scholarly journals Factors that impact the accuracy with which nurses place preterm infants with respiratory distress syndrome in the prone position

2021 ◽  
Vol 43 (s1) ◽  
Author(s):  
Nur Fitri ◽  
Defi Efendi
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Prone Position ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Research Subjects ◽  
Cross Sectional

Prone positioning is an important treatment procedure for preterm infants with Respiratory Distress Syndrome (RDS). However, the accuracy with which preterm infants in the Neonatal Intensive Care Unit (NICU) are placed in the prone position is impacted by several factors. The current study aimed to identify these factors. One hundred and twenty-eight nurses were included in this cross-sectional study. Direct observations of the research subjects were used to collect the research data. The participants completed a research questionnaire that included their demographic data and three others to obtain information on their clinical experience, knowledge of positioning, caring behaviors, and efficacy. Independent factors likely to affect preterm infant positioning were evaluated using multivariate logistic regression. The alpha level was set at 5%. Knowledge (p=0.002) and caring behavior (p=0.009) significantly influenced the accuracy with which nurses placed preterm infants with RDS in the prone position. Nursing efficacy, infant’s bodyweight, gestational age, the institution, and DNR decisions did not significantly impact accuracy. NICU nursing staff require interventions to increase their knowledge of the accurate positioning of preterm infants with RDS.

scholarly journals Magnitude of preterm hospital neonatal mortality and associated factors in northern Ethiopia: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051161
Author(s):  
Bekahegn Girma ◽  
Jemberu Nigussie
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Associated Factors ◽  
Distress Syndrome ◽  
Cross Sectional Study ◽  
Northern Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

ObjectiveThis study aimed to assess the magnitude of preterm neonatal mortality in hospitals and associated factors in northern Ethiopia.DesignInstitutional-based cross-sectional study.SettingComprehensive specialised hospitals in the Tigray region, northern Ethiopia.ParticipantsPreterm neonates admitted in Ayder and Aksum comprehensive specialised hospitalsPrimary outcomeMagnitude of preterm neonatal mortality.Secondary outcomeFactors associated with preterm neonatal mortalityResultThis study was conducted from 1 April 2019 to 15 May 2019 among 336 participants with a response rate of 96.8%. The magnitude of preterm neonatal mortality was 28.6% (95% CI: 24.0 to 33.7). In multivariable logistic regression, respiratory distress syndrome (adjusted odd ratio (AOR)=2.85; 95% CI: 1.35 to 6.00), apnoea of prematurity (AOR=5.45; 95% CI: 1.32 to 22.5), nulli parity (AOR=3.63; 95% CI: 1.59 to 8.24) and grand parity (AOR=3.21; 95% CI: 1.04 to 9.94) were significant factors associated with preterm neonatal mortality. However, receiving Kangaroo mother care (AOR=0.08; 95% CI: 0.03 to 0.20) and feeding initiated during hospitalisation (AOR=0.07; 95% CI: 0.03 to 0.15) were protective against preterm neonatal mortality.ConclusionsThe magnitude of preterm neonatal mortality in hospitals was still high. Interventions geared towards curbing preterm in-hospital neonatal mortality should strengthen early diagnosis and treatment of preterm newborns with respiratory distress syndrome and apnoea of prematurity; while concomitantly reinforcing the implementation of kangaroo care and early feeding initiation is important.

scholarly journals Lung ultrasound features predict admission to the neonatal intensive care unit in infants with transient neonatal tachypnoea or respiratory distress syndrome born by caesarean section

2020 ◽  
Author(s):  
Antonio Poerio ◽  
Silvia Galletti ◽  
Michelangelo Baldazzi ◽  
Silvia Martini ◽  
Alessandra Rollo ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Late Preterm ◽  
Late Preterm Infants ◽  
Nicu Admission

Abstract We aimed to evaluate the reliability of lung ultrasound (LU) to predict admission to the neonatal intensive care unit (NICU) for transient neonatal tachypnoea or respiratory distress syndrome in infants born by caesarean section (CS). A prospective, observational, single-centre study was performed in the delivery room and NICU of Sant’Orsola-Malpighi Hospital in Bologna, Italy. Term and late-preterm infants born by CS were included. LU was performed at 30’ and 4 h after birth. LU appearance was graded according to a previously validated three-point scoring system (3P-LUS: type-1, white lung; type-2, black/white lung; type-3, normal lung). Full LUS was also calculated. One hundred infants were enrolled, and seven were admitted to the NICU. The 5 infants with bilateral type-1 lung at birth were all admitted to the NICU. Infants with type-2 and/or type-3 lung were unlikely to be admitted to the NICU. Mean full-LUS was 17 in infants admitted to the NICU, and 8 in infants not admitted. In two separate binary logistic regression models, both the 3P- and the full LUS proved to be independently associated with NICU admission (OR [95% CI] 0.001 [0.000–0.058], P = .001, and 2.890 [1.472–5.672], P = .002, respectively). The ROC analysis for the 3P-LUS yielded an AUC of 0.942 (95%CI, 0.876–0.979; P<.001), while ROC analysis for the full LUS yielded an AUC of 0.978 (95%CI, 0.926–0.997; P<.001). The AUCs for the two LU scores were not significantly different (p = .261). Conclusion: the 3P-LUS performed 30 min after birth proved to be a reliable tool to identify, among term and late preterm infants born to CS, those who will require NICU admission for transient neonatal tachypnoea or respiratory distress syndrome. What is known• Lung ultrasound (LU) has become an attractive diagnostic tool in neonatal settings, and guidelines on point-of-care LU in the neonatal intensive care unit (NICU) have been recently issued.• LU is currently used for diagnosing several neonatal respiratory morbidities and has been also proposed for predicting further intervention, such as NICU admission, need for surfactant treatment or mechanical ventilation in preterm infants. What is new• LU performed 30′ after birth and evaluated through a simple three-point scoring system represents a reliable tool to identify, among term and late preterm infants born to caesarean section, those with transient neonatal tachypnoea or respiratory distress syndrome who will require NICU admission.• LU performed in the neonatal period confirms its potential role in ameliorating routine neonatal clinical management.

scholarly journals Health Economics and Outcomes of Surfactant Treatments for Respiratory Distress Syndrome Among Preterm Infants in US Level III/IV Neonatal Intensive Care Units

2019 ◽  
Vol 24 (2) ◽  
pp. 117-127
Author(s):  
Krishnamurthy Sekar ◽  
Daniel Fuentes ◽  
Michelle R. Krukas-Hampel ◽  
Frank R. Ernst
Keyword(s):  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Hospital Costs ◽  
Neonatal Intensive Care Units ◽  
Multivariable Regression ◽  
Surfactant Administration

OBJECTIVE To compare length of stay (LOS), costs, mechanical ventilation (MV), and mortality in preterm infants treated in the Neonatal Intensive Care Unit (NICU) with beractant (BE), calfactant (CA), and poractant alfa (PA) for Respiratory Distress Syndrome (RDS). METHODS This study evaluated preterm infants born between 2010 and 2013 with RDS diagnosis, gestational age of 25 to 36 weeks, birthweight of ≥500 g, and age of ≤2 days on first surfactant administration. Multivariable regression was used to evaluate all NICU outcomes. RESULTS Of 13,240 infants meeting the study criteria, 4136 (31.2%) received BE, 2502 (18.9%) received CA, and 6602 (49.9%) received PA. Adjusted analyses estimated similar mean LOS (BE 26.7 days, CA 27.8 days, and PA 26.2 days) and hospital costs (BE: $50,929; CA: $50,785; and PA: $50,212). Compared to PA, BE and CA were associated with greater odds of MV use on day 3 (OR = 1.56 and 1.60, respectively) and day 7 (OR = 1.39 and 1.28, respectively; all p &lt; 0.05). Adjusted NICU mortality was significantly higher only with CA vs PA (OR = 1.51; p = 0.015). CONCLUSION Adjusted NICU LOS and costs were similar among BE, CA, and PA. Infants receiving PA were less likely to be on MV at 3 and 7 days, and PA treatment was associated with lower odds of NICU mortality when compared to CA.

scholarly journals Trial of aerosolised surfactant for preterm infants with respiratory distress syndrome

2021 ◽  
pp. fetalneonatal-2021-321645
Author(s):  
Luke Jardine ◽  
Kei Lui ◽  
Helen G Liley ◽  
Timothy Schindler ◽  
James Fink ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Failure Criteria ◽  
Open Label ◽  
Dose Escalation Study ◽  
Safety Issues ◽  
Label Dose ◽  
Historical Controls

ObjectiveTo evaluate the safety of an aerosolised surfactant, SF-RI 1, administered via nasal continuous positive airway pressure (nCPAP) and a prototype breath synchronisation device (AeroFact), to preterm infants with respiratory distress syndrome (RDS).DesignMulticentre, open-label, dose-escalation study with historical controls.SettingNewborn intensive care units at Mater Mothers’ Hospital, Brisbane, and Royal Hospital for Women, Sydney, Australia.PatientsInfants 26 weeks through 30 weeks gestation who required nCPAP 6–8 cmH2O and fraction of inspired oxygen (FiO2) <0.30 at <2 hours of age.InterventionsIn part 1, infants received a single dose of 216 mg/kg of aerosolised surfactant. In part 2, infants could receive up to four doses of aerosolised surfactant. Three historical control infants were matched for each enrolled infant.Main outcome measuresTreatment failure was defined as Respiratory Severity Score (FiO2×cmH2O nCPAP) >2.4, nCPAP >8 cmH2O, arterial carbon dioxide >65 mm Hg, pH <7.20 or three severe apnoeas within 6 hours during the first 72 hours of life. Other outcomes included tolerance of the AeroFact treatment and complications of prematurity.Results10 infants were enrolled in part 1 and 21 in part 2 and were compared with 93 historical controls. No safety issues were identified. In part 2, 6 of 21 (29%) AeroFact-treated infants compared with 30 of 63 (48%) control infants met failure criteria. Kaplan-Meier analysis of patients in part 2 showed a trend towards decreased rate of study failure in the AeroFact-treated infants compared with historical controls (p=0.10).ConclusionThe AeroFact system can safely deliver aerosolised surfactant to preterm infants with RDS who are on nCPAP.Trial registration numberACTRN12617001458325.

Surfactant therapy via thin catheter in preterm infants with or at risk of respiratory distress syndrome

2021 ◽  
Author(s):  
Mohamed E Abdel-Latif ◽  
Peter G Davis ◽  
Kevin I Wheeler ◽  
Antonio G De Paoli ◽  
Peter A Dargaville
Keyword(s):  
At Risk ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Surfactant Therapy
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