What happens to babies when they leave intensive care?

Much as people would like to believe everything ends happily ever after once babies are sent home from an intensive care unit (NICU)many of them remain poorly and end up having to come back to hospital every so often. In this study Dennis Z. Kuo, from the University at Buffalo, in New York, led a team of researchers looking into what happened to 4,973 babies once they left the intensive-care unit. Most (69.5%) of the health-care costs generated by the babies occurred in the first year after they had left the NICU. Inpatient costs accounted for most of this spending. The percentages of babies with a 1-year readmission or visit to an emergency department were 36.8% and 63.7% respectively. Babies who were dependent on medical technology were 17.8 times more likely to be readmitted to hospital and 2.3 times as likely to be admitted to an emergency department.

You can read the abstract of this article here.

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Reach out and read on the neonatal unit

Hearing people talk, or being read to, is important for young babies’ developing brains but doesn’t happen very often in neonatal intensive care units (NICUs). In this study Bernadette M. Levesque, from Boston University School of Medicine, led a team of researchers who introduced a scheme called Reach Out and Read in a NICU. 98 babies took part in the study and the researchers found books in their mothers’ languages for 95% of them. The parents enjoyed reading to their children, noted positive effects and intended to keep reading to their children after their babies had been sent home.

You can read the abstract of this article here.

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Listening to Relaxing Music Improves Physiological Responses in Premature Infants: A Randomized Controlled Trial

Premature infants are exposed to high levels of noise in the neonatal intensive care unit (NICU).

This Spanish study evaluated the effect of a relaxing music therapy intervention composed by artificial intelligence on respiratory rate, systolic and diastolic blood pressure, and heart rate.

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Basic Knowledge of Tracheoesophageal Fistula and Esophageal Atresia

Tracheoesophageal fistula (TEF) and esophageal atresia (ET) are rare anomalies in neonates. Up to 50% of neonates with TEF/EA will have Vertebral anomalies (V), Anal atresia (A), Cardiac anomalies (C), Tracheoesophageal fistula (T), Esophageal atresia (E), Renal anomalies (R), and Limb anomalies (L) (VACTERL) association, which has the potential to cause serious morbidity.

Timely management of the neonate can greatly impact the infant’s overall outcome. Spreading latest evidence-based knowledge and sharing practical experience with clinicians across various levels of the neonatal intensive care unit and well-baby units have the potential to decrease the rate of morbidity and mortality.

Advancements in both technology and medicine have helped identify and decrease postsurgical complications. More understanding and clarity are needed to manage acid suppression and its effects in a timely way.

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Nursing Assessment of Intra-abdominal Hypertension and Abdominal Compartment Syndrome in the Neonate

Abdominal compartment syndrome in the surgical neonate is a low-frequency, high-risk occurrence that if overlooked is often accompanied with long-term sequelae and sometimes death. The importance of early detection of signs and symptoms through expert nursing assessment cannot be overstated.

The article describes the onset of abdominal compartment syndrome in the neonate. Early detection of this low-frequency, high-risk occurrence hinges on expert nursing assessment. Complications of abdominal compartment syndrome in the neonate involve bowel perforation, short bowel syndrome, and sometimes death. Components of this expert nursing assessment and its relationship to the pathophysiology of compartment syndrome are presented.

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The effect of twin-to-twin delivery time intervals on neonatal outcome for second twins

This retrospective, hospital-based study, performed at a university teaching hospital in Western Sweden examines the effect of twin-to-twin delivery intervals on neonatal outcome for second twins.

Twin deliveries between 2008 and 2014 at ≥32 + 0 weeks of gestation, where the first twin was delivered vaginally, were included. Primary outcome was a composite outcome of metabolic acidosis, Apgar < 4 at 5 min or peri/neonatal mortality in the second twin. Secondary outcome was a composite outcome of neonatal morbidity.

An association, but not necessarily a causality, between twin-to-twin delivery interval and primary outcome was seen. An upper time limit on twin-to-twin delivery time intervals may be justified. However, the optimal time interval needs further studies.

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Saving babies’ lives project impact and results evaluation (SPiRE): a mixed methodology study

Reducing stillbirth and early neonatal death is a national priority in the UK. Current evidence indicates this is potentially achievable through application of four key interventions within routine maternity care delivered as the National Health Service (NHS) England’s Saving Babies’ Lives care bundle. However, there is significant variation in the degree of implementation of the care bundle between and within maternity units and the effectiveness in reducing stillbirth and improving service delivery has not yet been evaluated. This study aims to evaluate the impact of implementing the care bundle on UK maternity services and perinatal outcomes.

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