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Seminars in Fetal & Neonatal Medicine最新文献

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The physiology, assessment, and treatment of neonatal pain 新生儿疼痛的生理、评估和治疗
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-08-01 DOI: 10.1016/j.siny.2023.101465
Megan H. Tucker , Priya Tiwari , Brian S. Carter
{"title":"The physiology, assessment, and treatment of neonatal pain","authors":"Megan H. Tucker ,&nbsp;Priya Tiwari ,&nbsp;Brian S. Carter","doi":"10.1016/j.siny.2023.101465","DOIUrl":"10.1016/j.siny.2023.101465","url":null,"abstract":"<div><p>Studies have clearly shown that development of pain receptors<span> starts as early as 20-weeks’ gestation. Despite contrary belief, the human fetus develops a similar number of receptive pain fibers as seen in adults. These receptors' maturation is based on response to sensory stimuli<span><span> received after birth which makes the </span>NICU<span><span> a critical place for developing central nervous system's </span>pain perception<span>. In practice, the assessment of pain relies mostly on bedside staff. In this review we will discuss the various developing features of pain pathways in the neonatal brain and the modification of pain perception secondary to various interactions immediately after birth. We also discuss the various tools utilized in the NICU for pain assessment that rely on physiological and behavioral patterns. Finally, we address the management of pain in the NICU by either pharmacological or non-pharmacological intervention while highlighting potential benefits, disadvantages, and situations where one may be preferred over another.</span></span></span></span></p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 4","pages":"Article 101465"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10537283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The logistics of withdrawing life-sustaining medical treatment in the neonatal intensive care unit 在新生儿重症监护室撤回维持生命的药物治疗的后勤
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-08-01 DOI: 10.1016/j.siny.2023.101443
Erin Rholl, Steven R. Leuthner
{"title":"The logistics of withdrawing life-sustaining medical treatment in the neonatal intensive care unit","authors":"Erin Rholl,&nbsp;Steven R. Leuthner","doi":"10.1016/j.siny.2023.101443","DOIUrl":"10.1016/j.siny.2023.101443","url":null,"abstract":"<div><p><span>Withdrawal of life sustaining medical treatments is a common mode of death in the </span>neonatal intensive care unit. Shared decision making and communication are crucial steps prior to, during and after a withdrawal of life sustaining medical treatments. Discussion should include the steps to occur during the withdrawal. Physicians should recommend appropriate withdrawal steps based on family goals. Stepwise approach should be taken only if a family requests. Care should continue for the family and staff after the withdrawal and the infant's death.</p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 4","pages":"Article 101443"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10223651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Counseling for the option of termination of pregnancy for severe fetal anomalies in light of the recent Supreme Court ruling to remove the constitutional right to an abortion 根据最高法院最近取消宪法规定的堕胎权的裁决，为严重胎儿异常终止妊娠的选择提供咨询
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-06-01 DOI: 10.1016/j.siny.2023.101441
Amos Grünebaum , Jonathan D. Moreno , Susan Pollet Esq , Frank A. Chervenak
{"title":"Counseling for the option of termination of pregnancy for severe fetal anomalies in light of the recent Supreme Court ruling to remove the constitutional right to an abortion","authors":"Amos Grünebaum ,&nbsp;Jonathan D. Moreno ,&nbsp;Susan Pollet Esq ,&nbsp;Frank A. Chervenak","doi":"10.1016/j.siny.2023.101441","DOIUrl":"10.1016/j.siny.2023.101441","url":null,"abstract":"<div><p>A birth defect<span><span> is a structural or chromosomal change present at birth<span> that can affect almost any part or parts of the body. Birth defects can vary from mild to severe. On June 24, 2022, with its Dobbs v Jackson Women's Health Organization decision the Supreme Court of the United States overturned Roe v. Wade, removing the longstanding landmark 1973 ruling that secured a person's constitutional right to an abortion. With this decision individual states can now decide their own abortion laws. In about one-half of the states that continue the legality of </span></span>pregnancy termination, the process of offering, discussing, and performing terminations of pregnancy remain the same as previously. In states where abortions are not legal, there will be conflicts between the law and the ethical responsibility of physicians to offer and discuss termination of pregnancy for severe anomalies.</span></p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 3","pages":"Article 101441"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9660107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Ethics at the end of life in the newborn intensive care unit: Conversations and decisions 新生儿重症监护病房生命末期的伦理学:对话与决定
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-06-01 DOI: 10.1016/j.siny.2023.101438
Mark R. Mercurio , Lynn Gillam
{"title":"Ethics at the end of life in the newborn intensive care unit: Conversations and decisions","authors":"Mark R. Mercurio ,&nbsp;Lynn Gillam","doi":"10.1016/j.siny.2023.101438","DOIUrl":"10.1016/j.siny.2023.101438","url":null,"abstract":"<div><p><span><span>The unexpected birth of a critically ill baby raises many ethical questions for neonatologists. Some of these are obviously ethical questions, about whether to attempt resuscitation, and, if the baby is resuscitated and survives, whether to continue life sustaining interventions. Other ethical decisions are more related to what to say rather than what to do. Although less obvious, they are equally as important, and may also have far-reaching ramifications. This essay presents the story of a </span>newborn with profound hypoxic-ischemic encephalopathy, and reviews decisions regarding resuscitation, withdrawal of </span>mechanical ventilation, withdrawal of medically administered nutrition and hydration, and active euthanasia. An overview of the ethical issues at work at each decision point is presented, as well as guidance regarding discussions with parents throughout the process, including specific wording. This may serve as a helpful guide for ethical deliberation, and helpful scripting for parental discussion, in similar cases.</p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 3","pages":"Article 101438"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9604138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Paediatric palliative care in the NICU: A new era of integration 新生儿重症监护室的儿科姑息治疗:一体化的新时代
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-06-01 DOI: 10.1016/j.siny.2023.101436
Sophie Bertaud , Angela M. Montgomery , Finella Craig
{"title":"Paediatric palliative care in the NICU: A new era of integration","authors":"Sophie Bertaud ,&nbsp;Angela M. Montgomery ,&nbsp;Finella Craig","doi":"10.1016/j.siny.2023.101436","DOIUrl":"10.1016/j.siny.2023.101436","url":null,"abstract":"<div><p>We are entering a new era of integration between neonatal medicine and paediatric palliative care<span>, with increasing recognition that the role and skills of palliative care<span><span> extend beyond care of only the terminally ill infant. This paper addresses the principles of paediatric palliative care and how they apply in the </span>NICU, considers who provides palliative care in this setting and outlines the key components of care. We consider how the international standards of palliative care pertain to neonatal medicine and how a fully integrated approach to care may be realised across these two disciplines.</span></span></p><p>Palliative care is so much more than end-of-life care, offering a proactive and holistic approach which addresses the physical, emotional, spiritual and social needs of the infant and family. This is a truly interdisciplinary endeavour, relying on a harmonisation of the skills from both the neonatal and palliative care teams to deliver high-quality coordinated care.</p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 3","pages":"Article 101436"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9961343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Neurological conditions: Prognostic communication, shared decision making, and symptom management 神经系统状况：预后沟通、共同决策和症状管理
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-06-01 DOI: 10.1016/j.siny.2023.101457
Dana Peralta , Jori Bogetz , Monica E. Lemmon
{"title":"Neurological conditions: Prognostic communication, shared decision making, and symptom management","authors":"Dana Peralta ,&nbsp;Jori Bogetz ,&nbsp;Monica E. Lemmon","doi":"10.1016/j.siny.2023.101457","DOIUrl":"https://doi.org/10.1016/j.siny.2023.101457","url":null,"abstract":"","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 3","pages":"Article 101457"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49816558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Decision-making for extremely preterm infants with severe hemorrhages on head ultrasound: Science, values, and communication skills 头部超声显示严重出血的极早产儿的决策:科学、价值观和沟通技巧
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-06-01 DOI: 10.1016/j.siny.2023.101444
M. Chevallier , K.J. Barrington , P. Terrien Church , T.M. Luu , A. Janvier
{"title":"Decision-making for extremely preterm infants with severe hemorrhages on head ultrasound: Science, values, and communication skills","authors":"M. Chevallier ,&nbsp;K.J. Barrington ,&nbsp;P. Terrien Church ,&nbsp;T.M. Luu ,&nbsp;A. Janvier","doi":"10.1016/j.siny.2023.101444","DOIUrl":"10.1016/j.siny.2023.101444","url":null,"abstract":"<div><p>Severe intracranial hemorrhages<span> are not rare in extremely preterm infants. They occur early, generally when babies require life-sustaining interventions. This may lead to ethical discussions and decision-making about levels of care. Prognosis is variable and depends on the extent, location, and laterality of the lesions, and, importantly also on the subsequent occurrence of other clinical complications or progressive ventricular dilatation. Decision-making should depend on prognosis and parental values. This article will review prognosis and the uncertainty of outcomes for different lesions and provide an outline of ways to conduct an ethically appropriate discussion on the decision of whether to continue life sustaining therapy. It is possible to communicate in a compassionate and honest way with parents and engage in decision-making, focussing on personalized information and decisions, and on function, as opposed to diagnosis.</span></p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 3","pages":"Article 101444"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9606811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Editorial: Palliative and end of life care in the NICU issue I 社论:NICU的姑息治疗和临终关怀问题1
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-06-01 DOI: 10.1016/j.siny.2023.101466
Mark R. Mercurio , Renee D. Boss
{"title":"Editorial: Palliative and end of life care in the NICU issue I","authors":"Mark R. Mercurio ,&nbsp;Renee D. Boss","doi":"10.1016/j.siny.2023.101466","DOIUrl":"10.1016/j.siny.2023.101466","url":null,"abstract":"","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 3","pages":"Article 101466"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9662223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neonatal euthanasia in the context of palliative and EoL care 新生儿安乐死在姑息和EoL护理的背景下
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-06-01 DOI: 10.1016/j.siny.2023.101439
A.A. Eduard Verhagen
{"title":"Neonatal euthanasia in the context of palliative and EoL care","authors":"A.A. Eduard Verhagen","doi":"10.1016/j.siny.2023.101439","DOIUrl":"10.1016/j.siny.2023.101439","url":null,"abstract":"<div><p>Neonatal deaths can be categorized in 5 modes along the dimension of intervention and physiology. This classification can be helpful to analyze the choices that can be made in end-of-life care in the NICU. In the Netherlands, neonatal euthanasia became an optional 6th mode of death since publication and legalization of the Groningen Protocol. This paper summarizes the history, legal status and ethical justification of the Groningen Protocol, and describes end-of-life practice in the subsequent years. Since the implementation of the Groningen Protocol, the practice of neonatal euthanasia has almost disappeared. Simultaneously, there has been spectacular growth in neonatal palliative care programs in the Netherlands. Is there still a need for this last-resort option?</p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 3","pages":"Article 101439"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9605477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Maternal-fetal surgery as part of pediatric palliative care 母婴手术作为儿科姑息治疗的一部分
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-06-01 DOI: 10.1016/j.siny.2023.101440
Felix R. De Bie , Tyler Tate , Ryan M. Antiel
{"title":"Maternal-fetal surgery as part of pediatric palliative care","authors":"Felix R. De Bie ,&nbsp;Tyler Tate ,&nbsp;Ryan M. Antiel","doi":"10.1016/j.siny.2023.101440","DOIUrl":"10.1016/j.siny.2023.101440","url":null,"abstract":"<div><p>Maternal-fetal surgical interventions have become a more common part of prenatal care. This third option, beside termination or post-natal interventions, complicates prenatal decision-making: while interventions may be lifesaving, survivors may face a life with disability. Pediatric palliative care<span> (PPC) is more than end of life or hospice care, it aims at helping patients with complex medical conditions live well. In this paper, we briefly discuss maternal-fetal surgery, challenges regarding counseling and benefit-risk evaluation, argue that PPC should be a routine part of prenatal consultation, discuss the pivotal role of the maternal-fetal surgeon in the PCC-team, and finally discuss some of the ethical considerations of maternal-fetal surgery. We illustrate this with a case example of an infant diagnosed with congenital diaphragmatic hernia (CDH).</span></p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 3","pages":"Article 101440"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9978612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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