Neonatology
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Oxygen delivery to the brain is dependent on cardiac output and arterial oxygen content. ⋯ During postnatal transition, term infants with a left-to-right shunt via the DA have significantly higher cerebral rSO2 values compared to infants without shunt flow.
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Higher patient-to-nurse ratios and nursing workload are associated with increased mortality in the adult intensive care unit (ICU). Most neonatal ICUs (NICUs) in the United Kingdom do not meet national staffing recommendations. The impact of staffing on outcomes in the NICU is unknown. ⋯ Nurse-to-patient ratios appear to affect outcomes of neonatal intensive care, but limitations of the existing literature prevent clear conclusions about optimal staffing strategies. Evidence-based standards for staffing could impact public policy and lead to improvements in patient safety and decreased rates of adverse outcomes. More research on this subject, including a standard and valid measure of nursing workload, is urgently needed.
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Randomized Controlled Trial Comparative Study
Closed versus open endotracheal suctioning in extremely low-birth-weight neonates: a randomized, crossover trial.
Endotracheal suctioning, which is frequently necessary in mechanically ventilated patients, might cause complications, especially in patients with compromised lung function such as extremely low-birth-weight (ELBW) neonates. ⋯ CS was superior to OS on oxygenation values. To prove its overall superiority, further research is required. So, in this group of patients, CS should currently be administered on an individual basis.
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Randomized Controlled Trial
Pasteurization of mother's own milk for preterm infants does not reduce the incidence of late-onset sepsis.
Feeding preterm infants human milk has a beneficial effect on the risk of late-onset sepsis (LOS). Due to lack of microbiological standards, practices such as pasteurization of mother's own milk differ widely among neonatal intensive care units worldwide. ⋯ For preterm infants, pasteurization of mother's own milk shows a trend towards an increase in infectious morbidity, although no statistical significance was reached. Practices should focus on collection, storage and labeling procedures to ensure the safety and quality of expressed milk.
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Comparative Study Observational Study
Cerebral near-infrared spectroscopy during transition of healthy term newborns.
Values of regional cerebral tissue oxygen saturation (cStO2) have been described during transition of term and preterm infants after birth. However, use of different devices precludes comparison of measurements. ⋯ Healthy term newborns had similar cStO2 changes from 2 min after birth regardless of the mode of delivery. cStO2 of healthy term infants was lower than cStO2 of VLBW infants during transition. cStO2 values as measured by the FORE-SIGHT oximeter seem in the range of values as measured by the NIRO 300 oximeter. They were lower than values as measured by the INVOS 5100 oximeter.