Neonatal Critical Care Units Research Articles

Assessment of Nurse's Knowledge toward Human Herpes Virus 6 HHV-6 Infection in NICU

Background: The infant contracted Herpes Simplex Virus (HSV) during the process of being born. The worldwide occurrence of NH is approximately 10 cases per 100,000 births, and it is associated with substantial risks of illness and death. Objective: To evaluate nurses' level of understanding regarding HHV-6 infection in the neonatal intensive care unit (NICU) for newborn infants. The study employed a descriptive research design methodology to achieve its objective. A representative sample of 50 nurses currently employed in neonatal critical care units. Tool I: An Arabic-language structured interview questionnaire. The study encompassed many demographic factors of nurses, such as gender, age, educational attainment, years of experience in the Neonatal Intensive Care Unit (NICU), completion of training on HHV-6 infection, and the source of information. The second tool, the knowledge assessment sheet, focused on HHV-6 infection. The findings indicate that the study included exclusively female nurses, comprising 46.0% of the sample, while males accounted for 54%. Furthermore, the educational background of the participants primarily consisted of graduates from nursing institutes and colleges, with each group representing a substantial proportion of 34%. Conclusion: Our findings indicate that we have chosen to dismiss the null hypothesis, which posits that there is no correlation between the demographic attributes of nurses and their degree of understanding regarding herpes virus type 6 infection. Instead, we have opted to embrace the alternative hypothesis. Recommendations: Provide nurses with a thorough knowledge of the viral causes and risk factors linked to HSV type 6 infections in pregnant women.

Association Between Antibiotic Duration and Recurrence of Urinary Tract Infection in the Neonatal Critical Care Unit.

Urinary tract infection (UTI) is the most common bacterial infection in infants. Current practice guidelines suggest a treatment duration of 7 to 14 days. Suboptimal therapy may increase the risk for recurrent UTIs leading to renal scarring and possibly chronic kidney disease. The primary objective is to evaluate the duration of therapy for UTIs and its association with the incidence of recurrent UTIs in a neonatal intensive care unit (NICU). The secondary objectives are to identify the risk factors and the most common organisms for recurrent UTIs. Patients were identified via the diagnosis codes for UTIs and were included if admitted to the NICU and if they received antibiotics prior to hospital discharge. Patients were divided into 2 groups: antibiotic treatment for 7 days or fewer and antibiotic treatment for greater than 7 days. Eighty-six infants were included in the study. Twenty-six patients received antibiotics for 7 days or fewer, and 60 for more than 7 days. In the study, the median birth weight was 977 g and the median gestational age was 27.6 weeks. There was no significant difference in the rate of recurrent UTIs between the 2 groups (p = 0.66). However, in the subgroup analysis, the incidence was higher for patients receiving antibiotic therapy for fewer than 7 days versus 7 days (p = 0.03). There was no difference in recurrence of UTI between treatment groups (≤7 days versus >7 days), and recurrence was seen in a higher percentage of patients with a urinary tract anomaly.

Magnitude of preterm birth and associated factors Among mothers who gave birth in Debre Berhan comprehensive specialized hospital.

Premature deliveries are a major public health issue, with high health, economic, and productivity costs associated with lengthy hospitalizations in neonatal critical care units. The goal of this study was to determine the number of premature births in Ethiopia's Debre Berhan Comprehensive Specialized Hospital and the factors that influence them. The Debre Berhan Comprehensive Specialized Hospital conducted an institution-based cross-sectional study between February and April 2020. A total of 325 study participants were selected using systematic random sampling. Face-to-face interviews using a pre-tested semi-structured questionnaire were used to collect data. For data entry and analysis, Epi data version 3.1 and SPSS version 20 were used. At a P-value of 0.2, bivariate logistic regression analysis was used to categorize candidate variables to the next level, and variables in multivariate logistic regression models with a p-value of 0.05 were considered statistically significant. Preterm births accounted for 16.1% of all births at Debre Berhan Comprehensive Specialized Hospital. Cesarean section [AOR = 2.412; 95% CI (1.154, 5.0370)], twin pregnancy [AOR = 3.524; 95% CI (1.114, 11.150)], and maternal anemia during pregnancy [AOR = 3.124; 95% CI (1.417, 6.887)] were statistically significant associations with the outcome variable in the final logistic regression model. Preterm birth was found to be greater in the study area than in the Global Action Report for Sub-Saharan Africa and a few other countries. Efforts should be made to prevent maternal health issues that lead to caesarean section, and all pregnant mothers should be supplemented with iron and folic acid as soon as feasible. This study suggests that there is still a gap in the field in terms of health service intervention.

Retinopathy of Prematurity in Neonatal Intensive Care Unit at King Fahd University Hospital, Eastern Province: Prevalence, Risk Factors, and pattern of severity Seven years’ experience.

Background Premature newborns are susceptible to retinopathy of prematurity (ROP), a vasoproliferative disease of the developing retinal vessels, which is a major cause of potentially avoidable blindness. Due to geographical variations in newborn care, geographic variations in the epidemiology of ROP have been observed internationally during the last several decades. There was a correlation between the severity of the condition and the number of prenatal, postnatal, and other risk factors. This study aimed to examine the incidence and risk factors associated with retinopathy of prematurity in preterm infants. Methods A retrospective review of preterm newborns evaluated for retinopathy of prematurity between January 2016 and December 2022 was carried out at King Fahd Hospital of the University (KFHU), Khobar, Saudi Arabia. Infants who fulfilled the screening criteria (GA < 34 or Birth Weight (WT) ≤ 1500 g) underwent the screening test, and the International Classification of Retinopathy of Prematurity was used to classify retinopathy of prematurity. Risk factors and demographic information regarding ROP were assessed. Statistical analysis was performed using SPSS (version 20) with a 95% confidence interval (CI). Statistical significance was set at p < 0.05. Results Among the 200 preterm neonates that were evaluated and admitted to neonatal critical care units, 37% exhibited premature retinopathy, with 46.7% of those cases being in stage 1. The development of ROP was linked to gestational age, length of mechanical ventilation, septicemia, intraventricular hemorrhage, bronchopulmonary dysplasia, respiratory distress syndrome, and septicemia, according to univariate and multivariate logistic regression analyses. Conclusion The incidence of total retinopathy in premature infants in this population was 37%. Evaluating these risk factors during the screening of high-risk premature infants will help determine the appropriate timing of examinations and treatment.

The Prevalence and Associated Risk Factors for Neonatal Thrombocytopenia Among Newborns Admitted to the Neonatal Intensive Care Unit.

Background Thrombocytopenia is the most prevalent hematological condition in neonates that develops in the neonatal intensive care unit (NICU). This set of illnesses is caused by either decreased platelet production due to placental insufficiency, increased platelet breakdown (consumption), or a combination of the two causes. Based on platelet count, it is defined as mild, moderate, or severe thrombocytopenia, with early and late onset. Purpose The purpose of this study is to determine the prevalence of thrombocytopenia and the factors that contribute to it in newborns hospitalized in the neonatal critical care unit at the Maternity and Children Hospital in Al Ahsa, Saudi Arabia. Methods This descriptive retrospective cross-sectional study was carried out at the NICU of the Maternity and Children Hospital in Al Ahsa, Saudi Arabia, over the span of one year (August 2022 to August 2023) among hospitalized neonates with thrombocytopenia. Thrombocytopenia is defined as a platelet count of 150,000 or less. These patients were monitored until they recovered or died. Results The inclusion criteria were met by a total of 242 newborns with thrombocytopenia. Half of the neonates (57%) were full-term, with Apgar scores greater than 5 at the first (84%) and fifth (93%) minutes, respectively. The great majority of individuals (84%) experienced early-onset thrombocytopenia of mild severity (62%) and were asymptomatic (93%). The majority of the cases resolved spontaneously, with only 21%requiring platelet transfusion. There was a significant relationship discovered between gestational age and the severity of thrombocytopenia, with very preterm infants having moderate to severe thrombocytopenia, as well as birth weight (p=0.001). Furthermore, neonates with severe thrombocytopenia had a considerably higher mortality rate (p=0.001). Conclusion The mortality and morbidity of newborns with perinatal risk for neonatal thrombocytopenia can be reduced with timely detection of the cause and development of thrombocytopenia, as well as adequate and early care.

Training perinatal nurses in palliative communication by using scenario-based simulation: A quasi-experimental study

AimThis study aimed to assess the impact of two educational modules on enhancing the communication confidence, competence and performance of perinatal nurses in the context of palliative care. BackgroundConcerns have arisen regarding the preparedness of perinatal nurses in delivering palliative care, especially in terms of deficiencies in communication skills and negative attitudes toward making life-support decisions for parents facing neonates with terminal conditions. Bridging this gap necessitates improved perinatal palliative care education for healthcare providers. Research has shown that simulation-based teaching effectively enhances procedural competence, communication skills and confidence among healthcare professionals. However, comprehensive curricula focusing on perinatal palliative communication remain limited. DesignThis study used a quasi-experimental design employing a two-group repeated measure approach. It involved a purposive sample of 79 perinatal nurses from a hospital in northern Taiwan. MethodsA palliative communication course specifically designed for registered nurses in perinatal units was developed. Participants were allocated to either the experimental group (Scenario-Based Simulation, SBS) or the control group (traditional didactic lecture). Communication confidence and competence were assessed before and immediately after the course through structured questionnaires. Learning satisfaction was collected post-intervention and participants underwent performance evaluation by standardized parents one week later. ResultsA significant training gap in palliative care exists among nurses in OB/GYN wards, delivery rooms and neonatal critical care units, highlighting the need for continuing education. All 79 participants completed the training course. Following the intervention, nurses in the SBS group (n=39) exhibited significant improvements in self-reported confidence (p <0.05), competence (p <0.01) and performance (p <0.001) in neonatal palliative communication compared with the traditional didactic lecture group (n=40). The SBS group also received higher satisfaction ratings from nurse learners (p <0.001). ConclusionsThe research findings support scenario-based simulation as a more effective educational approach compared with traditional didactic lectures for enhancing communication confidence and competence. These results were further reinforced by evaluation from standardized patients, highlighting the value of direct feedback in enhancing nurses' performance. Tailoring SBS designs to diverse nursing contexts and incorporating a flipped approach can further enrich the overall learning experience. Given its high effectiveness and positive reception, we recommend integrating this educational module into palliative care training programs for perinatal nurses.

Pericardial Effusion and Superficial Abdominal Abscess as Complications of Malposed PICC Line in a Preterm Neonate: A Case Report

In neonatal critical care units, peripherally inserted central catheter lines are frequently used to provide venous access for continuous parenteral nutrition and medications in newborns. In this case report, a male neonate weighing 1270 grams was on Continuous Positive Airway Pressure (CPAP) for hyaline membrane disease and initially received Total Parenteral Nutrition (TPN) through a Peripherally Inserted Central Catheter (PICC) in the left long saphenous vein on the second day. The baby developed tachycardia, respiratory distress requiring mechanical ventilation, and erythematous swelling over the paraumbilical region. A diagnosis of pericardial effusion and superficial abdominal abscess secondary to a malposed PICC line in a preterm, very low birth weight neonate was made. Suspecting a misplaced line, it was immediately removed, and the patient showed improvement over the next 24 hours. Within the next 48 hours, the patient was extubated to CPAP. Therefore, daily inspection by an expert, as well as confirmation of the central line tip, will aid in preventing delays in detecting complications.

Intestinal Obstruction by Meconium Ileus in the Newborn Revealing Cystic Fibrosis

Objective: To report a case of a preterm infant with meconium ileus at birth and cystic fibrosis. Background: The meconium ileus corresponds to the obstruction of the terminal ileum by an abnormally thick meconium; it is observed most often in neonates with cystic fibrosis. Case description: a female infant was born by cesarean delivery section on severe pre-eclampsia with oligohydramnios and intrauterine growth restriction, weighing 1230 g at 36 weeks of gestational age, with Apgar scores of 10/10. His mother was a 26-year-old G2P2 who had attended three prenatal consultations with negative serology for vertical infections. Immediately after birth, the newborn was referred to our neonatal critical care unit due to severe abdominal distension. the Newborn had a delay in meconium emission of more than 48 hours. an abdominal X-ray showed significant intestinal distension and a barium enema was performed showing meconium plugs with a colon of normal topography and caliber, initially put on antibiotic therapy with enema by gastroraphy twice a day, an etiological assessment was carried: A genetic study was conducted, revealing that the newborn is a carrier of a variant (c.1521-1523delCTT,p.Phe508del F50 del) associated with a classic form of cystic fibrosis in a homozygous state and the first immunoreactive trypsinogen (IRT) was &gt; 1300 ug/l (reference value &gt;1000 ug/l), in view of the non-improvement the newborn benefited from an ileostomy. Comments: This case illustrates the rapid evolution of CF in a premature patient with meconium ileus as the first clinical manifestation.

Neonatal Intraventricular Hemorrhage Presenting as Pyrexia of Newborn: A Case Report

Abstract: &#x0D; Background Temperature instability is a relatively common presenting symptom in a Neonatal Intensive Care Unit (NICU) with sepsis being one of the major etiologies that need to be ruled out. However, an important differential diagnosis is a central fever. Many cases of Intracranial Hemorrhage/Intraventricular Hemorrhage (ICH/IVH) present with temperature dysregulation with no other clear associated symptoms, and cranial imaging for early identification and treatment of ICH/IVH is crucial. &#x0D; Case report A 3-day-old male born at 33 weeks and four days of gestation who was admitted to the neonatal critical care unit due to prematurity and respiratory distress was noted to be febrile during the fourth hospital day. The septic screen was negative, and the patient continued to spike fever while on broad-spectrum antimicrobial treatment. Due to an unexplained drop in his hematocrit, cranial ultrasound was done, and grade III IVH was identified. The patient continued to improve clinically, but the exact etiology of his IVH was not identified. His fever resolved without interventions, and his IVH continued to decrease in size. Serial cranial imaging was done in NICU, and no neurosurgical interventions were warranted. He was referred to neurosurgery and neurology and followed in the infant’s high-risk clinic. &#x0D; Discussion Sepsis is the top of differentials when managing a newborn infant in NICU. However, we must always keep our minds open to other differentials, including central hyperthermia. Extreme prematurity is a major risk factor for ICH/IVH in the neonatal period; nonetheless, other risk factors are identified, and many cases of ICH/IVH had no identified causative factor or even risk factors. &#x0D; Conclusion Identifying clinical presentation and risk factors associated with ICH and IVH in NICU patients is crucial for early diagnosis and offers appropriate management. A high index of suspicion is required to promptly diagnose ICH/IVH resulting in central fever and avoid unnecessary workup and treatment.

Predictors of Neonatal Intensive Care Unit Admission and Adverse Outcomes Related to Gestational Diabetes.

Gestational diabetes mellitus (GDM) is a type of diabetes that manifests itself in pregnant women. It poses a significant risk to the mother's health as well as the health of the infant, including more babies being brought to the neonatal intensive care unit (NICU). It puts both the mother's and the child's health at serious risk, increasing the likelihood that newborns may need to be treated in a neonatal critical care unit. This study aimed to determine the factors that predict GDM-related NICU admission and other adverse newborn outcomes. The study was a cross-sectional analysis of 175 pregnant women who presented with gestational diabetes at the Maternity and Children's Hospital in Bisha (MCH-Bisha), Saudi Arabia, between January 1and December31, 2022. A logistic regression model was used to analyze the data to predict adverse outcomes for newborns and NICU admissions and identify associations between maternal variables and outcomes. Maternal characteristics highly associated with adverse neonatal outcomes included advanced maternal age (greater than 30 years), a family history of DM, and a history of greater than or equal to four previous pregnancies. Logistic regression models revealed that newborns delivered to mothers older than 30 years were 7.17 times more likely to be admitted to the NICU than newborns born to mothers younger than 30 years. Saudi nationality, urban residence, and cesarean section delivery factors account for nearly all adverse neonatal outcomes (91%, 75%, and 91%, respectively). Newborns delivered by cesarean section were 3.38 times more likely to be admitted to NICU, and the association was significant. Maternal age greater than 30 years and a history of more than or equal to four pregnancies were the strongest indicators of infant adverse outcomes and NICU admittance among women with gestational diabetes. These findings highlight the need for approaches to GDM management that are efficient, thorough, and multidisciplinary.

Morphometric Analysis of Placental Terminal Villi, Capillaries, and Intervillous Space in Normal and Pre-Eclamptic Pregnancies

Background: The placenta reflects the prenatal problems that are linked to high perinatal morbidity and mortality both macroscopically and microscopically. A pregnancy syndrome called pre-eclampsia has terrible consequences for both the mother and the unborn child. It may result in more frequent inductions of labor, fetal growth limitation, respiratory issues in newborns, increased admission rates to neonatal critical care units, and an elevated risk of perinatal or fetal death. To understand the relation of preeclampsia and fetal growth identification of its effects on various components of the placenta is mandatory hence the current study was designed to evaluate the Placental Terminal Villi, Capillaries, and Intervillous Space in Normal and Pre-eclamptic Pregnancies. Methodology: It was a cross sectional study, carried out on 50 samples of placentas, out of which 25 were preeclamptic and 25 were normal. The placentas were recruited after cesarean session, processed as per guidelines and were analyzed for histopathological examination. The set inclusion criteria were Registered cases of Pre-eclampsia, Blood Pressure ≥ 140/90 mmHg, Parity 0 – 4, Age of mother (25 – 35) Years., Gestational Age (36 – 42) Weeks, Mode of delivery Cesarean Sections. The set exclusion criteria were known hypertensive patients, and patient diagnosed with other chronic illnesses. Results: Number of terminal villi, Transverse diameter of terminal villi (μm), Intervillous space (μm), and Transverse diameter of terminal villous capillaries decreased significantly (p=0.001) in preeclamptic group however, Number of terminal villous Capillaries were found to be increased in preeclamptic group (p=0.001). Conclusion: Preeclampsia leads to more significant alterations in placental structure compared to normal pregnancies, emphasizing the importance of early detection and management of this condition to improve maternal and fetal outcomes. Keywords: Pregnancy, preeclampsia, terminal villi, Intervillous space, terminal villous Capillaries

Knowledge of Jordanian women of reproductive age who underwent bariatric surgery and its effect on birth outcomes: A cross-sectional study.

This study aims at exploring the knowledge of women of reproductive age who underwent bariatric surgery in Jordan regarding its effect on birth outcomes. A cross-sectional study was conducted on 183 women (aged 15-49) who had undergone bariatric surgery at the Jordan University Hospital in Amman, Jordan, between 2016 and 2019, using telephone interviews with conveniently selected participants' samples. The survey tool obtained data on women's knowledge and other sociodemographic, obstetric health, and bariatric surgery information. Unfavorable birth outcomes include preterm delivery, small for gestational age, congenital abnormalities, low birth weight, and admission to the neonatal critical care unit. More than half of the participants did not know about the possible unfavorable birth outcomes after bariatric surgery and related practice guidelines. This is shown in their median score of 3 (interquartile range: 2-4) out of a maximum possible score of 8. Women who had a good score (>4) had received counseling about unfavorable bariatric surgery outcomes from their surgeon (p < 0.013); those who had educational qualifications higher than secondary school (p < 0.001) as well as those who were employed (p < 0.008) and believed that the surgery would affect the newborn (p < 0.001). The median score was also unfavorably associated with the parity of the participants (p < 0.003). The extent of knowledge regarding the unfavorable birth outcome of bariatric surgery is low among women who underwent bariatric surgery at Jordan University Hospital in Jordan. Improving health literacy and information on bariatric surgery implications on pregnancy and birth outcomes amongst women of reproductive age is a recommendation from this study.

Impact of Coronavirus Disease 2019 (COVID-19) on Healthcare-Associated Infections in Arizona Acute Care Hospitals: 2016-2020 HAI Progress Report

BackgroundSince March 2020, coronavirus disease 2019 (COVID-19) has impacted clinical practices among Arizona acute care hospitals (ACHs), potentially affecting healthcare-associated infection (HAI) rates among these facilities. The Arizona Department of Health Services (ADHS) analyzed the impact of the COVID-19 pandemic on HAI occurrence among Arizona ACHs by utilizing data from the National Healthcare Safety Network (NHSN).MethodsStandardized infection ratios (SIRs) from NHSN's National and State HAI Progress Reports (2016-2020) along with 2015 national baselines and 2020 Health and Human Services (HHS) HAI target goals were compiled to evaluate trends for central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), methicillin-resistant Staphylococcus aureus (MRSA) bloodstream events, and Clostridioides difficile infections (CDI). CLABSI and CAUTI SIRs among intensive care units (ICUs), ward locations, and neonatal critical care units (CLABSI only) were also analyzed. To calculate statistical significance, 95% confidence intervals were used.ResultsAmong reporting Arizona ACHs (n= 66-71, depending on year and HAI type) from 2016-2020, all four HAI SIRs decreased significantly from 2016 through 2019—CLABSI, 32% decrease; CAUTI, 25% decrease; MRSA, 41% decrease; and CDI, 36% decrease. However, CLABSI and MRSA SIRs increased significantly (60% and 45%, respectively) during 2020. Arizona CAUTI SIRs have been statistically significantly lower than the national SIRs from 2016-2020, remaining below the HHS target goal (SIR- 0.75) even during the onset of the pandemic (Arizona 2020 CAUTI SIR- 0.64). Among reporting ICUs during 2020, the CLABSI SIR increased 176% to 1.20 (significantly higher than the 2015 national baseline) and the ICU CAUTI SIR increased 49% to 0.69.ConclusionsArizona ACH HAI incidence significantly increased during the COVID-19 pandemic, especially for CLABSIs. Future recommendations for Arizona ACHs should focus on prevention activities and interventions specific to CLABSI and CAUTI occurrence among ICUs.

Determine the Rate of Harmful Maternal and Foetal Outcomes in Pregnant Adolescents

Objective: The purpose of this research is to examine whether or not adolescent pregnant women have adverse maternal and foetal outcomes. Study Design: Randomized controlled trial Place and Duration: The study was conducted at Gynaecology department of DHQ Teaching Hospital, Sargodha and DHQ Hospital Mianwali for duration of four months from August 2021 to November 2021. Material and Methods: In all, there were 84 participants in this research. Patients were between the ages of 14 and 45 years. After obtaining written agreement from patients, demographic data was collected. The patients were split into two groups, I and II, which were evenly distributed. Group I included 42 patients between the ages of 14 and 19, and Group II included 42 patients between the ages of 19 and over. Cesarean sections, instrumental deliveries, labour inductions and labour prolongations, hypertensive disorders, and other negative results were observed for the two cohorts. High rates of perinatal death and admission to the neonatal intensive care unit (NICU) were also found. SPSS 20.0 was used to analyse all of the data. Results: In group I mean age of the patients was 16.65±8.51 years and had mean BMI 20.05±6.33 Kg/m2 while in second group the mean age was 23.15±6.22 years and had mean BMI 24.7±9.51 Kg/m2. Study participants in adolescence (I) were more likely to have unfavourable foetal (perinatal death, low birth weight and low apgar score) and mother outcomes (C-section, Instrumental delivery, induction of labour, and prolonged labour) than those in the adult group (II). Conclusion: According to this research, premature neonatal critical care unit admissions and delayed intrauterine development are both on the increase. Pregnant teenagers are more likely to suffer from anaemia, a urinary tract infection, high blood pressure pregnancy, and a need for a surgical birth. Keywords: Maternal outcome, Partum haemorrhage, Fetal outcome, Pre-eclampsia,

Comparison of Bubble Continuous Positive Airway Pressure Versus Conventional Ventilation In Neonates with Respiratory Distress Syndrome

Aim: The use of positive airway pressure in babies with respiratory failure has been associated with significant reductions in respiratory failure, morbidity, and death. The two most popular CPAP techniques are bladder CPAP (B-CPAP) and ventilator-assisted CPAP (V-CPAP). We wanted to see if B-CPAP and V-CPAP have different survival rates and problems. Methods: This retrospective medical trial included 60 preterm babies between 1500- 2500 g who were hospitalized to Mayo Hospital's neonatal critical care unit for breathing difficulties between May 2019 and April 2020. Between May 2019 and April 2020, they were hospitalized for respiratory distress. The patients were allocated to therapy groups at random. To calculate and evaluate survival rates, a survival analysis was done. To compare rates of survival. The t-test for sample data was used to assess the length of supplemental oxygen, hospital stay, and cost of hospital stay. Results: At 24 hours, the predicted survival rates in the B-CPAP and V-CPAP subgroups were 100% and 78%, correspondingly. The comparable results after 48 hours were 100% and 72%. Furthermore, the V-CPAP group's hospitalization expenditures were considerably greater than the B-CPAP groups. Conclusion: Based on our findings, B-CPAP was helpful in treating newborns with breathing difficulties and reduced the hospitalization. In addition to the usual benefits, the lower cost of B-CPAP may be a factor for its widespread use when contrasted to V-CPAP. Keywords: Bubble Continuous Positive Airway Pressure, Versus Conventional Ventilation, Neonates With Respiratory.

Pravastatin effect on Obstetrics Complications Associated with Uteroplacental Insufficiency: A systematic review and Meta-Analysis

To assess statins' effect on pregnancy prolongation as well as neonatal and maternal morbidity in a distinct group of uteroplacental insufficiency disorders. Electronic databases were searched from 1953 to April 2021 for cohort studies and randomized controlled trials evaluating the effect of statins treatment on pregnancies with uteroplacental insufficiency disorders compares to control. The primary outcome was pregnancy prolongation from randomization. Secondary outcomes included neonatal parameters such as birth weight, death, and critical care unit admission, and maternal outcome occurrence as the development of preeclampsia. Pooled odds ratios were calculated using a random-effects model and meta-regression was utilized when applicable. Seven cohort and RCTs studies were included in the analysis with a total of 200 parturients with uteroplacental insufficiency disorders. Of whom, 105 were treated with pravastatin and 95 did not. Parturients that received Pravastatin showed significant prolongation of gestational age from randomization to delivery, (mean difference= 6.1 weeks, 95%CI;1.4-10.8, p=0.01, I2=98%) and less neonatal critical care unit admission (OR=0.21, 95%CI; 0.07-0.64, p=0.01, I2=32%). There was a trend in a decrease in perinatal death (OR=0.3, 95%CI;0.08-1.02, p=0.05, I2=19%), and an increase in neonatal birth weight (mean difference=771gr, CI; 2–1540, p=0.05, I2=97.4%). A new diagnosis of preeclampsia occurred less under Pravastatin treatment, yet not statistically significant (OR 0.38, CI;0.13–1.12, p=0.08, I=0%). In a meta-regression, an association between prolongation of pregnancy from randomization (R2=0.7) and birth weight (R2=0.6) to study type (RCT vs cohort) was demonstrated. No statistically significant dose-response effect or gestational age at initiation of treatment effect was found. Treatment with Pravastatin in parturients who have a high risk for developing uteroplacental insufficiency-associated disorders or have an existing preeclampsia/severe IUGR may improve their neonatal outcomes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Increasing the Registered Dietitian Full-Time Equivalents to the Neonatal Critical Care Unit Improved Incidence of Growth Outcomes in Preterm Infants

Increasing the Registered Dietitian Full-Time Equivalents to the Neonatal Critical Care Unit Improved Incidence of Growth Outcomes in Preterm Infants

Comparison Between Nasal High-Frequency Oscillatory Ventilation And Nasal Continuous Positive Airway Pressure In The Management Of Respiratory Distress Syndrome

Context: A neonatal respiratory distress syndrome occurs at or soon after delivery (<24 hours). Premature newborns with respiratory distress syndrome (RDS) often need breathing assistance. There has been a tendency to reduce in the previous decade the use of non-invasive ventilation modes (NIV) in neonatal intensive care units to prevent ventilator-induced lung damage, in particular after recent data showing NIV in preterm babies has equivalent efficiency compared to EMV. In practical practise, different forms of NIV may be employed include nasal continuing positive airway pressure and noninvasive intermittent positive airway pressure. Nasal continuous positive airway pressure is one of the most often utilised non-invasive techniques (NCPAP). Although HFV has been used in several neonatal critical care units, a relatively novel modality of nasal high frequency oscillatory ventilation (nHFOV) is limited in evidence of its utility. The objective of this research has been to examine the effectiveness and safety of nasal oscillatory ventilation with nasal airway continuous pressure in preterm baby respiratory distress syndrome therapy. Methods: This research is a (60 instances) clinical experiment conducted with respiratory distress syndrome (admitted to the Benha University Hospital Neonatal Intensive Care Unit and Benha Kids Hospital) between the 1–28 day age range. Cases were randomly picked in two groups: Group I: 30 instances of high-frequency oscillatory nasal ventilation were treated (nHFOV). Group II: 30 individuals with constant nasal airway pressure were treated (NCPAP). Methods: Detailed history of medicine. Total usage time NHFV and NCPAP usage time and oxygenation time required for each instance. Complication detection occurs during non-invasive breathing (pulmonary air leak syndrome, IVH, nasal injury and other.) Studies of imagery. Outcomes: There was no statistically significant difference in demographic data between the two groups. There was a statistically significant difference in IVH complication between Group I and Group II. The percentage of nasal septal injuries in Group I was significantly lower than in Group II. The rate of intervention failure (intubing and ventilator demand) in Group I was significantly lower than in Group II (3.3 percent, (26.6 percent) p value=0.030. Conclusion: High frequency nasal ventilation has a greater impact than continuous airway pressure on infants and is less complicated. This research revealed that the length of non-invasive respiratory support was greatly shortened by high frequency nasal ventilation and the necessity for intubation was minimised compared to the continuous positive airway pressure of RDS infants.

Cuidado espiritual a las madres de neonatos críticos hospitalizados

Objetivo: Describir y comprender el cuidado espiritual que se brinda a las madres de neonatos críticos hospitalizados en un hospital público de Chiclayo, Perú. Material y métodos: Investigación cualitativa exploratoria descriptiva; la muestra fue no probabilística y el tamaño se determinó por la técnica de saturación y redundancia, siendo los sujetos de estudio 12 madres que tienen a sus hijos hospitalizados en la Unidad de Cuidados Intensivos Neonatales, y 12 enfermeras, esto permitió triangular la información; además los datos se recolectaron a través de la entrevista semiestructurada a profundidad, luego fueron procesados de manera manual mediante el análisis de contenido. Resultados: a) Reconocimiento de las creencias religiosas, b) La oración como el principal recurso espiritual, c) Facilidades para prácticas devotas. Conclusión: En el ambiente de neonatología, las madres tienen un lactario que está decorado con símbolos religiosos como el Divino Niño y la Virgen María. Mientras tanto, en la unidad de cuidados críticos neonatales, las enfermeras facilitan el ingreso de diferentes líderes religiosos. Algunas madres dejan en las incubadoras estampitas, rosarios u otro símbolo religioso de acuerdo a su cultura. Independientemente de la religión, la oración es el recurso espiritual más practicado en este contexto, pues las enfermeras rezan al iniciar el turno de trabajo o lo hacen luego con las madres, quienes oran junto a sus niños y en grupo. En el estudio, la mayoría profesa la religión católica, pero encontraron como limitante al escaso tiempo que tienen para dar mayor énfasis al cuidado espiritual.

Neonatal Nurses Book Club: A Novel Approach to Promote Nursing Resilience.

The Neonatal Critical Care Unit Book Club began with a common passion for reading and a need for socialization. There was also the hope that the club would foster a positive work culture and increase staff morale and resilience. In addition, the book club provided a mechanism for obtaining continuing education.The purpose of this article is to describe how a group of nurses participating in a book club were able to find support and encouragement during a pandemic.