Correlation of preterm infant illness severity with placental histology.

Introduction: A major goal of neonatal medicine is to identify neonates at highest risk for morbidity and mortality. Previously, we developed PhysiScore (Saria et al., 2010), a novel tool for preterm morbidity risk prediction.

Using simulation to study difficult clinical issues: prenatal counseling at the threshold of viability across American and Dutch cultures.

Objective: Prenatal counseling at the threshold of viability is a challenging yet critically important activity, and care guidelines differ across cultures. Studying how this task is performed in the actual clinical environment is extremely difficult. In this pilot study, we used simulation as a methodology with 2 aims as follows: first, to explore the use of simulation incorporating a standardized pregnant patient as an investigative methodology and, second, to determine similarities and differences in content and style of prenatal counseling between American and Dutch neonatologists.

Comparing the utility of a novel neonatal resuscitation cart with a generic code cart using simulation: a randomised, controlled, crossover trial.

Objective: To compare a novel neonatal resuscitation cart (NRC) to a generic code cart (GCC).

Study Design: A prospective, randomised, controlled, crossover trial was performed to compare the utility of the NRC with the GCC during simulated deliveries of extremely low birthweight infants and infants with gastroschisis. Fifteen subjects participated.

The accuracy of human senses in the detection of neonatal heart rate during standardized simulated resuscitation: implications for delivery of care, training and technology design.

Aim: Auscultation and palpation are recommended methods of determining heart rate (HR) during neonatal resuscitation. We hypothesized that: (a) detection of HR by auscultation or palpation will vary by more than ± 15BPM from actual HR; and (b) the inability to accurately determine HR will be associated with errors in management of the neonate during simulated resuscitation.

Subjects And Methods: Using a prospective, randomized, controlled study design, 64 subjects participated in three simulated neonatal resuscitation scenarios.

Comparison of umbilical venous and intraosseous access during simulated neonatal resuscitation.

Objective: Emergent umbilical venous catheter (UVC) placement for persistent bradycardia in the delivery room is a rare occurrence that requires significant skill and involves space constraints. Placement of an intraosseous needle (ION) in neonates has been well described. The ION is already used in the pediatric population and is placed at an anatomic location distant from where chest compressions are performed.

Combining Structured and Free-text Data for Automatic Coding of Patient Outcomes.

Integrating easy-to-extract structured information such as medication and treatments into current natural language processing based systems can significantly boost coding performance; in this paper, we present a system that rigorously attempts to validate this intuitive idea. Based on recent i2b2 challenge winners, we derive a strong language model baseline that extracts patient outcomes from discharge summaries. Upon incorporating additional clinical cues into this language model, we see a significant boost in performance to F1 of 88.

Integration of early physiological responses predicts later illness severity in preterm infants.

Physiological data are routinely recorded in intensive care, but their use for rapid assessment of illness severity or long-term morbidity prediction has been limited. We developed a physiological assessment score for preterm newborns, akin to an electronic Apgar score, based on standard signals recorded noninvasively on admission to a neonatal intensive care unit. We were able to accurately and reliably estimate the probability of an individual preterm infant's risk of severe morbidity on the basis of noninvasive measurements.

Delivery room management of the newborn.

Neonatal resuscitation is an attempt to facilitate the dynamic transition from fetal to neonatal physiology. This article outlines the current practices in delivery room management of the neonate. Developments in cardiopulmonary resuscitation techniques for term and preterm infants and advances in the areas of cerebral resuscitation and thermoregulation are reviewed.