Primary respiratory support of extremely preterm neonates in the Netherlands: a national survey.

Introduction: Non-invasive respiratory support strategies have evolved to avoid bronchopulmonary dysplasia (BPD) in preterm infants. However, consensus on the best treatment strategy remains lacking. This study aims to investigate current practices and variations in primary respiratory support for extremely preterm neonates across neonatal intensive care units (NICUs) in the Netherlands.

Quality improvement initiative: implementing and redefining video review of real-time neonatal procedures using action research.

Video review (VR) of procedures in the medical environment can be used to drive quality improvement. However, first it has to be implemented in a safe and effective way. Our primary objective was to (re)define a guideline for implementing interprofessional VR in a neonatal intensive care unit (NICU).

Record, reflect and refine: using video review as an initiative to improve neonatal care.

Background: The goal of every medical team is to provide optimal care for their patients. We aimed to use video review (VR) sessions to identify and address areas for improvement in neonatal care.

Methods: For nine months, neonatal procedures (stabilization at birth, intubations and sterile line insertions) were video recorded and reviewed with the neonatal care providers.

Using the providers' perspective on video review of neonatal procedures to create a roadmap: a qualitative study.

Objective: To examine the providers' perceptions and experiences on implementation of video review (VR) of procedures in the neonatal intensive care unit (NICU).

Design: Qualitative study using semi-structured interviews with neonatal care providers about their experiences with VR. Interviews were audio-recorded, transcribed and thematically analysed using the data analysis software Atlas.

De novo heterozygous missense variants in as cause of fetal pleural effusions and progressive fetal hydrops.

Fetal hydrops as detected by prenatal ultrasound usually carries a poor prognosis depending on the underlying aetiology. We describe the prenatal and postnatal clinical course of two unrelated female probands in whom heterozygous missense variants in the planar cell polarity gene were detected using exome sequencing. Using several in vitro assays, we show that the p.

Minimising alarm pressure on a single room NICU through automated withdrawal of resolved alarms.

Aim: In 2017, the Leiden University Medical Centre implemented a secondary alarm system using handheld devices to ensure accurate patient monitoring on the single room NICU. Initially, alarms remained active on the handheld devices until one of the caregivers in the alarm chain accepted the alarm. In 2020, a bidirectional communication protocol (BCP) was implemented, enabling automated withdrawal of resolved alarms.

[Apgar score: time to "call it"?].

Virginia Apgar designed the apgar score during a breakfast with colleagues in response to a discussion about the need to evaluate newborns at birth. She scribbled down the score on a piece of paper and the score has been indispensable ever since, not just for reflecting the clinical condition and to indicate whether intervention was needed, but also to predict outcome. The reliability and validity have been often questioned, also in a recent study.

Video recording emergency care and video-reflection to improve patient care; a narrative review and case-study of a neonatal intensive care unit.

As the complexity of emergency care increases, current research methods to improve care are often unable to capture all aspects of everyday clinical practice. Video recordings can visualize clinical care in an objective way. They can be used as a tool to assess care and to reflect on care with the caregivers themselves.

Consent for Delivery Room Studies: What Can Be Learned from Perceptions of Parents.

Background: Obtaining ethically valid consent to participate in delivery room (DR) studies from parents facing an imminent premature birth can be challenging. This study aims to provide insight into parental experiences with and perceptions of consent for DR studies.

Methods: Semistructured interviews were conducted with parents of very and extreme preterm infants.

Video-based reflection on neonatal interventions during COVID-19 using eye-tracking glasses: an observational study.

Objective: The aim of this study was to determine the experience with, and the feasibility of, point-of-view video recordings using eye-tracking glasses for training and reviewing neonatal interventions during the COVID-19 pandemic.

Design: Observational prospective single-centre study.

Setting: Neonatal intensive care unit at the Leiden University Medical Center.

Risk Factors for Retinopathy of Prematurity in the Netherlands: A Comparison of Two Cohorts.

Introduction: Retinopathy of prematurity (ROP) remains an important cause for preventable blindness. Aside from gestational age (GA) and birth weight, risk factor assessment can be important for determination of infants at risk of (severe) ROP.

Methods: Prospective, multivariable risk-analysis study (NEDROP-2) was conducted, including all infants born in 2017 in the Netherlands considered eligible for ROP screening by pediatricians.

Comparison of two devices for automated oxygen control in preterm infants: a randomised crossover trial.

Objective: To compare the effect of two different automated oxygen control devices on target range (TR) time and occurrence of hypoxaemic and hyperoxaemic episodes.

Design: Randomised cross-over study.

Setting: Tertiary level neonatal unit in the Netherlands.

Reviewing recordings of neonatal resuscitation with parents.

Background: Recording of neonatal resuscitation, including video and respiratory parameters, was implemented for research and quality purposes at the neonatal intensive care unit (NICU) of the Leiden University Medical Center, and parents were offered to review the recording of their infant together with a neonatal care provider. We aimed to provide insight in parental experiences with reviewing the recording of the neonatal resuscitation of their premature infant.

Methods: This study combined participant observations during parental review of recordings with retrospective qualitative interviews with parents.

Survival and causes of death in extremely preterm infants in the Netherlands.

Objective: In the Netherlands, the threshold for offering active treatment for spontaneous birth was lowered from 25 to 24 weeks' gestation in 2010. This study aimed to evaluate the impact of guideline implementation on survival and causes and timing of death in the years following implementation.

Design: National cohort study, using data from the Netherlands Perinatal Registry.

Improving the Quality of Provided Care: Lessons Learned From Auditing Neonatal Stabilization.

Video and physiological parameter recording of neonatal stabilization was implemented at the Neonatal Intensive Care Unit (NICU) of the Leiden University Medical Center. In order to improve documentation and the quality of care provided during neonatal transition, we implemented weekly plenary audits reviewing recordings of neonatal stabilization in 2014. In audits, provided care is reviewed, discussing, among others, mask technique, compliance to the prevailing local guideline, and clinical decision making and alternative treatment options.

Automated oxygen control in preterm infants, how does it work and what to expect: a narrative review.

Background: Automated oxygen control systems are finding their way into contemporary ventilators for preterm infants, each with its own algorithm, strategy and effect.

Objective: To provide guidance to clinicians seeking to comprehend automated oxygen control and possibly introduce this technology in their practice.

Method: A narrative review of the commercially available devices using different algorithms incorporating rule-based, proportional-integral-derivative and adaptive concepts are described and explained.

Increase in treatment of retinopathy of prematurity in the Netherlands from 2010 to 2017.

Purpose: Compare patients treated for Retinopathy of Prematurity (ROP) in two consecutive periods.

Methods: Retrospective inventory of anonymized neonatal and ophthalmological data of all patients treated for ROP from 2010 to 2017 in the Netherlands, subdivided in period (P)1: 1-1-2010 to 31-3-2013 and P2: 1-4-2013 to 31-12-2016. Treatment characteristics, adherence to early treatment for ROP (ETROP) criteria, outcome of treatment and changes in neonatal parameters and policy of care were compared.

Improving Guideline Compliance and Documentation Through Auditing Neonatal Resuscitation.

Evaluate whether weekly audits of neonatal resuscitation using video and physiological parameter recordings improved guideline compliance and documentation in medical records. Neonatal care providers of the Neonatal Intensive Care Unit (NICU) of Leiden University Medical Center reviewed recordings of neonatal resuscitation during weekly plenary audits since 2014. In an observational pre-post cohort study, we studied a cohort of infants born before and after implementation of weekly audits.

Correction: Putting genome-wide sequencing in neonates into perspective.

The original version of this Article contained an error in the spelling of the author Pleuntje J. van der Sluijs, which was incorrectly given as Eline (P. J.

Putting genome-wide sequencing in neonates into perspective.

Purpose: Several studies have reported diagnostic yields up to 57% for rapid exome or genome sequencing (rES/GS) as a single test in neonatal intensive care unit (NICU) patients, but the additional yield of rES/GS compared with other available diagnostic options still remains unquantified in this population.

Methods: We retrospectively evaluated all genetic NICU consultations in a 2-year period.

Results: In 132 retrospectively evaluated NICU consultations 27 of 32 diagnoses (84.

Long-Term Neurodevelopmental and Respiratory Outcome after Intrauterine Therapy for Fetal Thoracic Abnormalities.

Introduction: The aim of this study is to evaluate long-term neurodevelopmental and respiratory outcome after fetal therapy for fetal pleural effusion, congenital cystic adenomatoid malformation, and bronchopulmonary sequestration.

Methods: Children ≥18 months of age underwent an assessment of neurologic, motor, and cognitive development. Medical records were reviewed to determine respiratory outcome.