Effect of Study-Duration and Time of Day on Multichannel Sleep Study Findings in Former Preterm Infants.

Background/objectives: Determine the appropriate duration for multichannel sleep studies in former preterm infants with cardio-respiratory events beyond term equivalent age.

Hypothesis: A sleep study of 10 h will provide equivalent information compared to a 20-h study to detect significant cardio-respiratory abnormalities in this population.

Methods: Single-center retrospective study of 50 infants with 20-h sleep study.

Increase in Oxytocin From Skin-to-Skin Contact Enhances Development of Parent-Infant Relationship.

Objective: To examine changes that occur in infant and parent salivary oxytocin (OT) and salivary cortisol (SC) levels during skin-to-skin contact (SSC) and whether SSC alleviates parental stress and anxiety while also supporting mother-father-infant relationships.

Methods: This randomized crossover study was conducted in the neonatal intensive care unit (NICU) with a sample of 28 stable preterm infants and their parents. Saliva samples were collected from infants, mothers, and fathers on Days 1 and 2 (1/parent) for OT and cortisol measurement pre-SSC, during a 60-min SSC session, and a 45-min post-SSC.

Case Report of Haemophilus parainfluenzae Sepsis in a Newborn Infant Following Water Birth and a Review of Literature.

Water birth has grown in popularity over the recent years. Although beneficial for mothers, there are concerns for the infants. There are previous reports of infection following water birth.

Neonatal/infant validation study of the CAS model 740 noninvasive blood pressure monitor with the Orion/MaxIQ NIBP module.

Objective: Blood pressure monitoring is an essential vital sign when caring for critically ill children. Invasive monitoring is considered the gold standard, but is not always feasible. The following study compared the CAS model 740 noninvasive blood pressure monitor with the Orion/MaxIQ NIBP module with the reference (invasive arterial measurement).

A computerized system to diagnose and treat neonatal apnea using vibrotactile stimulation.

Aim: To develop an appropriate apparatus for monitoring physiological signals and offering noninvasive automated mechanical stimulations for interrupting apneic events in neonates.

Rationale: Vibrotactile stimulation (VTS) maybe an effective, safer alternative to nursing hand stimulation in treating neonatal apnea. We therefore developed a new diagnostic and therapeutic instrument.

Feasibility of an electronic stethoscope system for monitoring neonatal bowel sounds.

Objective: Bowel dysfunction remains a major problem in neonates. Traditional auscultation of bowel sounds as a diagnostic aid in neonatal gastrointestinal complications is limited by skill and inability to document and reassess. Consequently, we built a unique prototype to investigate the feasibility of an electronic monitoring system for continuous assessment of bowel sounds.

Informed consent for procedures in the Neonatal Intensive Care Unit.

Establishing those procedures that require documentation of specific informed consent in a Neonatal Intensive Care Unit (NICU) setting remains controversial. Although documentation of specific informed consent for blood transfusions is universally mandated, consent for other procedures such as umbilical catheterizations may or may not be obtained and/or documented. In a retrospective study, medical charts of 116 neonates were reviewed to determine if consent for umbilicalvein and arterial catheterizations, blood transfusions, and procedures that require documentation of consent at Connecticut Children's Medical Center (CCMC), had been obtained.

Does a mother singing to her premature baby affect feeding in the neonatal intensive care unit?

Recent studies suggest that premature neonates exposed to music have reduced symptoms of stress, faster weight gain, and shorter neonatal intensive care unit (NICU) stays. This pilot study attempted to measure contingent effects of mothers' singing during feedings. Mothers sang to their babies during 2 of 4 feedings on 2 consecutive days, logging songs they sang, and subjectively evaluating each feeding.

Vibrotactile stimulation system to treat apnea of prematurity.

We modified a system that uses vibrotactile stimulation (VTS) to treat apnea (a cessation of respiration) in neonates in order to make the system more portable and easier to use by clinicians and nurses. The biomedical engineering department at Hartford Hospital (Hartford, CT) together with the Neonatology Division at the Connecticut Children's Medical Center (CCMC) (Hartford, CT) has been involved in developing the VTS system. Clinical trails were conducted in the neonatal intensive care unit of CCMC, and further preliminary data were collected.

Do newborn intensive care unit staff know the gender and first names of their patients?

We studied whether or not our personnel knew the gender and first names of their neonatal patients. A volunteer high-school student interviewed 18 NICU nurses without their awareness as to the true nature of the study. While asking open-ended questions, the interviewer would listen for the newborn to be correctly or incorrectly identified by gender and first name.

Prediction of outcome based on clinical seizure type in newborn infants.

Objective: To determine whether the clinical features of neonatal seizures are of value in predicting outcome.

Study Design: Demographic features, clinical seizure types, etiologic factors, and laboratory findings of all 77 patients with seizures admitted to our neonatal intensive care unit over a consecutive 7-year period were extracted from the medical records.

Results: Twenty-three (30%) died; 59% of the survivors had abnormal neurologic examinations, 40% were mentally retarded, 43% had cerebral palsy, and 21% were epileptic at mean follow-up of 3.

Hypoplastic left heart syndrome: factors influencing therapeutic choice.

Parent's choices among therapeutic options for their infants born with hypoplastic left heart syndrome are difficult and controversial. Currently, management options include surgical reconstruction, cardiac transplantation, and comfort measures only. We retrospectively reviewed medical records of 47 patients (1989-1999) to create a database of clinical features of infants who received either an operation or comfort care only.

The design and development of a biosensor to measure the concentration of meconium in amniotic fluid.

Meconium aspiration syndrome occurs in 0.2% to 1% of all deliveries and has a mortality rate as high as 18%. The disease is responsible for 2% of all perinatal deaths.

Placental blood sampling: an aid to the diagnosis of neonatal sepsis.

Objective: To determine the usefulness of placental blood cultures in establishment of the diagnosis of early onset sepsis.

Study Design: Babies born to mothers with suspected intraamniotic fluid infection had blood cultures obtained from a branch of the umbilical vein on the fetal surface of the placenta immediately after delivery. The babies at highest risk (n = 35) had subsequent neonatal blood cultured from a peripheral vein (group 1), whereas 26 newborns at a lower risk did not (group 2).

Nosocomial sepsis in neonates with single lumen vascular catheters.

Catheter-related sepsis is commonly encountered in the neonatal intensive care unit. We retrospectively studied infants with vascular catheters at 2 NICUs. Data were obtained from the computerised admission records available at both the hospitals.

New syndrome of hydrocephalus, endocardial fibroelastosis, and cataracts (HEC syndrome).

We report on two unrelated male infants with similar findings of communicating hydrocephalus, endocardial fibroelastosis (EFE) and congenital cataracts, who died at 4 months of age. Both mothers reported an upper respiratory infection during the first trimester of pregnancy which was further complicated by polyhydramnios in the third trimester. The infants were diagnosed with bilateral congenital nuclear cataracts at birth.

Lack of compliance with influenza immunization for caretakers of neonatal intensive care unit patients.

Background: Both the Centers for Disease Control and Prevention and the American Academy of Pediatrics have recommended influenza immunizations for neonatal intensive care unit staff. Compliance rates for influenza immunization among neonatal intensive care unit staff have not yet been reported.

Methods: To determine both the rates and the associated factors for compliance between 1990 and 1993 among neonatal intensive care unit nursing staff, interviews were conducted at three Hartford area hospitals by means of a structured questionnaire.

Surveillance for influenza in a newborn intensive care unit.

Although influenza may cause fatal neonatal infections, the current prevalence of disease in newborn intensive care units (NICU) is unknown. Furthermore, because compliance of NICU staff with annual influenza immunization is poor, absence of antibody may provide an indication of influenza susceptibility for neonatal patients and staff. We studied our NICU staff and patients during the winter of 1992-93 to determine seroprevalence of influenza antibody and attempted to document infection serologically or by culture in symptomatic staff and by culture in neonatal patients.

Effect of corticosteroids on the maturation of neutrophil motility in very low birthweight neonates.

Neutrophil (PMN) chemotaxis and chemokinesis were longitudinally studied in a group of 17 neonates with birthweights between 750 and 1250 g. Five of the 17 neonates were treated with prenatal betamethasone to attempt to prevent hyaline membrane disease, six received postnatal dexamethasone in an effort to reduce bronchopulmonary dysplasia, three received both, and three were not treated with corticosteroids. The group of 17 neonates were tested on four separate occasions: (1-2, 3-4, 7-8, and 10-14 postnatal days).

Variable clinical expression of mosaic trisomy 16 in the newborn infant.

Trisomy 16 is common in embryos and fetuses aborted early during development. Mosaicism for trisomy 16 is sometimes encountered during prenatal diagnosis, particularly with chorionic villi biopsy specimens, and, until recently, was thought to be confined to the placenta. However, recently, several liveborn infants with trisomy 16 mosaicism have been described.