Impact of dexmedetomidine during hypothermia on initiation of enteral feeding in newborns with hypoxic-ischemic encephalopathy.

Background: After early studies suggested safety and potential for benefit of dexmedetomidine use in neonatal hypoxic-ischemic encephalopathy (HIE), our neonatal intensive care unit (NICU) decided to transition from morphine to dexmedetomidine as our standard sedative during therapeutic hypothermia (TH). The primary aim was to monitor the possible side effects of transitioning from morphine to dexmedetomidine with a primary goal of reducing the days to initiation of enteral feeds to less than 3 days, with the hypothesis that the gastrointestinal motility effects of morphine may have been hindering feeding progress during TH. The secondary aim was to determine rates of hemodynamically significant bradycardia.

Increasing Skin-to-Skin in a Level IV NICU: A Quality Improvement Project.

Purpose: To evaluate the effect of a bundled intervention on the number of skin-to-skin ("kangaroo care") events occurring in a level IV NICU.

Design: A quality improvement effort centering around the introduction of an intervention bundle intended to safely increase the rate of skin-to-skin holding. Rates of unplanned extubations were recorded as a balancing measure to estimate safety.