Journal of perinatology : official journal of the California Perinatal Association
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Randomized Controlled Trial Clinical Trial
Fibronectin levels in premature infants with late-onset sepsis.
Physical features do not reliably distinguish premature infants with bacterial infections from those with noninfectious conditions. We evaluated the association of depressed plasma fibronectin with sepsis among hospitalized very low birth weight infants (< 1500 gm). ⋯ Overall, the sensitivity and specificity of the finding of depressed fibronectin levels were 53% and 94%, respectively. These data suggest that depression of plasma fibronectin occurs commonly in association with late-onset sepsis among hospitalized premature infants.
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We have discussed the ethical principles of beneficence, nonmaleficence, fidelity, and justice as they relate to a case involving what to do when there are too many sick neonates in an NICU. The use of ethical principles clarified the issues surrounding the shift in power and the decision making. This clarification led to the various short-term and long-term strategies that were designed to resolve the ethical dilemma. ⋯ Providing for individuals in a fair manner reduces the potential for harm. Focusing on ethical principles may serve to deemphasize and diffuse the control and territorial issues that may arise in similar cases. This refocusing will then enable all parties to address their common concern--how to provide due care to sick neonates and their families.