Journal of neonatal-perinatal medicine
-
J Neonatal Perinatal Med · Jan 2013
Resuscitation at the limit of viability: trapped between a rock and a hard place.
Current professional guidelines, such as the Neonatal Resuscitation Program, specify significant roles for parents in decision-making at periviability. However, current federal regulations and some legal precedents indicate that resuscitation decisions should be made by the physician at the time of delivery, based on physical assessment of the infant. The enforcement of such approach would potentially increase the resuscitation of infants with poor prognoses. ⋯ Our findings suggest that resuscitation of premature infants at 24 weeks gestation is the standard of care in New Jersey, a socioeconomically and ethnically diverse state that may represent broader national trends. The high compliance with parental wishes at 22 or 23 weeks is probably related to physicians' expectation of poor outcomes at these gestational ages. This approach is consistent with current recommendations of the Neonatal Resuscitation Program but may not be compatible with existing federal statutes and legal precedent.
-
J Neonatal Perinatal Med · Jan 2013
Randomized Controlled Trial Comparative StudyA comparison of two nasal continuous positive airway pressure interfaces--a randomized crossover study.
-
J Neonatal Perinatal Med · Jan 2013
Randomized Controlled Trial Comparative StudyDoes daily kangaroo care provide sustained pain and stress relief in preterm infants?
1. Determine whether stress in preterm infants, measured with salivary cortisol, decreases after five days of Kangaroo Care (KC) compared to five days of Standard Care (SC). 2. To determine whether kangaroo care provides sustainable pain relief beyond the period of skin-to-skin holding. ⋯ 1. KC did not affect salivary cortisol levels in preterm neonates, but levels in both the KC and SC groups decreased over time from DOL five to ten. Salivary cortisol may vary with age of infant. 2. Infants experience pain during routine suctioning and may require pain management.
-
Probiotics are live microbial feed supplements that beneficially affect the recipient by improving intestinal balance. In an updated systematic review, nineteen trials randomizing more than 2800 infants were included. ⋯ The included trials reported no systemic infection with - supplemented probiotics. Recent data in addition to a report by the European Society for Pediatric Gastroenterology (ESPGAN) concluded probiotics could be generally considered safe.
-
J Neonatal Perinatal Med · Jan 2013
Comparative StudyValidation of near infrared spectroscopy to measure abdominal somatic tissue oxygen saturation in neonates.
In this study, we validated the use of the FORE-SIGHT® (CAS Medical Systems, Branford, CT USA) tissue oximeter monitor on abdominal tissue oxygenation in infants ≤4 kg using a stool-interference compensation algorithm. ⋯ Data from this validation study suggest that the FORE-SIGHT monitor, which compensates for the optical properties of stools in neonates, can yield accurate measures of abdominal tissue oxygen saturation.