scholarly journals Delivery Room Intensive Care Unit: 5 Years' Experience in Assistance of High-Risk Newborns at a Referral Center

2021 ◽  
Vol 9 ◽  
Author(s):  
Silvia Buratti ◽  
Elisabetta Lampugnani ◽  
Monica Faggiolo ◽  
Isabella Buffoni ◽  
Dario Paladini ◽  
...  

Objective: The aim of the study is to describe a delivery room intensive care unit (DRICU) model and evaluate its effectiveness in preventing morbidity and mortality in high-risk newborns.Design: This retrospective case series includes all DRICU procedures performed from 2016 to 2020.Setting: Gaslini Children's Hospital is a major pediatric tertiary care center where high-risk pregnancies are centralized. The Neonatal and Pediatric Intensive Care Unit admits every year about 100 high-risk newborns.Patients: The selected patients are newborns at risk of critical conditions immediately after birth for respiratory or cardiovascular congenital disorders.Interventions: The perinatal plan is defined by the multidisciplinary team of Fetal and Perinatal Medicine. The DRICU procedure provides highly specialized care through a protocol that includes logistics, personnel, equipment, and clinical pathways.Main Outcome Measures: The primary outcome is the prevention of acute complications and mortality in the delivery room and early neonatal period.Results: From 2016 to 2020, 40 DRICU procedures were performed. The main prenatal diagnoses included congenital heart disease with a high risk of life-threatening events immediately after birth (38%), congenital diaphragmatic hernia (35%), and fetal hydrops/hydrothorax (23%). Mean gestational age was 35.9 weeks (range: 31–39), and mean birth weight was 2,740 grams (range: 1,480–3,920). DRICU assistance completed in all patients by neonatal intensivists included tracheal intubation and arterial and central venous cannulation; complex procedures such as ex-utero intrapartum technique and extracorporeal membrane oxygenation cannulation are described. No deaths nor severe acute complications occurred in the delivery room or in the immediate postnatal period.Conclusions: The outcome in critical newborns is potentially affected by planned assistance strategies and specialized competencies through the implementation of a DRICU protocol.

2021 ◽  
Vol 25 (10) ◽  
pp. 1191-1194
Author(s):  
Nikhil Kothari ◽  
Amit Goyal ◽  
Ankur Sharma ◽  
Shilpa Goyal ◽  
Pradeep K Bhatia ◽  
...  

2000 ◽  
Vol 21 (8) ◽  
pp. 527-529 ◽  
Author(s):  
Luis Ostrosky-Zeichner ◽  
Rosa Baez-Martinez ◽  
M. Sigfrido Rangel-Frausto ◽  
Samuel Ponce-de-León

Twelve nosocomial outbreaks over 14 years at a tertiary-care center in Mexico are described. Overall mortality was 25.8%, one half due to pneumonia. The most common organism was Pseudomonas aeruginosa. Incidence was three outbreaks per 10,000 discharges; outbreak-related infections comprised 1.56% of all nosocomial infections. Incidence in the intensive care unit was 10-fold higher.


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