Building Relationships: Advanced Practice Providers and Fellows in Neonatal-Perinatal Medicine.

Objective: Advanced practice providers (APPs) are a critical component of health care teams, especially in the neonatal intensive care unit. At times, APPs and neonatal-perinatal medicine (NPM) fellows may experience tension in their professional relationship. They may perceive the other's performance and abilities differently.

Assessing Barriers to Utilization of Premedication for Neonatal Intubation Based on the Theoretical Domains Framework.

Objective: This study aimed to identify barriers and facilitators of premedication utilization for nonemergent neonatal intubations (NIs) in a level IV neonatal intensive care unit (NICU).

Study Design: Between November 2018 and January 2019, multidisciplinary providers at a level IV NICU were invited to participate in an anonymous, electronic survey based on Theoretical Domains Framework to identify influences on utilization of evidence-based recommendations for NI premedication.

Results: Of 186 surveys distributed, 84 (45%) providers responded.

How Good is Good Enough?: Current-Day Pediatric Residency Program Directors' Challenges in Assessing and Achieving Resident Procedural Competency.

Objective: Significant gaps exist in the pediatric resident (PR) procedural experience. Graduating PRs are not achieving competency in the 13 ACGME recommended procedures. It is unclear why PR are not able to achieve competency, or how existing gaps may be addressed.

Pivot and Persist: A Technical Report on Adapting an Existing Multi-Institutional Bootcamp to a Hybrid Platform.

The coronavirus disease 2019 (COVID-19) pandemic has disrupted most in-person simulation training, including established simulation-based medical bootcamps. These sessions are important for the preparation of new trainees to think critically about common clinical scenarios, practice technical skills, and optimize leadership, teamwork, and communication. Having the opportunity to hone these skills in a safe environment is instrumental for the development of trainees' confidence and professional identity formation, and may contribute to patient safety.

Impact of telemedicine on neonatal resuscitation in the emergency department: a simulation-based randomised trial.

Background: The delivery and initial resuscitation of a newborn infant are required but rarely practised skills in emergency medicine. Deliveries in the emergency department are high-risk events and deviations from best practices are associated with poor outcomes.

Introduction: Telemedicine can provide emergency medicine providers real-time access to a Neonatal Resuscitation Program (NRP)-trained paediatric specialist.

Perceptions of Neonatal Palliative Care: Similarities and Differences between Medical and Nursing Staff in a Level IV Neonatal Intensive Care Unit.

A significant number of newborns are affected by life-limiting or life-threatening conditions. Despite this prevalence, there are inconsistencies in attitudes toward, and delivery of, neonatal palliative care. Implementing neonatal palliative care practice requires a multidisciplinary, collaborative effort.

Reducing Unplanned Extubations Across a Children's Hospital Using Quality Improvement Methods.

Introduction: Children who require an endotracheal (ET) tube for care during critical illness are at risk of unplanned extubations (UE), or the unintended dislodgement or removal of an ET tube that can lead to significant patient harm. A proposed national benchmark is 1 UE per 100 ventilator days. We aimed to reduce the rate of UEs in our intensive care units (ICUs) from 1.

MRI Differences Associated with Intrauterine Growth Restriction in Preterm Infants.

Background: Preterm infants are at risk for neurodevelopmental impairment. Intrauterine growth restriction (IUGR) further increases this risk. Brain imaging studies are often utilized at or near term-equivalent age to determine later prognosis.

Cost-effective and low-technology options for simulation and training in neonatology.

The purpose of this review is to explore low-cost options for simulation and training in neonatology. Numerous cost-effective options exist for simulation and training in neonatology. Lower cost options are available for teaching clinical skills and procedural training in neonatal intubation, chest tube insertion, and pericardiocentesis, among others.

CRIB scores as a tool for assessing risk for the development of pulmonary hypertension in extremely preterm infants with bronchopulmonary dysplasia.

Objective: Bronchopulmonary dysplasia (BPD) increases the risk for developing pulmonary hypertension (PH). However, the risk factors associated with BPD-associated PH remain unclear. Our primary aim was to determine perinatal risk factors associated with the development of PH in infants with BPD.

Screening for Critical Congenital Heart Disease in Newborns.

CCHD affects more than 25% of neonates born with congenital heart disease. Patients with CCHD require timely intervention in the form of surgery or cardiac catheterization to survive. These interventions may improve survival and outcomes for these patients.

Do you see what I see? A randomised pilot study to evaluate the effectiveness and efficiency of simulation-based training with videolaryngoscopy for neonatal intubation.

Introduction: Direct laryngoscopy (DL) and airway intubation are critical for neonatal resuscitation. A challenge in teaching DL is that the instructor cannot assess the learners' airway view. Videolaryngoscopy (VL), which allows display of a patient's airway on a monitor, enables the instructor to view the airway during the procedure.

Haemorrhagic stroke in term and late preterm neonates.

Objective: Few data regarding causes and outcomes of haemorrhagic stroke (HS) in term neonates are available. We characterised risk factors, mechanism and short-term outcomes in term and late preterm neonates with acute HS.

Design: Prospective cohort.

Nitric oxide counteracts the hyperoxia-induced proliferation and proinflammatory responses of mouse astrocytes.

Preclinical studies in the premature baboon evaluating the efficacy and potential toxicity of inhaled nitric oxide indicated a significant effect on astrocyte area density, suggesting phenotypic and functional changes in astrocytes upon exposure to nitric oxide. However, the effects of nitric oxide and oxygen, the two major therapeutic gases utilized in neonatal intensive care, on astrocyte morphology and function remain vastly unknown. Herein, we report that exposure of mouse neonatal cortical astrocytes to hyperoxia results in a proinflammatory phenotype and increase in proliferation without significant changes in cellular morphology or levels of intermediate filament proteins.

Periocular ulcerative dermatitis associated with gentamicin ointment prophylaxis in newborns.

A recent shortage of erythromycin ointment has resulted in the use of alternative agents for newborn ocular infection prophylaxis in the United States. We report a series of 26 newborns in whom a characteristic periocular ulcerative dermatitis developed after gentamicin ointment administration at 2 Philadelphia hospitals.

The association between maternal body mass index and severity of neonatal illness in very low birth weight infants.

Objective: To determine the effect of maternal body mass index (BMI) and pregnancy weight gain on neonatal illness severity in very low birth weight infants.

Methods: Cohort study of infants with birth weight less than 1500 g at a level 3 Neonatal Intensive Care Unit from July 2003 to July 2005, n = 301. The main outcome included neonatal illness severity, as measured by the Score for Neonatal Acute Physiology (SNAP).