Reducing light and sound in the neonatal intensive care unit: an evaluation of patient safety, staff satisfaction and costs.

Objectives: To modify an existing Level III neonatal intensive care unit and to compare light and sound levels in the renovated nursery with an adjacent traditionally configured nursery. Further, to assess the impact of this practice on patient safety, staff perceptions of the nursery environments, and to document costs of renovation.

Study Design: Prospective comparison of light and sound levels in identical six-bed patient rooms within an existing intensive care unit.

Persistent pulmonary hypertension of the newborn in the era before nitric oxide: practice variation and outcomes.

Objectives: In the era before widespread use of inhaled nitric oxide, to determine the prevalence of persistent pulmonary hypertension (PPHN) in a multicenter cohort, demographic descriptors of the population, treatments used, the outcomes of those treatments, and variation in practice among centers.

Study Design: A total of 385 neonates who received >/=50% inspired oxygen and/or mechanical ventilation and had documented evidence of PPHN (2D echocardiogram or preductal or postductal oxygen difference) were tracked from admission at 12 Level III neonatal intensive care units. Demographics, treatments, and outcomes were documented.

Inhaled nitric oxide in premature neonates with severe hypoxaemic respiratory failure: a randomised controlled trial.

Background: Inhaled nitric oxide improves oxygenation and lessens the need for extracorporeal-membrane oxygenation in full-term neonates with hypoxaemic respiratory failure and persistent pulmonary hypertension, but potential adverse effects are intracranial haemorrhage and chronic lung disease. We investigated whether low-dose inhaled nitric oxide would improve survival in premature neonates with unresponsive severe hypoxaemic respiratory failure, and would not increase the frequency or severity of intracranial haemorrhage or chronic lung disease.

Methods: We did a double-blind, randomised controlled trial in 12 perinatal centres that provide tertiary care.

Use of real time pulsed field gel electrophoresis to guide interventions during a nursery outbreak of Serratia marcescens infection.

Background: Pulsed field gel electrophoresis (PFGE) is a commercially available technique that can establish clonal relationships among many common hospital-derived organisms with a high degree of accuracy and can yield results in a sufficiently short time to guide interventions during an outbreak investigation.

Methods: The CHEF Genomic Bacterial DNA Plug Kit (Bio-Rad) was applied to an unfolding nursery outbreak of Serratia marcescens infections according to the manufacturer's guidelines. Bacterial genomic DNA was digested with XbaI or SpeI and separated on 1% agarose gels, and the isolates were grouped by restriction endonuclease patterns according to established standards.