Early human development
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The importance of vascular access in neonatal clinical practice is increasing, because of the survival of a larger number of premature babies, who require administration of long-term intravenous fluids and medications than in the past. In these newborn central venous lines are preferred to peripheral lines, particularly Peripherally Inserted Central Venous Catheter (PICC). Despite of the benefits of this device, PICC complications can negatively affect morbidity and mortality of the neonate. This article describes the principal strategies and recommendations for the success of the PICC insertion procedure and for its better management.
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Early human development · Sep 2009
Randomized Controlled TrialKangaroo Care modifies preterm infant heart rate variability in response to heel stick pain: pilot study.
Heel stick is the most common painful procedure for preterm infants in neonatal intensive care units. Resultant pain causes adverse physiological effects in major organ systems. Kangaroo Care (KC), involving mother-infant skin-to-skin contact is a promising analgesic for infant pain; however, the effect of KC on the autonomic nervous system's response to pain is unknown. ⋯ Infants experienced better balance in response in KC than IC condition as shown by more autonomic stability during heel stick. KC may be helpful in mediating physiologic response to painful procedures in preterm infants.
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Early human development · Sep 2009
Pain and distress reactivity and recovery as early predictors of temperament in toddlers born preterm.
Pain reactivity may reflect underlying mechanisms of constitutional aspects of temperament. ⋯ The findings highlight the relevance of the neonatal individual characteristics of reactivity for identifying more vulnerable infants for future problems in biobehavioral regulation.
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Early human development · Sep 2009
Measuring preterm cumulative stressors within the NICU: the Neonatal Infant Stressor Scale.
Stress experiences, while pervasive, are less likely than painful experiences to be managed in still-hospitalised preterm infants. ⋯ Based on these results we developed the Neonatal Infant Stressor Scale to help track, measure and manage presumed accumulated stress in preterm neonates.
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Early human development · Aug 2009
Skin bilirubin measurement during phototherapy in preterm and term newborn infants.
The few existing studies evaluating the reliability of transcutaneous bilirubin monitoring during phototherapy gave controversial results. ⋯ BiliCheck can be safely used for the evaluation of bilirubin levels in newborn infants under phototherapy. Its reliability on patched skin of the forehead is high enough to consistently reduce blood draws and to ascertain when to discontinue phototherapy. Because of the individual variance, any clinical decision has to be taken on the basis of the transcutaneous bilirubin trend more than on a single value.