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Ill Neonates (ill + neonate)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Neonatal end-of-life care in Sweden

NURSING IN CRITICAL CARE, Issue 5 2003
Anita Lundqvist
Summary , A survey was carried out of Swedish neonatal end-of-life regarding practice before birth, at birth, during dying and after death using a descriptive questionnaire with close-ended questions and individual comments , The practice in 32 of 38 neonatal units, as described by the head nurse or the registered nurses, was largely similar. Respectful treatment of both the neonate and the parents during neonatal end-of-life care was indicated , Differences were found in pre-natal care concerning the information about the risks of pre-term birth, the opportunity for parents to view a pre-term neonate and meet its family, as well as a social worker , Practice directly after birth was also different. A little less than half of the units answered that they gave a description of the seriously ill neonate to the parents before the first visit to the ward , Practice during dying indicated that only a few units permitted the neonate to die at home [source]

Longtime performance and reliability of two different PtcCO2 and SpO2 sensors in neonates

PEDIATRIC ANESTHESIA, Issue 9 2008
VERA BERNET
Summary Objectives:, Blood gas monitoring is necessary in treatment of critically ill neonates. Whereas SaO2 can be estimated by pulse oximetry, PaCO2 is still most often assessed from blood samples. Aim:, To compare long time performance of an ear sensor for combined assessment of transcutaneous carbon dioxide (PtcCO2) and oxygen saturation (SpO2) (TOSCA Monitor; Radiometer, Switzerland) with a conventional PtcCO2 monitor (MicroGas 7650-500 rapid, Radiometer, Switzerland) in critically ill neonates. Methods:, Prospective, observational study. Twenty critically ill neonates were monitored for PtcCO2 and SpO2 using the Tosca and the MicroGas monitor for 24 h. TOSCA ear sensor was changed to the other ear lobe after 12 h and the MicroGas sensor four hourly on the trunk. Values obtained were compared with SaO2 and PaCO2 from arterial blood gas analysis using Bland,Altman analysis. Data are presented as median (range). Results:, Eighty-two paired measurements were obtained. Median age of the 20 patients was 4.5 days (1,26 days) and weight was 3.05 kg (0.98,3.95 kg). Bias and precision between PaCO2 and PtcCO2 were 0.14 and 1.45 kPa for the Tosca monitor and ,0.08 and 1.2 kPa for the MicroGas monitor, respectively. The two biases were significantly different (P = 0.0036). SpO2 assessment by TOSCA was comparable to SaO2 values (bias 0.26% and precision 4.14%). Conclusion:, The TOSCA monitor allows safe estimation of PtcCO2 and SaO2 in neonates. Measurements of PtcCO2 were less reliable with TOSCA compared with conventional monitoring but still allow assessing a trend of ventilation status in newborn patients. [source]

Detection of peripherally inserted central catheter occlusion by in-line pressure monitoring

PEDIATRIC ANESTHESIA, Issue 7 2002
Junichi Arai MD
SummaryBackground: Peripherally inserted central catheters (PICC) are being increasingly used in neonatal practice. Their use is not without technical difficulty. This report describes the use of continuous pressure monitoring to detect catheter occlusion in critically ill neonates. Methods: In-line venous pressure of the PICC line was monitored by pressure transducer in neonates; 28-gauge 20 cm PICC or 29-gauge 25 cm PICC were used. Results: In-line pressure of the PICC was monitored 64 times in 50 neonates. Increases in the in-line pressure were observed when the catheter tip was against the vessel wall and the catheter was obstructed partially or completely. Decreases were observed when the infusion syringe was changed and when an inappropriate infusion rate was set. Two infants experienced marked variations of blood pressure due to intermittent catheter occlusion of the tip against the vessel wall. These infants were receiving dopamine via a PICC line. Conclusions: In critically ill infants, in-line pressure monitoring of the PICC is helpful in detecting the occlusion of the catheter. [source]

Combination propofol,ketamine anaesthesia in sick neonates

PEDIATRIC ANESTHESIA, Issue 1 2001
Samuel Golden MD
Two critically ill, opioid-tolerant neonates were anaesthetized using pancuronium and a mixture of propofol (PROP) and ketamine (KET). Three mg of KET were added per ml (10 mg) of PROP in a single syringe and infused at a rate of 100,150 ,g·kg,1·min,1 of the PROP component (30,45 ,g·kg,1·min,1 KET). Total doses of 12,15 and 3.6,4.5 mg·kg,1 of PROP and KET, respectively, were administered. Both patients remained haemodynamically stable throughout their surgical procedures. PROP-KET is a rational and effective combination for intravenous anaesthesia in critically ill neonates who are likely to be opioid-tolerant when an anaesthesia vaporizer is not readily available. [source]