Trends in morbidities of late preterm infants in the neonatal intensive care unit.

Objective: To characterize demographics and trends in length of stay (LOS), morbidities, and mortality in late preterm infants.

Study Design: Cohort study of infants born between 34 and 36 weeks gestation between 1999 and 2018 without major congenital anomalies at Pediatrix Medical Group neonatal intensive care units (NICUs).

Results: 307,967 infants from 410 NICUs met inclusion criteria.

Management of Air Leaks in the Newborn.

Background: Air leaks, especially pulmonary interstitial emphysema (PIE), are increasingly uncommon respiratory complications of the newborn. Despite PIE having a decreasing incidence, it continues to have a high morbidity and mortality rate. This makes PIE one of the most severe respiratory complications to affect a newborn.

Recent Review of Germinal Matrix Hemorrhage-Intraventricular Hemorrhage in Preterm Infants.

Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) is a particular type of intracranial hemorrhage that affects the preterm population. GMH-IVH originates from bleeding within the highly vascular area near the center of the brain known as the germinal matrix. The pathogenesis of GMH-IVH is unclear; it is likely related to hemodynamic changes and fluctuations in cerebral blood flow within a fragile developing brain.

Integration of the Saline Process on Holistic Patient Care to Improve Student Understanding of Interprofessional Team Roles, Values, and Ethics.

Description Of The Problem: Healthcare practitioner students currently report feeling underprepared to provide holistic and spiritual care to their patients upon transitioning into practice, and there is currently little data on the efficacy of holistic care-focused interventions on interprofessional outcomes. The goal of this research was to assess the impact of an interprofessional training session on holistic care on student perceptions of interprofessional 1) roles/responsibilities and 2) values/ethics.

The Innovation: A live, interactive interprofessional training session to address holistic patient care was implemented in fall of 2017.

Clinical Presentation and Multifactorial Pathogenesis of Necrotizing Enterocolitis in the Preterm Infant.

Background: Necrotizing enterocolitis (NEC) is a serious infection of the bowel wall induced by multiple pathological factors, which include inflammation and tissue invasion with bacteria known to cause severe infections. NEC is now understood to be several disease processes under one umbrella. The most common form occurs in premature infants and can exert significant impacts to preterm morbidity and mortality.

A Case Report of Donnai-Barrow Syndrome.

Background: A genetic disorder should be considered when an infant presents with multiple congenital anomalies. Because of the acute presentation of an infant with multiple life-threatening defects, a genetic diagnosis of a rare disorder took weeks to delineate.

Clinical Findings: This case describes a late preterm infant who presented at birth with congenital diaphragmatic hernia, tetralogy of Fallot, cleft lip, low-set ears, and hypertelorism.

Pharmacologic Management of Neonatal Abstinence Syndrome Using a Protocol.

Background: The opioid epidemic in the United States has reached unprecedented proportions with far-reaching impacts on the most vulnerable population. The number of neonates born addicted to opioids has grown exponentially over the last several decades, leading to increased neonatal intensive care unit admissions and rising healthcare costs. Recent studies have yielded mixed results regarding which medication is most effective at relieving the symptoms of opioid withdrawal and reducing the weaning timeframe for babies with neonatal abstinence syndrome (NAS).

Case Report of Anemia Following Fetal-Maternal Hemorrhage.

Background: Any maternal history of blood loss, ABO or Rh incompatibility, and hydrops fetalis often leads to suspicion of neonatal anemia postnatally. When maternal history consists only of decreased fetal movement, recognition of neonatal anemia can be problematic.

Clinical Findings: This case was a transported late preterm neonate who presented initially with persistent hypoxia unresponsive to usual respiratory support.

Managing common neonatal respiratory conditions during transport.

As neonatal care in the tertiary setting advances, neonatal transport teams are challenged with incorporating these innovations into their work environment. One of the largest areas of advancement over the last decade involves respiratory support and management. Many major respiratory treatments and the equipment required have been adapted for transport, whereas others are not yet feasible.

How long is too long? Recovery time of outpatients with sleep apnea after procedural sedation.

The aim of this study was to determine whether a postoperative stay of 3 hours is warranted for patients with obstructive sleep apnea (OSA). The secondary focus was to examine those patients who left against medical advice without complications. This retrospective chart review examined adult patients with previously diagnosed sleep apnea treated with pressure-emitting machines that underwent outpatient procedures with moderate sedation.

Peritoneal dialysis in the neonatal intensive care unit. Management of acute renal failure after a severe subgaleal hemorrhage.

Acute renal failure is common in the neonatal intensive care unit but is often not recognized in its early phases, when it is potentially reversible. The typical patient with acute renal failure is premature, but many term infants are also at risk. One such group is those with severe bleeding, such as a subgaleal hemorrhage.

Nursing update on retinopathy of prematurity.

One of the problems that plagues premature infants is retinopathy of prematurity, a potentially blinding disease that occurs because the retina is immature before 34 weeks gestation and must develop in a suboptimal environment when a baby is born early. Prevention by minimizing oxygen exposure has been somewhat effective, but survival of the tiniest babies has led to a recent resurgence in cases. Oxygen targeting and early surgery show promise to reduce the risk of blindness in the smallest premature infants.

Special Premie Oxygen Targeting (SPOT): a program to decrease the incidence of blindness in infants with retinopathy of prematurity.

Infants born prematurely have a plethora of medical problems. Some have cerebral palsy, resulting in limited mobility, while others require oxygen, hearing aids, and/or glasses for medical problems. Most of these could have been prevented if preterm birth was avoided, but efforts to curb this have been slow.