scholarly journals Motor performance evaluation of newborns with gastroschisis after surgical correction

2021 ◽  
Vol 31 (2) ◽  
pp. 217-223
Author(s):  
Gislaine Aparecida de Oliveira Mota ◽  
Glaucia Yuri Shimizu ◽  
Ana Lucia Capelari Lahoz ◽  
Carla Marques Nicolau ◽  
Lucia Cândida Soares de Paula ◽  
...  
Keyword(s):  
Intensive Care ◽  
Motor Performance ◽  
Neonatal Intensive Care ◽  
Care Center ◽  
Surgical Correction ◽  
Motor Assessment ◽  
Average Hospital ◽  
Long Time ◽  
Early Developmental

Introduction: Gastroschisis is a congenital malformation that has risk factors for delayed neuropsychomotor development. That is why it is important to recognize early developmental changes in these newborns during hospitalization in the Neonatal Intensive Care Unit. Objective: To evaluate the motor performance of newborns with gastroschisis after surgical correction. Methods: An observational and retrospective study was carried out with newborns with gastroschisis, assessed by the Test of Infant Motor Performance at the Neonatal Intensive Care Center 2 of the Instituto da Criança e do Adolescente. The test allows the classification of the risk for developmental delay in 4 categories: within the average for age, low average, below average, and well below average. Maternal, neonatal, surgical, and motor assessment data were collected through electronic medical records. Results: Motor assessment was performed on 17 newborns, where 88.23% were classified as “below average” for age. The mean maternal age was 20 years, and the average gestational age and birth weight were 36.38 weeks and 2343.9 grams, respectively, with the majority being female. Simple gastroschisis accounted for 64.71%, and primary closure was possible in 82.35%. The average hospital stay of 53.24 days, and sepsis was the most frequent complication (64.71%). Conclusion: Newborns with gastroschisis remain hospitalized for a long time and are susceptible to complications. It was possible to identify the delay in the development of these newborns early during hospitalization, which allows intervention by physiotherapy before the delay worsens.

scholarly journals Effects of a Parent-Administered Exercise Program in the Neonatal Intensive Care Unit: Dose Does Matter—A Randomized Controlled Trial

2020 ◽  
Vol 100 (5) ◽  
pp. 860-869
Author(s):  
Gunn Kristin Øberg ◽  
Gay L Girolami ◽  
Suzann K Campbell ◽  
Tordis Ustad ◽  
Ivar Heuch ◽  
...  
Keyword(s):  
Intensive Care ◽  
Motor Performance ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Exercise Program ◽  
Control Group ◽  
Z Score ◽  
Control Groups ◽  
Significant Difference ◽  
Motor Outcome

Abstract Background Despite the risk of delayed motor development in infants born preterm, knowledge about interventions in the neonatal intensive care unitt (NICU) and the effects of dosing is sparse. Objective The objectives of this study were to examine the effectiveness of a parent-administered exercise program in the NICU on motor outcome at 3 months corrected age (CA) and the effect of dosing on motor performance. Design This was a randomized clinical trial. Setting The study was conducted at 3 university hospitals in Tromsø, Trondheim, and Oslo, Norway. Participants A total of 153 infants with gestational age <32 weeks at birth were randomly assigned to intervention or control groups. Intervention A 3-week parent-administered intervention designed to facilitate movements in preterm infants was performed in the NICU. Parents were asked to administer the intervention 10 minutes twice a day. Measurements Test of Infant Motor Performance (TIMP) was used to assess short-term outcome at 3 months CA. Results No significant difference in the TIMP z-score was found between intervention and control groups at follow-up 3 months CA, but a significant positive relationship was found between total intervention dose and TIMP z-scores. The adjusted odds of having a clinical z-score < 0 at 3 months CA was about 6 times higher for infants with less than median intervention time than for infants with a longer intervention time. Limitations The number of infants born before 28 weeks was small. A spillover effect in favor of the control group was possible. We do not know if the infants received physical therapy after discharge from the hospital. Conclusions There was no difference in motor performance between the intervention group and the control group at 3 months CA. However, an increased intervention dose was positively associated with improved motor outcome.

Laryngomalacia in Neonates Versus Older Infants: HCUP-KID Perspective

2020 ◽  
Vol 59 (7) ◽  
pp. 679-685
Author(s):  
Michele M. Carr ◽  
Jad Ramadan ◽  
Emma Bauer
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Neonatal Intensive Care ◽  
International Classification Of Diseases ◽  
Classification Of Diseases ◽  
Cost Utilization ◽  
Inpatient Database ◽  
Total Charges

This study evaluated the hospital course for neonates and older infants with a diagnosis of laryngomalacia (LM). Data came from the 2016 Kids’ Inpatient Database of the Healthcare Cost Utilization Project. A total of 6537 children aged <1 year with a diagnosis of LM (International Classification of Diseases, 10th Revision, code Q31.5) were identified: 2212 neonates and 4325 non-neonates. Neonates had a higher mortality rate, 1.31% versus 0.72% in older infants, had more diagnoses (median 9 vs 7) and procedures (mean 85.24 vs 21.83), longer length of stay (median 10 vs 4 days), and higher total charges (median US$65 722 vs US$25 582). A total of 23.3% of neonates born during the admission and diagnosed with LM had undergone laryngoscopy. Second airway lesions were present in 12.33% of neonates and 15.77% of older infants. It appears that neonates are being discharged with a diagnosis of LM without laryngoscopy. Neonatal intensive care unit and newborn nursery policies should require visualization of the larynx prior to diagnosis of LM.

Back Transporting Infants From Neonatal Intensive Care Units to Community Hospitals for Recovery Care: Effect on Total Hospital Charges

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 22-26
Author(s):  
Ciaran S. Phibbs ◽  
Lynn Mortensen
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Community Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Small Sample ◽  
Hospital Charges ◽  
Neonatal Intensive Care Units ◽  
Community Hospitals

Many neonates are referred to neonatal intensive care units (NICUs) for specialized care far from their parents' residence. This distance can add to the stress of the parents and reduce the contact of the parents with their newborn. Small studies have found that back transporting these neonates to hospitals closer to their homes is safe and cost-effective. Despite these findings, the reluctance of many insurers to pay for back transports prevents or delays many back transports. Insurers may not consider the findings of the previous studies to be conclusive, given that the comparisons were between small numbers of neonates back transported and neonates who remained in tertiary care, and the potential for differences in severity of illness between the groups is significant. In this study the effect on hospital charges of back transports was examined by comparing the charges for care in community hospitals with what these charges would have been in a tertiary care center. The advantage of this method is that it avoids case-mix differences between the groups and thus minimizes the potential for small-sample bias. Data were collected for all back transports from a NICU to non-tertiary care centers (n = 90) for a 9-month period. We were able to obtain the itemized bills for the care at community hospitals for 42 of these patients. Each bill was recalculated using the charges for the NICU to determine potential for savings. The average charges for recovery care were about $6200 lower at the community hospital than they would have been at the NICU. When the charges for the back transport are subtracted (mean = $1603), the average net savings are $4,600. These savings are even larger ($6163) for neonates who stayed at the community hospital for more than 7 days.

Covering the Costs of Care in Neonatal Intensive Care Units

PEDIATRICS ◽  
1992 ◽  
Vol 89 (1) ◽  
pp. 56-61
Author(s):  
Allen W. Imershein ◽  
Carolyn Turner ◽  
Janice G. Wells ◽  
Allen Pearman
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Cost Containment ◽  
Neonatal Intensive Care ◽  
Health Care Cost ◽  
Care Center ◽  
Government Support ◽  
Neonatal Intensive Care Units ◽  
Cost Shifting

The continued rise of health care costs, despite private and governmental control efforts, has sustained cost containment as a central issue for health care researchers and policy makers. In keeping with these concerns, the Florida Health Care Cost Containment Board conducted a study of neonatal intensive care units (NICUs) in Florida to ascertain the costs, charges, and net revenues associated with NICU services in individual hospitals, to document cost shifting and cross-subsidization as a means of financing NICU care for indigent populations, and to assess the fiscal impact of NICUs in state-sponsored vs non-state-sponsored Regional Perinatal Intensive Care Center hospitals providing NICU care. Hospitals in the state-sponsored program reported a loss of approximately $16.5 million in contrast to the non-state-sponsored hospitals, which reported a gain of $1 million. Payment being generated by privatepay patients amounted to almost 60% of total revenues but constituted less than one third of the costs in statesponsored hospitals, indicating a high level of cost shifting. Government support of state-sponsored NICUs, while substantial, has been insufficient; increasing constraints on this funding source would likely worsen the deficit and increase the necessity of cost shifting.

Humidification Solution as a Source for Spreading Burkholderia cepacia in a Neonatal Intensive Care Unit

2020 ◽  
Vol 15 (05) ◽  
pp. 262-264
Author(s):  
Bora Baysal
Keyword(s):  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Burkholderia Cepacia ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Tracheal Aspirate ◽  
Screening Tests ◽  
Long Time ◽  
Natural Ecology

Abstract Burkholderia cepacia is an important opportunistic organism in hospitalized and immunocompromised patients especially in newborns. The natural ecology of these bacteria associated with plants is also a cause of infectious potential. The disease-causing potential of bacteria as a nosocomial pathogen may be due to its ability to survive in antiseptic solutions, contamination equipment. The patient was hospitalized for prematurity and respiratory distress syndrome. He was treated with surfactant intratracheally for the respiratory distress syndrome. Umbilical catheter was inserted. Ampicillin and gentamicin treatments were initiated. The patient who received respiratory support for a long time was given a steroid protocol because of bronchopulmonary dysplasia. Burkholderia cepacia was detected in the blood and tracheal aspirate cultures of the patient, whose infection markers increased and a new area of infection was detected on the chest radiograph. Colistin and ciprofloxacin treatments were given according to the culture antibiogram. Screening tests revealed B. cepacia colonization in incubator moistening solutions. All incubator humidification solutions in the hospital were changed. Burkholderia cepacia is a rare cause of nosocomial infection in intensive care units but resistant to many treatments. With its capability to colonize water and grow on microbicides, the presence of B. cepacia in a patient's blood warrants further investigation in institutions providing care.

scholarly journals Successful treatment of a premature newborn with isolated gastric perforation

2020 ◽  
Vol 179 (3) ◽  
pp. 58-61
Author(s):  
I. H. Shidakov ◽  
B. M. Kalniyazov ◽  
E. A. Kuznetsova ◽  
L. I. Alakaeva
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Posterior Wall ◽  
Postnatal Period ◽  
Premature Newborn ◽  
Newborn Girl ◽  
Long Time ◽  
Perinatal Center ◽  
Small And Large Intestine

In the Republican perinatal center, there was a premature newborn girl who had a combination of various risk factors in the antenatal and postnatal period. From birth, the child was in the intensive care unit, required intensive care. Against the backdrop of positive dynamics, at the 4th week of life, the child’s condition worsened noticeably, signs of pneumoperitoneum appeared. After emergency laparocentesis, it took several days to stabilize the condition. Laparotomy was performed in a deferred order, in which isolated perforation of the posterior wall of the stomach was detected. The scope of the operation was limited to suturing the opening, since no other changes from the small and large intestine were detected. In the postoperative period, the child’s condition remained severe for a long time, was in the neonatal intensive care unit. The child was discharged home with recovery after 3 months.

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