Neonatal transport: parental needs and potential for improvement - a single-center cross-sectional study.

Objective: Neonates with medical problems need transfer from the place of birth to a neonatal (intensive care) unit after birth by a specialized neonatal transport team. Neonatal transport is accompanied by a high emotional burden for the families due to spatial separation, uncertainty and care for the neonate. This survey of parents' needs was a quality control project of the neonatal transport team of the University Children's Hospital Zurich, Switzerland.

Effect of vertical stopcock position on start-up fluid delivery in syringe pumps used for microinfusions.

The purpose of this in vitro study was to evaluate the impact of the vertical level of the stopcock connecting the infusion line to the central venous catheter on start-up fluid delivery in microinfusions. Start-up fluid delivery was measured under standardized conditions with the syringe outlet and liquid flow sensors positioned at heart level (0 cm) and exposed to a simulated CVP of 10 mmHg at a set flow rate of 1 ml/h. Flow and intraluminal pressures were measured with the infusion line connected to the stopcock primarily placed at vertical levels of 0 cm, + 30 cm and - 30 cm or primarily placed at 0 cm and secondarily, after connecting the infusion line, displaced to + 30 cm and - 30 cm.

Analgosedation for less-invasive surfactant administration: Variations in practice.

Background: Less-invasive surfactant administration (LISA) is widely used for surfactant delivery to spontaneously breathing preterm infants on nasal CPAP. However, the use of analgesia and/or sedation for the LISA procedure remains controversial.

Methods: We conducted a cross-sectional survey of all tertiary neonatal intensive care units (NICUs) in Austria, Germany, and Switzerland to assess current practices of analgosedation for LISA in preterm infants.

Pressure-adjusted venting eliminates start-up delays and compensates for vertical position of syringe infusion pumps used for microinfusion.

Microinfusions are commonly used for the administration of catecholamines, but start-up delays pose a problem for reliable and timely drug delivery. Recent findings show that venting of the syringe infusion pump with draining of fluid to ambient pressure before directing the flow towards the central venous catheter does not counteract start-up delays. With the aim to reduce start-up delays, this study compared fluid delivery during start-up of syringe infusion pumps without venting, with ambient pressure venting, and with central venous pressure (CVP)-adjusted venting.

Effect of vertical pump position on start-up fluid delivery of syringe pumps used for microinfusion.

Background: Connection and opening a syringe infusion pump to a central venous line can lead to acute anterograde or retrograde fluid shifts depending on the level of central venous pressure. This may lead to bolus events or to prolonged lag times of intravenous drug delivery, being particularly relevant when administering vasoactive or inotropic drugs in critically ill patients using microinfusion. The aim of this study was to assess the effect of syringe pump positioning at different vertical heights on start-up fluid delivery before versus after purging and connection the pump to the central venous catheter.

Parents' Experiences of Therapeutic Hypothermia for Neonates With Hypoxic-Ischemic Encephalopathy (HIE): A Single-Center Cross-Sectional Study.

Background And Objectives: The purpose of the study is to assess parental experiences of therapeutic hypothermia for moderate to severe hypoxic-ischemic encephalopathy with the goal of improving local clinical practice guidelines and fostering family-integrated care in neonates with hypoxic-ischemic encephalopathy.

Methods: This single-center retrospective cross-sectional study included neonates and their parents registered in the Swiss National Asphyxia and Cooling Register between 2011 and 2021. Based on a literature review, an anonymous survey of parents of neonates with hypoxic-ischemic encephalopathy was developed and conducted using an online survey tool.

Increase in Standardized Management of Neonates with Hypoxic-Ischemic Encephalopathy Since Implementation of a Patient Register.

The Swiss National Asphyxia and Cooling Register was implemented in 2011. This study assessed quality indicators of the cooling process and (short-term) outcomes of neonates with hypoxic-ischemic encephalopathy (HIE) receiving therapeutic hypothermia (TH) longitudinally over time in Switzerland. This is a multicenter national retrospective cohort study of prospectively collected register data.

Sponsorship in academic medicine in Switzerland: Push and pull.

Introduction: Mentorship provides general career guidance in academic medicine. Sponsorship advocates for a sponsee by endorsing this person for a position or role. Sponsorship is less common and originates from the corporate world.

Association of perinatal sentinel events, placental pathology and cerebral MRI in neonates with hypoxic-ischemic encephalopathy receiving therapeutic hypothermia.

Objective: Placental pathology might provide information on the etiology of hypoxic-ischemic encephalopathy (HIE). To evaluate the association of perinatal sentinel events (PSE), placental pathology and cerebral MRI in cooled neonates with moderate/severe HIE.

Study Design: Retrospective analysis of 52 neonates with HIE registered in the Swiss National Asphyxia and Cooling Register 2011-2019.

Centre-specific differences in short-term outcomes in neonates with hypoxic-ischaemic encephalopathy.

Aims Of The Study: To investigate and compare the centre-specific short-term outcome indicators seizures, arterial hypotension, infection and mortality during therapeutic hypothermia until discharge from the neonatal/paediatric intensive care unit in term and near-term neonates with hypoxic-ischaemic encephalopathy (HIE) registered in the Swiss National Asphyxia and Cooling Register between 2011 and 2018.

Methods: Retrospective analysis of prospectively collected national register data between 1 January 2011 and 31 December 2018. Pregnancy, maternal, delivery and neonatal characteristics were compared between the centres.

Insertion of cuff inflation line into pediatric tracheal tubes related to oral and nasal tracheal intubation depth.

Background: In clinical practice, the cuff inflation line of cuffed pediatric tracheal tubes often interferes with securing tracheal tubes.

Methods: The insertion site of the cuff inflation lines and the lengths of four different brands and nine sizes of commonly used cuffed pediatric tracheal tubes were measured and compared in vitro with oral and nasotracheal intubation depths as calculated by different formulas for pediatric patients aged from birth to 16 years. Motoyama's recommendation was used for age-related size selection of cuffed pediatric tracheal tubes.

Cuffed endotracheal tubes in neonates and infants of less than 3 kg body weight-A retrospective audit.

Background: Large prospective clinical studies have shown that modern cuffed pediatric tracheal tubes can be used safely, even in children weighing ≥3 kg. There is a growing interest in their use in children weighing <3 kg so that they, too, can benefit from the potential advantages, particularly the high probability of these tubes fitting into and sealing the pediatric airway at the first intubation attempt. This study aimed to find a cut-off body weight for procedures requiring a cuffed tracheal tube to seal the airway in children weighing <3 kg and to evaluate the frequency and predictive factors for the requirement to place a cuffed instead of an uncuffed tracheal tube.

Risk factors for postoperative hyperglycemia in neonates.

Objective: Postoperative hyperglycemia has been shown to be associated with higher morbidity and mortality in pediatric patients. Data on risk factors for neonatal patients is limited. The objective of this study was to identify pre- and intraoperative risk factors associated with postoperative glucose in neonates.

Neonatal transport in Switzerland: a retrospective single-centre analysis - quo vadis?

Aim: To assess neonatal transport activities by the neonatal transport teams of the University Children’s Hospital Zurich in order to identify opportunities for improvement in the organisation of these transports.

Methods: Retrospective analysis of prospectively collected data on neonatal transports by the neonatal transport teams of the University Children’s Hospital Zurich between January 2014 and December 2018. Data on transports affecting neonates with a corrected gestational age of up to 44 weeks and a weight less than 5 kg were extracted from registration forms, transport forms, transport reports and the neonates’ medical charts.

Flow irregularities from syringe infusion pumps caused by syringe stiction.

Objective: The current study aimed to evaluate the extent of the slide-stick phenomenon in differently designed infusion syringes at various infusion rates and filling positions.

Methods: Fluid delivery from three 50-mL infusion syringe brands (BD; Codan; Fresenius) was investigated using a flow sensor at flow rates of 0.5, 1.

Association between Transport Risk Index of Physiologic Stability in Extremely Premature Infants and Mortality or Neurodevelopmental Impairment at 18 to 24 Months.

Objectives: To examine the association between mortality or neurodevelopmental impairment at 18-24 months of corrected age and the Transport Risk Index of Physiologic Stability (TRIPS) score on admission to the neonatal intensive care unit (NICU) in extremely premature infants.

Study Design: Retrospective cohort study of extremely premature infants (inborn and outborn) born at 22-28 weeks of gestational age and admitted to NICUs in the Canadian Neonatal Network between April 2009 and September 2011. TRIPS scores and clinical data were collected from the Canadian Neonatal Network database.

Short-term neurological improvement in neonates with hypoxic-ischemic encephalopathy predicts neurodevelopmental outcome at 18-24 months.

Objectives To evaluate the association of short-term neurological improvement until day of life 4 in neonates with hypoxic-ischemic encephalopathy (HIE) receiving therapeutic hypothermia (TH) with neurodevelopmental outcome at 18-24 months. Methods This is a retrospective analysis of prospectively collected data of 174 neonates with HIE registered in the Swiss National Asphyxia and Cooling Register between 2011 and 2013. TH was initiated according to national guidelines, and Sarnat staging was performed daily.

Performance of modern syringe infusion pump assemblies at low infusion rates in the perioperative setting.

Background: Syringe infusion pumps are used for the precise continuous administration of intravenous drugs. Their compliance and mechanical deficiencies have been found to cause considerable start-up delays, flow irregularities during vertical displacement, as well extensive delays of occlusion alarms at low infusion rates. The aim of this study was to evaluate the performance of several modern syringe infusion pumps at low infusion rates and the impact on drug concentration.

Cuffed pediatric endotracheal tubes-Outer cuff diameters compared to age-related airway dimensions.

Background: Reliable sealing of the pediatric airway requires appropriately sized tracheal tube cuffs. The aim of this study was to compare residual cuff diameters of pediatric tracheal tubes with pediatric airway dimensions.

Methods: Cuff diameters of five different brands of locally marketed pediatric cuffed tracheal tubes with internal diameters of 3.

Implementation of amplitude-integrated electroencephalography in tertiary Canadian Neonatal Intensive Care Units-a longitudinal study.

Aim: To investigate the implementation of amplitude-integrated electroencephalography (aEEG) as bedside monitoring tool of cerebral function in tertiary Canadian Neonatal Intensive Care Units (NICU) over the past decade.

Methods: Longitudinal study consisting of online surveys of neonatologists on the use of aEEG in 2009 and 2018.

Results: The response rate to the survey was 72 of 149 (49%) in 2009 and 18 of 30 (60%) in 2018, respectively.