Journal of perinatology : official journal of the California Perinatal Association
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Catheterization of the aorta through the umbilical artery and/or of peripheral arteries in neonates may be accompanied by a number of complications, of which thrombotic phenomena and peripheral vasospasm are the most common. Two neonates with peripheral ischemia caused by vasospasm from indwelling umbilical artery catheterization and one infant with left hand ischemia due to a left radial artery line were successfully treated with 2% nitroglycerin ointment. No adverse effects were noted.
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Pulse oximetry is widely used in the NICU, but clinicians often distrust the displayed values during patient motion, i.e., questionable oxygen saturation (SpO(2)) and pulse rate (PR) values. Masimo Corporation (Irvine, CA) has developed pulse oximetry with claims of resistance to sources of interference. To test this premise, we compared the performance of the Masimo SET pulse oximeter to a conventional device, Nellcor N-200, and then with three other new-generation pulse oximeters, Nellcor N-395, Novametrix MARS, and Philips Viridia 24C. ⋯ Routine use of Masimo SET pulse oximetry in the NICU could improve clinician confidence in the parameter leading to more judicious titration of oxygen with possible reductions in hypoxic (e.g., pulmonary hypertension) and hyperoxic (e.g., retinopathy of prematurity) pathology. Additionally, a more trustworthy technology should equate with fewer confirmatory arterial blood gas analyses (less blood loss), and faster weaning from the mechanical ventilation (less chronic lung disease).
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Comparative Study
Comparison of kangaroo care and standard care: behavioral organization, development, and temperament in healthy, low-birth-weight infants through 1 year.
To determine whether Kangaroo Care (KC) for healthy, low-birth-weight (LBW) infants can promote better behavioral and developmental outcomes. ⋯ KC effectively promoted neonatal behavioral organization and enhanced developmental outcome over the first year of life for LBW infants.
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To determine mean arterial pressure values during the first 24 hours for "stable" and "unstable" extremely low birth weight (ELBW) infants and to ascertain its association with perinatal factors. ⋯ There is a wide variation of GA among ELBW infants. MAPs increase with GA and with postnatal age. Shortly after birth, arterial pressures are similar for stable and unstable infants. Failure to increase MAP between 3 and 6 hours of life should create concern. MAP < or = 28 Torr at 3 hours of life is a reasonable, but not absolute, predictor of the need for hypotension treatment.
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Mnemonics have long been used to help learners remember facts in various disciplines of medicine. With the introduction of the revised Neonatal Resuscitation Program (NRP), it is vital for learners to know and remember important changes to the NRP curricula. While teaching the new curricula, we found that learners appeared confused, being unable to provide the correct sequence of answers to the questions posed during the assessment phase of the course. Mnemonics were developed to aid memory recall and optimize resuscitation skills.