Advances in neonatal care : official journal of the National Association of Neonatal Nurses
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The purpose of this study was to delineate current practice for the selection of nonoral feeding routes in level III neonatal intensive care units (NICUs) across Canada. ⋯ The results of this survey indicate that there are no clear clinical guidelines currently in place to determine route of feeding tubes in NICUs across Canada. Physician preference or history of the institution appears to be the most important variable in determining tube selection. Given the high prevalence of acute and chronic feeding difficulties among NICU survivors, the choice of route of tube should be guided by specific evidence-based criteria.
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Retinopathy of prematurity (ROP) remains a concern for many preterm infants. Early detection and timely treatment have been shown to be effective in improving visual outcomes; moreover, it is crucial that a series of indirect ophthalmic examinations be performed until an infant is considered no longer at risk for the disease. The purpose of this systematic review is to summarize and evaluate the published evidence regarding characteristics and effectiveness of pain management interventions during the ROP examination. ⋯ Despite the general consensus that ROP examination is a painful procedure with considerable amount of discomfort, evidence shows that pain management during the ROP examination is inadequate. Although there are currently clear recommendations and guidelines for performing the ROP examination, there are no standard protocols for pharmacological and nonpharmacological pain management during the ROP examination. This is an area where much work is still needed to address the needs of the infant during this critical examination.
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Klippel-Trenaunay syndrome is a rare but well-documented congenital malformation. Klippel-Trenaunay syndrome has sometimes been used interchangeably with Klippel-Trenaunay-Weber syndrome. However, Klippel-Trenaunay syndrome is the correct term used for the triad of congenital anomalies. ⋯ It is important to differentiate between the 2 syndromes because treatment and prognosis are so different. Parkes-Weber syndrome has a poor prognosis for limb viability. This article describes a case study of an infant presenting with Klippel-Trenaunay including a review of the syndrome and treatment recommendations.
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A preliminary study of a new optical oscillometric method to noninvasively measure systolic, mean, and diastolic blood pressures, in addition to heart and respiratory rates in very small extremities, is described. It employs transillumination of an extremity and measures the optical oscillation amplitude during cuff deflation from suprasystolic to zero pressure. The amplitude of the optical pulsatile oscillations is similar to that produced with the conventional pneumatic oscillometric method; however, the pulsatile optical signal is much larger and is present at all times when the cuff is deflated. ⋯ This new optical oscillometric technique simplifies noninvasive blood pressure measurement because it was designed specifically for small-diameter extremities such as those found in low birth-weight infants. This new optical oscillometric device has the added benefit of continually monitoring pulse and respiration rates.
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Letter Historical Article
Learning from our past, looking forward to our future.