scholarly journals Targeting Risk Factors for the Control of Central Line-Associated Bloodstream Infection in the Neonatal Intensive Care Unit: A Single Tertiary Center Experience

2021 ◽  
Vol 28 (3) ◽  
pp. 116-123
Author(s):  
Jiyoon Jeong ◽  
Yoojin Kwun ◽  
Min-ju Kim ◽  
Sang-Ho Choi ◽  
Euiseok Jung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Infection Control ◽  
Neonatal Intensive Care Unit ◽  
Bloodstream Infection ◽  
Neonatal Intensive Care ◽  
Central Line ◽  
High Risk Infants

Purpose: The aim of this study was to estimate the effect of targeting risk factors for the control of central line-associated bloodstream infection (CLABSI) among high-risk infants in a tertiary neonatal intensive care unit (NICU).Methods: Infants admitted to the NICU and diagnosed with CLABSI from January to December 2013 were eligible for inclusion to the study. The CLABSI group (n=47) was matched in a 1:2 ratio to the control group (n=94) based on gestational age, birth weight, and Score for Neonatal Acute Physiology-II. Risk factors for CLABSI were identified using the Cox proportional hazard model, and analysis of the effect of these risk factors targeting infection control was performed.Results: The risk factors associated with CLABSI were prolonged central line dwell days (adjusted hazard ratio [HR], 1.028; 95% confidence interval [CI], 1.011 to 1.045; P=0.001), use of a silicone catheter (adjusted HR, 5.895; 95% CI, 1.893 to 18.355; P=0.002), surgical treatment (adjusted HR, 3.793; 95% CI, 1.467 to 9.805; P=0.006), and less probiotic supplementation (adjusted HR, 0.254; 95% CI, 0.068 to 0.949; P=0.042). By targeting these risk factors with a quality improvement initiative, the mean CLABSI incidence rate per 1,000 catheter-days decreased from 6.6 to 3.1 (P=0.004).Conclusion: Targeting risk factors for infection control significantly reduced the rate of CLABSI among high-risk infants in the NICU.

scholarly journals Auditory Screening Test of the High Risk Infants in the Neonatal Intensive Care Unit.

1998 ◽  
Vol 41 (3) ◽  
pp. 200-206 ◽  
Author(s):  
Fumiko Hata ◽  
Mariko Tanaka ◽  
Keisuke Kitaoku ◽  
Kazuhiko Nario ◽  
Takashi Matsunaga
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Neonatal Intensive Care Unit ◽  
Screening Test ◽  
Neonatal Intensive Care ◽  
High Risk Infants

Unexpected Hearing Loss in High-Risk Infants

PEDIATRICS ◽  
1986 ◽  
Vol 78 (3) ◽  
pp. 417-422
Author(s):  
Toni A. Nield ◽  
Shirley Schrier ◽  
Angela D. Ramos ◽  
Arnold C. G. Platzker ◽  
David Warburton
Keyword(s):  
Intensive Care Unit ◽  
Hearing Loss ◽  
Intensive Care ◽  
High Risk ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Auditory Brainstem ◽  
Auditory Brainstem Responses ◽  
Newborn Period ◽  
High Risk Infants

Eleven high-risk infants who had normal auditory brainstem responses at the time of discharge from the neonatal intensive care unit were found on follow-up between 13 and 48 months later to have significant sensorineural hearing loss. All 11 infants were the products of high-risk pregnancies and deliveries. Birth weights ranged from 890 to 3,700 g, but seven had birth weights of more than 1,500 g. Gestational ages ranged from 28 to 42 weeks. The length of hospitalization ranged from 45 to 167 days. All of the infants had respiratory distress, requiring prolonged mechanical ventilation with resultant chronic lung disease. All of the infants had received pancuronium, morphine, ampicillin, and gentamicin, and ten had also received furosemide and chlorothiazide. Other frequent clinical complications included abnormal CNS findings during the neonatal intensive care unit stay (ten infants), acidosis (pH < 7.25) on the initial blood gas test (eight infants), and persistent fetal circulation in all seven infants with birth weights greater than 1,500 g. Developmentally, eight of nine children tested between 12 and 36 months of age were normal in all respects other than the hearing loss and the related language impairment. We conclude that infants who have been very ill in the newborn period, including term infants, may remain at risk for development of significant sensorineural hearing loss even though they have passed an initial auditory brainstem responses screening test in the newborn period.

scholarly journals Clinical profile of neonates with acute renal injury in neonatal intensive care unit at GMERS Medical College and General Hospital, Gotri, Vadodara, Gujarat, India

2019 ◽  
Vol 6 (3) ◽  
pp. 1136
Author(s):  
Kajal Lakhubhai Katariya ◽  
Nimisha K. Pandya
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Neonatal Intensive Care Unit ◽  
General Hospital ◽  
Neonatal Intensive Care ◽  
Birth Asphyxia ◽  
Female Ratio ◽  
Medical College

Background: Acute kidney injury (AKI) is defined as an acute deterioration in ability of the kidneys to maintain homeostasis of body fluids and electrolytes leading to retention of wasted and toxic metabolic end products. It is fairly common in newborn population and is a major contributor of neonatal mortality and morbidity. The aim was to study the incidence of renal failure in high risk neonates and risk factors for renal failure.Methods: A prospective observational study was done to evaluate renal profile in high risk neonates admitted to neonatal intensive care unit, GMERS Medical College and General Hospital, Gotri, Vadodara, Gujarat, India over a 1-year period. nRifle criteria was used for classification of acute kidney injury.Results: The incidence of AKI in high risk newborns admitted in this study was 52 (37.14%). The male to female ratio in current study was 2.46:1. Majority of neonates with AKI were out born 44 (84.6%). The incidence of AKI was higher in term newborns. Mean weight in AKI group was 2048 grams. The highest incidence of AKI was found in AFD newborns (57.69%). nRifle criteria was used to diagnose AKI in this study. Out of 52 neonates who had AKI, 27 (51.9%) were in risk category, 21 (40.4%) were in injury group and 4 (7.7%) were in failure group. Mortality in these groups were 5 (18.51%), 7 (33.33%) and 3 (75%) respectively. Highest correlation of risk factors for AKI was found with birth asphyxia 18 (34.9%) followed by sepsis 12 (23.1%) and shock 15 (28.5%). 29 (55.76%) neonates had non oliguric AKI. 28 (53.8%) neonates with AKI developed dyselectrolytemia.Conclusions: Early recognition and management of risk factors can help in reducing the occurrence and improve outcomes in them.

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