded in the control group. The long-term follow-up of protocol group was normal in almost half of cases. Conclusion. Our first experience with the controlled TH supports its beneficial effect in newborns with HIE. This treatment must be available in all the centers involved in the neonatal care in Morocco.

The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

2019 ◽  
Vol 4 (6) ◽  
pp. 1507-1515
Author(s):  
Lauren L. Madhoun ◽  
Robert Dempster
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Hospital Discharge ◽  
Neonatal Intensive Care ◽  
Oral Feeding ◽  
Medical Attention ◽  
Primary Role ◽  
Speech Language Pathologists ◽  
The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

Sign in / Sign up

Export Citation Format

Share Document