Content Analysis of Debriefing after Simulation-based Nursing Education on Respiratory Distress Syndrome in the Neonatal Intensive Care Unit

Abstract Background: Trophic feeding is a small volume, hypo-caloric feeding, gut priming or minimal enteral feeding acclimate the immature gut of enteral fasting preterm neonates. Delayed starting of trophic feeding had resulted in short and long-term physical and neurological sequels. The current study aimed to assess time to initiate trophic feeding and its predictors among preterm neonates admitted in the neonatal intensive care unit of Debre Markos, Felege Hiwot, and Tibebe Ghion comprehensive specialized hospitals.Methods: An institutional-based prospective follow-up study was conducted among 210 neonates. The data were collected with interview and chart review, entered into Epi data 3.1 and exported to Stata 14.1 for analysis. Multivariable Cox regression models were fitted to identify predictors of time to initiate trophic feeding. Result: A total of 210 neonates were followed for 10136 person-hours of risk time and 191 (90.95%) of neonates were started trophic feeding. The overall incidence of starting trophic feeding was 2 per 100 (95% CI: 2, 2.2) person-hours observations. The median survival time was 42 hours (95% CI: 36, 48). APGAR- score at first minute <7 (AHR: 0.6, 95% CI: 0.44, 0.82), gestational age of <34 weeks (AHR: 0.69, 95% CI: 0.5, 0.94), presence of respiratory distress syndrome (AHR: 0.5, 95% CI: 0.36, 0.68), presence of hemodynamic instability (AHR: 0.37, 95% CI: 0.24, 0.57), presence of perinatal asphyxia (AHR: 0.63, 95% CI: 0.44, 0.89), cesarean section delivery (AHR: 0.63, 95% CI: 0.44, 89) and being delivered within the study hospitals (AHR: 0.54, 95% CI: 0.39, 0.74) were found to be statistically significant predictors of time to initiate trophic feeding.Conclusion: There was a significant delay to initiate trophic feeding in the studied hospitals. Gestational age of below 34 weeks, APGAR-score of less than seven, out-born delivery, cesarean delivery, presence of respiratory distress syndrome; perinatal asphyxia, and hemodynamic instability were predictors of delay in starting of trophic feeding. Standardized feeding guideline has to be implemented to overcome delays in enteral feeding initiation.

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Assistência fisioterapêutica em prematuros com Síndrome do Desconforto Respiratório: uma revisão de literatura

Scire Salutis ◽

10.6008/cbpc2236-9600.2018.002.0005 ◽

2018 ◽

Vol 8 (2) ◽

pp. 43-53

Author(s):

Simone Amancio Teles ◽

Marineth Ferreira de Carvalho Teixeira ◽

Daniela Maristane Vieira Lopes Maciel

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Physical Therapy ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Premature Infants ◽

Neonatal Intensive Care ◽

Distress Syndrome ◽

Terapia Intensiva

A Síndrome do Desconforto Respiratório (SDR) é um distúrbio que acomete principalmente os recém-nascidos prematuros pela imaturidade pulmonar, resultante da deficiência ou inativação do surfactante. O surfactante é uma substância lipoprotéica produzida pelas células pneumócitos tipo II e armazenado nos corpos lamelares para, posteriormente, ser liberado no espaço alveolar, sintetizado a partir da 20º semana de gestação, com pico de produção por volta da 35º semana. A função do surfactante é diminuir a tensão superficial dos alvéolos, evitando o colabamento na expiração. Quanto menor a idade gestacional de nascimento, maior o risco de desenvolver a SDR. A prematuridade e a imaturidade do sistema respiratório levam à maior necessidade de suporte ventilatório invasivo, oxigenioterapia, assistência fisioterapêutica e internação na unidade de terapia intensiva neonatal. A fisioterapia respiratória tem papel importante na manutenção da permeabilidade das vias aéreas, prevenção de complicações respiratórias, promoção da higiene brônquica, otimização da reexpansão pulmonar, posicionamento adequado e vigilância nos ajustes dos parâmetros da ventilação mecânica invasiva e não invasiva. Este estudo tem o objetivo de realizar uma revisão bibliográfica para identificar as estratégias terapêuticas respiratórias utilizadas pelo fisioterapeuta na assistência ao recém-nascido prematuro com Síndrome do Desconforto Respiratório. Para este fim, fizemos um levantamento de artigos científicos em bases de dados eletrônicos como SciELO, LILACS, Google Acadêmico e PubMed, através dos cognatos ‘Síndrome do Desconforto Respiratório’, ‘prematuros’, ‘unidade de terapia intensiva neonatal’, ‘fisioterapia’ e ‘ventilação mecânica’, e seus correlatos em inglês ‘Respiratory Distress Syndrome’, ‘premature infants’, ‘neonatal intensive care unit’, e ‘physical therapy and mechanical ventilation’. A assistência fisioterapêutica a neonatos prematuros com SDR na UTIN é imprescindível para o sucesso da terapêutica e melhora progressiva da função pulmonar até a alta. O fisioterapeuta deve exercer um plano de tratamento integral e humanizado indo desde o ajuste ventilatório invasivo e não invasivo a execução de manobras terapêuticas, posicionamento e cuidados com a ocorrência de sequelas como hemorragia intraperiventricular e displasia broncopulmonar que podem comprometer o desenvolvimento neuropsicomotor e qualidade de vida após alta hospitalar.

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Acute respiratory distress syndrome: A pediatric intensive care unit experience from an eastern Indian state

JOURNAL OF PEDIATRIC CRITICAL CARE ◽

10.21304/2017.0403.00188 ◽

2017 ◽

Vol 4 (3) ◽

pp. 16

Author(s):

BijayKumar Meher ◽

Leena Das ◽

BalajiBhusan Patnaik ◽

DeeptiDamayanty Pradhan ◽

Jatadhari Mahar

Keyword(s):

Intensive Care Unit ◽

Acute Respiratory Distress Syndrome ◽

Intensive Care ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Pediatric Intensive Care Unit ◽

Distress Syndrome ◽

Pediatric Intensive Care ◽

Indian State

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Evaluation of Morbidities and Complications of Neonatal İntensive Care Unit Patients with Respiratory Disorders at Different Gestational Ages

American Journal of Perinatology ◽

10.1055/s-0041-1722942 ◽

2021 ◽

Author(s):

Erbu Yarci ◽

Fuat E. Canpolat

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Neonatal Intensive Care Unit ◽

Respiratory Distress ◽

Gestational Age ◽

Neonatal Intensive Care ◽

Respiratory Diseases ◽

Respiratory Disorders ◽

Live Births

Objective Respiratory distress presented within the first few days of life is life-threatening and common problem in the neonatal period. The aim of this study is to estimate (1) the incidence of respiratory diseases in newborns and related mortality; (2) the relationship between acute neonatal respiratory disorders rates and gestational age, birth weight, and gender; and (3) the incidence of complications associated with respiratory disturbances. Study Design Only inborn patients with gestational age between 230/7 and 416/7 weeks having respiratory distress were included in the study. The data were collected from the medical records and gestational age was based on the menstrual dating. Results There were 8,474 live births between January 1, 2013 and June 30, 2013 in our hospital. A total of 1,367 newborns were hospitalized and oxygen therapy was applied in 903 of them because of respiratory distress. An acute respiratory disorder was found to be in 10.6% (903/8,474) among all live births. Mortality was 0.76% (66/8,474). The incidence of respiratory distress syndrome was 2.8% (n = 242). The occurrence of transient tachypnea of newborn was 3.1% (n = 270). Meconium aspiration syndrome, pneumonia, congenital diaphragmatic hernia, and pulmonary maladaptation and primary persistent pulmonary hypertension rates were 0.1, 0.7, 2.2, and 0%, respectively. Overall, 553 (61%) of the 903 newborns having respiratory diseases had complications. The occurrence of necrotizing enterocolitis, patent ductus arteriosus, bronchopulmonary dysplasia, intraventricular hemorrhage and air leak was 6.8, 19.8, 4.7, 24.9, and 5%, respectively. Conclusion This study offers an epidemiological perspective for respiratory disorders from a single-center level-III neonatal intensive care unit. Although number of births, premature newborns, extremely low birth weight/very low birth weight infants, and complicated pregnancies increase in years, decreasing rates of mortality and complications are very promising. As perinatal and neonatal cares are getting better in every day, we think that more promising results can be achieved over the coming years. Key Points

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A Mixed Methods Analysis of Parental Perspectives on Diagnosis and Prognosis of Neonatal Intensive Care Unit Graduates With Cerebral Palsy

Journal of Child Neurology ◽

10.1177/0883073820901412 ◽

2020 ◽

Vol 35 (5) ◽

pp. 336-343

Author(s):

Katherine Guttmann ◽

John Flibotte ◽

Sara B. DeMauro ◽

Holli Seitz

Keyword(s):

Intensive Care Unit ◽

Cerebral Palsy ◽

Content Analysis ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Thematic Analysis ◽

Neonatal Intensive Care ◽

Free Text ◽

Word Count ◽

Linguistic Inquiry

This study aimed to evaluate how parents of former neonatal intensive care unit patients with cerebral palsy perceive prognostic discussions following neuroimaging. Parent members of a cerebral palsy support network described memories of prognostic discussions after neuroimaging in the neonatal intensive care unit. We analyzed responses using Linguistic Inquiry and Word Count, manual content analysis, and thematic analysis. In 2015, a total of 463 parents met eligibility criteria and 266 provided free-text responses. Linguistic Inquiry and Word Count analysis showed that responses following neuroimaging contained negative emotion. The most common components identified through the content analysis included outcome, uncertainty, hope/hopelessness, and weakness in communication. Thematic analysis revealed 3 themes: (1) Information, (2) Communication, and (3) Impact. Parents of children with cerebral palsy report weakness in communication relating to prognosis, which persists in parents’ memories. Prospective work to develop interventions to improve communication between parents and providers in the neonatal intensive care unit is necessary.

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