Neonatal network : NN
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In spring 2006, the American Academy of Pediatrics (AAP) and the American Heart Association (AHA) will introduce revised materials for the Neonatal Resuscitation Program (NRP). These revisions affect the practice of neonatal resuscitation as well as the administrative components of the NRP. ⋯ The fifth edition of the Textbook of Neonatal Resuscitation is currently in press. The AAP granted permission to use material from the forthcoming edition in this article.
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Neonatal network : NN · Jan 2006
Historical ArticleEmbracing bioethics in neonatal intensive care, part I: evolving toward neonatal evidence-based ethics.
Ethical treatment dilemmas are not new to the NICU. With technologic advances over the past 20 years, NICU care has developed rapidly, and survival rates have improved for some of the tiniest and most critically ill infants. ⋯ Part I of this article presents a historical review of neonatal care and an overview of cases that have set precedents in neonatal ethical debate. It also includes recommendations for enhancing the skills of neonatal nurses as patient advocates in NICU ethical issues, an area that is, at times, controversial and baffling to clinicians.
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Elevated sound levels in the NICU may contribute to undesirable physiologic and behavioral effects in preterm infants. This study describes sound levels in a busy NICU in the southeastern U.S. and compares the findings with recommended NICU noise level standards. ⋯ The overall average hourly Leq (M = 60.44 dB, range = 55-68 dB), L10 (M = 59.26 dB, range = 55-66 dB), and Lmax (M = 78.39, range = 69-93 dB) were often above the recommended sound levels (hourly Leq <50 dB, L10 <55 dB, and 1-second Lmax <70 dB). In addition, certain times of day, such as 6-7 AM and 10 AM-12 noon, were noisier than other times of day.
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PTXF appears to be a promising adjunct to antibiotic therapy in neonatal sepsis. No adverse effects were noted in either study reported in the literature. However, there is a need for large randomized clinical trials to confirm or refute the role of PTXF in the treatment of sepsis in neonates. ⋯ Comparison of PTXF with immunomodulatory agents such as colony-stimulating factors and intravenous immunoglobulins is suggested. Part II of this five-part series on immunomodulation will explore the use of colony-stimulating factors in neonates. Other topics will include the amino acid glutamine, intravenous immunoglobulins, and probiotics.
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Neonatal network : NN · May 2005
ReviewParents and professionals in the NICU: communication within the context of ethical decision making--an integrative review.
Communication between parents and professionals in the NICU is a necessary part of collaborative decision making in the provision of family-centered care. Decisions with ethical components, those regarding treatment plans or neonatal research enrollment, need to be made conjointly with parents and health care professionals. This article reviews the present state of knowledge of how parents' input can be facilitated in regard to decisions made about their children. Research studies involving decisions made with ethical components in the NICU since the advent of the Baby Doe regulations reveal parents' frustration with communication practices, their need for control of information, and the trust in their children's health care providers that is required to best facilitate their input into ethical decisions made about their children.