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Tertiary Neonatal Units (tertiary + neonatal_unit)
Selected AbstractsImmunisation practices in infants born prematurely: Neonatologists' survey and clinical auditJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 10 2009Nigel W Crawford Aim: To determine Australian neonatologists' recommendations for the immunisation of ex-preterm infants and compare their actual immunisation status with recommended Australian guidelines. Methods: A self-administered nine-part questionnaire of current immunisation practices was sent to all Neonatologists in Australia (2006). A complementary retrospective immunisation audit was conducted in two tertiary neonatal units in Melbourne. Hospital records and the Australian Childhood Immunisation Register (ACIR) were reviewed; consenting parents were interviewed and primary care physicians' vaccination records were requested. A random sample of preterm infants born between July 2003 and June 2005 at <32 weeks' gestation were selected. Results: (i) Neonatologists Survey: The response rate was 68% and the majority of neonatologists (89%) were aware of the current guidelines, but adherence to them varied from 43% to 79%. One-fifth of neonatologists personally do not receive annual influenza vaccination; and (ii) Immunisation Audit: Conducted between October 2006-May 2007 it included: 100 hospital records; 97 ACIR records; 47 parent interviews and 43 primary care vaccination records. Overall vaccination coverage was 90% at 12 months of age. Only 20% (10/50) of infants with chronic lung disease received an influenza vaccination. Vaccines were delayed by greater than one month in 15% of participants for the 2 month DTPa vaccine and 43% at 6 months. Conclusions: The neonatologists survey highlighted variable adherence with immunisation guidelines. The audit confirmed preterm infants are frequently experiencing delayed vaccination and recommended additional vaccinations are often not being received. Formulation of strategies to ensure complete and timely immunisation are required, including better utilisation of the ACIR. [source] Survey of the management of neonatal hyperglycaemia in AustralasiaJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 9 2007Jane M Alsweiler Aim: Hyperglycaemia is a common problem in very low birthweight (VLBW) preterm neonates and has been associated with an increase in intraventricular haemorrhage and mortality. There are few data to guide clinicians on the best range of blood glucose levels to aim for when treating hyperglycaemic preterm babies with insulin. The aim of this study was to survey all Australasian tertiary neonatal intensive care units for their current practice in the definition and management of neonatal hyperglycaemia to aid in the design of a randomised controlled trial of the effect of tight glycaemic control on long-term outcome in VLBW babies. Methods: An online survey was sent to the 27 tertiary neonatal units in Australasia asking the respondents for details of their unit's definition and management of hyperglycaemia in VLBW infants. Results: Twenty-three tertiary neonatal units responded to the questionnaire. There were six different definitions of hyperglycaemia, with most units defining neonatal hyperglycaemia as a blood glucose level greater than 10 mM. There were large variations in the criteria for commencing insulin (blood glucose level 8,15 mM ± glycosuria) and target blood glucose ranges for babies on insulin (ranging from 2.5,8 mM to 8,15 mM). Conclusions: There is a wide variation in the management of neonatal hyperglycaemia between tertiary neonatal units in Australasia. This reflects the paucity of data available in this area. Further research on the management of neonatal hyperglycaemia is needed. [source] Use of premedication for intubation in tertiary neonatal units in the United KingdomPEDIATRIC ANESTHESIA, Issue 7 2009RAJIV CHAUDHARY MBBS MRCPCH Summary Background:, Endotracheal intubation and laryngoscopy are frequently performed procedures in neonatal intensive care. These procedures represent profoundly painful stimuli and have been associated with laryngospasm, bronchospasm, hemodynamic changes, raised intracranial pressure and an increased risk of intracranial hemorrhage. These adverse changes can cause significant neonatal morbidity but may be attenuated by the use of suitable premedication. Aims:, To evaluate current practices for premedication use prior to elective intubation in UK tertiary neonatal units. Methods:, Telephone questionnaire survey of all 50 tertiary neonatal units in the UK. Results:, Ninety percent of units report the routine use of sedation prior to intubation and 82% of units routinely use a muscle relaxant. Morphine was the most commonly used sedative and suxamethonium was the most commonly used muscle relaxant. Approximately half of the units also used atropine during intubation. Seventy seven percent of units had a written policy for premedication. Ten percent of the units did not routinely use any sedatives or muscle relaxants for elective intubation. Conclusions:, In comparison with data from a 1998 survey, our study demonstrated an increase in the number of units that have adopted a written policy for premedication use, and in the number routinely using premedication drugs for elective intubation. There remains little consensus as to which drugs should be used and in what dose. [source] Retinopathy of prematurity in a Copenhagen high-risk sample 1997,98ACTA OPHTHALMOLOGICA, Issue 3 2000The allover surveillance for ROP appears more, more complete ABSTRACT. Purpose: From two recent materials to describe the present clinical status regarding retinopathy of prematurity in Denmark, and to outline trends over time. Methods: A) Results of regular ophthalmic surveillance of 201 clinically selected (higher risk of ROP than average) pre-term infants of birth year 1997,98 taken care of in the two greater Copenhagen tertiary neonatal units, in an intended prospective design. Gestational age range was 24,32 weeks at delivery; birth weights 490,2200 g. Median values 28 weeks and 1090 g. B) A brief account of the latest ROP-associated registrations of visual impairment in Danish children aged 0,17 years (n=138). Results: A) ROP was observed in 31.3% (n=201). Retinal cryotherapy was given to eleven ,own' cases and to two from elsewhere (n=13, gestational age at delivery 25,31 weeks). Five had cryotherapy twice. Four of the 13 were later registered for visual impairment. B) Comparing the first and the latest third of the registrations, visual impairment has dropped in frequency and severity over the period from 1981 till now. Conclusions: Compared to previous data the present clinical profile of ROP in Denmark indicates a relatively lower overall frequency of ROP and a decrease in eventual severe visual impairment. Undoubtedly, the continued refinement of neonatal care has been of relevance, but the definite decline in visual impairment further reflects a more complete ophthalmic surveillance, on a national basis. The advanced cases are generally detected in time and retinal ablation therapy offered. [source] | ||||||||||