Retrospective analysis of inpatient polysomnogram characteristics and discharge outcomes in infants with bronchopulmonary dysplasia requiring home oxygen therapy.

Rationale: Little is known about the polysomnogram (PSG) characteristics in infants with bronchopulmonary dysplasia (BPD), especially severe BPD, who do not need home ventilatory support but are at increased risk for chronic hypoxia and are vulnerable to its effects.

Objective: This study aims to assess PSG characteristics and change in discharge outcomes in premature infants with BPD who required oxygen therapy at discharge.

Methods: This is a retrospective chart review of premature infants with BPD who were admitted to a quaternary newborn and infant intensive care unit from January 1, 2012 to December 31, 2015 and who underwent polysomnography before discharge.

Teaching Infant Cardiopulmonary Resuscitation to Caregivers in the Emergency Department.

Objectives: Infant cardiopulmonary resuscitation (CPR) has been taught to caregivers of infants in inpatient settings. There are no studies to date that look at teaching infant CPR in the emergency department (ED). Using a framework of cognitive load theory, we compared teaching infant CPR to caregivers in a pediatric ED versus an inpatient setting.

Simulation in Neonatal-Perinatal Medicine Fellowship Programs.

Objective: This study aimed to investigate the use of simulation in neonatal-perinatal medicine (NPM) fellowship programs.

Study Design: This was a cross-sectional survey of program directors (PDs) and simulation educators in Accreditation Council for Graduate Medical Education (ACGME) accredited NPM fellowship programs.

Results: Responses were received from 59 PDs and 52 simulation educators, representing 60% of accredited programs.

Resource utilization patterns using non-invasive ventilation in neonates with respiratory distress syndrome.

Objectives: To describe the frequency of non-invasive ventilation (NIV) and endotracheal intubation use in neonates diagnosed with respiratory distress syndrome (RDS); to describe resources utilization (length of stay (LOS), charges, costs) among NIV and intubated RDS groups.

Study Design: Retrospective study from the national Kid's Inpatient Database of the Healthcare Cost and Utilization Project, for the years 1997-2012. Propensity scoring and multivariate regression analysis used to describe differences.

The Role of Extracorporeal Membrane Oxygenation Simulation Training at Extracorporeal Life Support Organization Centers in the United States.

Introduction: Extracorporeal membrane oxygenation (ECMO) requires a multidisciplinary healthcare team. The Extracorporeal Life Support Organization publishes training guidelines but leaves specific requirements up to each institution. Simulation training has shown promise, but it is unclear how many institutions have incorporated simulation techniques into ECMO training to date.

Systemic and cerebral hemodynamics during the transitional period after premature birth.

Little is known about the effect on clinically relevant outcomes of the complex hemodynamic changes occurring during adaptation to extrauterine life in preterm neonates, particularly in very low birth weight neonates. As cardiovascular adaptation in this extremely vulnerable patient population is complicated by immaturity of all organ systems, especially that of the cardiorespiratory, central nervous, and endocrine systems, maladaptation has been suspected, but not necessarily proven, to contribute to mortality and long-term morbidities. This article describes recent advances in the understanding of hemodynamic changes in very low birth weight neonates during postnatal transition, and reviews the complex and developmentally regulated interaction between systemic and cerebral hemodynamics and the effect of this interaction on clinically relevant outcomes.

Effect of a laboratory result pager on provider behavior in a neonatal intensive care unit.

Introduction: Automated paging systems that inform providers about abnormal laboratory values may alter their behavior.

Methods: We prospectively studied provider behavior before and after implementation of a laboratory paging system that utilizes a filtering mechanism.

Results: The proportion of laboratory results that were acted upon did not change significantly.

Medication errors in neonates.

Prevention of harm from medication errors has become a national priority. Medication errors in the neonatal intensive care unit are common, and most can be avoided. This article reviews the prevalence and types of medication errors affecting the care of the neonate and summarizes approaches that have been used to reduce these errors.

Simulation: translation to improved team performance.

Traditional medical education has emphasized autonomy, and until recently issues related to teamwork have not been explicitly included in medical curriculum. The Institute of Medicine highlighted that health care providers train as individuals, yet function as teams, creating a gap between training and reality and called for the use of medical simulation to improve teamwork. The aviation industry created a program called Cockpit and later Crew Resource Management that has served as a model for team training programs in medicine.