Fresh frozen plasma and cryoprecipitate: Can we safely reduce their use in the NICU?

Objective: To study patterns of use of Fresh Frozen Plasma (FFP) and Cryoprecipitate (CRYO) in a level 4 NICU and assess what proportions were not supported by literature.

Study Design: single centered retrospective observational. Charts of neonates admitted between 1/1/2010 to 12/31/2017 to CT Children's level 4 NICU were reviewed.

Clinical and nutritional outcomes of two liquid human milk fortifiers for premature infants.

Background: In preterm infants fortification of human milk with human milk fortifiers (HMF) to optimize nutrition and growth is standard practice. We compared clinical, nutrition and growth outcomes in infants receiving two types of liquid HMF (LHMF).

Methods: Clinical, nutrition and growth outcomes were compared between infants admitted to a level IV NICU, and born with birth weight less than or equal to 1800 grams, between 10/1/2014-12/31/2014 and received human milk with acidified LHMF (ALHMF) and between 1/1/2015-4/31/2015 and received human milk with heat treated LHMF (HTLHMF).

Rates of intrauterine fetal demise and neonatal morbidity at term: determining optimal timing of delivery.

Objective: To examine rates of unexplained intrauterine fetal demise (IUFD) and neonatal morbidity in uncomplicated term pregnancies to identify the optimal gestational age for delivery.

Methods: A retrospective case control study was performed with singleton pregnancies delivered between 37 0/7 weeks and 42 6/7 weeks. Exclusion criteria were "complicated pregnancies": emergency deliveries, maternal hypertension, diabetes, infection, fetal disease/malformations and placental abnormalities.

Postpartum triage, services provided, and length of stay for infants born at 35 weeks gestation.

Objectives: The aim of this article is to (1) compare the care setting to which 35-week infants are initially triaged postpartum to the level of services subsequently provided; and (2) identify factors known at delivery or immediately postpartum associated with services received and length of stay during the birth hospitalization.

Study Design: In this multicenter retrospective study of 35-week infants born between 2007 and 2008, service capabilities of the initial postpartum care setting were categorized as level 1 or neonatal intensive care unit (NICU) using American Academy of Pediatrics definitions. Subsequent services actually provided were categorized as routine care, level 1, or >level 1.

Optimal periods of exclusive breastfeeding associated with any breastfeeding duration through one year.

Objective: To quantify optimal minimum durations of exclusive breastfeeding associated with maintenance of any breastfeeding at 15 time points during the first year of life.

Study Design: Mothers (n = 1189) from the prospective Infant Feeding Practices Study II cohort who initiated exclusive breastfeeding with healthy term infants were included. In a 80:20 split-sample validation study, receiver operating characteristic curves estimated optimal minimum durations of exclusive breastfeeding needed to predict maintenance of any breastfeeding at 15 time points during the first year (n = 951).

Variability of Criteria for Pasteurized Donor Human Milk Use: A Survey of U.S. Neonatal Intensive Care Unit Medical Directors.

Background: Use of donor human milk (DHM) is increasing, but criteria for its use are not well defined.

Materials And Methods: We conducted a 34-question Internet-based survey of medical directors of U.S.

Patterns and predictors of donor human milk non-consent in the neonatal ICU.

Background: Previous research has not evaluated predictors of donor human milk (DHM) non-consent status in a neonatal intensive care unit (ICU) setting within the United States. The purpose of this study is to identify and describe maternal and infant factors associated with DHM consent status in a Level IV inner-city neonatal ICU.

Materials And Methods: Demographics and additional maternal/infant data were stratified by DHM consent and compared with the appropriate parametric/nonparametric hypothesis testing statistic.

The Effect of a Donor Milk Policy on the Diet of Very Low Birth Weight Infants.

Background: Use of donor milk (DM) to supplement mother's own milk (MOM) in the neonatal intensive care unit (NICU) is steadily increasing based on health and developmental benefits to premature infants. A paucity of data exists documenting the effect of DM use on the diet of very low birth weight (VLBW) infants related to the implementation of a DM policy.

Objective: This study aimed to compare VLBW enteral intake type in the first 28 days of life before versus after establishing a DM policy.

Independent predictors of human milk receipt at neonatal intensive care unit discharge.

Objective: The aim of this study is to construct a predictive model for very low birth weight (VLBW) infants' receipt of mother's own milk within 24 hours before neonatal intensive care unit (NICU) discharge.

Study Design: Vermont Oxford Network (VON) clinical data were analyzed retrospectively for VLBW infants admitted between 2002 and 2012 at an inner city, level IV NICU with a well-established lactation program. Bivariate analyses compared infant characteristics between recipients and nonrecipients of human milk before 24 hours of NICU discharge.

Donor human milk bank data collection in north america: an assessment of current status and future needs.

Background: The Human Milk Banking Association of North America (HMBANA) is a nonprofit association that standardizes and facilitates the establishment and operation of donor human milk (DHM) banks in North America. Each HMBANA milk bank in the network collects data on the DHM it receives and distributes, but a centralized data repository does not yet exist. In 2010, the Food and Drug Administration recognized the need to collect and disseminate systematic, standardized DHM bank data and suggested that HMBANA develop a DHM data repository.

Increased neonatal morbidity despite pulmonary maturity for deliveries occurring before 39 weeks.

Objective: To compare neonatal outcomes following deliveries <39 weeks after confirmation of fetal lung maturity with scheduled deliveries ≥39 weeks.

Methods: A retrospective cohort study examining neonatal outcomes of women who were delivered following documented fetal pulmonary maturity at 36, 37, and 38 weeks compared to women undergoing a scheduled delivery at 39, 40, and 41 weeks. The χ(2)-test and Student's t-test were used to compare categorical and continuous data, respectively.

Midaortic syndrome in a premature infant.

Hypertension is an unusual finding in premature infants and warrants an extensive workup. Well-known causes of hypertension include endocrine, renal and cardiac anomalies. Coarctation of the thoracic aorta, a well-recognized cardiac anomaly leading to hypertension can manifest at various ages including the newborn period.

Full-term neonatal intenstive care unit admission in an urban community hospital: the role of respiratory morbidity.

Objective: To investigate the incidence of respiratory morbidity among full-term neonatal intenstive care unit (NICU) admissions and identify risk factors for such admissions.

Methods: We performed a retrospective cohort study of NICU admissions between 1/06 and 12/08. We included neonates between 37 and 40 weeks with a diagnosis of transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), pneumonia, pneumothorax, and meconium aspiration syndrome.

Perinatal and neonatal outcomes of triplet gestations based on placental chorionicity.

The purpose of our study was to evaluate perinatal and neonatal outcomes in triplet gestations in relation to placental chorionicity. We hypothesized that triplets containing a monochorionic pair (dichorionic triamniotic) would have increased morbidity compared with triplets without a monochorionic pair (trichorionic triamniotic). We retrospectively analyzed all triplet sets > or =20 weeks delivering at our institutions from January 1995 through April 2007.

Betamethasone vs dexamethasone for the prevention of morbidity in very-low-birthweight neonates.

Objective: The purpose of this study was to compare neonatal outcomes in very-low-birthweight infants who were exposed to antenatal betamethasone vs dexamethasone.

Study Design: We reviewed all inborn very-low-birthweight infants from January 1997 through February 2006. Maternal medical records were reviewed to determine the type of antenatal steroids that each patient received; neonatal outcomes were compared using chi-square and Student t tests.

Have the year 2000 neonatal resuscitation program guidelines changed the delivery room management or outcome of meconium-stained infants?

Objective: To study the impact of neonatal resuscitation program (NRP) guidelines on delivery room (DR) management of infants born through meconium-stained amniotic fluid (MSAF).

Study Design: A retrospective study of all term (>or=37 weeks) infants born through MSAF was performed. Patients were divided into two periods: pre year 2000 NRP and post year 2000 NRP.

Is bloodstream infection preventable among premature infants? A tale of two cities.

Background: Bloodstream infection (BSI) is a significant cause of morbidity and death encountered in the NICU. The rates of BSIs vary significantly in NICUs across the nation. However, no attempt has been made to correlate this variation with specific infection-control practices and policies.

Prothrombotic risk factors in infants of diabetic mothers.

Background: Infants of diabetic mothers (IDMs) are at an increased risk for thromboembolic disease. The mechanism(s) to explain this association is unclear. We hypothesized that the pathophysiology of thrombosis in IDMs is multifactorial and likely involves interactions among genetic and acquired factors affecting the procoagulant, anticoagulant and fibrinolytic pathways.

Can oral sucrose reduce the pain and distress associated with screening for retinopathy of prematurity?

Objective: Infants undergoing eye exams to screen for retinopathy of prematurity (ROP) demonstrate physiologic and behavioral manifestations of pain and distress. Oral sucrose has analgesic properties that might reduce these effects.

Aim: To determine the efficacy of oral sucrose in reducing the pain/distress of eye exams for ROP.

Can nitroglycerine ointment facilitate newborn heelstick blood collection? A randomized controlled trial.

Unlabelled: Newborn heelstick blood collection can be a painful procedure in part because of the time required to obtain sufficient quantity of blood. No previous studies have determined whether local vasodilatation using topical nitroglycerine ointment (NGO) would facilitate heelstick blood collection.

Objective: To determine if the topical application of NGO would reduce the time needed to collect the required amount of blood for newborn metabolic screening and, in turn, reduce the pain/distress of the procedure.

Fibrin glue for persistent pneumothorax in neonates.

Fibrin glue was used to treat significant pneumothoraces persisting for an average of 10 days in eight newborns. Six of the eight infants had reduction or resolution of persistent air leak within 24 hours of therapy. Two infants received a second course of therapy for recurrences.

Contribution of elective delivery to severe respiratory distress at term.

We sought to determine the contribution of elective delivery to severe respiratory distress syndrome (RDS) on a weekly basis from 37-40 weeks' gestation. Chart reviews confirmed gestational age, delivery reason, and primary diagnosis of all inborn neonates with RDS requiring mechanical ventilation delivered at 37 0/7-40 6/7 weeks' gestation from 1/1/90-12/31/99. Exclusion criteria were sepsis, pneumonia, meconium aspiration, asphyxia, pulmonary hemorrhage, hydrops, chromosomal abnormality, or congenital malformations affecting respiration.