Neonatal Network最新文献

{"title":"Eyesight to the Blind-Pharmacotherapy for Retinopathy of Prematurity.","authors":"Christopher McPherson","doi":"10.1891/NN.2022-0054","DOIUrl":"https://doi.org/10.1891/NN.2022-0054","url":null,"abstract":"<p><p>Retinopathy of prematurity (ROP) places preterm infants at significant risk for blindness. Angiogenesis of retinal blood vessels relies on vascular endothelial growth factor (VEGF) released in response to physiologic in utero hypoxia. Relative hyperoxia and disruption in the supply of growth factors after preterm birth lead to cessation of normal vascular growth. Recovery of VEGF production after 32 weeks' postmenstrual age results in aberrant vascular growth, including the formation of fibrous scars with the potential to detach the retina. Ablation of aberrant vessels by mechanical or pharmacologic methods relies on timely diagnosis in the early stages of ROP. Mydriatic medications dilate the pupil to allow examination of the retina. Mydriasis is typically accomplished using a combination of topical phenylephrine, a potent alpha-receptor agonist, and cyclopentolate, an anticholinergic. Systemic absorption of these agents results in a high incidence of cardiovascular, gastrointestinal, and respiratory adverse effects. Procedural analgesia should include the topical anesthetic proparacaine, oral sucrose, and nonpharmacologic interventions like non-nutritive sucking. Analgesia is often incomplete, leading to investigation of systemic agents like oral acetaminophen. If ROP threatens retinal detachment, laser photocoagulation is utilized to arrest vascular growth. More recently, the VEGF-antagonists, bevacizumab and ranibizumab, have emerged as treatment options. Systemic absorption of intraocular bevacizumab and the profound consequences of diffuse disruption of VEGF in the setting of rapid, neonatal organogenesis require dose optimization and careful evaluation of long-term outcomes in clinical trials. Intraocular ranibizumab is likely a safer alternative; however, outstanding questions remain regarding efficacy. Optimal patient outcomes rely on a combination of risk management throughout neonatal intensive care, timely diagnosis through careful ophthalmologic examinations, and treatment when indicated with laser therapy and/or anti-VEGF intravitreal injection.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"42 2","pages":"88-95"},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10847410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NICU Parents Desperately Need a \"Heather\" After Discharge Day.","authors":"Deb Discenza","doi":"10.1891/NN.2022-0042","DOIUrl":"https://doi.org/10.1891/NN.2022-0042","url":null,"abstract":"<p><p>Neonatal therapists are a key team member, especially, when in concert with the medical teams, especially nurses. This column speaks of the challenges the author faced as a parent in the NICU then delves into an interview with Heather Batman, a feeding occupational and neonatal therapist who provides personal and professional insight into how those NICU days and the team members ultimately benefit that infant's long-term outcome.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"42 2","pages":"99-102"},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10847412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Developmental Participation Skills Assessment: Development and Content Validation.","authors":"Kristy Fuller,&nbsp;Tara DeWolfe,&nbsp;Mary Coughlin","doi":"10.1891/NN.2022-0029","DOIUrl":"https://doi.org/10.1891/NN.2022-0029","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Purpose:&lt;/b&gt; The Developmental Participation Skills Assessment (DPS) is designed to assist clinicians who work with hospitalized infants in thoughtfully and accurately identifying infant readiness and the capacity for an infant's participation during caregiving interactions as well as offering an opportunity for the caregiver(s) to reflect upon the experience. Non-contingent caregiving impairs an infant's autonomic, motor and state stability which interferes with regulation and negatively impacts neurodevelopment. By providing an organized way to assess readiness for care and capacity to participate in care, the infant may experience less stress and trauma. The DPS is completed by the caregiver following any caregiving interaction. &lt;b&gt;Methods:&lt;/b&gt; Following a literature review, the development of the DPS items were extrapolated from well-established tools to achieve the most evidence-based criteria. Following item inclusion generation, the DPS went thru five phases of content validation: (a) Initial tool development and use by five NICU professionals as part of their developmental assessment. Expansion of the use of the DPS to include three more hospital NICUs within the health system (b) Item adjustment and use as part of a bedside training program at a Level IV NICU (c) Focus group of professionals using the DPS provided feedback and scoring was added (d) Pilot of DPS by multidisciplinary focus group in a Level IV NICU (e) Feedback form sent to 20 NICU experts and content of DPS finalized with reflective portion added. &lt;b&gt;Main Outcome Variable:&lt;/b&gt; The establishment of an observational instrument, the Developmental Participation Skills Assessment, provides a means for identifying infant readiness, assessing the quality of infant participation, and prompting clinician reflective processing. &lt;b&gt;Results:&lt;/b&gt; A total of 50 professionals across the Midwest (4 OT, 2 PT, 3 SLP, 41 nurses) utilized the DPS as a part of standard practice throughout the phases of development. Assessments were completed on both full-term and preterm hospitalized infants. Professionals within these phases utilized the DPS with infants within a wide range of adjusted gestational ages from 23 weeks to 60 weeks (20 weeks post term). Infants ranged in severity from breathing room air to being intubated on a ventilator. After all phases of development and expert panel feedback, with an additional 20 neonatal experts, the final result was the formation of an easy-to-use observational tool for assessing infant readiness prior to caregiving, participation during caregiving, and stability following caregiving. In addition, there is the opportunity for the clinician to reflect following the caregiving interaction in a concise, consistent way. &lt;b&gt;Conclusion:&lt;/b&gt; Identifying readiness, and assessing the quality of the infant's experience while also prompting clinician reflection following the experience has the potential to reduce toxic stress for the baby and promote mindful","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"42 2","pages":"72-80"},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10847413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not Just an Intrapartum Problem: Late-Onset Group B Streptococcus Disease.","authors":"Lauren H Lucas,&nbsp;Mary T Earp,&nbsp;Melissa Bauserman","doi":"10.1891/NN.2022-0027","DOIUrl":"https://doi.org/10.1891/NN.2022-0027","url":null,"abstract":"<p><p>Group B streptococcal (GBS) infection is a leading cause of neonatal morbidity and mortality globally. While prevention strategies for early onset GBS disease are well established, methods to prevent late-onset GBS disease do not eliminate disease burden, leaving potential for infection, and devastating consequences for affected neonates. Furthermore, the incidence of late-onset GBS has risen in recent years, with preterm infants at the highest risk of infection and death. Meningitis remains the most common and serious complication associated with late onset disease, occurring in 30 percent of cases. The assessment of risk for neonatal GBS infection should not be limited to the birth process or maternal screening results and intrapartum antibiotic prophylaxis treatment status. Horizontal transmission after birth from mothers, caregivers, and community sources has been observed. Late-onset GBS disease and its sequelae remain a significant risk to neonates, and clinicians should be able to recognize the signs and symptoms to provide timely antibiotic therapy. This article discusses of the pathogenesis, risk factors, clinical manifestations, diagnostics, and treatment of neonatal late-onset GBS infection and identifies implications for practicing clinicians.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"42 2","pages":"81-87"},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10847409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Step 3: Critically Appraising Evidence: Systematic Review or Metasynthesis of Qualitative Studies.","authors":"Susan Givens Bell","doi":"10.1891/NN.2022-0059","DOIUrl":"https://doi.org/10.1891/NN.2022-0059","url":null,"abstract":"<p><p>Critical appraisal of the evidence is the third step in the evidence-based practice (EBP) process. Many questions in nursing cannot be answered using quantitative methods. We often desire a better understanding of people's lived experiences. In the NICU, these questions may be related to the experiences of families or staff. Qualitative research can provide a deeper understanding of lived experiences. This column, the fifth in a multipart series describing the critical appraisal process focuses on the critical appraisal of a systematic review of qualitative studies.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"42 2","pages":"96-98"},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9076130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Substance P, Neurokinin A, Neuropeptide Y, and Cortisol in Assessing Neonatal Pain.","authors":"Christina Dionysakopoulou,&nbsp;Loukia Lianou,&nbsp;Barbara Boutopoulou,&nbsp;Margarita Giannakopoulou,&nbsp;Efrosini Vlachioti,&nbsp;Despoina Koumpagioti,&nbsp;Evangelos Bozas,&nbsp;Vasiliki Matziou","doi":"10.1891/NN.2022-0006","DOIUrl":"https://doi.org/10.1891/NN.2022-0006","url":null,"abstract":"<p><p><b>Introduction:</b> Our aim was to investigate biomarkers of neonatal pain and their association with two pain scales. <b>Methods:</b> This prospective study included 54 full-term neonates. Levels of substance P (SubP), neurokinin A (NKA), neuropeptide Y (NPY), and cortisol were recorded and two pain scales (Premature Infant Pain Profile [PIPP] and Neonatal Infant Pain Scale [NIPS]) were used. <b>Results:</b> A statistically significant decrease in the levels of NPY (<i>p</i> = 0.02) and NKA (<i>p</i> = 0.03) was detected. A significant increase in NIPS scale (<i>p</i> < 0.001) and PIPP scale (<i>p</i> < 0.001) postpainful intervention was also detected. There was a positive correlation between cortisol and SubP (<i>p</i> = 0.01), NKA and NPY (<i>p</i> < 0.001) and between NIPS and PIPP (<i>p</i> < 0.001). A negative correlation was found for NPY with SubP (<i>p</i> = 0.004), cortisol (<i>p</i> = 0.02), NIPS (<i>p</i> = 0.001) and PIPP (<i>p</i> = 0.002). <b>Conclusions:</b> Novel biomarkers and pain scales may help in designing an objective tool for the quantification of neonatal pain in the everyday practice.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"42 2","pages":"65-71"},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10847411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feeling Burnt Out? You're Not Alone.","authors":"Debbie Fraser","doi":"10.1891/NN.2022-0067","DOIUrl":"https://doi.org/10.1891/NN.2022-0067","url":null,"abstract":"","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"42 2","pages":"63-64"},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10860630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuing Education Course: March/April 2023.","authors":"","doi":"10.1891/0730-0832.42.2.103","DOIUrl":"https://doi.org/10.1891/0730-0832.42.2.103","url":null,"abstract":"","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"42 2","pages":"103-104"},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10860628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academy News.","authors":"Stephanie Abbu,&nbsp;Debbie Fraser,&nbsp;Rachel Joseph,&nbsp;Jody Ridky,&nbsp;Kathryn Rudd,&nbsp;Sheron Wagner,&nbsp;Lori Williams","doi":"10.1891/NN.42.2.news","DOIUrl":"https://doi.org/10.1891/NN.42.2.news","url":null,"abstract":"","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"42 2","pages":"105-110"},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10860629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Touch Experiences of Preterm Infants During Essential Nursing Care.","authors":"Marliese Dion Nist,&nbsp;Tondi M Harrison,&nbsp;Rita H Pickler","doi":"10.1891/NN-2022-0010","DOIUrl":"https://doi.org/10.1891/NN-2022-0010","url":null,"abstract":"<p><p><b>Purpose:</b> To characterize and quantify touch experienced by preterm infants in the NICU during essential nursing care, identify instances of skin-to-skin touch between infants and caregivers, and identify clinical/demographic variables associated with touch experiences. <b>Design:</b> Cross-sectional study. <b>Sample:</b> Preterm infants (<i>N</i> = 20) born 27-32 weeks post-menstrual age. <b>Main Outcome Variable:</b> Categories of touch during observations. <b>Results:</b> Touch experienced by infants during day and night shifts was primarily direct touch that was further categorized as general handling. During day shifts, 30 percent of direct touch was provided for comfort, but only 9.7 percent of touch was provided exclusively for comfort (i.e., without more intrusive touch). During night shifts, 10.6 percent of direct touch was provided for comfort, and 3 percent was categorized as exclusive comforting touch. Caregivers wore gloves for >89 percent of infant touch. Only the level of respiratory support was associated with touch categories during both shifts.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"42 1","pages":"13-22"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9083702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}